Nokea
The first step in the treatment of sleep disorders is to:
- A. Teach prevention.
- B. Give hypnotics for sleep.
- C. Evaluate sleeping patterns.
- D. None of the above.
Correct Answer: C
Rationale: The correct answer is C: Evaluate sleeping patterns. This is the first step in treating sleep disorders because it helps identify the underlying causes and specific nature of the disorder. By understanding the patterns, triggers, and behaviors related to sleep, healthcare providers can tailor effective treatment plans. Choice A (Teach prevention) is incorrect as evaluation comes before prevention strategies. Choice B (Give hypnotics for sleep) is incorrect as medication should be considered only after thorough evaluation. Choice D (None of the above) is incorrect as evaluating sleeping patterns is crucial for effective treatment.
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A client with moderate to severe dementia does not remember her son's name. The son repeatedly questions the mother when he visits the dementia facility, asking, 'Do you know my name?' The mother invariably becomes agitated. The nurse can most effectively intervene by explaining to the son:
- A. Your mother is angry with you and is punishing you by 'forgetting' who you are. Be patient and she'll get over it.'
- B. I know it is difficult for you, but your mother's dementia is severe and she cannot retain information even for short periods of time. She senses your distress and becomes agitated.'
- C. Although it's a strain for you, you will need to reorient your mother as often as you can, during the time you are with her. With repetition, she may be able to understand and recall what you are saying.'
- D. Because you become so distressed, it might be better if you come to see your mother only once a week and stay for only a short time.'
Correct Answer: B
Rationale: Rationale:
1. Correct Answer (B): Explains the son's mother's inability to retain information due to severe dementia, causing agitation. Validates son's feelings and provides insight into the mother's behavior.
2. Incorrect Answer (A): Falsely suggests the mother is punishing the son by forgetting, potentially causing misunderstanding and blame.
3. Incorrect Answer (C): Implies the son should solely focus on reorienting the mother, overlooking the emotional impact and distress caused by repetitive questioning.
4. Incorrect Answer (D): Suggests limiting visits based on the son's distress, rather than addressing the root cause of agitation caused by the mother's dementia.
A nurse and social worker co-lead a reminiscence group for eight young-old adults. Which activity is most appropriate to include in the group?
- A. Mild aerobic exercise
- B. Singing a song from World War II
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in today's newspaper
Correct Answer: C
Rationale: The correct answer is C. Discussing national leadership during the Vietnam War is most appropriate as it aligns with the reminiscence therapy goal of recalling past experiences to promote social interaction and cognitive stimulation. It is relevant to the age group of young-old adults who may have lived through that era, sparking meaningful discussions. Choice A does not directly relate to reminiscence therapy. Choice B may not resonate with all group members. Choice D focuses on negative news, which is not conducive to the therapeutic purpose.
The most common eating disorder seen in patients presenting to hospital in Singapore is:
- A. Anorexia Nervosa
- B. Bulimia Nervosa
- C. Binge-Eating Disorder
- D. ARFID
Correct Answer: A
Rationale: Anorexia Nervosa is the most common eating disorder requiring hospital presentation in Singapore due to its severity and medical complications.
A client being treated for anorexia nervosa is 5 feet 10 inches tall and weighs 100 pounds. The client believes she is overweight. On the days the client is scheduled to be weighed, the nurse should be prepared for the client to:
- A. eagerly ask for information about her present weight.
- B. dress in several layers of clothing.
- C. suggest that the scale numbers be hidden from her view.
- D. remind the nurse that she is ready to be weighed.
Correct Answer: B
Rationale: Correct Answer: B - Dress in several layers of clothing.
Rationale: An individual with anorexia nervosa often engages in behaviors to manipulate their weight, such as wearing heavy clothing to increase their weight on the scale. This behavior is a result of distorted body image and fear of gaining weight. By dressing in several layers of clothing, the client may attempt to influence the scale reading to align with their perceived body image.
Summary of other choices:
A: Eagerly asking for information about her present weight is unlikely as individuals with anorexia nervosa typically avoid discussions or confrontations related to their weight.
C: Suggesting that the scale numbers be hidden is not as likely as the client may want to see the numbers to validate their belief of being overweight.
D: Reminding the nurse that she is ready to be weighed may occur, but it does not address the behavior of dressing in layers to manipulate weight.
A patient with an eating disorder states, 'I heard people laughing behind me in the check-out line at the department store. I bet they thought it was hysterically funny that I gained a pound in the last few days.' The nurse documents that the patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?
- A. Magnification
- B. Personalization
- C. Overgeneralization
- D. Dichotomous thinking
Correct Answer: B
Rationale: The correct answer is B: Personalization. Personalization is a cognitive distortion where an individual takes responsibility for events that are not entirely their fault. In this scenario, the patient is attributing the laughter of people in the check-out line to being about them and their weight gain, when in reality, the laughter may have had nothing to do with them. This distortion can contribute to feelings of guilt, shame, and self-blame.
A: Magnification involves exaggerating the importance or meaning of an event, which is not evident in the scenario.
C: Overgeneralization involves making broad negative conclusions based on a single event, which is not demonstrated here.
D: Dichotomous thinking is the tendency to view situations in black and white terms, with no middle ground, which is not present in the patient's statement.