Nokea
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.
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A patient with severe dementia can no longer recognize her only daughter and becomes anxious and agitated when the daughter attempts to reorient her. An alternative the nurse could suggest to the daughter is to:
- A. Wear a large name tag.
- B. Visit her mother less often.
- C. Talk about experiences they've shared.
- D. None of the above.
Correct Answer: C
Rationale: The correct answer is C: Talk about experiences they've shared. This option is the most appropriate because reminiscing about past shared experiences can help trigger memories and emotions in the patient with dementia, potentially reducing anxiety and agitation. It can provide comfort and a sense of familiarity to the patient. Wearing a large name tag (option A) may not address the core issue of memory loss. Visiting less often (option B) could lead to further feelings of isolation and confusion for the patient. Option D, None of the above, is incorrect as option C provides a constructive and person-centered approach to improving the interaction between the patient and her daughter.
A patient with borderline personality disorder cut her wrists while out on a pass. For future planning, staff should consider that the reason for the self-mutilation is probably related to:
- A. an inherited disorder that manifests itself as an incapacity to tolerate stress.
- B. fear of abandonment associated with relationships or increasing autonomy.
- C. use of projective identification and splitting to bring anxiety to manageable levels.
- D. a constitutional inability to regulate affect, predisposing to psychic disorganization.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Borderline personality disorder is characterized by fear of abandonment.
2. Self-mutilation can be a maladaptive coping mechanism to alleviate this fear.
3. The behavior is often triggered by perceived threats to relationships or autonomy.
4. Therefore, considering fear of abandonment in future planning is crucial.
Summary of other choices:
A: Inherited disorder is not the primary reason for self-mutilation in borderline personality disorder.
C: Projective identification and splitting are defense mechanisms, not primary reasons for self-mutilation.
D: Constitutional inability to regulate affect may contribute, but fear of abandonment is more central in borderline personality disorder.
A patient, aged 82 years, has Alzheimer's disease. She lives with her daughter's family and goes to a day care facility on weekdays. The nurse at the day care center noticed the patient was unkempt and had multiple bruises. When the daughter arrived to pick her up, the nurse discussed her observations. The daughter became defensive and said that her mother was very difficult to manage. She stated, "My mother is not my mother anymore. She is confused, and she wanders all night. We have to watch her constantly. Last night I fell asleep, and she fell down the stairs. Sometimes I just cannot bear to care for her."Â Which nursing diagnosis would be most important to address for this patient?
- A. Risk for injury related to impaired cognition, judgment, and coordination and lack of caregiver supervision
- B. Nonadherence related to confusion and disorientation, as evidenced by lack of cooperation
- C. Anxiety related to increasing disorientation, as evidenced by the patient wandering at night
- D. Impaired verbal communication related to brain impairment, as evidenced by the patient's confusion
Correct Answer: A
Rationale: The correct answer is A: Risk for injury related to impaired cognition, judgment, and coordination and lack of caregiver supervision. The rationale is that the patient's Alzheimer's disease has led to impaired cognitive function, making her at risk for injury due to wandering and falls. The daughter's lack of supervision and inability to manage the patient's needs further exacerbate this risk. Choices B, C, and D are incorrect because they do not directly address the immediate safety concern of the patient being at risk for injury. Nonadherence, anxiety, and impaired communication are important issues but do not take precedence over the patient's safety in this context.
A nurse is caring for a patient with bulimia nervosa who has not eaten for 24 hours. The nurse should first:
- A. Encourage the patient to eat a full meal immediately.
- B. Assess the patient's vital signs and hydration status.
- C. Provide the patient with a menu to select food for the next meal.
- D. Contact the physician for a medication prescription.
Correct Answer: B
Rationale: The correct answer is B because assessing vital signs and hydration status is crucial in identifying potential complications from prolonged fasting in a patient with bulimia nervosa. This step helps determine the patient's immediate needs for intervention and guides further care planning. Encouraging the patient to eat a full meal immediately (Choice A) may lead to refeeding syndrome due to electrolyte imbalances. Providing a menu for the next meal (Choice C) is not the priority when the patient has not eaten for 24 hours. Contacting the physician for a medication prescription (Choice D) is not necessary at this point without first assessing the patient's current physical status.
An appropriate outcome for a patient with a personality disorder and a nursing diagnosis of Ineffective coping as evidenced by use of manipulation would be that the patient will:
- A. refrain from manipulative behavior at all times
- B. use manipulation only to get legitimate needs met
- C. acknowledge manipulative behavior when it is pointed out
- D. identify when he is experiencing feelings of anger
Correct Answer: C
Rationale: Rationale: Choice C is correct as it focuses on the patient acknowledging manipulative behavior when pointed out. This is important for growth and self-awareness in handling emotions and behaviors effectively. Choices A and B are extreme and unrealistic expectations, as complete cessation or selective use of manipulation may not be achievable. Choice D is irrelevant to the nursing diagnosis and does not address the core issue of ineffective coping through manipulation.