The mother of a teen with an eating disorder tells the nurse, 'Our family is pretty well-adjusted. It's hard for me to imagine what we could have done to have this happen.' The nurse can promote more complete understanding of the etiology of eating disorders by mentioning that young women are also influenced by:
- A. The abundance of nutritious foods available.
- B. The fashion industry's idealization of thinness.
- C. Competition in the workplace.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: The fashion industry's idealization of thinness. This is correct because the portrayal of ultra-thin models in the fashion industry can contribute to societal pressure on young women to achieve an unrealistic body image, leading to body dissatisfaction and potentially eating disorders. The other choices are incorrect because option A does not address the societal influences on body image ideals, option C is not directly related to the etiology of eating disorders in young women, and option D is incorrect as the fashion industry can indeed play a significant role in shaping perceptions of beauty and body image.
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Which is the most appropriate response when a patient with bulimia nervosa expresses feelings of shame about their purging behaviors?
- A. Encourage the patient to avoid discussing their eating habits.
- B. Agree with the patient's feelings and offer reassurance.
- C. Focus on helping the patient identify triggers for purging behaviors.
- D. Provide education on the benefits of purging for weight management.
Correct Answer: C
Rationale: The correct answer is C because focusing on helping the patient identify triggers for purging behaviors is essential in addressing the underlying issues contributing to their behavior. By identifying triggers, the patient can develop coping strategies and alternative behaviors.
Choice A is incorrect as avoiding discussing eating habits can hinder progress in therapy. Choice B is incorrect as simply agreeing and offering reassurance without addressing the root cause may not lead to lasting change. Choice D is incorrect as it promotes the harmful behavior of purging for weight management, which goes against the goal of treating bulimia nervosa.
The nurse at the clinic is interviewing a patient who offers a number of vague somatic complaints that might not ordinarily prompt a visit to a caregiver: fatigue, back pain, headaches, and sleep disturbance. The patient seems tense, and after having spoken of the symptoms, seems reluctant to provide more information and is in a hurry to leave. The nurse can best serve the patient by:
- A. Asking if the patient has ever had psychiatric counseling.
- B. Completing a structured abuse assessment protocol.
- C. Exploring the possibility of patient social isolation.
- D. Asking the patient to disrobe to check for signs of abuse.
Correct Answer: B
Rationale: The correct answer is B: Completing a structured abuse assessment protocol. Given the patient's vague complaints, tension, reluctance to provide more information, and hurry to leave, these could be signs of potential abuse. Completing a structured abuse assessment protocol allows the nurse to systematically assess for any signs of abuse, which could be contributing to the patient's somatic complaints. This approach is necessary to ensure the patient's safety and well-being.
Incorrect choices:
A: Asking if the patient has ever had psychiatric counseling - This choice does not directly address the potential abuse concerns indicated by the patient's behavior.
C: Exploring the possibility of patient social isolation - While social isolation could be a contributing factor, the urgency to leave and reluctance to provide information are more indicative of potential abuse.
D: Asking the patient to disrobe to check for signs of abuse - This choice is invasive and inappropriate without first completing a structured abuse assessment protocol to determine if abuse is likely.
An elderly patient brings a bag of medications to the clinic. The nurse finds a bottle labeled Ativan and one labeled lorazepam, both of which are to be taken BID. There are also bottles labeled hydrochlorothiazide, Inderal, and rofecoxib, each to be taken once daily. Which conclusion is accurate?
- A. Rofecoxib should not be taken with Ativan.
- B. Lorazepam interferes with the action of Inderal.
- C. The patient should not self-administer medication.
- D. Lorazepam and Ativan are the same drug, so the dose is excessive.
Correct Answer: D
Rationale: Lorazepam and Ativan are generic and trade names for the same drug (D), creating an accidental misuse situation with an excessive dose. The patient needs medication education and help with proper labeling; there is no evidence they cannot self-administer (C). Options A and B are not factually supported.
A short-term goal for a patient with Alzheimer disease is:
- A. Improved functioning in the least restrictive environment
- B. improved problem solving in activities of daily living
- C. increased self-esteem and improved self-concept
- D. regained sensory perception and cognitive function
Correct Answer: A
Rationale: Promoting function in a safe, least restrictive setting is realistic and achievable given Alzheimer's progressive nature.
A patient diagnosed with schizophrenia has been rehospitalized after a relapse. A priority intervention in designing a discharge plan to prevent relapses will be:
- A. helping the patient's family develop tolerance for the cognitive symptoms.
- B. mobilizing the family to provide structure to reduce social dysfunction.
- C. working on self-concept to reduce abolition, anhedonia, and dysphoria.
- D. early identification of signs of impending relapse and coping strategies.
Correct Answer: D
Rationale: The correct answer is D because early identification of signs of impending relapse and coping strategies are crucial in preventing relapses in schizophrenia. By recognizing early warning signs, the patient can receive timely intervention and support to prevent further deterioration. This proactive approach enables healthcare providers to adjust treatment plans and provide necessary resources, ultimately reducing the likelihood of rehospitalization.
Choice A is incorrect because developing tolerance for cognitive symptoms may be beneficial but not a priority in preventing relapses. Choice B is incorrect as family support is important but solely relying on family for structure may not address all factors contributing to relapse. Choice C is incorrect as working on self-concept may be helpful but not directly related to preventing relapses.