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The nurse asks, 'Do your parents drink every day?' The adolescent suddenly shouts, 'I'm not going to talk about that! It's none of your business, anyway! Leave me alone!' How does the nurse interpret the adolescent's behavior?
- A. The adolescent is acting out and needs to be brought under control so the conference can continue.
- B. The adolescent is trying to shift the focus of the conference away from himself, and the nurse needs to refocus.
- C. The adolescent is demonstrating that this problem requires the assistance of a psychiatrist.
- D. The adolescent is responding to the discrediting of his parents, which causes anxiety.
Correct Answer: D
Rationale: Discrediting parents threatens the child's security and creates anxiety.
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How does the nurse describe a person who is bulimic?
- A. Severely underweight
- B. Alternates binge eating with purging
- C. Introverted perfectionist
- D. Has extremely close family relationships
Correct Answer: B
Rationale: Bulimia is characterized by alternating binge eating and purge behavior.
Which statement made by a parent of an adolescent with anorexia nervosa indicates an understanding of this condition?
- A. There really isn't anything to worry about. Don't they say you can never be too thin?'
- B. My daughter just doesn't have much of an appetite.'
- C. She is just trying to punish me for divorcing her father.'
- D. She seems to see herself as fat, even though her weight is below normal.'
Correct Answer: D
Rationale: Individuals with anorexia nervosa have a disturbed body image, which this parent correctly recognizes.
The nurse is planning the care of an adolescent with anorexia nervosa. What characteristic(s) cause this disorder? (Select all that apply.)
- A. Discomfort relative to emerging sexuality
- B. Fear of intimacy
- C. Pervasive high self-esteem
- D. Egocentricity
- E. Inability to meet developmental needs
Correct Answer: A,B,D,E
Rationale: Discomfort with emerging sexuality, fear of intimacy, egocentricity, and inability to meet developmental needs are causes of anorexia nervosa, while low self-esteem, not high, is also a factor.
The nurse is assessing a 16-year-old female for characteristics of anorexia nervosa. Which assessment finding(s) would lead the nurse to suspect the possibility of this diagnosis? (Select all that apply.)
- A. Amenorrhea
- B. Severe weight loss
- C. Oily skin
- D. Hypertension
- E. Lanugo on back
Correct Answer: A,B,E
Rationale: Primary symptoms of anorexia nervosa include severe weight loss, amenorrhea, and lanugo hair over the back and extremities.
The nurse is answering phone calls at a local suicide prevention hotline. Which statement would be recognized as the greatest risk of suicide?
- A. I just needed to talk to someone to keep myself from thinking silly thoughts about killing myself.'
- B. My parents aren't home and won't be back for 4 hours. That should be enough time for the pills to work. I've got a hundred of them.'
- C. My dad will be home first, so he'll find me. So I think I'll use his gun. I hope he didn't lock the cabinet.'
- D. My girlfriend is here with me. She told me to call because I was talking crazy about killing myself.'
Correct Answer: B
Rationale: The risk of death increases when there is a definite plan of action, the means are readily available, and the person has few resources for help and support.