Population Based Health Care

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The nurse has recently set limits for a patient with borderline personality disorder. The patient tells the nurse, 'You used to care about me. I thought you were wonderful. Now I can see I was mistaken. You're hateful.' Which phenomenon is represented by this response?

  • A. Splitting
  • B. Denial
  • C. Reaction formation
  • D. Projection
Correct Answer: A

Rationale: The correct answer is A: Splitting. Splitting is a defense mechanism commonly seen in individuals with borderline personality disorder where they perceive others as either all good or all bad. In this scenario, the patient's sudden shift from viewing the nurse as wonderful to hateful demonstrates splitting. The patient is unable to integrate both positive and negative aspects of the nurse's behavior, leading to extreme and polarized perceptions.

Choice B: Denial involves refusing to accept reality to protect oneself from uncomfortable truths, which is not demonstrated in this response.

Choice C: Reaction formation is a defense mechanism where an individual behaves in a way that is opposite to their true feelings, which is not evident in the patient's response.

Choice D: Projection involves attributing one's own unacceptable thoughts or feelings onto someone else, which is not the case in this scenario.

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The subjective internal feeling of being either male of female is called

  • A. Gender identity
  • B. Sexuality
  • C. Gender identity disorder
  • D. Sexual orientation
Correct Answer: A

Rationale: Gender identity refers to one's internal sense of being male, female, or another gender, distinct from sexual orientation or physical traits.

Explain four (4) the behavioral features of Anorexia Nervosa

  • A. Restricting food intake
  • B. Excessive exercise
  • C. Body image distortion
  • D. Fear of weight gain
Correct Answer: A

Rationale: These behaviors reflect the core features of anorexia: restriction, overactivity, distorted perception, and weight obsession.

A 72-year-old patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. Family members are very anxious and express their concerns about placing the patient in a nursing home. What information should serve as a basis for the nurse's reply?

  • A. Delirium is reversible, and the patient will likely recover.
  • B. The symptoms are related to depression, which can be treated.
  • C. Delirium usually progresses to dementia, which is usually permanent.
  • D. Home care should be attempted; a nursing home should be the last resort.
Correct Answer: A

Rationale: Correct Answer: A

Rationale:
1. Delirium is an acute, reversible condition caused by underlying factors like medication toxicity.
2. By addressing the anticholinergic medication toxicity, the delirium can be resolved, leading to recovery.
3. The patient's age does not necessarily indicate a progression to dementia.
4. Placing the patient in a nursing home is not the immediate solution; resolving the toxicity should be the priority.

Summary:
Choice A is correct because delirium is reversible with appropriate treatment. Choices B, C, and D are incorrect because they do not address the underlying cause of delirium or provide accurate information about its progression or management.

A newly admitted client has the diagnosis of catatonic schizophrenia. The nurse would expect to assess:

  • A. Psychomotor symptoms
  • B. Intense suspiciousness
  • C. Inappropriate affect
  • D. Clanging communication
Correct Answer: A

Rationale: Rationale:
A: Psychomotor symptoms are characteristic of catatonic schizophrenia, such as stupor or excessive motor activity.
B: Intense suspiciousness is more indicative of paranoid schizophrenia, not catatonic schizophrenia.
C: Inappropriate affect is a symptom seen in other types of schizophrenia but not specific to catatonic schizophrenia.
D: Clanging communication is associated with disorganized schizophrenia, not catatonic schizophrenia.
In catatonic schizophrenia, psychomotor symptoms like stupor, rigidity, or excitement are prominent.

Prior to discharge, the nurse plans to teach the client and family about relapse. Which items will the nurse include in the teaching?

  • A. Recognition of warning signs of relapse
  • B. Notify the nurse of warning signs present for more than one month
  • C. Lower medication dosage to manage emerging side effects
  • D. Use street drugs judiciously and only in small amounts
Correct Answer: A

Rationale: The correct answer is A because recognizing warning signs of relapse is crucial for early intervention. By identifying these signs, the client and family can seek help promptly, preventing a full relapse. Choice B is incorrect as waiting for signs to persist for more than one month delays intervention. Choice C is incorrect as altering medication dosage without medical advice can be dangerous. Choice D is incorrect as using street drugs is never a safe or appropriate way to manage relapse.

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