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The nurse is caring for a patient with anorexia nervosa. Which intervention is a priority?
- A. Establish a no-contact rule with the patient's family.
- B. Monitor the patient's food intake and weight closely.
- C. Encourage the patient to exercise to improve health.
- D. Focus primarily on addressing the patient's body image issues.
Correct Answer: B
Rationale: The correct answer is B because monitoring food intake and weight closely is crucial in managing anorexia nervosa to prevent further complications like malnutrition and dehydration. By closely monitoring these factors, the nurse can ensure the patient is receiving adequate nutrition and is not losing weight rapidly. Establishing a no-contact rule with the family (A) could hinder the patient's support system. Encouraging exercise (C) may worsen excessive calorie expenditure. Focusing on body image (D) is important but addressing immediate health risks takes precedence.
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The nurse is working with a patient diagnosed with bulimia nervosa. Which assessment is most important?
- A. Monitor electrolyte levels and cardiac function.
- B. Observe for compulsive eating behaviors.
- C. Track the patient's ability to self-regulate food intake.
- D. Assess for symptoms of depression and anxiety.
Correct Answer: A
Rationale: The correct answer is A because patients with bulimia nervosa are at risk for electrolyte imbalances and cardiac issues due to purging behaviors. Monitoring electrolyte levels and cardiac function is crucial for early detection and intervention. Option B is incorrect as it focuses on behaviors rather than potential medical complications. Option C is less critical than monitoring electrolytes and cardiac function. Option D, although important, is not as immediately critical as monitoring electrolyte levels and cardiac function in this context.
An 82-year-old widow with Alzheimer's disease lives with her daughter's family, which owns a catering business. During the week, the patient attends a daycare center for patients. During the evenings, members of the family care for the patient. One day, the nurse at the daycare center notices the patient's appearance is disheveled and that she has bruises on her wrists and back when escorted to the bathroom. What most likely explains the nurse's observations?
- A. The patient is being neglected and abused within the family.
- B. The dementia is progressing, reducing self-care and increasing falls.
- C. The patient is experiencing normal aging symptoms.
- D. The patient is suffering from a new medical condition.
Correct Answer: A
Rationale: The correct answer is A because the nurse's observations of disheveled appearance, bruises, and signs of physical abuse indicate possible neglect and abuse within the family. This is supported by the presence of Alzheimer's disease, vulnerability due to age, and the patient's living situation with family members who own a catering business. Choice B is incorrect as it does not explain the bruises and neglect observed. Choice C is incorrect as normal aging symptoms would not typically include bruises and neglect. Choice D is incorrect as there is no indication of a new medical condition causing these specific observations.
Which of the following is an example of an intellectual disability?
- A. Dyslexia
- B. ADHD
- C. Mental Retardation
- D. Autistic spectrum disorders
Correct Answer: C
Rationale: Mental Retardation: A DSM-IV-TR defined disorder in which an individual has significantly below average intellectual functioning characterised by an IQ of 70 or below.
A physical therapist recently convicted of multiple counts of Medicare fraud is brought to the emergency department after taking an overdose of sedatives. He tells the nurse, 'Sure I overbilled. Why not? Everybody takes advantage of the government. They have too many rules. No one can abide by all of them.' These statements can be assessed as showing:
- A. glibness and charm.
- B. superficial remorse.
- C. lack of guilt feelings.
- D. excessive suspiciousness.
Correct Answer: C
Rationale: The correct answer is C: lack of guilt feelings. The physical therapist's statements reveal a lack of remorse or guilt for committing Medicare fraud, indicating a disregard for ethical standards and a lack of moral responsibility. This behavior is indicative of a lack of guilt feelings, as the individual shows no remorse for their actions.
Summary of other choices:
A: Glibness and charm typically involve smooth talking and being persuasive, which is not demonstrated in the scenario.
B: Superficial remorse implies a shallow or insincere apology, but the individual does not express any form of remorse in this situation.
D: Excessive suspiciousness refers to being overly mistrustful or paranoid, which is not evident in the physical therapist's statements.
Retreat from reality by hallucinations and delusions and by social withdrawal typically characterizes
- A. somatoform disorders
- B. anxiety disorders
- C. psychotic disorders
- D. personality disorders
Correct Answer: C
Rationale: Psychotic disorders, like schizophrenia, involve hallucinations, delusions, and withdrawal, distinguishing them from other categories.