Nokea
The nurse is caring for a teenage client diagnosed with anorexia nervosa. The client's mother asks the nurse about eating disorders in general. Which information would the nurse provide? Select all that apply.
- A. Anorexia nervosa is more common than bulimia.
- B. Clients with bulimia may have erosion of the tooth enamel.
- C. Binging and purging can occur in both anorexia nervosa and bulimia.
- D. Extreme exercising and calorie restriction is common with anorexia nervosa.
- E. Clients with eating disorders may develop the disorders because of issues of power and control.
- F. Clients with anorexia have a distorted body image and think that they are fat even if they are very thin.
Correct Answer: B,C,D,E,F
Rationale: Bulimia is more common than anorexia, making A incorrect. Tooth enamel erosion, binging/purging, extreme exercising, power/control issues, and distorted body image are all accurate.
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The nurse provides care for a client diagnosed with bulimia. Which nursing action is most helpful in determining what precipitates the client'sEating disorder?
- A. Observe the family communication patterns at a monitored mealtime.
- B. Distract the client at mealtimes.
- C. Assign the client a food/feelings/thoughts action journal.
- D. Ask the client to write a history of eating behaviors.
Correct Answer: C
Rationale: A food/feelings/thoughts journal helps identify triggers and patterns associated with binge-purge behaviors, providing insight into precipitants. Observing family dynamics is useful but less direct, and distraction or history-writing are less focused on current triggers.
The nurse is admitting a client with schizophrenia. The client is extremely socially withdrawn, is unable to perform activities of daily living, has an inappropriate affect, and has grimacing mannerisms. The nurse understands that this client is experiencing which type of schizophrenia?
- A. residual schizophrenia
- B. paranoid schizophrenia
- C. catatonic schizophrenia
- D. disorganized schizophrenia
- E. undifferentiated schizophrenia
Correct Answer: D
Rationale: Disorganized schizophrenia is characterized by social withdrawal, inappropriate affect, grimacing, and impaired daily functioning. Residual (A) involves milder symptoms, paranoid (B) involves delusions, catatonic (C) involves motor issues, and undifferentiated (E) lacks specific features.
Which psychosocial factor obtained during an assessment of an older client places the client most at risk for abuse?
- A. The client resides in an apartment in a low-income neighborhood.
- B. The client shows several signs and symptoms of clinical depression.
- C. The client is completely dependent on family members for both food and medicine.
- D. The client has been diagnosed with and is being treated for several chronic illnesses.
Correct Answer: C
Rationale: Elder abuse is sometimes the result of frustrated adult children who find themselves caring for dependent parents. Increasing demands by parents for care and financial support can cause resentment and a feeling of being burdened. The issues of abuse are not bound to socioeconomic status (option 1). Option 2 relates to depression rather than the risk for abuse. Option 4 relates to a physical factor rather than a psychosocial factor.
An older client is brought to the emergency department by a family member with whom the client lives. The nurse observes that the client has poor hygiene, contractures, and pressure ulcers on the sacrum, the scapula, and the heels. Based on the nurse's assessment data, the client is suspected of which form of victimization?
- A. Sexual abuse
- B. Physical abuse
- C. Emotional abuse
- D. Psychological abuse
Correct Answer: B
Rationale: Victimization in a family can take many forms. When analyzing a specific client situation, it is important to understand which form of abuse is being considered. Physical abuse can take the form of battering (hitting, slapping, striking), or it can be more subtle, such as neglect (the failure to meet basic needs). Sexual abuse can involve unwanted sexual remarks, sexual advances, and physical sexual acts. Emotional and psychological abuse can involve inflicting verbal statements that cause mental anguish or alienation of the victim.
A nurse on the mental health unit is preparing a presentation on suicide for a group of student nurses. Which information would be included in this presentation? Select all that apply.
- A. Chronic pain or serious, disabling illness has little to no effect on suicide risk.
- B. Hispanic Americans attempt suicide at a greater rate than whites or African Americans.
- C. Suicide risk declines sharply once antidepressant medication has been taken for a few weeks.
- D. White males over the age of 80 are at the greatest risk among all age, race, and gender groups.
- E. Threatened suicide and/or gestures should be taken seriously and handled by trained professionals.
Correct Answer: D,E
Rationale: Chronic pain and serious illness increase suicide risk, making A incorrect. Data shows Hispanic Americans have lower suicide rates than whites, making B incorrect. Antidepressants may initially increase risk, making C incorrect. White males over 80 have the highest suicide rates, and all threats should be taken seriously, making D and E correct.