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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A 17-year-old female with a self-admitted opioid addiction is seen by the nurse in a mental health clinic. Which intervention would the nurse not consider in establishing a therapeutic relationship?
- A. discuss the impact of substance use
- B. require the client to attend all therapy sessions
- C. explore alternative approaches to managing stress
- D. assess the presence of other psychiatric disorders
Correct Answer: B
Rationale: Mandating attendance can undermine trust and autonomy, hindering a therapeutic relationship.
The nurse is assessing a client who was admitted to the hospital with a diagnosis of urinary calculi. The client received 4 mg of morphine sulfate approximately 2 hours previously. The client states to the nurse, 'I'm scared to death that it'll come back.' Based on these statements, which concern should the nurse identify for this client at this time?
- A. Fear of dying
- B. Lack of understanding about the disease process
- C. Anxiety about the anticipation of recurrent severe pain
- D. Retention of urine from the obstruction of the urinary tract by calculi
Correct Answer: C
Rationale: The client stated, 'I'm scared to death that it'll come back.' The anticipation of the recurring pain produces anxiety and threatens the client's psychological integrity. There is no evidence that the client has a calculus in the right ureter. There is also no evidence that the client has lack of knowledge or urinary retention.
The nurse is giving a client diagnosed with heart failure home care instructions for use after hospital discharge. The client interrupts, saying, 'What's the use? I'll never remember all of this, and I'll probably die anyway!' The nurse determines that the client's statement is most likely due to which psychosocial concern?
- A. Anger about the new medical regimen
- B. The teaching strategies used by the nurse
- C. Insufficient financial resources to pay for the medications
- D. Anxiety about the ability to manage the disease process at home
Correct Answer: D
Rationale: Anxiety and fear often develop after heart failure, and they can further tax the failing heart. The client's statement is made in the middle of receiving self-care instructions. There is no evidence in the question to support option 1, 2, or 3.
Following a train accident, the nurse triages a group of victims. When the nurse asks how one of the clients is feeling, the client states matter-of-factly, 'Look at all the rescue trucks. It's like watching a movie.' Which defense mechanism does the nurse identify that the client is using?
- A. Dissociation.
- B. Regression.
- C. Projection.
- D. Denial.
Correct Answer: A
Rationale: Dissociation involves detaching from reality to cope with trauma, as seen in the client’s detached, movie-like perception of the accident. Regression, projection, and denial involve different coping mechanisms not reflected in this statement.
The nurse notes that an assigned client is lying tense in bed and staring at the cardiac monitor. The client states, 'There sure are a lot of wires around there. I sure hope we don't get hit by lightning.' Which is the most appropriate nursing response?
- A. Your family can stay tonight if they wish.'
- B. Would you like a mild sedative to help you relax?'
- C. The hospital is well equipped to shield a lightning strike.'
- D. Yes, all the wires must be scary. Let's talk about the cardiac monitor.'
Correct Answer: D
Rationale: The nurse should initially validate the client's concern and then assess the client's knowledge regarding the cardiac monitor. This gives the nurse an opportunity to provide client education if necessary. None of the remaining options address the client's concern. In addition, pharmacological interventions should be considered only if necessary.