Nokea
The nurse who works in a sleep clinic knows that approximately ______% of adults suffer from insomnia.
- A. 10 to 20.
- B. 30 to 40.
- C. 50 to 60.
- D. 70 to 80.
Correct Answer: B
Rationale: The correct answer is B (30 to 40%). Insomnia is a common sleep disorder, affecting around 30-40% of adults. This range reflects the prevalence rates reported in various studies. Choices A, C, and D are incorrect because they provide prevalence rates that are either too low (A) or too high (C, D) compared to the generally accepted range for insomnia in adults. It is essential for the nurse in a sleep clinic to understand the prevalence of insomnia accurately to provide appropriate care and support to patients.
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A client tells the nurse, 'I hear people whispering about me. When I'm in the day room and they do that, I want to punch them.' The information the nurse should give to staff in report consists of which of the following?
- A. Treat this client matter-of-factly. Be direct; don't talk about him or others in his presence.'
- B. Stay away from this client. The fewer interactions you have with him, the fewer misinterpretations there will be.'
- C. Stay close to this client and use touch as you interact with him.'
- D. To help him become less anxious with whispering, speak in a very soft voice when you are near him.'
Correct Answer: A
Rationale: The correct answer is A: "Treat this client matter-of-factly. Be direct; don't talk about him or others in his presence." This response is appropriate because it emphasizes the importance of respecting the client's privacy and dignity by not discussing him or others in his presence. By being direct and matter-of-fact, the nurse can establish trust and build a therapeutic relationship with the client. This approach also helps maintain boundaries and avoids escalating the situation.
Choice B is incorrect because avoiding the client may lead to feelings of rejection and worsen his symptoms. Choice C is incorrect because using touch without the client's consent may be inappropriate and could escalate the situation. Choice D is incorrect because speaking softly does not address the underlying issue of the client feeling threatened by whispering.
When told that he is scheduled to interview a patient with narcissistic personality disorder, the nurse can anticipate the assessment findings will include the following:
- A. charm, drama, seductiveness, and admiration seeking.
- B. preoccupation with minute details and perfectionism.
- C. difficulty being alone, indecisiveness, and submissiveness.
- D. grandiosity, self-importance, and a sense of entitlement.
Correct Answer: D
Rationale: The correct answer is D. In narcissistic personality disorder, individuals exhibit grandiosity, self-importance, and a sense of entitlement. This is a key feature of the disorder where individuals have an inflated sense of their own importance and require excessive admiration. This behavior is often accompanied by a lack of empathy and exploitation of others.
Choice A (charm, drama, seductiveness, and admiration seeking) is more characteristic of histrionic personality disorder.
Choice B (preoccupation with minute details and perfectionism) is more characteristic of obsessive-compulsive personality disorder.
Choice C (difficulty being alone, indecisiveness, and submissiveness) does not align with the typical presentation of narcissistic personality disorder.
A client tried to gouge out his eye in response to auditory hallucinations commanding, 'If thine eye offend thee, pluck it out.' The nurse would analyze this behavior as indicating:
- A. Impaired impulse control
- B. Inability to manage anger
- C. Derealization
- D. Inappropriate affect
Correct Answer: A
Rationale: The correct answer is A: Impaired impulse control. This behavior shows a lack of control over impulsive actions, as the client acted immediately on the auditory hallucination without considering the consequences. Choice B is incorrect because anger management is not directly related here. Choice C, derealization, refers to feeling disconnected from reality, which is not evident in the scenario. Choice D, inappropriate affect, does not fit as the client's action is more about impulsivity than emotional expression. Ultimately, the client's behavior aligns most closely with impaired impulse control due to the immediate and extreme response to the auditory hallucination.
What should the nurse focus on when planning care for a patient with anorexia nervosa?
- A. Encourage the patient to restrict food intake and control weight.
- B. Provide a structured meal plan and monitor nutritional intake.
- C. Allow the patient to eat freely without any food restrictions.
- D. Encourage daily exercise to help manage weight.
Correct Answer: B
Rationale: The correct answer is B because providing a structured meal plan and monitoring nutritional intake is crucial in the care of a patient with anorexia nervosa to ensure they receive adequate nutrition. By following a structured plan, the patient can gradually restore a healthy relationship with food and gain weight safely. Encouraging the patient to eat freely (choice C) can lead to further disordered eating behaviors. Encouraging food restriction and weight control (choice A) can worsen the patient's condition. Encouraging daily exercise (choice D) may exacerbate the patient's excessive focus on weight and body image. In summary, choice B is the best option as it focuses on promoting healthy eating habits and addressing the nutritional needs of the patient with anorexia nervosa.
A patient with bulimia nervosa expresses that they feel better after purging. How should the nurse respond?
- A. Encourage the patient to continue purging to maintain weight.
- B. Explain that purging has long-term harmful effects on the body.
- C. Agree that purging can help with weight control and self-esteem.
- D. Tell the patient that purging is an effective method to prevent weight gain.
Correct Answer: B
Rationale: The correct answer is B because purging in bulimia nervosa is a maladaptive behavior with severe health consequences. The nurse should educate the patient about the long-term harmful effects of purging, such as electrolyte imbalances, dental issues, and organ damage. Encouraging the patient to continue purging (A) reinforces the harmful behavior. Agreeing with the patient (C) or suggesting purging as an effective weight management method (D) further perpetuates the unhealthy behavior and fails to address the underlying issues. Overall, educating the patient about the risks of purging is essential in promoting recovery and better health outcomes.