Nokea
The Omnibus Budget Reconciliation Act (OBRA) provides standards of care for which of the following:
- A. Very young
- B. Older adults
- C. Those who have certain intellectual communication difficulties
- D. Those without medical insurance
Correct Answer: B
Rationale: OBRA provides regulations for proper assessment of the elderly (B); for this reason, registered nurses have to provide the initial physical assessment.
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Care planning requires that a nurse recognize that the dynamic focus directing a patient with anorexia nervosa is:
- A. managing weight gain.
- B. controlling personal stressors.
- C. maintaining a sense of control.
- D. avoiding social interactions.
Correct Answer: C
Rationale: Step 1: Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image.
Step 2: Patients often use strict control over food intake as a way to cope with underlying emotional issues.
Step 3: Maintaining a sense of control is crucial in managing anorexia nervosa as it addresses the core psychological aspects driving the disorder.
Step 4: Managing weight gain (A) is not the primary focus as patients may resist gaining weight due to their fear.
Step 5: Controlling personal stressors (B) may be important but does not address the underlying issue of control related to food and body.
Step 6: Avoiding social interactions (D) does not address the core psychological need for control and can further isolate the patient.
An adult experienced a myocardial infarction six months ago. At a follow-up visit, this adult says, 'I haven't had much interest in sex since my heart attack. I finished my rehabilitation program, but having sex strains my heart. I don't know if my heart is strong enough.' Which nursing diagnosis applies?
- A. Deficient knowledge related to faulty perception of health status
- B. Disturbed self-concept related to required lifestyle changes
- C. Disturbed body image related to treatment side effects
- D. Sexual dysfunction related to self-esteem disturbance
Correct Answer: A
Rationale: The correct answer is A: Deficient knowledge related to faulty perception of health status. The patient's statement indicates a lack of understanding about their health status and the impact of their myocardial infarction on their sexual activity. The patient is attributing their decreased interest in sex to a fear of straining their heart, indicating a faulty perception of their health status. This nursing diagnosis addresses the patient's need for education and clarification about their condition to alleviate their concerns and improve their confidence in engaging in sexual activity safely.
Choices B, C, and D are incorrect because they do not directly address the patient's lack of knowledge and faulty perception about their health status. Disturbed self-concept (B) relates more to how the patient perceives themselves due to lifestyle changes, while disturbed body image (C) pertains to physical appearance changes. Sexual dysfunction (D) is related to difficulties in sexual function, which is not the primary issue in this scenario.
A patient tells the nurse, 'I can't go to any unit meetings because when I get in that room, everyone can hear my thoughts.' The nurse can correctly assess this symptom as:
- A. concrete thinking.
- B. loose associations.
- C. thought broadcasting.
- D. auditory hallucinations.
Correct Answer: C
Rationale: The correct answer is C: thought broadcasting. This is when a person believes that others can hear their thoughts. In this scenario, the patient's belief that everyone in the unit meetings can hear their thoughts aligns with the symptom of thought broadcasting. It is a common manifestation of certain psychiatric disorders like schizophrenia.
Choice A, concrete thinking, refers to literal thinking without abstract reasoning and is not applicable in this context. Choice B, loose associations, involves disorganized and illogical thought patterns, which are not evident in the patient's statement. Choice D, auditory hallucinations, refers to hearing voices when no external stimulus is present, which is different from the patient's belief that others can hear their thoughts.
The extreme reaction known as fugue refers to
- A. physical flight to escape conflict
- B. severe depression
- C. hallucinations
- D. obsessive behavior
Correct Answer: A
Rationale: Fugue is a dissociative state involving sudden travel or flight, often to escape stress.
Which of the following behaviors is characteristic of anorexia nervosa?
- A. Binge eating followed by purging.
- B. Self-induced vomiting after meals.
- C. Restricting food intake and an intense fear of gaining weight.
- D. Eating large quantities of food and then exercising excessively.
Correct Answer: C
Rationale: The correct answer is C because anorexia nervosa is characterized by restricting food intake and having an intense fear of gaining weight. This behavior leads to severe weight loss and malnutrition. Choice A is typically associated with bulimia nervosa, where binge eating is followed by purging. Choice B also aligns with bulimia, as self-induced vomiting is a common purging behavior. Choice D describes behaviors more typical of binge eating disorder, where individuals consume large quantities of food followed by excessive exercise. In anorexia nervosa, the primary focus is on severe food restriction and the fear of weight gain, leading to significantly low body weight.