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What is a common consequence of long-term purging in patients with bulimia nervosa?
- A. Improved digestive health and better nutrient absorption.
- B. Increased risk of dehydration and electrolyte imbalances.
- C. Improved self-esteem and body image.
- D. Decreased risk of cardiovascular problems and hypertension.
Correct Answer: B
Rationale: The correct answer is B because long-term purging in patients with bulimia nervosa can lead to increased risk of dehydration and electrolyte imbalances. Purging behaviors such as vomiting or laxative abuse can disrupt the body's fluid and electrolyte balance, potentially causing dehydration and electrolyte imbalances. These imbalances can have serious health consequences, including cardiac arrhythmias, muscle weakness, and kidney damage.
Incorrect choices:
A: Improved digestive health and better nutrient absorption - Purging does not improve digestive health or nutrient absorption; rather, it can lead to nutrient deficiencies.
C: Improved self-esteem and body image - Purging behaviors are harmful and do not lead to improved self-esteem or body image.
D: Decreased risk of cardiovascular problems and hypertension - Purging behaviors can actually increase the risk of cardiovascular problems due to electrolyte imbalances and dehydration.
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In clinical supervision, the nurse caring for the patient with a paranoid personality disorder tells the advanced practice nurse, 'I tried being caring and empathetic, but the patient just kept telling me to stay away.' Which response by the advanced practice nurse would be best?
- A. Acting somewhat cynical and aloof, like they do, will make it easier for paranoid persons to bond with you over time. That, plus humor.'
- B. You may be trying too hard too soon. Back off, give him some time to get used to you, then try your caring and empathetic approach again.'
- C. Mistrustful people do not bond as others do, so first it's important to be realistic. Second, a neutral yet courteous approach will work better.'
- D. You are on the right track, but give it more time. Actively conveying empathy and care will work, but paranoid persons respond more slowly.'
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the unique challenges of working with individuals with paranoid personality disorder. The response emphasizes the importance of being realistic about the patient's mistrust and suggests a neutral yet courteous approach. This approach recognizes the need to build trust gradually and not rush into being overly caring or empathetic, which could further trigger the patient's paranoia.
Choice A is incorrect because adopting a cynical and aloof attitude is not conducive to building rapport with individuals with paranoid personality disorder. Humor may also be perceived as mocking or dismissive.
Choice B is incorrect because it suggests backing off completely before trying a caring and empathetic approach again. This approach may not effectively address the patient's needs for support and may reinforce their feelings of isolation.
Choice D is incorrect because it suggests continuing with the caring and empathetic approach without acknowledging the need for a more cautious and neutral approach with individuals who are mistrustful. This approach may not effectively address the patient's specific needs and could potentially worsen the
Which information should the nurse include when teaching a client with a personality disorder?
- A. Journal writing will help you recognize feeling states.'
- B. Try problem solving independently to help with difficult relationships.'
- C. Identify people and circumstances that create conflict; then avoid them.'
- D. Try to alleviate behaviors that cause problems relating with others.'
Correct Answer: A
Rationale: The correct answer is A because journal writing can help individuals with personality disorders recognize and better understand their emotions, leading to improved self-awareness and emotional regulation. This can be a useful tool in therapy and self-management.
Choice B is incorrect because individuals with personality disorders often struggle with interpersonal relationships and might benefit from seeking support or guidance rather than attempting to solve problems independently.
Choice C is incorrect because avoidance does not address the underlying issues and can lead to isolation and maladaptive coping mechanisms.
Choice D is incorrect because simply trying to alleviate problematic behaviors without addressing the underlying emotional issues may not lead to long-term improvement in relationships.
A patient whose boyfriend raped her during an argument tells the nurse, 'It's no use reporting it. No one will ever believe me, because everyone knows I've been sexually intimate with him many times before.' Which response by the nurse would have the greatest therapeutic value initially?
- A. You will need to talk to someone. Do you have a best friend to talk to?'
- B. It's not your fault. He needs to get help controlling his anger.'
- C. The police need to be aware that your boyfriend is willing to act this way when he's angry.'
- D. If you said 'no,' your boyfriend needs to respect your wishes. He needs help so this will never happen again.'
Correct Answer: D
Rationale: Rationale for Correct Answer D:
1. Acknowledges the patient's agency and emphasizes consent.
2. Validates the patient's experience and emphasizes boundaries.
3. Encourages the patient to prioritize her safety and well-being.
4. Addresses the need for intervention and prevention of future harm.
Summary:
A: Does not address the issue of consent or the need for intervention.
B: Shifts focus from perpetrator to victim, potentially placing blame.
C: Focuses on legal action without addressing the patient's emotional needs.
D: Empowers the patient, emphasizes consent, and prioritizes safety and prevention.
When people successfully adapt to their environment by using logical thought and socially appropriate ways, they are said to be functioning at the adaptive end of the _____ continuum.
- A. Emotional
- B. Self-protective
- C. Neurobiological
- D. Psychobiological
Correct Answer: C
Rationale: The correct answer is C: Neurobiological. This is because neurobiological factors refer to the brain's functioning and how it affects behavior and cognition. When individuals adapt to their environment using logical thought and socially appropriate ways, it indicates a high level of cognitive and behavioral functioning, which is closely tied to neurobiological processes.
A: Emotional is incorrect because emotional factors focus on feelings and affective responses, not necessarily on logical thought and social appropriateness.
B: Self-protective is incorrect as it pertains to behaviors aimed at ensuring one's safety and security, which may not necessarily involve logical thought and social appropriateness.
D: Psychobiological is incorrect as it encompasses the interaction between psychological and biological processes, which may not specifically relate to adaptive functioning in the given context.
The parent of a seriously mentally ill adult asks the nurse, 'Why are you making a referral to a vocational rehabilitation program? My child wont ever be able to hold a job.' Which is the nurses best reply?
- A. We make this referral to continue eligibility for federal funding.'
- B. Are you concerned that were trying to make your child too independent?'
- C. If you think the program would be detrimental, we can postpone it for a time.'
- D. Most patients are capable of employment at some level, competitive or supported.'
Correct Answer: D
Rationale: Studies have shown that most patients who complete vocational rehabilitation programs are capable of some level of employment. They also demonstrate significant improvement in assertiveness and work behaviors as well as decreased depression.