What is a key consideration when treating a patient with anorexia nervosa?
- A. Addressing the patient's weight first and foremost.
- B. Focusing on nutrition and caloric intake without addressing underlying issues.
- C. Addressing the psychological and emotional factors that contribute to the disorder.
- D. Providing strict dietary restrictions to help the patient regain control over food.
Correct Answer: C
Rationale: The correct answer is C because addressing the psychological and emotional factors is crucial in treating anorexia nervosa. This disorder is not solely about weight or food intake; it often involves deeper psychological issues such as body image distortion, low self-esteem, and control issues. By focusing on the underlying psychological and emotional factors, therapists can help patients understand and cope with these issues, leading to more effective and sustainable recovery. Choices A, B, and D are incorrect because they overlook the complexity of anorexia nervosa and may even exacerbate the patient's condition by neglecting the root causes of the disorder.
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A client admitted with delusions, hallucinations, and thought disorder has the admitting diagnosis schizophreniform disorder R/O organic pathology. Based on this information, the nurse can expect that the client will:
- A. Undergo an MRI test
- B. Have psychological testing
- C. Have an immunologic assay performed
- D. Participate in a dexamethasone suppression test
Correct Answer: A
Rationale: Step 1: The client is admitted with symptoms suggestive of a psychotic disorder, specifically schizophreniform disorder.
Step 2: The admitting diagnosis includes ruling out organic pathology, indicating a need to investigate potential physical causes.
Step 3: An MRI test is a non-invasive imaging procedure that can help identify any structural abnormalities in the brain.
Step 4: This test is appropriate in ruling out organic causes of the symptoms presented by the client.
Step 5: Psychological testing (Choice B) is more focused on assessing cognitive and emotional functioning, not ruling out organic pathology.
Step 6: Immunologic assay (Choice C) is used to detect antibodies or antigens in the blood, not typically relevant in this context.
Step 7: Dexamethasone suppression test (Choice D) is used to assess for abnormalities related to cortisol levels in conditions like depression, not specific to ruling out organic pathology in psychotic disorders.
Summary: Choice A is correct because an MRI test is the most relevant
A nurse assessing an elderly patient for depression and suicide potential should include questions about mood as well as: (Select one tha does not apply)
- A. anhedonia.
- B. increased appetite.
- C. sleep pattern changes.
- D. increased concerns with bodily functions.
Correct Answer: B
Rationale: The correct responses (A, C, E) relate to symptoms often noted in elderly patients with depression: anhedonia (loss of pleasure), sleep changes, and somatic concerns. Increased appetite (B) is less typical than anorexia, and grandiosity (D) relates to bipolar disorder, not depression.
A 76-year-old is regressed, indifferent, and responds to others only when they initiate an interaction. What form of group therapy would be most useful to promote resocialization?
- A. Remotivation
- B. Activity group
- C. Psychotherapy
- D. Reminiscence (life review)
Correct Answer: A
Rationale: Remotivation therapy helps to resocialize regressed and apathetic patients by focusing on a single topic, creating a bridge to reality as group members talk about the world in which they live and work and hobbies related to the topic. Group leaders give members acceptance and appreciation. Group psychotherapy would not be effective for this patient. An activity group does not address the patients problem.
The caregiver for a client with moderate to severe dementia tells the nurse, 'I'm exhausted. He wanders at night instead of sleeping, so I get no rest. I'm afraid to leave him during the day, so I have to take him to the grocery store and to the laundromat. When I'm busy there, he often wanders off. Still, I have to do it all.' The nurse recognizes the need to provide teaching for this caregiver. An appropriate outcome is that the caregiver will:
- A. Develop strategies to ensure the client's safety.
- B. Seek respite care to get a break.
- C. Join a support group for caregivers.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Develop strategies to ensure the client's safety. This is the most appropriate outcome as it directly addresses the caregiver's concerns of the client wandering and ensures their safety. By developing strategies such as installing door alarms, creating a safe sleeping environment, and establishing a routine, the caregiver can mitigate the risks associated with wandering behavior.
Summary:
- B: Seek respite care to get a break: While respite care is important for caregiver well-being, it does not directly address the safety concerns of the client wandering.
- C: Join a support group for caregivers: While support groups can be beneficial for emotional support, they may not provide immediate solutions to ensure the client's safety.
A client has been diagnosed with a dementia secondary to cerebral disease. The family members note the client 'has not been as sharp as he once was' and that he has developed urinary incontinence and a gait disturbance. They attributed the first symptom to normal aging but were alarmed by the latter two symptoms. Based on this history, which of the following should come to mind?
- A. Normal pressure hydrocephalus
- B. Vitamin B12 deficiency
- C. Hepatic disease
- D. Tuberculosis
Correct Answer: A
Rationale: Step 1: The client presents with urinary incontinence and a gait disturbance, suggestive of normal pressure hydrocephalus (NPH) due to cerebral disease.
Step 2: NPH is characterized by the triad of cognitive decline, gait disturbances, and urinary incontinence.
Step 3: Symptoms of NPH can mimic normal aging but are distinct from other conditions.
Step 4: Vitamin B12 deficiency (B) primarily presents with anemia and neurological symptoms, not the triad seen in NPH.
Step 5: Hepatic disease (C) typically presents with symptoms related to liver dysfunction, not the triad of NPH.
Step 6: Tuberculosis (D) manifests with respiratory symptoms and constitutional symptoms, not the cognitive decline and gait issues seen in NPH.