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What is an appropriate goal for a nurse working with a patient who has bulimia nervosa?
- A. The patient will engage in daily exercise to control weight.
- B. The patient will eliminate purging behaviors and establish healthy eating habits.
- C. The patient will maintain a low weight and avoid binge episodes.
- D. The patient will adopt a restrictive diet to manage their eating behaviors.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Eliminating purging behaviors addresses the primary symptom of bulimia nervosa.
2. Establishing healthy eating habits promotes long-term recovery and overall well-being.
3. Focusing on behavior change rather than weight control aligns with evidence-based treatment.
4. This goal is client-centered, prioritizing the patient's mental and physical health.
Summary:
A: Focusing solely on exercise does not address the root cause of bulimia.
C: Emphasizing weight maintenance may reinforce unhealthy body image and behaviors.
D: Adopting a restrictive diet can exacerbate disordered eating patterns and harm health.
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Which of these assessment findings would indicate that a rape victim is exhibiting behavior typically seen in the acute stage of sexual assault?
- A. Patient is very demanding and controlling in manner when dealing with staff.
- B. Patient appears to be confused, restless, and fearful when left alone.
- C. Patient uses profanity to describe the events surrounding the attack.
- D. Patient experiences a panic attack on the anniversary of the attack.
Correct Answer: B
Rationale: The correct answer is B because exhibiting confusion, restlessness, and fear when left alone aligns with the acute stage of sexual assault trauma. During this stage, victims often experience shock, disbelief, and heightened anxiety. This behavior reflects immediate emotional distress and trauma response. Choice A indicates characteristics of control and demanding behavior, which are not typically seen in the acute stage. Choice C suggests using profanity, which may vary based on individual coping mechanisms. Choice D indicates a specific trigger response on the anniversary, suggesting a later stage of processing trauma, not the acute phase.
A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:
- A. Haloperidol (Haldol).
- B. Olanzapine (Zyprexa).
- C. Diphenhydramine (Benadryl).
- D. Chlorpromazine (Thorazine).
Correct Answer: B
Rationale: The correct answer is B: Olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that has been shown to effectively target negative symptoms of schizophrenia, such as apathy, poverty of thought, and social isolation. It also helps with mood stabilization and cognitive function, which can improve the patient's ability to work and engage in social interactions.
Choice A: Haloperidol (Haldol) is a typical (first-generation) antipsychotic like the current medication, which is less effective in treating negative symptoms and can potentially worsen them.
Choice C: Diphenhydramine (Benadryl) is an antihistamine and not indicated for treating schizophrenia symptoms.
Choice D: Chlorpromazine (Thorazine) is another typical (first-generation) antipsychotic, similar to the current medication, and may not adequately address the negative symptoms the patient is experiencing.
The distinction between obsessions and compulsions is the distinction between
- A. engaging in behaviors that are merely inconvenient and those that are severely disruptive
- B. having positive and negative feelings toward an object or event
- C. thoughts that are evidence of neurosis or those that are evidence of psychosis
- D. having repetitious thoughts or engaging in repetitious actions
Correct Answer: D
Rationale: Obsessions are intrusive thoughts, while compulsions are repetitive actions to relieve them.
A woman has concerns about a man she recently began to date. She confides to her friend, a nurse in the clinic, that she recently discovered that he had been charged with domestic violence in a previous relationship. She asks if this means he will also hurt her and what signs would indicate that he is likely to be abusive. What should the nurse tell her friend?
- A. If he hasn't been abusive or controlling so far, chances are he won't be abusive later.
- B. Abuse occurs within dysfunctional relationships, so it may not occur in your situation.
- C. Danger signs include pathological jealousy and controlling the partner's activities.
- D. Because you are not masochistic or provocative, it is unlikely you will be abused.
Correct Answer: C
Rationale: The correct answer is C because it provides specific warning signs of potential abuse, such as pathological jealousy and controlling behavior. These behaviors are often early indicators of an abusive relationship. Option A is incorrect as past behavior can indicate future behavior. Option B is not correct as abuse can occur in any type of relationship. Option D is also incorrect as it implies that abuse is the fault of the victim, which is not true. It is important to educate the woman on recognizing red flags and seeking help if needed.
A patient has a maladaptive response to eating regulation. Findings include the following: height, 5 feet 3 inches; current weight, 80 pounds with weight loss of 30% of body weight over the past 3 months; T, 96.6m F; BP, 68/40; P, 40; R, 20; poor skin turgor; lanugo; amenorrhea of 6 months' duration; admits to restricting intake to 350 calories daily; is a vegetarian; dissatisfied with eating pattern as evidenced by patient statement, 'I need to lose another 10 pounds to be at ideal weight'; diagnostic testing reveals serum potassium of 2.9 mEq/L and urine specific gravity of 1.028. Which of the following would be the highest priority nursing diagnosis for this patient?
- A. Imbalanced nutrition, less than body requirements.
- B. Disturbed body image.
- C. Deficient fluid volume.
- D. Powerlessness.
Correct Answer: C
Rationale: The correct answer is C: Deficient fluid volume. The patient is displaying signs of severe malnutrition and dehydration, as evidenced by significant weight loss, low blood pressure, low heart rate, and poor skin turgor. The low serum potassium and high urine specific gravity indicate dehydration. Addressing fluid volume deficiency is the top priority to stabilize the patient's condition and prevent further complications like electrolyte imbalances and organ damage. Choices A and B are important but secondary to addressing the immediate threat of dehydration. Choice D is not the priority as the patient's primary concern is physiological rather than psychological.