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What is the key component of treatment for a patient with anorexia nervosa?
- A. Encouraging rapid weight gain and exercise.
- B. Establishing a structured meal plan and emotional support.
- C. Restricting food intake to avoid further weight gain.
- D. Promoting independence and avoidance of therapy.
Correct Answer: B
Rationale: The correct answer is B because establishing a structured meal plan helps regulate eating behaviors and promotes nutrition restoration, while emotional support addresses underlying psychological issues. Rapid weight gain and exercise (A) can be harmful due to medical complications. Restricting food intake (C) worsens the condition. Promoting independence and avoiding therapy (D) hinder recovery by neglecting the importance of professional help.
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Therapeutic nutrition begins for a patient with anorexia nervosa who is 70% of ideal body weight. Which nursing intervention is most important to add to the plan of care?
- A. Communicate empathy for the patient's feelings.
- B. Observe for adverse effects associated with refeeding.
- C. Teach patient about psychological origins of the disorder.
- D. Direct the patient to balance energy expenditure and caloric intake.
Correct Answer: B
Rationale: The correct answer is B: Observe for adverse effects associated with refeeding. This is important because refeeding syndrome can occur when a severely malnourished individual is reintroduced to nutrition too quickly, leading to potentially life-threatening electrolyte imbalances. Monitoring for signs such as fluid retention, electrolyte abnormalities, and changes in vital signs is crucial in preventing these complications.
Choice A: Communicating empathy is important in building trust and rapport with the patient, but it is not the most critical intervention in this scenario.
Choice C: Teaching the patient about the psychological origins of the disorder is important for long-term treatment, but it is not the most immediate concern when starting therapeutic nutrition.
Choice D: Directing the patient to balance energy expenditure and caloric intake is important for overall health, but it is not the priority when the patient is severely malnourished and at risk for refeeding syndrome.
The physician and advanced practice nurse are considering which antipsychotic medication to prescribe for a patient with schizophrenia who demonstrates auditory hallucinations, apathy, anhedonia, and poor social functioning. The patient is overweight and has hypertension. Bearing these facts in mind, the drug the nurse should advocate would be:
- A. clozapine (Clozaril).
- B. haloperidol (Haldol).
- C. olanzapine (Zyprexa).
- D. aripiprazole (Abilify).
Correct Answer: D
Rationale: The correct answer is D: aripiprazole (Abilify). Aripiprazole is a second-generation antipsychotic that is less likely to cause weight gain and metabolic side effects compared to other antipsychotics. This is important since the patient is already overweight and has hypertension. Aripiprazole also has a lower risk of causing sedation, which can be beneficial for addressing apathy and anhedonia without worsening social functioning.
A: Clozapine is effective for treatment-resistant schizophrenia but is associated with significant weight gain and metabolic side effects.
B: Haloperidol is a first-generation antipsychotic with a high risk of extrapyramidal side effects and is not ideal for a patient with hypertension.
C: Olanzapine is known for causing significant weight gain and metabolic effects, making it a less suitable choice for an overweight patient with hypertension.
Psychological dependence on mood- or behavior-altering drugs is known as
- A. drug psychosis
- B. a substance related disorder
- C. an orthopsychosis
- D. a psychotropic disorder
Correct Answer: B
Rationale: Substance-related disorders encompass psychological dependence on drugs altering mood or behavior.
Which instruction has priority when teaching a patient taking clozapine (Clozaril)?
- A. Avoid unprotected sex.
- B. Report sore throat and fever immediately.
- C. Reduce foods high in polyunsaturated fats.
- D. Use over-the-counter preparations for rashes.
Correct Answer: B
Rationale: The correct answer is B: Report sore throat and fever immediately. This is because clozapine can cause a serious condition called agranulocytosis, which is characterized by a dangerously low white blood cell count. Sore throat and fever can be early signs of this condition, so it is crucial to report them immediately to prevent serious complications.
Avoiding unprotected sex (choice A) is important for overall health but is not directly related to clozapine use. Reducing foods high in polyunsaturated fats (choice C) is not a priority as it does not impact the safety or effectiveness of clozapine. Using over-the-counter preparations for rashes (choice D) is not advised as rashes can be a side effect of clozapine, and professional medical advice should be sought.
A client has been diagnosed with Alzheimer's disease, stage 1. The nurse would expect to help the family plan measures to assist the client with:
- A. Recent memory loss
- B. Catastrophic reactions
- C. Progressive gait disturbances
- D. Perseveration
Correct Answer: A
Rationale: The correct answer is A: Recent memory loss. In stage 1 of Alzheimer's disease, the primary symptom is mild memory loss, particularly with recent events and information. The nurse would help the family plan measures to assist the client by implementing strategies to support memory, such as setting reminders, organizing daily routines, and using memory aids. Choice B, catastrophic reactions, is more commonly associated with later stages of the disease. Choice C, progressive gait disturbances, is not a typical symptom of stage 1 Alzheimer's. Choice D, perseveration, involves the repetition of a particular response or behavior and is not a primary concern in stage 1 Alzheimer's disease.