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What is the most appropriate initial treatment goal for a patient with anorexia nervosa?
- A. Achieve rapid weight gain to restore nutritional status.
- B. Restore the patient's nutritional balance through gradual weight gain.
- C. Focus on addressing body image issues before weight gain.
- D. Encourage the patient to participate in group therapy for support.
Correct Answer: B
Rationale: The correct initial treatment goal for a patient with anorexia nervosa is to restore the patient's nutritional balance through gradual weight gain. This approach is crucial as rapid weight gain can lead to refeeding syndrome, a potentially life-threatening complication. Gradual weight gain allows the body to adjust to increased caloric intake safely. Addressing body image issues is important but can be more effectively tackled after nutritional balance is restored. Group therapy can be beneficial but should not be the primary focus initially. Thus, choice B is the most appropriate initial treatment goal.
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A woman was bound, taken to a remote location, and raped at gunpoint. When found, she was examined and treated in the emergency department. Which aspect of this crisis produced the greatest amount of psychological trauma?
- A. The threat to her life
- B. Collection of evidence
- C. Physical pain experienced
- D. Being in a remote location
Correct Answer: A
Rationale: The correct answer is A: The threat to her life. This aspect produced the greatest psychological trauma as the fear of losing one's life triggers intense emotional distress and long-lasting psychological effects such as anxiety and PTSD. The threat of death during a traumatic event can lead to profound feelings of helplessness and vulnerability. In comparison, while the other aspects (B: Collection of evidence, C: Physical pain experienced, D: Being in a remote location) also contribute to the trauma experienced, they do not elicit the same level of fear and existential threat as the possibility of losing one's life.
A nurse would assess for which feature in a patient diagnosed with anorexia nervosa without bingeing or purging?
- A. Extroverted personality traits
- B. Abuse of diuretics and laxatives
- C. Claims of sexual activity
- D. Denial of hunger at all times
Correct Answer: D
Rationale: The correct answer is D: Denial of hunger at all times. In anorexia nervosa without bingeing or purging, patients typically deny hunger despite severe weight loss. This is due to their distorted body image and fear of gaining weight. Assessing for denial of hunger helps in understanding their mindset and severity of the disorder.
Explanation of why other choices are incorrect:
A: Extroverted personality traits - Anorexia nervosa is often associated with introverted personality traits, not extroverted.
B: Abuse of diuretics and laxatives - This behavior is more characteristic of bulimia nervosa, not anorexia nervosa without bingeing or purging.
C: Claims of sexual activity - This choice is unrelated to the typical features of anorexia nervosa without bingeing or purging.
Which environmental factor most hinders mental development?
- A. Lack of sleep
- B. Poor nutrition
- C. Excessive screen time
- D. Noisy surroundings
Correct Answer: B
Rationale: Poor nutrition (B) most hinders mental development by limiting brain growth and function. Sleep (A), screen time (C), and noise (D) impact development, but nutrition is foundational.
When a patient with anorexia nervosa expresses a fear of weight gain, the nurse should respond by:
- A. Minimizing the patient's concerns to avoid anxiety.
- B. Encouraging weight loss to meet the patient's goals.
- C. Explaining that weight gain is part of the treatment plan.
- D. Agreeing with the patient's view on body image to reduce conflict.
Correct Answer: C
Rationale: The correct response is C: Explaining that weight gain is part of the treatment plan. This answer is correct because in treating anorexia nervosa, it is essential for patients to understand that weight gain is necessary for recovery and overall health improvement. By explaining this, the nurse can help the patient develop a more positive attitude towards weight gain and recognize it as a crucial aspect of the treatment process.
Choices A, B, and D are incorrect:
A: Minimizing the patient's concerns may invalidate their feelings and hinder therapeutic communication.
B: Encouraging weight loss would be counterproductive and reinforce the patient's negative behaviors and beliefs.
D: Simply agreeing with the patient's view on body image without addressing the need for weight gain would not promote positive change or support the patient's recovery.
At 11:00 AM, a patient with schizophrenia who exhibits concrete thinking asks the nurse for PRN acetaminophen (Tylenol). However, he last had it at 8:00 AM, and it is ordered only every 4 hours. Which nursing response would be most therapeutic?
- A. I'm sorry, it's not quite time yet; please come back again in 1 hour.'
- B. I'm sorry, it's not quite time yet; please come back again at 12 noon.'
- C. It's not time yet; please come back when both hands of the clock point straight up.'
- D. It's not time yet; I will let you know when it is time. Perhaps a nap would help?'
Correct Answer: C
Rationale: The correct answer is C because it provides a clear, concrete instruction that the patient can easily understand. By stating "come back when both hands of the clock point straight up," the nurse offers a specific and visual cue for the patient to know when it's time for the medication. This approach aligns with the patient's concrete thinking and helps him grasp the concept of time more effectively.
Choice A is incorrect because stating "in 1 hour" may be too abstract for a patient with concrete thinking. Choice B is also incorrect as it provides a general time frame without a visual reference, which may confuse the patient. Choice D is incorrect as suggesting a nap does not address the patient's request for medication and does not provide a clear time frame.