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What is the most appropriate intervention for a patient with bulimia nervosa who is refusing to eat?
- A. Encourage the patient to eat small, frequent meals without pressure.
- B. Force the patient to eat larger meals to prevent further weight loss.
- C. Allow the patient to skip meals to avoid feeling overwhelmed.
- D. Focus only on addressing the patient's mental health concerns, not eating habits.
Correct Answer: A
Rationale: The correct answer is A because encouraging the patient to eat small, frequent meals without pressure promotes a balanced approach to eating. This intervention helps to establish a regular eating pattern and prevents episodes of binge-eating. It also respects the patient's autonomy and can help build trust between the patient and healthcare provider.
Choice B is incorrect because forcing the patient to eat larger meals can lead to increased anxiety and resistance, worsening the eating disorder. Choice C is incorrect as allowing the patient to skip meals can perpetuate unhealthy behaviors and reinforce the cycle of restriction and bingeing. Choice D is incorrect because neglecting the patient's eating habits can overlook a crucial aspect of their overall well-being and exacerbate the eating disorder.
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An acutely psychotic individual diagnosed with schizophreniaform disorder at admission is immediately placed on daily doses of risperidone. A hospitalization of 8 days' duration has been authorized by the HMO. By what hospital day would the nurse expect to note that client was demonstrating beginning trust in the nurse and reduction in hallucinations and delusions?
- A. Day of admission
- B. Day 3 of hospitalization
- C. Day 5 of hospitalization
- D. Day 7 of hospitalization
Correct Answer: B
Rationale: The correct answer is B: Day 3 of hospitalization. Typically, antipsychotic medications like risperidone take a few days to start showing noticeable effects in reducing hallucinations and delusions. By day 3, the medication would have had enough time to begin its therapeutic effect. Building trust with a psychotic patient also takes time, so by day 3, the patient may start showing signs of trust in the nurse. Day of admission (Choice A) is too early for the medication to take effect. Day 5 (Choice C) and Day 7 (Choice D) are too late as the medication usually shows noticeable improvement within the first few days.
Disorders related to abnormal functioning of the sleep-wake cycle or timing mechanisms of the body are called:
- A. Sleep apnea.
- B. Primary sleep disorders.
- C. Tertiary sleep disorders.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Primary sleep disorders. These disorders directly affect the sleep-wake cycle or timing mechanisms of the body. Sleep apnea (A) is a specific disorder characterized by pauses in breathing during sleep, not a general category. Tertiary sleep disorders (C) are not a recognized classification; the primary and secondary are the main categories. "None of the above" (D) is incorrect as primary sleep disorders are indeed related to abnormal functioning of the sleep-wake cycle.
A depressed patient is receiving imipramine (Tofranil) 300 mg daily. Which side effect requires seeking medical attention?
- A. Dry mouth
- B. Blurred vision
- C. Nasal congestion
- D. Urinary retention
Correct Answer: D
Rationale: The correct answer is D: Urinary retention. Imipramine is known to cause anticholinergic side effects, such as urinary retention. This side effect is serious and requires immediate medical attention to prevent complications like bladder distention or urinary tract infections. Dry mouth and blurred vision are common but less urgent side effects of imipramine, while nasal congestion is not typically associated with this medication. Thus, urinary retention stands out as the side effect requiring immediate medical attention among the choices provided.
The nurse who works in a sleep clinic knows that approximately ______% of adults suffer from insomnia.
- A. 10 to 20.
- B. 30 to 40.
- C. 50 to 60.
- D. 70 to 80.
Correct Answer: B
Rationale: The correct answer is B (30 to 40%). Insomnia is a common sleep disorder, affecting around 30-40% of adults. This range reflects the prevalence rates reported in various studies. Choices A, C, and D are incorrect because they provide prevalence rates that are either too low (A) or too high (C, D) compared to the generally accepted range for insomnia in adults. It is essential for the nurse in a sleep clinic to understand the prevalence of insomnia accurately to provide appropriate care and support to patients.
What behavior signals that a nurse caring for a patient with bulimia nervosa is experiencing rescue feelings? The nurse:
- A. Makes nonjudgmental comments.
- B. Refers the patient to a self-help group for persons with eating disorders.
- C. Teaches the patient about signs of increased anxiety and ways to intervene.
- D. Determines the patient has poor eating habits and provides a diet to follow.
Correct Answer: D
Rationale: The correct answer is D because providing a diet to follow indicates a rescuer mentality, where the nurse is assuming the role of fixing the patient's eating habits without addressing the underlying emotional issues. A, B, and C focus on supportive and empowering approaches which are more appropriate for helping the patient with bulimia nervosa.