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What is the most appropriate nursing goal for a patient with bulimia nervosa?
- A. To eliminate binge-purge episodes and restore healthy eating habits.
- B. To focus on weight loss and body image issues.
- C. To monitor calorie intake and restrict food consumption.
- D. To encourage excessive exercise to maintain weight control.
Correct Answer: A
Rationale: The correct answer is A: To eliminate binge-purge episodes and restore healthy eating habits. This goal is appropriate as it addresses the core issue of bulimia nervosa, which is the cycle of bingeing and purging. By focusing on eliminating these episodes and promoting healthy eating habits, the patient can achieve long-term recovery.
Choices B, C, and D are incorrect because they do not address the underlying psychological and behavioral aspects of bulimia nervosa. Weight loss and body image issues (B) may exacerbate the disorder, monitoring calorie intake and restricting food consumption (C) can reinforce the cycle of bingeing and purging, and encouraging excessive exercise (D) can lead to further health complications.
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The experienced nurse assessing a battered woman client uses many open-ended questions during the interview. The rationale for this is that:
- A. The woman will feel more in charge of the interview
- B. Such questions allow for simple yes or no answers when the client is upset
- C. The questions are direct and easily understood by anxious individuals
- D. Clients can refuse to answer when sensitive information is being probed
Correct Answer: A
Rationale: The correct answer is A because using open-ended questions allows the client to express themselves freely, promoting a sense of control and empowerment. This approach helps build trust and rapport, enabling the client to share their experiences more openly. Choice B is incorrect because closed-ended questions limit the client's ability to fully express themselves. Choice C is incorrect as open-ended questions encourage deeper reflection and discussion, which may not be easily understood by anxious individuals. Choice D is incorrect because while clients can refuse to answer sensitive questions, open-ended questions actually encourage them to share more, rather than withhold information.
The mother of a teenager diagnosed with an eating disorder asks, 'How long will my daughter have this problem?' The nurse answers with the knowledge that:
- A. recovery is usual after one severe episode.
- B. less than 30% show improvement after 5 years.
- C. weight restoration is sufficient for recovery.
- D. long-term therapy combined with medication results in the best outcomes.
Correct Answer: D
Rationale: The correct answer is D because long-term therapy combined with medication results in the best outcomes for individuals with eating disorders. Therapy helps address underlying psychological issues, while medication can help manage symptoms. Recovery is a complex process that often requires ongoing support. Choice A is incorrect as recovery is not always guaranteed after one severe episode. Choice B is incorrect as many individuals do show improvement over time. Choice C is incorrect as weight restoration alone may not address all aspects of the disorder.
Which statement about aging provides the best rationale for focused assessment of elderly patients?
- A. The elderly are usually socially isolated and lonely
- B. Vision, hearing, touch, taste, and smell decline with age
- C. The majority of elderly patients have some form of early dementia
- D. As people age, thinking becomes more rigid and learning is impaired
Correct Answer: B
Rationale: Only the key is a true statement. It cues the nurse to assess sensory function in the elderly patient. Correcting vision and hearing are critical to providing safe care. The distracters are myths about aging.
Conversion disorder and hypochondriasis are classified as
- A. physio-mental disorders
- B. somatoform disorders
- C. psychosomatic disorders
- D. somatization disorders
Correct Answer: B
Rationale: Somatoform disorders involve physical symptoms without medical cause, like conversion and hypochondriasis.
A 65-year-old woman has a two-year history of mucous diarrhoea due to a large villous adenoma of the rectum. She is also taking digoxin and diuretics for chronic congestive failure. Which of the following investigations would be the most helpful prior to surgery?
- A. Serum chloride.
- B. Serum digoxin.
- C. Serum calcium.
- D. Serum potassium.
Correct Answer: D
Rationale: Villous adenomas cause potassium loss via diarrhea, and diuretics exacerbate this, risking hypokalemia, which is dangerous with digoxin (toxicity risk). Serum potassium (D) is critical pre-surgery.