Nokea
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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A client with dementia was admitted to a dementia unit after she began persistently wandering away from home. The nursing staff should plan to:
- A. Provide unlimited freedom because the client has no place to go in the new neighborhood
- B. Provide one-to-one supervision when the client is ambulatory
- C. Place the client in a geriatric chair with a tray across the lap
- D. Provide the client with an electronic alarm that sounds when the client nears the exit door
Correct Answer: D
Rationale: The correct answer is D because providing the client with an electronic alarm that sounds when she nears the exit door is the best option to ensure her safety. This approach allows for monitoring without restricting her movement excessively. Choice A is incorrect as unlimited freedom poses risks. Choice B is not practical or feasible long-term. Choice C is not person-centered and may lead to discomfort and agitation. The electronic alarm in choice D is the most effective and least intrusive method to prevent wandering while respecting the client's autonomy.
A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?
- A. Hippocampus
- B. Frontal lobe
- C. Cerebellum
- D. Brainstem
Correct Answer: B
Rationale: The correct answer is B: Frontal lobe. Disorganized thinking in schizophrenia is often associated with executive function deficits, which are primarily controlled by the frontal lobe. This area is responsible for decision-making, problem-solving, and reasoning. Dysfunction here can lead to disorganized thoughts and behaviors. The other choices, such as the hippocampus (A), involved in memory, the cerebellum (C), involved in motor coordination, and the brainstem (D), involved in basic life functions, are less likely to be directly related to disorganized thinking in schizophrenia.
A patient with paranoid personality disorder is noted to sit alone in a corner of the unit living room. When anyone approaches, the patient is haughty or simply ignores the other person. When staff invite her to join an activity, she tells them, 'I do not care to be with people who do not like me.' A nursing diagnosis that should be considered is:
- A. splitting.
- B. activity intolerance.
- C. powerlessness.
- D. impaired social interaction.
Correct Answer: D
Rationale: The correct answer is D: impaired social interaction. This patient's behavior of sitting alone, being haughty, and refusing to engage with others indicates difficulty in social interactions. The patient's belief that others do not like her also suggests social challenges. Impaired social interaction relates to difficulty in establishing or maintaining relationships.
A: Splitting is a defense mechanism where the patient views people as all good or all bad, which is not evident in this scenario.
B: Activity intolerance refers to insufficient physiological or psychological energy to endure or complete required or desired daily activities. This does not apply here.
C: Powerlessness refers to the perception of lack of control over a situation, which is not the primary issue in this case.
Which of the following is NOT a suitable place for a family doctor outside the polyclinic to refer an adolescent patient for psychotherapy/counselling?
- A. Local Social Service Office
- B. Nearby polyclinic
- C. Patients school
- D. A reputable restructured hospital
Correct Answer: B
Rationale: A nearby polyclinic is less suitable for psychotherapy referral as it focuses on primary care, unlike the other options with counseling services.
A patient who takes lithium phones the nurse at the clinic to say, "I've had diarrhea for 4 days. I feel weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" Which instruction by the nurse is appropriate?
- A. Have someone bring you to the clinic immediately.
- B. Restrict food and fluids for 24 hours and stay in bed.
- C. Drink a large glass of water with 1 teaspoon of salt added.
- D. Take antidiarrheal medication hourly until the diarrhea subsides.
Correct Answer: A
Rationale: The correct answer is A: Have someone bring you to the clinic immediately. The patient is experiencing symptoms of lithium toxicity, including diarrhea, weakness, unsteadiness, and worsening hand tremor. These symptoms indicate a potential lithium overdose, which can be life-threatening. Bringing the patient to the clinic immediately is crucial for assessment, monitoring, and intervention.
Choice B is incorrect because restricting food and fluids can worsen dehydration and electrolyte imbalances. Choice C is incorrect as adding salt to water can exacerbate electrolyte abnormalities in lithium toxicity. Choice D is incorrect as taking antidiarrheal medication can further worsen the symptoms and delay appropriate medical treatment.