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What is the most effective intervention to address the disturbed body image in patients with anorexia nervosa?
- A. Help the patient engage in self-care routines.
- B. Provide psychotherapy to address the patient's perceptions.
- C. Encourage participation in group activities that require social interaction.
- D. Support the patient in selecting appropriate meals.
Correct Answer: B
Rationale: The correct answer is B because psychotherapy helps address the underlying psychological factors contributing to the disturbed body image in anorexia nervosa. Specifically, cognitive-behavioral therapy can challenge distorted thoughts about body image. Self-care routines (A) may not directly address the root cause. Group activities (C) may not target individual concerns effectively. Supporting meal selection (D) does not address the psychological aspect of body image distortion. In summary, psychotherapy is crucial in addressing the complex psychological issues associated with body image in anorexia nervosa.
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A 67-year-old woman recently noticed a non-painful lump in the right breast (see image). Which one of the following is the most likely diagnosis?
- A. Subacute mastitis with early abscess formation.
- B. Advanced adenocarcinoma of the breast.
- C. Early intraduct carcinoma with obstruction of ductal ampullae.
- D. Severe fibrocystic disease of the breast (fibroadenosis with multiple cysts).
Correct Answer: B
Rationale: A non-painful breast lump in a 67-year-old is most likely advanced adenocarcinoma (B), a common malignancy in this age group. Mastitis (A) is painful, early carcinoma (C) less likely advanced, and fibrocystic disease (D) or fat necrosis (E) are less typical without specific trauma or cysts.
Inappropriate, life-threatening or challenging behaviours may be inadvertently maintained by reinforcement from others in the environment. Which of the following is a process that can be carried out in order to help identify the factors maintaining the behaviour?
- A. Functional analysis
- B. Statistical analysis
- C. Behavioural analysis
- D. Procedural analysis
Correct Answer: A
Rationale: Functional Analysis: Using operant conditioning principles to identify rewarding or reinforcing factors maintaining behavior.
A man who regularly experiences premature ejaculation tells the nurse, 'I feel like such a failure. It's so awful for both me and my partner.' Select the nurse's most therapeutic response.
- A. I sense you are feeling frustrated and upset.
- B. Tell me more about feeling like a failure.
- C. You are too hard on yourself.
- D. What do you mean by awful?
Correct Answer: A
Rationale: The correct answer is A because it acknowledges the man's emotions of frustration and upset, showing empathy and understanding. This response validates his feelings and opens the door for further discussion. Choice B shifts the focus away from the man's current emotions. Choice C minimizes his feelings and may come across as dismissive. Choice D is too vague and doesn't address the man's emotional state directly. Overall, choice A is the most therapeutic as it validates the man's feelings and encourages him to express more.
A patient with the diagnosis of schizophrenia, disorganized type, approaches the nurse and says, "It's beat, it's eat. No room for doom." The nurse can correctly assess this verbalization as:
- A. Neologisms
- B. Clanging
- C. Ideas of reference.
- D. Associative looseness.
Correct Answer: B
Rationale: The correct answer is B: Clanging. Clanging refers to the association of words based on sound rather than meaning. In this case, the patient's verbalization "It's beat, it's eat. No room for doom" demonstrates a pattern of words that rhyme or have similar sounds but lack coherent meaning. This is characteristic of clanging seen in disorganized schizophrenia. Neologisms (A) are newly created words with unique meanings, which is not evident here. Ideas of reference (C) involve misinterpreting unrelated events as being personally significant, which is not demonstrated in the patient's statement. Associative looseness (D) is a thought disorder where ideas are loosely associated, but the patient's statement does not show this specific feature.
A short-term goal for a patient with Alzheimer disease is:
- A. Improved functioning in the least restrictive environment
- B. improved problem solving in activities of daily living
- C. increased self-esteem and improved self-concept
- D. regained sensory perception and cognitive function
Correct Answer: A
Rationale: Promoting function in a safe, least restrictive setting is realistic and achievable given Alzheimer's progressive nature.