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What is the most effective strategy for preventing relapse in a patient with anorexia nervosa?

  • A. Providing a rigid, inflexible meal plan with strict weight goals.
  • B. Offering therapy to address both physical and emotional factors.
  • C. Encouraging the patient to lose weight to maintain control.
  • D. Focusing on body image improvement before addressing nutrition.
Correct Answer: B

Rationale: The correct answer is B because offering therapy to address both physical and emotional factors is the most effective strategy for preventing relapse in a patient with anorexia nervosa. This approach helps the patient develop coping skills, explore underlying issues, and learn healthier ways to manage emotions and stress. By addressing both physical and emotional factors, the patient can build a strong support system, improve self-esteem, and work towards a sustainable recovery.

Choice A is incorrect because providing a rigid, inflexible meal plan with strict weight goals may increase anxiety and reinforce harmful behaviors associated with anorexia nervosa. Choice C is incorrect as encouraging the patient to lose weight to maintain control can perpetuate the disorder and increase the risk of relapse. Choice D is incorrect because focusing on body image improvement before addressing nutrition neglects the essential aspect of nutrition in recovery and may lead to distorted perceptions of health.

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The nurse knows that stimulant medication for ADHD should be administered:

  • A. At bedtime, to coincide with rising cortisol levels
  • B. Only on school days to improve performance
  • C. On an empty stomach
  • D. With breakfast and lunch
Correct Answer: D

Rationale: Because these medications can contribute to insomnia, it is best to administer them earlier in the day with food. These are generally taken daily unless the doctor orders a drug holiday.

A man with hypospadias tells the nurse, 'Intercourse with my new bride is painful.' Which term applies to the patient's complaint?

  • A. Dyspareunia
  • B. Erectile dysfunction
  • C. Premature ejaculation
  • D. Genito-pelvic pain/penetration disorder
Correct Answer: D

Rationale: The correct answer is D: Genito-pelvic pain/penetration disorder. This term is applicable because it specifically refers to pain experienced during intercourse, which aligns with the patient's complaint. Hypospadias can lead to difficulties in penetration and subsequent pain during intercourse.

Choice A: Dyspareunia refers to persistent or recurrent pain during sexual intercourse, which is a broader term than what the patient is experiencing.

Choice B: Erectile dysfunction is the inability to achieve or maintain an erection, which is not directly related to the patient's complaint of pain during intercourse.

Choice C: Premature ejaculation is the early release of semen during sexual activity, which is unrelated to the pain experienced by the patient during intercourse.

A 19-year-old woman, prescribed a triphasic oral contraceptive for the first time one month ago, complains of frequent spotting. Which one of the following is the most appropriate management?

  • A. Increase the dose of oestrogen.
  • B. Increase the dose of progestogen.
  • C. Advise alternative contraception.
  • D. Continue the medication and review in two months.
Correct Answer: D

Rationale: Spotting is common in the first few months of oral contraceptives as the body adjusts. Continuing the medication and reviewing later (D) is standard, rather than immediate dose changes (A, B), switching methods (C, E) without trial.

The nurse is explaining to the family of a patient diagnosed with schizophrenia that the disorder is considered to have neurobiological origins. When the patient's mother asks, 'What part of the brain is dysfunctional?' the nurse should reply, 'Research has implicated the:

  • A. medulla and cortex.
  • B. cerebellum and cerebrum.
  • C. hypothalamus and medulla.
  • D. prefrontal and limbic cortices.'
Correct Answer: D

Rationale: The correct answer is D: prefrontal and limbic cortices. The prefrontal cortex is involved in decision-making, planning, and social behavior, functions commonly impaired in schizophrenia. The limbic cortex regulates emotions and memory, areas affected in schizophrenia. Medulla (A, C) controls basic functions like breathing, not implicated in schizophrenia. Cerebellum (B) coordinates movement, unrelated to schizophrenia. Hypothalamus (C) regulates hormones, not directly linked to schizophrenia. In summary, D is correct as prefrontal and limbic cortices are key brain regions affected in schizophrenia, while the other choices are not directly involved in the disorder.

Which of the following statements by a patient with anorexia nervosa indicates a need for further education?

  • A. I want to gain weight, but only if I can stay under 120 pounds.
  • B. I understand that my body weight is dangerously low.
  • C. I know that food is the enemy and I need to avoid it at all costs.
  • D. I am willing to work with my healthcare team to improve my nutrition.
Correct Answer: C

Rationale: The correct answer is C because it indicates a misunderstanding of anorexia nervosa. Patients with anorexia often see food as the enemy, which is a distorted perception. Understanding that food is necessary for nourishment and health is crucial in recovery. Choice A shows an unhealthy weight goal, choice B shows awareness of low weight, and choice D shows willingness to work with the healthcare team, all of which are positive signs.

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