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What is the most effective strategy for preventing relapse in patients with anorexia nervosa?
- A. Providing a strict, rigid meal plan that the patient must follow.
- B. Offering frequent, supportive counseling to address underlying issues.
- C. Encouraging the patient to self-monitor their food intake only.
- D. Reassuring the patient that their weight will stabilize without further intervention.
Correct Answer: B
Rationale: The correct answer is B because offering frequent, supportive counseling to address underlying issues is the most effective strategy for preventing relapse in patients with anorexia nervosa. Counseling helps patients explore and work through the root causes of their disorder, such as body image issues, low self-esteem, or past trauma. It also provides ongoing support and guidance in developing healthy coping mechanisms and behaviors.
Choice A is incorrect because providing a strict, rigid meal plan can exacerbate feelings of control and restriction, which are common triggers for relapse in individuals with anorexia nervosa.
Choice C is incorrect as solely focusing on self-monitoring food intake may not address the psychological and emotional factors contributing to the disorder, which are crucial for long-term recovery.
Choice D is incorrect because reassuring the patient that their weight will stabilize without further intervention ignores the complexities of anorexia nervosa and does not address the underlying issues that need to be resolved for sustained recovery.
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The elderly spouse of a female Alzheimer's client states that his wife seems to wander aimlessly from room to room looking for things in incorrect places, such as kitchen utensils in the bedroom and laundry detergent in the kitchen. He asks the nurse for suggestions of what he can do to help her. What is the nurse's best response?
- A. Keep rooms well lit.'
- B. Keep the home environment simple and user-friendly for her.'
- C. Have clocks and calendars with large letters in several rooms of the house.'
- D. Place large signs on doors or entryways that identify the room.'
Correct Answer: D
Rationale: The correct answer is D: Place large signs on doors or entryways that identify the room. This is the best response because it directly addresses the issue of the client's confusion and disorientation by providing clear visual cues to help her navigate the home environment effectively. By labeling the rooms with large signs, the client can easily recognize where she is and find what she needs. This strategy helps reduce her anxiety and frustration, promoting a sense of independence and safety.
Choices A, B, and C are incorrect because they do not specifically target the client's cognitive challenges related to Alzheimer's disease. Keeping rooms well lit, having a simple environment, and using clocks with large letters are helpful suggestions but do not address the primary issue of the client's spatial disorientation and confusion. Placing large signs on doors directly addresses the client's specific needs and is the most effective strategy in this situation.
The mother of a client newly diagnosed with schizophrenia is a nurse. She unhappily tells the nurse on the unit, 'I've tried to be a good mother, but my daughter still developed schizophrenia. When I was in school, we were taught that it was the mother's fault if a child became schizophrenic. I wish I knew what I did wrong.' The response that would help the mother evaluate models explaining schizophrenia would be:
- A. I can see how you would be upset over this turn of events.'
- B. New findings suggest this disorder is biologic in nature.'
- C. Don't be so hard on yourself; your daughter needs you to be strong.'
- D. It's difficult to see that double-bind communication produces stress for the child at the time it's occurring.'
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Choice B is the correct answer because it provides the mother with new information that schizophrenia is biologic in nature, shifting the blame away from her.
2. This response helps the mother understand that her daughter's condition is not her fault, based on current scientific understanding.
3. By offering this information, the nurse helps the mother reevaluate her beliefs and perceptions about the causes of schizophrenia.
4. Choices A, C, and D do not address the mother's concerns directly or provide her with the necessary information to understand the biological basis of schizophrenia.
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.
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 patient with fluctuating levels of awareness, confusion, and disorientation shouts, 'The bugs, they are crawling on my legs! Get them off me!' The nurse's inspections show that no bugs are present. The nurse can best assess this presentation as:
- A. Perseveration.
- B. Hypermetamorphosis.
- C. Tactile hallucinations.
- D. None of the above.
Correct Answer: C
Rationale: The correct answer is C: Tactile hallucinations. Tactile hallucinations involve the perception of physical sensations such as bugs crawling on the skin when no external stimuli are present. In this scenario, the patient's complaint of bugs crawling on their legs despite the nurse's inspection confirming the absence of bugs indicates a sensory hallucination, specifically a tactile one. This is different from perseveration (repetition of a particular response or activity) and hypermetamorphosis (excessive attention to environmental details). Choosing "None of the above" would not address the specific symptom of tactile hallucinations described in the patient's presentation.