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What is the most important aspect of refeeding for a patient with anorexia nervosa?
- A. Refeeding should begin slowly to avoid complications.
- B. Rapid weight gain is essential to restore health.
- C. The patient should be encouraged to make independent food choices.
- D. Fluid intake should be restricted to avoid water retention.
Correct Answer: A
Rationale: The correct answer is A because refeeding should start slowly to prevent refeeding syndrome, a potentially life-threatening condition caused by rapid electrolyte shifts. Gradually increasing caloric intake allows the body to adjust and reduces the risk of complications. Rapid weight gain (B) is not recommended as it can lead to medical complications. Encouraging independent food choices (C) may not be suitable initially as structured meal plans are often necessary. Restricting fluid intake (D) is not advisable as adequate hydration is crucial during refeeding.
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Persons who are excessively narcissistic, dependent, or antisocial are characterized as having
- A. somatoform disorders
- B. generalized anxiety
- C. conversion reactions
- D. personality disorders
Correct Answer: D
Rationale: Narcissistic, dependent, and antisocial traits define personality disorders, affecting interpersonal functioning.
A novice nurse tells the assigned mentor, 'I admitted a patient today who has several bizarre delusions. I wanted to tell the patient that the ideas and conclusions simply are not logical. What do you think will happen if I do?' Which reply by the mentor is best?
- A. I think you'll give the patient something to think about.'
- B. The patient will probably incorporate you into the delusions as a persecutor.'
- C. Develop trust using empathy and calmness before pointing out discrepancies.'
- D. Initially, it would be better to go along with the patient's thinking to gain cooperation.'
Correct Answer: C
Rationale: Step 1: Establish trust - Developing trust with the patient is crucial in building a therapeutic relationship.
Step 2: Use empathy and calmness - Showing empathy helps the patient feel understood and valued.
Step 3: Point out discrepancies - Once trust is established, gently pointing out discrepancies in a non-confrontational manner can help the patient reflect on their delusions.
Summary: Choice C is the best because it emphasizes the importance of building trust and rapport before addressing the patient's delusions. Choices A, B, and D are incorrect because they do not prioritize the therapeutic relationship or show empathy towards the patient's experiences.
An elderly female client on the mental unit suddenly becomes upset because she can't remember where she is and she says, 'I can't think straight.' The staff has never witnessed this behavior in the client, and this type of complaint is not documented in the nursing history. What is the client most likely experiencing?
- A. Hallucinations
- B. Dementia
- C. Delusions
- D. Delirium
Correct Answer: D
Rationale: The correct answer is D: Delirium. Delirium is characterized by sudden onset confusion, disorientation, and impaired cognitive function. In this scenario, the elderly client's sudden confusion and inability to think straight suggest an acute change in mental status, which is indicative of delirium. Delirium is often triggered by underlying medical conditions or medications.
A: Hallucinations involve perceiving things that are not real, which is not described in the scenario.
B: Dementia is a chronic condition with gradual cognitive decline, not sudden onset confusion.
C: Delusions are fixed false beliefs, which are not mentioned in the scenario.
In summary, the client is most likely experiencing delirium due to the sudden onset of confusion and cognitive impairment, which is not consistent with hallucinations, dementia, or delusions.
A nurse is caring for a patient with bulimia nervosa. Which intervention should the nurse prioritize?
- A. Assist the patient in identifying triggers for binge-purge cycles.
- B. Focus solely on achieving a normal weight.
- C. Provide daily exercise routines to increase physical fitness.
- D. Discourage discussions about food to avoid increasing anxiety.
Correct Answer: A
Rationale: The correct answer is A. Assisting the patient in identifying triggers for binge-purge cycles is crucial in the treatment of bulimia nervosa. By understanding the triggers, the patient can learn to recognize and manage them effectively, leading to a reduction in the frequency of binge-purge episodes. This intervention helps address the root cause of the disorder and promotes long-term recovery.
Choice B is incorrect because solely focusing on achieving a normal weight overlooks the complex psychological factors involved in bulimia nervosa. Choice C is incorrect as providing daily exercise routines may exacerbate the patient's obsession with weight and body image. Choice D is incorrect as discouraging discussions about food can hinder the patient's ability to address their relationship with food and emotions.
A worker is characterized by her co-workers as 'painfully shy' and lacking in self-confidence. Her co-workers say she stays in her cubicle all day, never coming out for breaks or lunch. One day after falling on the ice in the parking lot, she goes to the nurse's office, where she apologizes for falling and mentions that she hopes the company will not fire her for being so clumsy. Which nursing approach or response would be most therapeutic?
- A. Remain professional and a bit detached so as not to arouse suspiciousness on her part.
- B. Reassure her that many others have fallen at work and not ever been criticized or fired.
- C. Acknowledge her concerns in a matter-of-fact manner and provide first aid as needed.
- D. Explain that an incident report about her fall will go to a manager who will contact her.
Correct Answer: B
Rationale: The correct answer is B because it focuses on reassurance and empathy, which are important in therapeutic communication. By reassuring the worker that others have fallen without facing negative consequences, the nurse is validating her feelings and reducing her anxiety. This approach helps build trust and rapport, essential for effective communication and support.
Choices A, C, and D are incorrect because they do not address the worker's emotional needs or provide the reassurance she requires. Option A suggests remaining detached, which may come across as uncaring. Option C focuses solely on providing first aid and does not acknowledge the worker's concerns. Option D introduces the fear of potential consequences without providing any reassurance or emotional support, which could increase the worker's anxiety.