Nokea
What is the primary concern when caring for a patient with bulimia nervosa who has been purging regularly?
- A. Managing the patient's weight gain.
- B. Assessing for complications related to electrolyte imbalances.
- C. Encouraging exercise to offset caloric intake.
- D. Promoting food restriction to control binge eating.
Correct Answer: B
Rationale: The correct answer is B: Assessing for complications related to electrolyte imbalances. This is the primary concern when caring for a patient with bulimia nervosa who has been purging regularly because purging behaviors, such as self-induced vomiting or laxative abuse, can lead to severe electrolyte imbalances which can be life-threatening. Electrolyte imbalances can result in cardiac arrhythmias, muscle weakness, and other serious complications. Managing weight gain (A), encouraging exercise (C), and promoting food restriction (D) are not appropriate approaches as they can exacerbate the patient's unhealthy behaviors and may worsen their condition. It is crucial to prioritize assessing and addressing electrolyte imbalances to ensure the patient's safety and well-being.
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A mother discusses her concerns about genetic transmission of schizophrenia with the nurse saying, 'My son is a fraternal twin. He has been diagnosed with schizophrenia. Will my other son develop schizophrenia, too?' The response that is both sensitive and shows understanding of the genetic component is:
- A. You poor woman! I wish I could tell you he will be free of the disorder.'
- B. Studies show that 50% of twins develop schizophrenia when it is present in the other twin.'
- C. No one can say what will happen, so we will hope for the best for you and your sons.'
- D. In fraternal twins, the chance of the other twin developing the disorder is quite small.'
Correct Answer: D
Rationale: The correct answer is D because it provides an accurate and sensitive response. Fraternal twins do not share the same genetic makeup as identical twins, so the genetic risk for the other twin developing schizophrenia is lower. By acknowledging this fact, the nurse offers reassurance to the mother without giving false hope or inaccurate statistics. This response shows understanding of the genetic component of schizophrenia and addresses the mother's concerns in a compassionate and informative manner.
Choices A, B, and C are incorrect:
A: This response is dismissive of the mother's concerns and does not provide any helpful information. It also lacks sensitivity and empathy towards the mother's situation.
B: This response provides an inaccurate statistic about the likelihood of the other twin developing schizophrenia. It does not consider the difference between identical and fraternal twins, leading to a potentially misleading statement.
C: This response is vague and does not address the mother's question directly. It does not provide any useful information or reassurance, leaving the mother uncertain and anxious about
A psychiatric technician asks the nurse to explain the difference between schizotypal personality disorder and schizophrenia. The information that should serve as the basis for the nurse's response is the fact that with schizotypal personality disorder:
- A. There is greater personality disorganization than in schizophrenia
- B. There may be misinterpretation of events but not psychosis
- C. The client will be sicker and require longer hospitalization
- D. The client will be more outgoing, actively seeking interactions with others
Correct Answer: B
Rationale: The correct answer is B: There may be misinterpretation of events but not psychosis. In schizotypal personality disorder, individuals may have odd beliefs, behaviors, and experiences, leading to misinterpretation of events, but they do not typically experience full-blown psychosis as seen in schizophrenia. This is a key distinction between the two disorders. Choice A is incorrect because schizophrenia is characterized by more severe disorganization of thoughts and behaviors. Choice C is incorrect as individuals with schizotypal personality disorder typically do not require long hospitalizations compared to those with schizophrenia. Choice D is incorrect as individuals with schizotypal personality disorder tend to be more socially isolated and have difficulty forming close relationships.
Which of the following is a common physical sign of anorexia nervosa?
- A. Hypoglycemia and tachycardia.
- B. Severe weight loss and dry skin.
- C. Increased appetite and excessive weight gain.
- D. High blood pressure and rapid heart rate.
Correct Answer: B
Rationale: The correct answer is B: Severe weight loss and dry skin. In anorexia nervosa, individuals typically experience significant weight loss due to severe restriction of food intake. This leads to a low body weight, which is a key physical sign of the disorder. Dry skin is also common in anorexia nervosa due to malnutrition.
Rationale:
A: Hypoglycemia and tachycardia are not specific physical signs of anorexia nervosa. While tachycardia (rapid heart rate) can occur due to the stress on the body, it is not as specific as severe weight loss.
C: Increased appetite and excessive weight gain are not characteristic of anorexia nervosa, as individuals with this disorder typically have a distorted body image and fear gaining weight.
D: High blood pressure and rapid heart rate are not typical physical signs of anorexia nervosa. Anorexia nervosa is more commonly associated with low blood pressure due to mal
A patient with schizophrenia tells the nurse, 'Everyone must listen to me. I am the redeemer. I will bring peace to the world.' From this the nurse can determine that an appropriate nursing diagnosis is:
- A. Disturbed sensory perception: auditory.
- B. Risk for other-directed violence.
- C. Chronic low self-esteem.
- D. Nonadherence: medication.
Correct Answer: C
Rationale: Step 1: The patient's statement indicates grandiosity and delusions of grandeur, common in schizophrenia.
Step 2: Chronic low self-esteem is a common nursing diagnosis for those with grandiose delusions.
Step 3: The patient's belief of being the redeemer suggests underlying feelings of inadequacy.
Step 4: Addressing self-esteem can help the patient cope with such delusions.
Summary: A is incorrect as there is no mention of auditory hallucinations. B is incorrect as there is no immediate threat of violence. D is incorrect as nonadherence to medication is not evident in the scenario.
An expected outcome for a client who hears voices telling him he is evil would be that by discharge, client will:
- A. Verbalize the reason the voices say he is evil
- B. Respond verbally to the voices
- C. Identify events that increase anxiety and promote hallucinations
- D. Integrate the voices into his personality structure in a positive manner
Correct Answer: C
Rationale: The correct answer is C because it focuses on addressing the underlying causes of the client's experience of hearing voices and feeling evil. By identifying events that increase anxiety and promote hallucinations, the client can work on reducing these triggers and managing his symptoms effectively. This approach is key for long-term improvement and recovery.
A: Verbalizing the reason the voices say he is evil does not address the root cause of the hallucinations and may not lead to effective coping strategies.
B: Responding verbally to the voices may not be therapeutic and could potentially reinforce the hallucinations.
D: Integrating the voices into his personality structure in a positive manner is not a recommended approach as it could lead to further distress and potentially harmful behaviors.