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What should the nurse focus on when planning care for a patient with anorexia nervosa?
- A. Encourage the patient to restrict food intake and control weight.
- B. Provide a structured meal plan and monitor nutritional intake.
- C. Allow the patient to eat freely without any food restrictions.
- D. Encourage daily exercise to help manage weight.
Correct Answer: B
Rationale: The correct answer is B because providing a structured meal plan and monitoring nutritional intake is crucial in the care of a patient with anorexia nervosa to ensure they receive adequate nutrition. By following a structured plan, the patient can gradually restore a healthy relationship with food and gain weight safely. Encouraging the patient to eat freely (choice C) can lead to further disordered eating behaviors. Encouraging food restriction and weight control (choice A) can worsen the patient's condition. Encouraging daily exercise (choice D) may exacerbate the patient's excessive focus on weight and body image. In summary, choice B is the best option as it focuses on promoting healthy eating habits and addressing the nutritional needs of the patient with anorexia nervosa.
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What is an appropriate goal for a nurse working with a patient with anorexia nervosa?
- A. The patient will gain weight rapidly to restore nutritional balance.
- B. The patient will express satisfaction with their body image by the end of treatment.
- C. The patient will eat three meals daily and demonstrate healthy eating behaviors.
- D. The patient will be able to resume normal physical activities without fatigue.
Correct Answer: C
Rationale: The correct answer is C because setting a goal for the patient to eat three meals daily and demonstrate healthy eating behaviors is a more realistic and achievable target for someone with anorexia nervosa. This goal focuses on establishing regular eating habits and promoting a healthy relationship with food, which are crucial in the treatment of anorexia nervosa. Choices A and D are incorrect as rapid weight gain and resuming normal physical activities may not be safe or sustainable goals for someone with anorexia nervosa. Choice B is also incorrect because body image satisfaction is a complex issue that may not be directly addressed solely through treatment for anorexia nervosa.
A physical therapist recently convicted of multiple counts of Medicare fraud is brought to the emergency department after taking an overdose of sedatives. He tells the nurse, 'Sure I overbilled. Why not? Everybody takes advantage of the government. They have too many rules. No one can abide by all of them.' These statements can be assessed as showing:
- A. glibness and charm.
- B. superficial remorse.
- C. lack of guilt feelings.
- D. excessive suspiciousness.
Correct Answer: C
Rationale: The correct answer is C: lack of guilt feelings. The physical therapist's statements reveal a lack of remorse or guilt for committing Medicare fraud, indicating a disregard for ethical standards and a lack of moral responsibility. This behavior is indicative of a lack of guilt feelings, as the individual shows no remorse for their actions.
Summary of other choices:
A: Glibness and charm typically involve smooth talking and being persuasive, which is not demonstrated in the scenario.
B: Superficial remorse implies a shallow or insincere apology, but the individual does not express any form of remorse in this situation.
D: Excessive suspiciousness refers to being overly mistrustful or paranoid, which is not evident in the physical therapist's statements.
What is the most appropriate intervention for a patient with bulimia nervosa who is refusing to eat?
- A. Encourage the patient to eat small, frequent meals without pressure.
- B. Force the patient to eat larger meals to prevent further weight loss.
- C. Allow the patient to skip meals to avoid feeling overwhelmed.
- D. Focus only on addressing the patient's mental health concerns, not eating habits.
Correct Answer: A
Rationale: The correct answer is A because encouraging the patient to eat small, frequent meals without pressure promotes a balanced approach to eating. This intervention helps to establish a regular eating pattern and prevents episodes of binge-eating. It also respects the patient's autonomy and can help build trust between the patient and healthcare provider.
Choice B is incorrect because forcing the patient to eat larger meals can lead to increased anxiety and resistance, worsening the eating disorder. Choice C is incorrect as allowing the patient to skip meals can perpetuate unhealthy behaviors and reinforce the cycle of restriction and bingeing. Choice D is incorrect because neglecting the patient's eating habits can overlook a crucial aspect of their overall well-being and exacerbate the eating disorder.
A client displays disorganized thinking, difficult-to-follow speech, and silly, inappropriate affect. The client isolates himself from other clients and staff, ignores unit activities, and often seems to be listening and responding to unseen stimuli. This client's behavior most closely conforms to the characteristic behavior of:
- A. Residual schizophrenia
- B. Schizoaffective disorder
- C. Paranoid schizophrenia
- D. Disorganized schizophrenia
Correct Answer: D
Rationale: The correct answer is D: Disorganized schizophrenia. This client's presentation aligns with the symptoms of disorganized schizophrenia, characterized by disorganized thinking, speech, and behavior, inappropriate affect, social withdrawal, and hallucinations. Residual schizophrenia (A) refers to a milder form of schizophrenia with lingering symptoms. Schizoaffective disorder (B) involves symptoms of both schizophrenia and mood disorders. Paranoid schizophrenia (C) is characterized by delusions and auditory hallucinations, which are not the primary symptoms displayed by the client in the question.
A newly admitted elderly client seems to become confused and agitated every evening after dinner. This client most likely is suffering from:
- A. Alzheimer's disease
- B. Acute dementia
- C. Sundown syndrome
- D. Delirium
Correct Answer: C
Rationale: The correct answer is C: Sundown syndrome. This is a condition where elderly individuals experience confusion and agitation in the evening. The symptoms are typically more pronounced during this time of day. It is not Alzheimer's disease (A) as that is a progressive neurodegenerative disorder. Acute dementia (B) is not a recognized medical term and does not accurately describe the symptoms. Delirium (D) is an acute state of confusion that can occur at any time of day, not just in the evening like sundown syndrome.