Nokea
When a person's sexual identity does not match his or her physical gender, the diagnosis is
- A. paraphilia
- B. sexual dysfunction
- C. gender identity disorder
- D. androgyny
Correct Answer: C
Rationale: Gender identity disorder (now gender dysphoria) describes a mismatch between identity and physical sex.
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Which expectation should be considered most critical prior to discharging a client with anorexia nervosa from the hospital?
- A. Attainment of minimum normal weight.
- B. Resumption of normal menstrual cycle.
- C. Knowledge of caloric and nutritional value of foods required for a balanced diet.
- D. Reduction of periods of active exercise to three times daily.
Correct Answer: A
Rationale: Rationale: A critical expectation before discharging a client with anorexia nervosa is the attainment of minimum normal weight. This is crucial for the client's physical health and to prevent complications like organ damage. Resuming a normal menstrual cycle (B) is important but not as critical as restoring weight. Knowing about nutrition (C) is valuable but not as urgent as weight gain. Reducing exercise (D) may be necessary, but weight restoration takes precedence for overall health.
Which statement by a patient with an eating disorder reflects a correct understanding of the condition?
- A. Gaining 1 pound is as much of a disaster as gaining 100 pounds.
- B. I was happy when I was a size 4, so I must diet to that size.
- C. I've been coping with my feelings by overeating.
- D. Binging is the only way I can soothe myself.
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the emotional aspect of eating disorders. Coping with feelings by overeating indicates insight into using food to manage emotions, a common characteristic of eating disorders. This understanding is crucial for addressing the underlying issues contributing to the disorder.
A: Incorrect. This statement suggests an extreme and distorted view of weight gain, which is not reflective of a healthy understanding of an eating disorder.
B: Incorrect. This statement implies a fixation on a specific size for happiness, which may perpetuate disordered eating behaviors.
D: Incorrect. This statement indicates reliance on binging as the sole coping mechanism, overlooking the emotional aspect of the disorder.
The sibling of a patient who was diagnosed with a serious mental illness asks why a case manager has been assigned. The nurses reply should cite the major advantage of the use of case management as:
- A. The case manager can modify traditional psychotherapy for homeless patients so that it is more flexible.
- B. Case managers coordinate services and help with accessing them, making sure the patients needs are met.
- C. The case manager can focus on social skills training and esteem building in the real world where the patient lives.
- D. Having a case manager has been shown to reduce hospitalizations, which prevents disruption and saves money.
Correct Answer: B
Rationale: Case managers coordinate services and access (B), overcoming obstacles for the mentally ill, making it the primary advantage. Other options (A, C, D) are less central to their role.
A patient admitted to the eating disorders unit has yellow skin, the extremities are cold, and the heart rate is 42 bpm. The patient weighs 70 pounds; height is 5 feet 4 inches. The patient is quiet during the assessment saying only, "I will not eat until I lose enough weight to look thin."Â Select the best initial nursing diagnosis.
- A. Anxiety related to fear of weight gain
- B. Disturbed body image related to weight loss
- C. Ineffective coping related to lack of conflict resolution skills
- D. Imbalanced nutrition: less than body requirements related to self-starvation
Correct Answer: D
Rationale: The correct initial nursing diagnosis is D: Imbalanced nutrition: less than body requirements related to self-starvation. The patient's presentation of yellow skin, cold extremities, bradycardia, low weight, and refusal to eat indicate severe malnutrition due to self-starvation. The key indicators are the physical signs of malnutrition and the patient's statement about not eating until they lose enough weight. Options A and B do not address the primary issue of malnutrition and self-starvation. Option C focuses on coping skills, which is not the priority in this case. Therefore, option D is the best initial nursing diagnosis to address the patient's life-threatening condition of malnutrition.
A client with anorexia nervosa engages in manipulative behavior. She tells the nurse, 'I can't get weighed this morning, because I drank a glass of juice a few minutes before breakfast.' The best approach by the nurse would be:
- A. I'm pleased that you took in some calories.'
- B. We can get around this, if you'll eat a doughnut, too.'
- C. The rule is 'weigh before eating'; now we have to put it off until tomorrow.'
- D. This is weight day. Please step on the scale.'
Correct Answer: D
Rationale: Step 1: The correct answer is D because it sets clear boundaries and enforces consistency by reminding the client of the established protocol.
Step 2: By stating "This is weight day. Please step on the scale," the nurse maintains the structure and accountability in the treatment plan.
Step 3: This response avoids reinforcing manipulative behavior and emphasizes the importance of following the agreed-upon rules for accurate monitoring.
Step 4: Other choices like A may inadvertently validate the manipulation, B suggests giving in to the client's avoidance tactic, and C delays the weighing without addressing the manipulation directly.