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When planning nursing care for a client with a dependent personality disorder, the nurse recognizes which of the following as characteristic behavior for someone with this disorder? The client:
- A. Perceives his or her behavior to be embarrassing
- B. Believes he or she cannot function without help of others
- C. Exaggerates the potential dangers of ordinary situations
- D. Demands excessive attention from others
Correct Answer: B
Rationale: The correct answer is B because individuals with dependent personality disorder typically believe they cannot function without the help of others. This is a key characteristic of the disorder as they rely heavily on others for decision-making and day-to-day tasks. This behavior stems from an intense fear of separation and abandonment.
Choice A (perceiving behavior as embarrassing) is incorrect as it is more aligned with social anxiety disorder rather than dependent personality disorder. Choice C (exaggerating dangers) is incorrect as it is more characteristic of individuals with anxiety disorders. Choice D (demanding excessive attention) is incorrect as it is more typical of individuals with histrionic personality disorder.
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You are a nurse meeting for the first time with a stage 3 Alzheimer's patient who is newly referred to your home health agency. Which assessment data about the patient and caregiver(s) would be most important to acquire during your first visit to the family's home?
- A. Is the house design such that patient access to exits and stairways can be restricted?
- B. Does the family understand that the disease is likely to prove fatal within 3 to 5 years?
- C. What resources is the patient's family able to access in their particular community?
- D. None of the above.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Ensuring patient safety is a top priority, especially for a stage 3 Alzheimer's patient.
2. Restricting access to exits and stairways can prevent wandering and potential accidents.
3. This assessment is crucial for creating a safe environment for the patient.
4. Understanding the house design is essential for implementing appropriate safety measures.
Summary of other choices:
B. Understanding the prognosis is important but not as immediately critical as ensuring patient safety.
C. Knowing community resources is valuable but not as urgent as addressing safety concerns.
D. This choice is incorrect as assessing the house design for safety is crucial in this scenario.
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.' 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. None of the above.
Correct Answer: D
Rationale: Rationale for Correct Answer (D): None of the above is the best initial nursing diagnosis because the patient's symptoms suggest a severe medical condition rather than psychological issues. The yellow skin, cold extremities, low heart rate, extreme low weight, and refusal to eat indicate severe malnutrition and possible organ failure. Therefore, the priority is to address the patient's immediate medical needs, such as restoring electrolyte balance and preventing further complications. Psychological assessments and diagnoses can follow once the patient's physical health is stabilized.
Summary of Other Choices:
A: Anxiety related to fear of weight gain - This choice focuses on psychological factors, but the patient's symptoms indicate severe physical malnutrition rather than anxiety.
B: Disturbed body image related to weight loss - While body image issues may be present, the patient's critical medical condition takes precedence over psychological concerns.
C: Ineffective coping related to lack of conflict resolution skills - This choice does not address the urgency of the patient's physical symptoms and is not the most
A 72-year-old female patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. A nurse planning discharge care must consider the need to teach the family to be alert for maladaptive cognitive symptoms because:
- A. delirium is a hypersensitivity reaction.
- B. the elderly often deny changes in cognition.
- C. elderly females are more prone to delirium than elderly males.
- D. slower metabolism in the elderly predisposes to medication toxicity.
Correct Answer: D
Rationale: The correct answer is D because slower metabolism in the elderly can lead to medication toxicity, including anticholinergic toxicity causing delirium. As people age, their metabolism slows down, making them more susceptible to drug accumulation and toxicity. This can result in cognitive symptoms like delirium.
A: Delirium is not a hypersensitivity reaction; it is an acute state of confusion.
B: Denial of cognitive changes is not directly related to the risk of medication toxicity in the elderly.
C: Gender is not a significant factor in medication toxicity leading to delirium; it is more related to individual metabolism and drug interactions.
An 18-year-old referred to the mental health center often cooks gourmet meals but eats only tiny portions. The patient wears layers of loose clothing saying, "I like the style."Â The patient's weight dropped from 130 to 95 pounds. She has amenorrhea. Which diagnosis is most likely?
- A. Eating disorder not otherwise specified
- B. Anorexia nervosa
- C. Bulimia nervosa
- D. Binge eating
Correct Answer: B
Rationale: The correct answer is B: Anorexia nervosa. This diagnosis fits the patient's symptoms of restrictive eating, significant weight loss, amenorrhea, and denial of the severity of the situation. The patient's behavior of cooking gourmet meals but eating tiny portions and wearing layers of clothes to hide weight loss are classic signs of anorexia nervosa. The other choices are incorrect because:
A: Eating disorder not otherwise specified does not fully capture the severity and specific symptoms exhibited by the patient.
C: Bulimia nervosa involves binge-eating followed by compensatory behaviors, which are not described in the scenario.
D: Binge eating disorder involves recurrent episodes of binge eating without compensatory behaviors, which is not indicated.
A client with borderline disorder tells the nurse, 'It's hard to figure out who I am. Sometimes I'm sexually attracted to women and sometimes to men.' The nurse using Freudian concepts can analyze this as a developmental problem related to:
- A. Lack of separation-individuation
- B. Isolation of affect during latency
- C. Impaired development of sexual identity during the phallic stage
- D. Overdevelopment of latency stage traits related to control issues
Correct Answer: C
Rationale: The correct answer is C: Impaired development of sexual identity during the phallic stage. According to Freudian theory, the phallic stage occurs around ages 3 to 6 and is when children become aware of their genitals. This stage is crucial for the development of sexual identity. In this case, the client's confusion about their sexual attraction to both men and women suggests a difficulty in establishing a clear sexual identity during this stage. This can lead to ongoing struggles with sexual orientation and identity.
Choice A (Lack of separation-individuation) is incorrect because this concept is related to the development of individuality and autonomy, not sexual identity.
Choice B (Isolation of affect during latency) is incorrect as it refers to a defense mechanism where emotions are separated from their associated ideas or events during the latency stage, not related to sexual identity development.
Choice D (Overdevelopment of latency stage traits related to control issues) is incorrect because it focuses on traits related to the