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When undertaking care for a patient with an eating disorder, a nurse should first:
- A. perform a complete patient assessment.
- B. obtain a history from the patient's family.
- C. examine his or her own feelings about weight.
- D. question the patient as to when he or she last ate a meal.
Correct Answer: C
Rationale: The correct answer is C because examining the nurse's own feelings about weight is essential to ensure they have a neutral and non-judgmental attitude towards the patient. This self-awareness helps the nurse avoid projecting biases onto the patient and fosters a therapeutic relationship. Performing a complete patient assessment (A) is important but not the first step. Obtaining a history from the patient's family (B) may be helpful but is not the initial priority. Questioning the patient about their last meal (D) is important but does not address the nurse's own attitudes and biases that could impact care.
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The family of a client mentions to the nurse, 'The family therapist talked to us about enmeshment. We're not sure we understood what it meant.' The nurse should base a response on knowledge that an enmeshed family is a unit in which:
- A. individuality is encouraged.
- B. boundaries are poorly defined.
- C. conflict is effectively resolved.
- D. social acceptance is deemed unimportant.
Correct Answer: B
Rationale: The correct answer is B: boundaries are poorly defined. In an enmeshed family, boundaries between family members are blurred, leading to a lack of individual autonomy and independence. Enmeshment can result in difficulties in establishing personal identities and healthy relationships. Choices A, C, and D are incorrect because individuality is not encouraged, conflict is not effectively resolved, and social acceptance is not necessarily deemed unimportant in an enmeshed family dynamic.
A victim of partner abuse, parent of one child, describes the partner as someone who is easily frustrated and more likely to be abusive after experiencing an event in which self-esteem is challenged. The most recent episodes of violence were related to feeling "upset"Â over a job loss. What type of therapy would provide the greatest help to the abuser?
- A. Voluntary individual or group therapy
- B. Court-ordered individual or group therapy
- C. Voluntary couples or family therapy
- D. Court-ordered couples or family therapy
Correct Answer: A
Rationale: The correct answer is A: Voluntary individual or group therapy. This type of therapy would provide the greatest help to the abuser because it focuses on addressing the underlying issues of frustration, self-esteem challenges, and abusive behavior. The key here is that the therapy is voluntary, which means the abuser is more likely to engage and actively participate in the process. In individual or group therapy, the abuser can explore and work on managing emotions, coping strategies, and developing healthier communication skills. Court-ordered therapy (choices B and D) may not be as effective because it could be seen as a punishment rather than a genuine effort to seek help. Couples or family therapy (choice C) may not be appropriate initially as the focus should be on the abuser's personal growth and behavior change.
In the powerpoint activity for this lesson, you witnessed photographs of typical weekly food consumptions for families in various countries. Which country depicted a photograph of a family who consumed the LEAST amount of fruits and vegetables and the MOST amount of processed food?
- A. Germany
- B. Poland
- C. Chad
- D. United States
Correct Answer: D
Rationale: The United States is often depicted with diets high in processed foods and low in fruits and vegetables, reflecting modern consumption patterns.
A patient diagnosed with a serious mental illness lives independently and attends a psychosocial rehabilitation program. The patient presents at the emergency department seeking hospitalization. The patient has no acute symptoms but says, 'I have no money to pay my rent or refill my prescription.' Select the nurses best action.
- A. Involve the patients case manager to provide crisis intervention
- B. Send the patient to a homeless shelter until housing can be arranged
- C. Arrange for a short in-patient admission and begin discharge planning
- D. Explain that one must have active psychiatric symptoms to be admitted
Correct Answer: A
Rationale: Impaired stress tolerance and problem-solving abilities can cause persons with SMI to experience relatively minor stressors as crises. This patient has run out of money, and this has overwhelmed her ability to cope, resulting in a crisis for which crisis intervention would be an appropriate response. Inpatient care is not clinically indicated nor is the patient homeless (although she may fear she is). Telling the patient that she is not symptomatic enough to be admitted may prompt malingering.
Which nursing intervention has highest priority for a patient with bulimia nervosa?
- A. Assist the patient to identify triggers to binge eating.
- B. Provide remedial consequences for weight loss.
- C. Assess for signs of impulsive eating.
- D. Explore needs for health teaching.
Correct Answer: A
Rationale: The correct answer is A: Assist the patient to identify triggers to binge eating. The highest priority for a patient with bulimia nervosa is addressing the root cause of the behavior, which is often triggered by emotional or situational factors. By identifying triggers, the patient can learn to recognize and manage them effectively, ultimately reducing the frequency of binge eating episodes. This intervention focuses on addressing the underlying issue and promoting long-term recovery.
Summary:
B: Providing remedial consequences for weight loss is not the priority as the main concern is addressing the binge eating behavior.
C: Assessing for signs of impulsive eating is important, but identifying triggers takes precedence in addressing the behavior.
D: Exploring needs for health teaching may be relevant, but addressing triggers to binge eating is more immediate and crucial for managing bulimia nervosa.