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Which assessment finding is most associated with bulimia nervosa?
- A. Prominent parotid glands
- B. Peripheral edema
- C. Thin, brittle hair
- D. Amenorrhea
Correct Answer: A
Rationale: The correct answer is A: Prominent parotid glands. This is associated with bulimia nervosa due to repeated vomiting, which can lead to enlargement of the parotid glands. This is known as parotid gland hypertrophy. The other choices (B: Peripheral edema, C: Thin, brittle hair, D: Amenorrhea) are more commonly associated with anorexia nervosa rather than bulimia nervosa. Edema is a sign of malnutrition in anorexia, while thin, brittle hair and amenorrhea are also common in anorexia due to severe weight loss and hormonal disturbances.
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A patient with anorexia nervosa in outpatient treatment has begun refeeding. Between the first and second appointment, the patient gained 8 pounds. The nurse should:
- A. Praise the weight gain.
- B. Assess lung sounds and extremities.
- C. Suggest implementation of an exercise program.
- D. Establish a higher target for weight gain for the next week.
Correct Answer: B
Rationale: The correct answer is B because assessing lung sounds and extremities is crucial after significant weight gain in a patient with anorexia nervosa to monitor for potential complications like refeeding syndrome. Praise in choice A may reinforce unhealthy behaviors. Choice C suggesting an exercise program may be harmful. Choice D could lead to excessive weight gain.
According to the Diagnostic and Statistical Manual, 5th Edition (DSM-5), how many symptoms should be present for at least two weeks before a diagnosis of adolescent depression is made?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: D
Rationale: DSM-5 requires 5 symptoms (including depressed mood or loss of interest) for at least 2 weeks for a Major Depressive Disorder diagnosis.
A patient with anorexia nervosa begins to refuse food. The nurse should first:
- A. Speak with the patient's family about the refusal.
- B. Focus on the patient's emotional distress and discuss it.
- C. Redirect the patient to a different activity to distract them.
- D. Encourage the patient to eat a small, manageable portion of food.
Correct Answer: D
Rationale: The correct answer is D because encouraging the patient to eat a small, manageable portion of food is the most immediate and vital intervention in addressing the patient's refusal to eat. This step is crucial in preventing further complications associated with anorexia nervosa, such as malnutrition and dehydration. By starting with a small portion, the patient can gradually reintroduce food and begin the process of recovery.
A: Speaking with the family may be important but not the first step in addressing the patient's refusal to eat.
B: Focusing on emotional distress is important but addressing the physical need for food should take priority.
C: Redirecting the patient to a different activity may temporarily distract them but does not address the underlying issue of malnutrition.
The parent of a seriously mentally ill adult asks the nurse, 'Why are you making a referral to a vocational rehabilitation program? My child wont ever be able to hold a job.' Which is the nurses best reply?
- A. We make this referral to continue eligibility for federal funding.'
- B. Are you concerned that were trying to make your child too independent?'
- C. If you think the program would be detrimental, we can postpone it for a time.'
- D. Most patients are capable of employment at some level, competitive or supported.'
Correct Answer: D
Rationale: Studies have shown that most patients who complete vocational rehabilitation programs are capable of some level of employment. They also demonstrate significant improvement in assertiveness and work behaviors as well as decreased depression.
A widowed patient tells a nurse that the door should be left unlocked because her husband will be coming home soon. Which response by the nurse would be most therapeutic?
- A. "You've forgotten that your husband's dead, haven't you?"Â
- B. "Just try to sleep. He won't be home for a long time yet."Â
- C. "You must miss him a lot. It almost seems he's here with you."Â
- D. "Your husband died 10 years ago. He won't be coming here."Â
Correct Answer: C
Rationale: The correct answer is C because it validates the patient's feelings without directly confronting or contradicting her belief. By acknowledging the patient's emotions and creating a sense of empathy, the nurse establishes a therapeutic rapport. Choice A is incorrect as it may be perceived as confrontational and insensitive. Choice B dismisses the patient's feelings and can be invalidating. Choice D is direct and may cause distress or confusion to the patient. In summary, option C is the best choice as it shows empathy and understanding towards the patient's emotional state.