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Which behavior is most characteristic of a patient with bulimia nervosa?
- A. Refusal to eat and excessive weight loss.
- B. Binge eating followed by purging or excessive exercise.
- C. Severe caloric restriction and weight obsession.
- D. Compulsive overeating with no attempt to control intake.
Correct Answer: B
Rationale: The correct answer is B because it describes the hallmark behavior of bulimia nervosa, which involves recurrent episodes of binge eating followed by compensatory behaviors such as purging or excessive exercise. This behavior pattern distinguishes bulimia from other eating disorders. Refusal to eat and excessive weight loss (A) is more indicative of anorexia nervosa. Severe caloric restriction and weight obsession (C) are more characteristic of anorexia as well. Compulsive overeating with no attempt to control intake (D) is more aligned with binge eating disorder, not bulimia nervosa.
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After a person was abducted and raped at gunpoint by an unknown assailant, which trauma syndrome is most likely to occur?
- A. Decreased motor activity.
- B. Confusion and disbelief.
- C. Flashbacks and dreams.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Confusion and disbelief. After experiencing a traumatic event like abduction and rape at gunpoint, it is common for individuals to feel confused and in disbelief due to the overwhelming nature of the experience. This reaction is part of the acute stress response and is a normal psychological defense mechanism. Decreased motor activity (choice A) is less likely to be the immediate response to such a traumatic event. Flashbacks and dreams (choice C) are more characteristic of post-traumatic stress disorder (PTSD), which may develop later on but are not the initial trauma syndrome. Choice D is incorrect as trauma responses are expected in this situation.
Which of the following statements by your ADHD childs parents indicate they need further teaching?
- A. We will establish firm but reasonable limits on his behavior
- B. We will give him his medication at night so it wont decrease his appetite
- C. We will set him up in a special program at his school so we he will get extra attention
- D. We will work to ensure he gets 8 hours of sleep a night
Correct Answer: B
Rationale: Stimulant medications are given for treatment of ADHD. These can cause insomnia if given later in the day.
Which of the following will lead one to need to consider autism spectrum disorder as a likely diagnosis?
- A. A girl spoke her first words at 14 months, enjoyed playing with Peppa Pig characters at age 2 daily. She tended to sit away from her classmates at recess at age 7 but when asked, would say she had 30 friends. She was very good at the piano and had strong knowledge of all the great composers at age 8. She entered the Gifted Education Programme at 10. At 13, she did poorly at group work, often talked about death and the afterlife, and became progressively silent
- B. A boy walked at 18 months, spoke his first words at 2 , and enjoyed playing Minecraft at 4 together with his friends. He participated at birthday parties. He struggled with composition writing, both for ideas and also for the efforts in writing in school, but managed an AL score of 18 and was promoted to secondary school
- C. A boy walked at 13 months and was a happy child in preschool. He started speaking at 18 months but did not recognise letters and numbers consistently until 4.5 years of age. He did not read until 7 . He was sometimes forgetful with instructions but did not cause disruption in school, though he was often the clown in class. He tended to not finish his work unless his parents sat with him. Nonetheless, he completed primary school with some extra time for exams and went on to secondary school
- D. A girl walked at 16 months and was often clumsy though she did not fall. She would bump into things and might drop items in her hands. She disliked writing and was slow to write. She could never complete her work in class. She would shade the wrong answers on the optical answer sheet although she knew the right answers. She had trouble with mathematics thoughout school but she enjoyed reading
Correct Answer: A
Rationale: Option A shows social withdrawal, poor group interaction, and restricted interests (music, death themes), aligning with ASD criteria in DSM-5, unlike the others with more typical development or specific learning/motor issues.
An 83-year-old man becomes lost while driving. He pulls into a driveway to turn around and cannot figure out how to put his car in reverse, so he drives into the yard, makes a circle, and drives back out of the driveway. He is stopped by police, who take him to the emergency department. The physician diagnoses him with Alzheimer's disease and refers him to the neurology clinic for follow-up. Given this diagnosis, which behaviors should the clinic nurse anticipate?
- A. Does not know today's date.
- B. Unable to shower without help.
- C. Denial of mental impairment.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Does not know today's date. This behavior is commonly associated with Alzheimer's disease due to memory impairment. The inability to recall the current date is a key symptom of cognitive decline. In this case, the man's difficulty with reversing his car and getting lost are indicative of cognitive impairment.
Choice B, Unable to shower without help, is a functional impairment and not specific to Alzheimer's disease. Choice C, Denial of mental impairment, may occur in some individuals with Alzheimer's but is not a consistent behavior. Choice D, None of the above, is incorrect as memory deficits, such as not knowing the date, are commonly seen in Alzheimer's disease.
Which intervention would be most appropriate for a patient with bulimia nervosa who is at risk for electrolyte imbalance?
- A. Offer the patient water or an electrolyte replacement solution.
- B. Encourage the patient to engage in regular physical activity.
- C. Administer a diuretic as prescribed by the physician.
- D. Withhold food to reduce the risk of further weight gain.
Correct Answer: A
Rationale: The correct answer is A: Offering the patient water or an electrolyte replacement solution. This intervention is appropriate because patients with bulimia nervosa are at risk for electrolyte imbalances due to purging behaviors. Providing water or electrolyte replacement solution helps to replenish lost electrolytes and maintain proper balance.
Option B is incorrect as excessive physical activity can further deplete electrolytes. Option C is inappropriate as administering a diuretic can worsen electrolyte imbalances. Option D is also incorrect as withholding food can exacerbate the patient's condition and increase the risk of electrolyte imbalances.