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Which complication is most likely in a patient with bulimia nervosa who purges frequently?
- A. Dehydration and electrolyte imbalances.
- B. Increased appetite and weight gain.
- C. Improved digestion and nutrient absorption.
- D. High blood pressure and rapid heart rate.
Correct Answer: A
Rationale: The correct answer is A: Dehydration and electrolyte imbalances. Purging in bulimia nervosa involves self-induced vomiting or misuse of laxatives, leading to fluid and electrolyte loss. This can result in dehydration, electrolyte imbalances, and potentially life-threatening complications like cardiac arrhythmias. Increased appetite and weight gain (B) are less likely due to purging. Improved digestion and nutrient absorption (C) are not associated with frequent purging. High blood pressure and rapid heart rate (D) may occur in severe cases but are not the most likely complication.
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Which is a hallmark characteristic of bulimia nervosa?
- A. Persistent restriction of caloric intake.
- B. Binge eating followed by purging behaviors.
- C. Severe weight loss due to food refusal.
- D. Excessive exercising to burn calories.
Correct Answer: B
Rationale: The correct answer is B because bulimia nervosa is characterized by recurrent episodes of binge eating followed by compensatory behaviors such as purging. Binge eating involves consuming a large amount of food in a short period, followed by feelings of loss of control. Purging behaviors like self-induced vomiting or misuse of laxatives are used to prevent weight gain. Choices A, C, and D are incorrect because bulimia nervosa typically involves normal or fluctuating weight, not severe weight loss or excessive exercise to burn calories. Persistent restriction of caloric intake is more indicative of anorexia nervosa, not bulimia nervosa.
Of the following interventions, which one would likely be most useful when attempting to prevent or lessen the symptoms associated with sundown syndrome?
- A. Keeping the patient's room quiet and dimly lit at night
- B. Interacting frequently with the patient during evening hours
- C. Providing the patient with a large protein-based bedtime snack
- D. Giving the patient a soft stuffed animal to provide a source of security
Correct Answer: B
Rationale: The correct answer is B because interacting frequently with the patient during evening hours can help provide comfort and reassurance, reducing anxiety and agitation associated with sundown syndrome. Interacting can stimulate the patient's senses and distract from negative symptoms.
Choice A is incorrect because a quiet and dimly lit room alone may not address the underlying emotional and psychological needs of the patient during sundown syndrome.
Choice C is incorrect because a large protein-based bedtime snack may not directly impact the behavioral symptoms of sundown syndrome.
Choice D is incorrect because while a soft stuffed animal can provide some comfort, it may not address the need for human interaction and engagement during the evening hours to prevent or lessen sundown syndrome symptoms.
A patient being treated for major depression is the CEO of her own business. She has shown significant improvement and is about to be discharged after completing a course of 15 electroconvulsive therapy sessions. She will continue on SSRI medications. The patient has been counseled not to make a major business decision for a month. The rationale for this is that:
- A. SSRIs may cause confusion in susceptible persons.
- B. ECT often causes temporary memory impairment.
- C. Lingering depression makes the patient incompetent.
- D. The patient needs months to readjust to work pressures.
Correct Answer: B
Rationale: The correct answer is B: ECT often causes temporary memory impairment. This is because electroconvulsive therapy (ECT) is known to have side effects, including temporary memory loss and confusion. As the patient has just completed a course of 15 ECT sessions, it is important to allow time for the effects of ECT to subside before making major decisions, especially in a high-pressure role like being a CEO. Choices A and C are incorrect as SSRIs do not typically cause confusion and lingering depression alone does not necessarily make a patient incompetent. Choice D is incorrect as there is no indication that the patient needs months to readjust to work pressures; the primary concern here is the potential memory impairment from ECT.
A client with schizophrenia tells the nurse that he is the President of the United States, and no logical reasoning with the client convinces him otherwise. This client is experiencing a:
- A. Mutism
- B. Delusion
- C. Neologism
- D. Flight of ideas
Correct Answer: B
Rationale: The correct answer is B: Delusion. A delusion is a fixed false belief that is not based on reality, such as believing one is a famous figure like the President. In this scenario, the client's belief is firmly held despite evidence to the contrary, indicating a delusion. Mutism (A) is a lack of verbal communication, not applicable here. Neologism (C) is creating new words or phrases, not seen in this example. Flight of ideas (D) is a rapid, continuous flow of speech with abrupt topic changes, which is not demonstrated in the client's behavior described.
The nurse is assessing a client who will be having an orthopedic surgery. The client takes an antipsychotic medication and shares that he has recently started using two herbal preparations for his nerves. The nurse should:
- A. Ask for the specific names of the herbal compounds
- B. Go on to another interview question since herbal compounds are not important
- C. Tell him to stop using the herbal preparations because they are not effective
- D. Explain that his physician will not be happy with his self-prescribing
Correct Answer: A
Rationale: Rationale:
A: Asking for the specific names of the herbal compounds is important to assess potential interactions with the antipsychotic medication.
B: Ignoring the herbal compounds could lead to adverse effects or interactions during surgery.
C: Telling him to stop may not be appropriate without knowing the specific compounds and their effects.
D: Discussing the physician's viewpoint is not as crucial as gathering information on potential interactions.