Nokea
Which complication should a nurse monitor for when treating a patient with bulimia nervosa who is experiencing frequent vomiting?
- A. Hypokalemia and dental enamel erosion.
- B. Hyperkalemia and elevated blood pressure.
- C. Severe dehydration and low blood sugar.
- D. Hypercalcemia and weight gain.
Correct Answer: A
Rationale: The correct answer is A: Hypokalemia and dental enamel erosion.
1. Bulimia nervosa involves frequent vomiting, leading to loss of potassium (hypokalemia) due to electrolyte imbalance.
2. Vomiting also damages tooth enamel, causing dental erosion.
3. Hyperkalemia and elevated blood pressure (choice B) are not typically associated with bulimia.
4. Severe dehydration and low blood sugar (choice C) are possible but not the primary concerns.
5. Hypercalcemia and weight gain (choice D) are not common complications of bulimia.
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The nurse notes that a male client, who is taking an antipsychotic medication, is constantly moving from chair to chair during a group activity, and he complains that he feels 'nervous and jittery inside.' The nurse is aware that this client most likely is experiencing:
- A. Akinesia
- B. Dystonia
- C. Dyskinesia
- D. Akathisia
Correct Answer: D
Rationale: The correct answer is D: Akathisia. Akathisia is a common side effect of antipsychotic medications characterized by restlessness, inability to sit still, and a feeling of inner restlessness or jitteriness. In this case, the client's constant movement and feeling of nervousness align with the symptoms of akathisia.
A: Akinesia is the opposite of what the client is experiencing, characterized by a lack of movement or muscle weakness.
B: Dystonia involves involuntary muscle contractions and abnormal postures, not constant movement.
C: Dyskinesia refers to abnormal, involuntary movements of the face, trunk, and limbs, which are not described in the scenario.
Which theme is most likely during family therapy with parents, siblings, and a teen patient with anorexia nervosa who engages in provocative behavior?
- A. Stable coalitions between family members
- B. Interpreting negative messages as positive
- C. Competition between the patient and father
- D. Lack of trust in the patient by family members
Correct Answer: C
Rationale: The correct answer is C: Competition between the patient and father. In family therapy with a teen patient with anorexia nervosa, the theme of competition between the patient and a parental figure, often the father, can be prominent. The rationale is that the father's influence and expectations can contribute to the teen's feelings of inadequacy and drive for control through anorexic behaviors. This dynamic can be explored and addressed in therapy to improve family relationships and support the patient's recovery.
A: Stable coalitions between family members - This is less likely as anorexia nervosa often disrupts family dynamics.
B: Interpreting negative messages as positive - While this can be a relevant theme, it is not as central to the specific scenario described.
D: Lack of trust in the patient by family members - While trust issues may exist, the theme of competition is more relevant in this context.
A patient with schizophrenia has been stabilized in the Crisis Center and is about to be discharged. He will be living with his family, but the family knows nothing about the patient's illness, its treatment, or the role they can play in his recovery. Which activity would be most beneficial for the family to attend?
- A. Psychoanalytic group
- B. Psychoeducational group
- C. Individual counseling
- D. Family therapy
Correct Answer: B
Rationale: The correct answer is B: Psychoeducational group. This option is most beneficial as it provides education and information to the family about the patient's illness, treatment options, and ways they can support his recovery. It helps them understand the challenges the patient faces and equips them with practical strategies to assist in his recovery process.
A: Psychoanalytic group focuses on exploring unconscious patterns of behavior and may not provide the necessary education and tools for the family to support the patient effectively.
C: Individual counseling is focused on the patient and may not involve the family members in understanding the illness and their role in the patient's recovery.
D: Family therapy involves the whole family in therapy sessions, but may not specifically focus on educating them about schizophrenia and its treatment, which is crucial for their support.
It is a secondary dementia indicated by loss of recent memory and disorientation to time and place.
- A. Alzheimer's disease.
- B. Vascular dementia.
- C. Lewy body dementia.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Alzheimer's disease. Alzheimer's disease is a common type of dementia characterized by progressive cognitive decline, including loss of recent memory and disorientation to time and place. This is due to the accumulation of amyloid plaques and neurofibrillary tangles in the brain. Vascular dementia (B) is caused by reduced blood flow to the brain, leading to cognitive impairment. Lewy body dementia (C) is characterized by the presence of abnormal protein deposits called Lewy bodies in the brain. Choosing D (None of the above) would be incorrect as Alzheimer's disease specifically matches the description provided in the question.
Which nursing intervention should be included in the care plan for a patient with anorexia nervosa who is at risk for refeeding syndrome?
- A. Refeed with high-calorie foods initially.
- B. Monitor serum electrolytes closely after refeeding begins.
- C. Increase fluid intake gradually over several days.
- D. Encourage early ambulation to prevent complications.
Correct Answer: B
Rationale: The correct answer is B: Monitor serum electrolytes closely after refeeding begins. Refeeding syndrome can occur in patients with anorexia nervosa when there is a rapid shift in electrolytes and fluid levels. Monitoring serum electrolytes closely after refeeding begins allows for early detection of any imbalances and prompt intervention. This helps prevent serious complications such as cardiac arrhythmias or neurological issues.
Choice A is incorrect because refeeding with high-calorie foods initially can exacerbate the risk of refeeding syndrome due to rapid changes in electrolyte levels. Choice C is incorrect as increasing fluid intake gradually may not directly address electrolyte imbalances. Choice D is incorrect as encouraging early ambulation is not directly related to preventing refeeding syndrome.