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Which expectation should be considered most critical prior to discharging a client with anorexia nervosa from the hospital?
- A. Attainment of minimum normal weight.
- B. Resumption of normal menstrual cycle.
- C. Knowledge of caloric and nutritional value of foods required for a balanced diet.
- D. Reduction of periods of active exercise to three times daily.
Correct Answer: A
Rationale: Rationale: A critical expectation before discharging a client with anorexia nervosa is the attainment of minimum normal weight. This is crucial for the client's physical health and to prevent complications like organ damage. Resuming a normal menstrual cycle (B) is important but not as critical as restoring weight. Knowing about nutrition (C) is valuable but not as urgent as weight gain. Reducing exercise (D) may be necessary, but weight restoration takes precedence for overall health.
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The nurse is administering donepezil (Aricept) to a client with stage 1 Alzheimer's disease. Based on this drug's mechanism of action, the nurse will seek evidence of improvement in the client's:
- A. Ability to remember
- B. Ability to tolerate stress
- C. Social behaviors
- D. Delusions and hallucinations
Correct Answer: A
Rationale: The correct answer is A: Ability to remember. Donepezil is a cholinesterase inhibitor that works by increasing levels of acetylcholine in the brain, which helps improve cognitive function, particularly memory. Therefore, the nurse should seek evidence of improvement in the client's ability to remember.
Choice B: Ability to tolerate stress is incorrect because donepezil does not directly impact stress tolerance.
Choice C: Social behaviors is incorrect as donepezil primarily targets memory and cognitive function, not social behaviors.
Choice D: Delusions and hallucinations is incorrect because donepezil does not specifically address these symptoms, which are more commonly associated with psychosis rather than Alzheimer's disease.
A major difference in assessment findings between a patient with anorexia nervosa and a patient with bulimia nervosa is the patient with bulimia:
- A. is well nourished while the patient with anorexia nervosa is malnourished.
- B. denies hunger while the patient with anorexia nervosa admits experiencing hunger.
- C. is often of near-normal weight while the patient with anorexia nervosa is underweight.
- D. has a distorted body image while the patient with anorexia nervosa has a realistic body image.
Correct Answer: C
Rationale: The correct answer is C because a major difference between anorexia nervosa and bulimia nervosa is that patients with bulimia are often of near-normal weight, while patients with anorexia are typically underweight. This is due to the different patterns of eating behaviors in the two disorders. In bulimia, individuals often engage in binge-eating episodes followed by compensatory behaviors such as purging, which may help maintain their weight. On the other hand, individuals with anorexia restrict their food intake significantly, leading to malnourishment and significant weight loss.
Choice A is incorrect because individuals with bulimia can still experience malnourishment due to the purging behaviors. Choice B is incorrect because both patients with anorexia and bulimia may deny hunger due to their disordered eating behaviors. Choice D is incorrect because both disorders involve a distorted body image, although the specific nature of the distortion may differ.
A newly admitted elderly client seems to become confused and agitated every evening after dinner. This client most likely is suffering from:
- A. Alzheimer's disease
- B. Acute dementia
- C. Sundown syndrome
- D. Delirium
Correct Answer: C
Rationale: The correct answer is C: Sundown syndrome. This is a condition where elderly individuals experience confusion and agitation in the evening. The symptoms are typically more pronounced during this time of day. It is not Alzheimer's disease (A) as that is a progressive neurodegenerative disorder. Acute dementia (B) is not a recognized medical term and does not accurately describe the symptoms. Delirium (D) is an acute state of confusion that can occur at any time of day, not just in the evening like sundown syndrome.
A patient with bipolar disorder has rapid cycles. To prepare teaching materials, the nurse anticipates which medication will be prescribed?
- A. Clonidine (Catapres)
- B. Phenytoin (Dilantin)
- C. Carbamazepine (Tegretol)
- D. Chlorpromazine (Thorazine)
Correct Answer: C
Rationale: Rationale: Carbamazepine (Tegretol) is commonly used in treating rapid cycling bipolar disorder due to its mood stabilizing properties. It helps regulate mood swings and prevent manic or depressive episodes. It is effective in managing rapid cycling symptoms. Clonidine (A) is used for ADHD and hypertension, not bipolar disorder. Phenytoin (B) is an anticonvulsant, not typically used for bipolar disorder. Chlorpromazine (D) is an antipsychotic mainly for schizophrenia, not specifically indicated for rapid cycling in bipolar disorder.
A 70-year-old woman is beginning to notice mild memory impairment. She fears she is developing dementia. What is the most likely cause of her memory impairment?
- A. Normal aging.
- B. Alzheimer's disease.
- C. Depression.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Alzheimer's disease. This is the most likely cause of memory impairment in a 70-year-old woman experiencing mild memory issues. Alzheimer's disease is a progressive neurodegenerative disorder that affects memory, thinking, and behavior. It is the most common cause of dementia in older adults. Normal aging (choice A) typically involves some mild memory decline, but significant impairment is not considered a normal part of aging. Depression (choice C) can also impact memory, but in this case, the woman's primary concern is memory impairment, not depressive symptoms. Choice D is incorrect as Alzheimer's disease is a possible explanation for her memory issues.