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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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For patients diagnosed with serious mental illness, what is the major advantage of case management?
- A. The case manager can modify traditional psychotherapy
- B. With one coordinator of services, resources can be more efficiently used
- C. The case manager can focus on social skills training and esteem building
- D. Case managers bring groups of patients together to discuss common problems
Correct Answer: B
Rationale: The case manager coordinates the care and multiple referrals that so often confuse the seriously mentally ill patient and the patients family. Case management promotes efficient use of services. The other options are lesser advantages or are irrelevant.
Which is a key nursing consideration when planning care for a patient with bulimia nervosa?
- A. Allow the patient to choose their preferred food options.
- B. Provide a structured environment with clear expectations around eating behaviors.
- C. Monitor for signs of weight gain and decrease calorie intake accordingly.
- D. Encourage the patient to participate in regular exercise routines.
Correct Answer: B
Rationale: The correct answer is B: Provide a structured environment with clear expectations around eating behaviors. This is important in managing bulimia nervosa as it helps establish a routine, promotes healthy eating habits, and prevents binge-purge cycles. It provides consistency and boundaries, reducing the likelihood of impulsive behaviors.
Incorrect choices:
A: Allowing the patient to choose their preferred food options can enable unhealthy eating patterns and reinforce disordered behaviors.
C: Monitoring for weight gain and decreasing calorie intake can worsen the patient's condition and perpetuate their obsession with weight and food.
D: Encouraging regular exercise routines may exacerbate the patient's unhealthy relationship with food and body image, leading to excessive exercising or compensatory behaviors.
A 17-year-old patient with anorexia nervosa has just been released from the hospital. To facilitate recovery at home, the psychiatric-mental health nurse instructs the family to:
- A. discourage the patient from sneaking food between meals, by unobtrusively reducing access to the kitchen
- B. encourage the patient's interest in menu planning, food magazines, and cooking lessons, by leaving information and materials around the house
- C. permit the patient to eat her meals privately to discourage family preoccupation with meals
- D. recommend that the patient joins in routine family meals and clears the dishes after dinner, even if they do not eat
Correct Answer: D
Rationale: Involving the patient in family meals normalizes eating behavior and provides structure, supporting recovery without enabling secrecy or avoidance.
A patient was admitted in a semistuporous catatonic state. Family states that the patient has neither left the apartment nor attended to personal hygiene for several weeks. The patient's last 48 hours have been spent lying in bed, mute and motionless. The nursing diagnosis that should be considered the priority is:
- A. self-care deficit.
- B. situational low self-esteem.
- C. disturbed thought processes.
- D. impaired verbal communication.
Correct Answer: A
Rationale: The correct answer is A: self-care deficit. The patient's symptoms indicate a lack of ability to perform self-care activities, which poses a risk to their health and well-being. This is a priority as addressing this issue will directly impact the patient's physical health and overall functioning. Situational low self-esteem (B) is not the priority as it focuses on the patient's emotional state rather than their immediate physical needs. Disturbed thought processes (C) and impaired verbal communication (D) may be present but are not the priority over the patient's inability to perform self-care activities.
The nurse is working with a patient diagnosed with bulimia nervosa. Which assessment is most important?
- A. Monitor electrolyte levels and cardiac function.
- B. Observe for compulsive eating behaviors.
- C. Track the patient's ability to self-regulate food intake.
- D. Assess for symptoms of depression and anxiety.
Correct Answer: A
Rationale: The correct answer is A because patients with bulimia nervosa are at risk for electrolyte imbalances and cardiac issues due to purging behaviors. Monitoring electrolyte levels and cardiac function is crucial for early detection and intervention. Option B is incorrect as it focuses on behaviors rather than potential medical complications. Option C is less critical than monitoring electrolytes and cardiac function. Option D, although important, is not as immediately critical as monitoring electrolyte levels and cardiac function in this context.