Nokea
Which factor least influences whether a country will have a higher life expectancy?
- A. The level of racial diversity
- B. Quality sanitation and sewage treatment facilities
- C. Access to food
- D. Access to medicine
Correct Answer: A
Rationale: Racial diversity has little direct impact on life expectancy compared to sanitation, food, and medical access, which are critical determinants.
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A nurse is working with a patient diagnosed with bulimia nervosa. Which of the following would be considered an appropriate outcome for this patient?
- A. The patient will engage in purging behavior once a week.
- B. The patient will eat three meals a day without purging behaviors.
- C. The patient will maintain a BMI of 18.5.
- D. The patient will avoid emotional support to prevent dependence.
Correct Answer: B
Rationale: The correct answer is B because it reflects a positive outcome for a patient with bulimia nervosa. Eating three meals a day without purging behaviors indicates improved eating habits and reduced harmful behaviors. This outcome promotes physical health and addresses the underlying issues of the disorder.
Choice A is incorrect as engaging in purging behavior is not a desirable outcome for a patient with bulimia nervosa. Choice C is incorrect because focusing solely on maintaining a specific BMI does not address the psychological and behavioral aspects of the disorder. Choice D is incorrect as emotional support is essential in the treatment of eating disorders and should not be avoided to prevent dependence.
A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:
- A. Appropriately express angry feelings.
- B. Verbalize two positive things about self.
- C. Verbalize the importance of eating a balanced diet.
- D. Identify two alternative methods of coping with loneliness and isolation.
Correct Answer: D
Rationale: The correct answer is D: Identify two alternative methods of coping with loneliness and isolation.
Rationale:
1. The nursing diagnosis is Ineffective coping related to feelings of loneliness and isolation, indicating the patient struggles with coping mechanisms.
2. The desired outcome is for the patient to identify alternative coping methods, which directly addresses the ineffective coping issue.
3. By identifying two alternative methods, the patient demonstrates an understanding of healthier coping strategies.
4. This outcome focuses on addressing the root cause of the behavior (loneliness and isolation) rather than just surface-level expressions or behaviors.
Summary:
A: Appropriately expressing angry feelings does not directly address coping mechanisms related to loneliness and isolation.
B: Verbalizing positive things about oneself is beneficial but does not address the core issue of ineffective coping.
C: Verbalizing the importance of a balanced diet is important but does not directly address coping with loneliness and isolation.
Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), gabapentin (Neurontin). Which drug also belongs with this group?
- A. Clonazepam (Klonopin)
- B. Lamotrigine (Lamictal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: B
Rationale: The correct answer is B: Lamotrigine (Lamictal). All the drugs listed are commonly used in the treatment of epilepsy and mood disorders. Lamotrigine is often prescribed alongside divalproex, carbamazepine, and gabapentin as a mood stabilizer and antiepileptic medication. It works by stabilizing electrical activity in the brain and preventing seizures. Clonazepam (A) is a benzodiazepine used for anxiety and seizures, not in the same class as the other drugs. Risperidone (C) and Aripiprazole (D) are antipsychotics used for schizophrenia and bipolar disorder, not primarily for epilepsy.
A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:
- A. haloperidol (Haldol).
- B. olanzapine (Zyprexa).
- C. diphenhydramine (Benadryl).
- D. chlorpromazine (Thorazine).
Correct Answer: B
Rationale: The correct answer is B: olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that addresses both positive and negative symptoms of schizophrenia. In this case, the patient still experiences negative symptoms like apathy, poverty of thought, and social withdrawal. Olanzapine has been shown to be effective in improving negative symptoms and overall functioning in patients with schizophrenia.
A: haloperidol is a typical (first-generation) antipsychotic that primarily targets positive symptoms like hallucinations, not negative symptoms.
C: diphenhydramine is an antihistamine with no known efficacy for treating schizophrenia symptoms.
D: chlorpromazine is a typical antipsychotic like haloperidol and is not typically used for addressing negative symptoms.
Which assessment finding is most associated with bulimia nervosa?
- A. Prominent parotid glands
- B. Peripheral edema
- C. Thin, brittle hair
- D. Amenorrhea
Correct Answer: A
Rationale: The correct answer is A: Prominent parotid glands. This is associated with bulimia nervosa due to repeated vomiting, which can lead to enlargement of the parotid glands. This is known as parotid gland hypertrophy. The other choices (B: Peripheral edema, C: Thin, brittle hair, D: Amenorrhea) are more commonly associated with anorexia nervosa rather than bulimia nervosa. Edema is a sign of malnutrition in anorexia, while thin, brittle hair and amenorrhea are also common in anorexia due to severe weight loss and hormonal disturbances.