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Which information would be of greatest assistance to a nurse assessing a patient's motivation to change behavior associated with maladaptive eating regulation responses?
- A. The number, on a scale of 1 to 10, that reflects the patient's desire for treatment.
- B. The name of a person the patient feels he or she can rely on for emotional support.
- C. The advantages the patient identifies as motivation for controlling the maladaptive behavior.
- D. The reasons the patient identifies as the factors that originally caused the maladaptive behavior.
Correct Answer: A
Rationale: The correct answer is A because assessing the patient's desire for treatment provides insight into their readiness and motivation to change behavior. This information indicates their willingness to engage in the treatment process and is a key factor in predicting behavior change.
Option B is incorrect because relying on emotional support may not necessarily reflect the patient's motivation to change their behavior. Option C is incorrect as identifying advantages for controlling maladaptive behavior does not directly address the patient's motivation level. Option D is incorrect because understanding the factors that caused the behavior does not necessarily indicate the patient's current motivation to change.
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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. None of the above.
Correct Answer: D
Rationale: Rationale:
1. Patient's diagnosis indicates coping issues, not anger expression or self-esteem.
2. Patient's coping mechanism involves overeating and vomiting, not diet.
3. Outcome should focus on coping skills improvement, not unrelated goals.
4. None of the choices address the root issue of coping with loneliness and isolation.
5. Thus, the correct answer is D, as none of the options directly address the patient's ineffective coping mechanism.
An 18-year-old referred to the mental health center often cooks gourmet meals but eats only tiny portions. The patient wears layers of loose clothing saying, "I like the style." The patient's weight dropped from 130 to 95 pounds. She has amenorrhea. Which diagnosis is most likely?
- A. Eating disorder not otherwise specified
- B. Anorexia nervosa
- C. Bulimia nervosa
- D. Binge eating
Correct Answer: B
Rationale: The correct diagnosis is B: Anorexia nervosa. This patient exhibits key symptoms such as restrictive eating leading to significant weight loss, wearing layers of clothing to hide body shape, and amenorrhea. These symptoms align with the diagnostic criteria for anorexia nervosa. The other choices are incorrect because they do not fully capture the combination of symptoms present in this case. Choice A (Eating disorder not otherwise specified) is too broad and does not specify the severity of the symptoms. Choice C (Bulimia nervosa) typically involves binge eating followed by compensatory behaviors, which is not indicated in this case. Choice D (Binge eating) focuses solely on overeating without the restrictive eating and weight loss seen in anorexia nervosa.
A nurse is educating a patient with anorexia nervosa about nutrition. What should the nurse focus on?
- A. Encouraging rapid weight gain through a high-calorie diet.
- B. Promoting gradual weight gain and nutritional rehabilitation.
- C. Providing a low-calorie diet to maintain a healthy weight.
- D. Focusing on weight maintenance without discussing food intake.
Correct Answer: B
Rationale: The correct answer is B because promoting gradual weight gain and nutritional rehabilitation is essential in treating anorexia nervosa. Rapid weight gain can lead to medical complications and mental distress. Providing a low-calorie diet (C) contradicts the goal of weight gain. Focusing on weight maintenance without discussing food intake (D) neglects the importance of nutrition in recovery.
A person who was raped comes to the hospital for treatment. The person abruptly decides to decline treatment and leave the facility. Before this person leaves, the nurse should:
- A. Say, "You may not leave until you're given prophylactic treatment for sexually transmitted diseases."Â
- B. Provide written information about physical and emotional reactions the person may experience.
- C. Explain the need and importance of HIV and pregnancy tests.
- D. Give verbal information about legal resources.
Correct Answer: B
Rationale: The correct answer is B because providing written information about physical and emotional reactions respects the individual's autonomy and empowers them to make informed decisions. It also ensures they have resources to understand and cope with potential consequences. Choice A violates the individual's right to refuse treatment. Choice C focuses on specific tests without addressing the person's immediate concerns. Choice D, while important, is not as immediate or relevant as providing information on potential reactions.
A person diagnosed with serious mental illness has frequent relapses, usually precipitated by situational stressors such as running out of money or the absence of key staff at the mental health center. Which interventions would the nurse suggest to reduce the risk of stressors to cause relapse? Select one tha does not apply.
- A. Discourage potentially stressful activities such as groups or volunteer work
- B. Develop written plans that will help the patient remember what to do in a crisis
- C. Help the patient identify and anticipate events that are likely to be overwhelming
- D. Encourage health-promoting activities such as exercise and getting adequate rest
Correct Answer: A
Rationale: Basic interventions for coping with crises involve anticipating crises where possible and then developing a plan with specific actions to take when faced with an overwhelming stressor. Written plans are helpful; it can be difficult for anyone, especially a person with cognitive or memory impairments, to develop or remember steps to take when under overwhelming stress. Health-promoting activities enhance a persons ability to cope with stress. As the name suggests, support groups help a person develop a support system, and they provide practical guidance from peers who learned from experience how to deal with issues the patient may be facing. Groups and volunteer work may involve a measure of stress but also provide benefits that help persons cope and should not be discouraged unless they are being done to excess.