Nokea
Which is a common physical finding in patients with bulimia nervosa?
- A. Low blood pressure and bradycardia.
- B. Hyperactivity and increased energy.
- C. Dental enamel erosion and swollen parotid glands.
- D. Constipation and abdominal bloating.
Correct Answer: C
Rationale: The correct answer is C, dental enamel erosion and swollen parotid glands, in patients with bulimia nervosa. This is due to frequent self-induced vomiting. Enamel erosion is caused by stomach acid exposure during vomiting. Swollen parotid glands result from repeated purging. Choices A, B, and D are incorrect because low blood pressure and bradycardia are more common in anorexia nervosa, hyperactivity and increased energy are not typical in bulimia nervosa, and constipation and abdominal bloating are not specific to this disorder.
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When undertaking care for a patient with an eating disorder, a nurse should first:
- A. perform a complete patient assessment.
- B. obtain a history from the patient's family.
- C. examine his or her own feelings about weight.
- D. question the patient as to when he or she last ate a meal.
Correct Answer: C
Rationale: The correct answer is C because examining the nurse's own feelings about weight is essential to ensure they have a neutral and non-judgmental attitude towards the patient. This self-awareness helps the nurse avoid projecting biases onto the patient and fosters a therapeutic relationship. Performing a complete patient assessment (A) is important but not the first step. Obtaining a history from the patient's family (B) may be helpful but is not the initial priority. Questioning the patient about their last meal (D) is important but does not address the nurse's own attitudes and biases that could impact care.
A woman, abducted and raped at gunpoint by an unknown assailant, was found confused and disoriented. The nurse makes these observations about the patient: talking rapidly in disjointed phrases, unable to concentrate, indecisive when asked to make simple decisions. What is the patient's level of anxiety?
- A. Weak
- B. Mild
- C. Moderate
- D. Severe
Correct Answer: D
Rationale: The correct answer is D: Severe. The patient's symptoms of talking rapidly, inability to concentrate, and indecisiveness are indicative of severe anxiety. Rapid speech and disjointed phrases suggest heightened arousal, while the inability to concentrate and make decisions point to severe impairment in cognitive functioning. These symptoms align with the DSM-5 criteria for severe anxiety, which includes extreme levels of distress and impairment in daily functioning. Weak (A), mild (B), and moderate (C) levels of anxiety would not typically manifest in such severe cognitive and behavioral symptoms.
A client on an antipsychotic medication develops a high fever, unstable blood pressure, and muscle rigidity. Her next dose of medication is due. The nurse should:
- A. Administer the medication and take the vital signs again
- B. Give a lower dose of the medication and take the blood pressure
- C. Prepare to give the pm anticholinergic, benztropine (Cogentin)
- D. Hold the medication and call the client's doctor immediately
Correct Answer: D
Rationale: The correct answer is D: Hold the medication and call the client's doctor immediately. This is the correct course of action because the client is exhibiting signs of neuroleptic malignant syndrome (NMS), a potentially life-threatening side effect of antipsychotic medications. Holding the medication is essential to prevent further complications. Calling the doctor is necessary to inform them of the situation and seek further instructions. Administering the medication (choice A) would exacerbate the symptoms, giving a lower dose (choice B) is not sufficient in this emergency situation, and administering an anticholinergic (choice C) is not the appropriate response for NMS.
A supervisor observes inconsistency in the psychiatric-mental health nurse's behavior toward a patient; the nurse is unreasonably concerned, overly kind, or irrationally hostile. The most appropriate explanation is that the nurse is displaying:
- A. countertransference
- B. empathic resonance
- C. splitting behavior
- D. transference
Correct Answer: A
Rationale: Countertransference involves the nurse's emotional reactions to the patient based on personal unconscious feelings, leading to inconsistent behavior.
Which therapy is shown through evidence to be the most effective for a patient with an eating disorder?
- A. Supportive therapy.
- B. Behavioral therapy.
- C. Cognitive behavioral therapy.
- D. Psychoanalytical group therapy.
Correct Answer: C
Rationale: The correct answer is C: Cognitive behavioral therapy (CBT). CBT is the most effective therapy for eating disorders based on research evidence. It helps patients identify and change negative thoughts and behaviors related to food and body image. CBT also teaches coping skills and strategies to manage triggers. Supportive therapy (choice A) offers emotional support but may not target the underlying issues. Behavioral therapy (choice B) focuses on changing specific behaviors but may not address cognitive patterns. Psychoanalytical group therapy (choice D) delves into past experiences but is not as effective as CBT in treating eating disorders.