Which is a hallmark characteristic of bulimia nervosa?
- A. Persistent restriction of caloric intake.
- B. Binge eating followed by purging behaviors.
- C. Severe weight loss due to food refusal.
- D. Excessive exercising to burn calories.
Correct Answer: B
Rationale: The correct answer is B because bulimia nervosa is characterized by recurrent episodes of binge eating followed by compensatory behaviors such as purging. Binge eating involves consuming a large amount of food in a short period, followed by feelings of loss of control. Purging behaviors like self-induced vomiting or misuse of laxatives are used to prevent weight gain. Choices A, C, and D are incorrect because bulimia nervosa typically involves normal or fluctuating weight, not severe weight loss or excessive exercise to burn calories. Persistent restriction of caloric intake is more indicative of anorexia nervosa, not bulimia nervosa.
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In an art therapy session, a client with anorexia nervosa was asked to draw a picture of herself. Which drawing would likely depict the client's view of herself?
- A. A tall, slim girl with obvious muscle definition.
- B. A malnourished teenager with thin, lanky extremities.
- C. A grossly obese figure lacking feminine characteristics.
- D. A shapely figure of a model who she admires.
Correct Answer: C
Rationale: The correct answer is C because individuals with anorexia nervosa often have a distorted body image and see themselves as larger than they actually are. Drawing a grossly obese figure lacking feminine characteristics reflects the distorted self-perception common in anorexia nervosa. Choice A is incorrect as it portrays a positive body image. Choice B may be close, but it focuses more on malnourishment rather than distorted body image. Choice D is incorrect as it reflects admiration for a shapely figure, which may not align with the client's self-perception.
When the family of a client who has been diagnosed with a dementia secondary to normal pressure hydrocephalus asks the nurse about prognosis, the nurse should reply:
- A. Unfortunately the prognosis is for a downhill course ending in death.'
- B. There will be good days and bad days for the rest of the client's life.'
- C. The symptoms usually remit after a shunt is inserted to drain fluid.'
- D. We'll try our very best, but only time will tell how successful we are.'
Correct Answer: C
Rationale: The correct answer is C because normal pressure hydrocephalus (NPH) symptoms typically improve after a shunt is inserted to drain the excess cerebrospinal fluid, leading to a better prognosis. This intervention can help alleviate symptoms such as gait disturbances, cognitive impairment, and urinary incontinence associated with NPH.
Choice A is incorrect as it inaccurately states that the prognosis is inevitably poor, which is not true for NPH with appropriate treatment. Choice B is incorrect because NPH symptoms can be effectively managed with treatment, so it is not accurate to say that there will always be good and bad days for the rest of the client's life. Choice D is incorrect as it does not provide specific information about the positive impact of shunt insertion on NPH symptoms and prognosis.
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
- A. medication nonadherence.
- B. a need for psychoeducation.
- C. the chronic nature of his illness.
- D. relapse of his schizophrenia.
Correct Answer: D
Rationale: The correct answer is D: relapse of his schizophrenia. The patient's symptoms of feeling tense, difficulty concentrating, poor sleep, and delusional beliefs about creatures at work indicate a worsening of his psychotic symptoms. This suggests a relapse of schizophrenia, a chronic mental illness characterized by periods of stability and exacerbation of symptoms. The patient's previous stability for a year makes medication nonadherence less likely. While psychoeducation may be beneficial, the patient's current symptoms require more immediate intervention for relapse management. The information provided does not directly indicate the chronic nature of his illness, but rather an acute exacerbation. Therefore, D is the most appropriate choice based on the presented symptoms and clinical understanding of schizophrenia.
A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?
- A. Hippocampus
- B. Frontal lobe
- C. Cerebellum
- D. Brainstem
Correct Answer: B
Rationale: The correct answer is B: Frontal lobe. Disorganized thinking in schizophrenia is often associated with executive function deficits, which are primarily controlled by the frontal lobe. This area is responsible for decision-making, problem-solving, and reasoning. Dysfunction here can lead to disorganized thoughts and behaviors. The other choices, such as the hippocampus (A), involved in memory, the cerebellum (C), involved in motor coordination, and the brainstem (D), involved in basic life functions, are less likely to be directly related to disorganized thinking in schizophrenia.
The mother of a teenager diagnosed with an eating disorder asks, 'How long will my daughter have this problem?' The nurse answers with the knowledge that:
- A. recovery is usual after one severe episode.
- B. less than 30% show improvement after 5 years.
- C. weight restoration is sufficient for recovery.
- D. long-term therapy combined with medication results in the best outcomes.
Correct Answer: D
Rationale: The correct answer is D because long-term therapy combined with medication results in the best outcomes for individuals with eating disorders. Therapy helps address underlying psychological issues, while medication can help manage symptoms. Recovery is a complex process that often requires ongoing support. Choice A is incorrect as recovery is not always guaranteed after one severe episode. Choice B is incorrect as many individuals do show improvement over time. Choice C is incorrect as weight restoration alone may not address all aspects of the disorder.