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Which is a major difference in the clinical manifestation of adolescents with anorexia nervosa compared to bulimia?
- A. Binge eating
- B. Purging
- C. Body image distortion
- D. Decreased self esteem
Correct Answer: C
Rationale: The major difference between adolescents with anorexia nervosa and those with bulimia is body image distortion. Clients with anorexia see themselves as being overweight no matter how underweight they become. Clients with bulimia see their weight realistically but have psychological problems that manifest in an eating disorder. Both disorders may involve binge eating and purging, but body image perception is a distinguishing factor.
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Which of the following physical manifestations of a client with anorexia nervosa best indicates compliance with the treatment plan of care?
- A. "A weekly weight gain of 1 kg (2.2 lb)"'
- B. "Daily bowel movements that are soft"'
- C. "Return of regular menstrual periods"'
- D. "Improvement of the oral mucosa"'
Correct Answer: A
Rationale: The correct answer is A: "A weekly weight gain of 1 kg (2.2 lb)". In anorexia nervosa, weight restoration is a key goal of treatment to address malnutrition and restore physiological functioning. A weekly weight gain of 1 kg indicates the client is consuming adequate nutrition and their body is responding appropriately to treatment. This physical manifestation suggests the client is compliant with the treatment plan.
Choice B, daily bowel movements that are soft, is not necessarily a direct indicator of compliance with the treatment plan for anorexia nervosa. While bowel movements can be influenced by dietary changes, they are not as specific or reliable as weight gain in assessing treatment compliance.
Choice C, return of regular menstrual periods, is a potential physical manifestation of improved health in anorexia nervosa, but it may not be the best indicator of compliance with the treatment plan, as it can be influenced by various factors.
Choice D, improvement of the oral mucosa, is important for
A nurse is caring for a client and her partner who have experienced a fetal death. Which of the following actions should the nurse take?
- A. Take photos of the newborn to give to the parents.
- B. Tell the parents that they can consider organ donations.
- C. Encourage the parents to avoid allowing older children to visit them in the hospital.
- D. Explain to the parents the need to name the newborn.
Correct Answer: A
Rationale: The correct answer is A because taking photos of the newborn allows the parents to create lasting memories and helps in the grieving process. It also validates the existence of the baby as a member of the family. Choice B may be insensitive as it might be too soon to discuss organ donation. Choice C may isolate the parents from their support system. Choice D may pressure the parents at a difficult time.
A nurse is caring for a client who is in active labor and has had no cervical change in the last 4 hr. Which of the following statements should the nurse make?
- A. Let me help you into a comfortable pushing position so you can begin bearing down.
- B. I am going to call the doctor to get a prescription for medication to ripen your cervix.
- C. I will give you some IV pain medicine to strengthen your contractions.
- D. Your provider will insert an intrauterine pressure catheter to monitor the strength of your contractions.
Correct Answer: D
Rationale: The correct answer is D. The nurse should inform the client about the provider inserting an intrauterine pressure catheter to monitor contraction strength. This is appropriate because lack of cervical change in active labor could indicate inadequate contractions. Monitoring contraction strength with an intrauterine pressure catheter can help determine if the contractions are effective in progressing labor. It allows for more accurate assessment and timely interventions if needed.
Choice A is incorrect because pushing without adequate cervical dilation can lead to complications. Choice B is incorrect as medication to ripen the cervix is not indicated in this scenario. Choice C is incorrect as IV pain medicine does not address the issue of inadequate cervical change.
In a child diagnosed with Tetralogy of Fallot, which of the following is a compensatory mechanism to decrease venous return to the heart?
- A. Squatting
- B. Clubbing
- C. Shortness of breath
- D. Polycythemia
Correct Answer: A
Rationale: Squatting is a compensatory mechanism that decreases venous return (deoxygenated blood) to the heart. This clinical sign is commonly seen in young children with Tetralogy of Fallot, a type of cyanotic heart disease. Squatting helps reduce the workload on the heart by decreasing the amount of deoxygenated blood returning to it.
A nurse is caring for a child with muscular dystrophy. Which of the following priority actions should the nurse include in the care of this child?
- A. Limit physical activity and plan frequent rest periods to avoid overexertion and exhaustion of muscle groups.
- B. Recommend genetic counseling for parents,male siblings and paternal uncles and their male offspring.
- C. Advise against flu and pneumococcal vaccines due to a compromised respiratory system.
- D. Have the child use an incentive spirometer and perform breathing exercises routinely.
Correct Answer: D
Rationale: The correct answer is D: Have the child use an incentive spirometer and perform breathing exercises routinely. This is the priority action because children with muscular dystrophy are at risk for respiratory complications due to weakened respiratory muscles. Using an incentive spirometer and performing breathing exercises help maintain lung function and prevent respiratory infections.
A: Limiting physical activity and planning rest periods is important, but respiratory care takes precedence in muscular dystrophy.
B: Genetic counseling is important for family planning but does not directly impact the child's care.
C: Advising against vaccines can increase the risk of infections in a child with compromised respiratory function.
E, F, G: No information provided.