Nokea
Which is the most appropriate response when a patient with bulimia nervosa expresses feelings of shame about their purging behaviors?
- A. Encourage the patient to avoid discussing their eating habits.
- B. Agree with the patient's feelings and offer reassurance.
- C. Focus on helping the patient identify triggers for purging behaviors.
- D. Provide education on the benefits of purging for weight management.
Correct Answer: C
Rationale: The correct answer is C because focusing on helping the patient identify triggers for purging behaviors is essential in addressing the underlying issues contributing to their behavior. By identifying triggers, the patient can develop coping strategies and alternative behaviors.
Choice A is incorrect as avoiding discussing eating habits can hinder progress in therapy. Choice B is incorrect as simply agreeing and offering reassurance without addressing the root cause may not lead to lasting change. Choice D is incorrect as it promotes the harmful behavior of purging for weight management, which goes against the goal of treating bulimia nervosa.
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A victim of physical abuse by her domestic partner is being treated for a broken humerus. Which indicator for the outcome of Abuse protection is most important to achieve before the patient leaves the emergency department?
- A. The patient has completed and reviewed a workable safety plan.
- B. She agrees to seek a restraining order limiting contact by the perpetrator.
- C. The patient demonstrates insight into the abusive nature of the relationship.
- D. She has been referred to counseling and battered-person support groups.
Correct Answer: A
Rationale: The correct answer is A because a safety plan is crucial for the victim's immediate safety and future protection. It helps the victim know what to do in case of danger, ensuring a proactive approach to safety. Choice B may not always be feasible or effective in preventing further abuse. Choice C, while important, does not guarantee safety outside the emergency department. Choice D is beneficial but does not address the immediate safety concerns as effectively as having a safety plan in place. Thus, completing and reviewing a workable safety plan is the most important indicator for the outcome of abuse protection in this scenario.
A 28-year-old female client was admitted 3 days ago after she ran nude through the streets, shouting that she was the 'Queen of Hearts.' The client has remained delusional since admission. An initial expected outcome would be that the client will:
- A. Allow the nurse to logically dispute the delusion
- B. Distinguish external boundaries
- C. Engage in reality-oriented conversation
- D. Explain why she thinks she is the 'Queen of Hearts'
Correct Answer: C
Rationale: The correct answer is C: Engage in reality-oriented conversation. This is the most appropriate initial expected outcome because it focuses on helping the client ground herself in reality. Engaging in reality-oriented conversation can help the client understand and acknowledge her delusions, leading to potential insight and eventual treatment.
A: Allowing the nurse to logically dispute the delusion may not be effective initially as the client may not be receptive to this approach during the acute phase of her delusion.
B: Distinguishing external boundaries may not address the underlying delusional beliefs and may not be the most immediate concern.
D: Explaining why she thinks she is the 'Queen of Hearts' may reinforce the delusion rather than challenging it.
A client with catatonic schizophrenia has been posturing, standing with his left arm upraised and his right foot off the floor. For the most part, he ignores attempts at nursing intervention but will occasionally walk, sit, or lie down for a few minutes. The client eats standing up if the nurse brings a tray to the room. The priority nursing order would be to:
- A. Insist that client sit or lie down for 30 minutes hourly
- B. Assess for lower extremity edema bid
- C. Provide high-calorie drinks hourly
- D. Take client to activities therapy once daily
Correct Answer: B
Rationale: The correct answer is B: Assess for lower extremity edema bid. It is important to assess for lower extremity edema in this client with catatonic schizophrenia as posturing in a standing position for prolonged periods can lead to decreased circulation and potential development of edema. This assessment is crucial to monitor the client's physical health and prevent complications such as deep vein thrombosis.
Choice A is incorrect as insisting the client sit or lie down for 30 minutes hourly may not address the underlying issue of potential lower extremity edema and could potentially worsen the client's condition by causing distress.
Choice C is incorrect as providing high-calorie drinks hourly does not address the immediate physical health concern of lower extremity edema and may not be appropriate without a comprehensive assessment of the client's nutritional needs.
Choice D is incorrect as taking the client to activities therapy once daily does not address the immediate need for assessing lower extremity edema and may not be suitable if the client's physical health
A student transfers from a hometown college to a university 200 miles away after breaking up with her boyfriend of 2 years. She was slow to make friends at the university. The history shows a close relationship with her mother and sister. She began eating large quantities when she felt sad, and then she induced vomiting. When the student's schoolwork declined, she sought help from the university health clinic. During the initial interview, what priority issue should the nurse address?
- A. Losses
- B. Sleep patterns
- C. School activities
- D. Menstrual flow
Correct Answer: A
Rationale: The correct answer is A: Losses. The priority issue the nurse should address is the student's recent breakup and difficulty making friends, which are significant losses impacting her emotional well-being. By addressing these losses, the nurse can help the student process her emotions and develop coping strategies.
B: Sleep patterns may be affected by the student's emotional distress, but it is a secondary concern compared to addressing the underlying losses.
C: School activities are important, but the root cause of the student's decline in schoolwork is likely related to her emotional state following the breakup.
D: Menstrual flow is not the priority issue at this time as it is not directly related to the student's emotional struggles and academic decline.
The mother of a teen with an eating disorder tells the nurse, 'Our family is pretty well-adjusted. It's hard for me to imagine what we could have done to have this happen.' The nurse can promote more complete understanding of the etiology of eating disorders by mentioning that young women are also influenced by:
- A. The abundance of nutritious foods available.
- B. The fashion industry's idealization of thinness.
- C. Competition in the workplace.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: The fashion industry's idealization of thinness. This is correct because the portrayal of ultra-thin models in the fashion industry can contribute to societal pressure on young women to achieve an unrealistic body image, leading to body dissatisfaction and potentially eating disorders. The other choices are incorrect because option A does not address the societal influences on body image ideals, option C is not directly related to the etiology of eating disorders in young women, and option D is incorrect as the fashion industry can indeed play a significant role in shaping perceptions of beauty and body image.