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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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The nursing approach that will minimize power struggles between the client with an eating disorder and the nurse is best characterized as:
- A. authoritarian and autocratic.
- B. laid-back and flexible.
- C. rigid and unyielding.
- D. compassionate and firm.
Correct Answer: D
Rationale: The correct answer is D: compassionate and firm. This approach balances empathy and boundaries, fostering trust and cooperation while maintaining structure. Compassion helps build rapport and understanding, essential for addressing the underlying issues of the eating disorder. Firmness sets clear limits and expectations, promoting accountability and progress. Authoritarian and autocratic (A) can create resistance and hinder therapeutic alliance. Laid-back and flexible (B) may enable unhealthy behaviors. Rigid and unyielding (C) can lead to power struggles and hinder therapeutic progress.
The persistent eating of nonfood items such as clay, laundry starch, insects, leaves, or pebbles that lasts for longer than 1 month is called:
- A. pica.
- B. bulimia.
- C. rumination.
- D. regurgitation.
Correct Answer: A
Rationale: Sure! The correct answer is A: pica. Pica is the persistent consumption of nonfood items lasting longer than 1 month. This condition is characterized by cravings for non-nutritive, nonfood substances. Bulimia (B) is a different eating disorder involving binge eating followed by purging behaviors. Rumination (C) is the repeated regurgitation and rechewing of food. Regurgitation (D) is the act of bringing swallowed food back to the mouth without nausea or retching.
A nurse is caring for a patient who has a maladaptive response to eating regulation. The patient tells the nurse, 'I know my parents are already upset, but I need to lose another 10 pounds to be at an ideal weight.' This statement suggests that the best treatment setting for this patient would be:
- A. the hospital.
- B. an outpatient program.
- C. a day treatment program.
- D. at home with weekly nursing visits.
Correct Answer: A
Rationale: The correct answer is A: the hospital. This patient's maladaptive eating behavior and desire to lose more weight despite concerns from family indicate a serious condition requiring intensive care and monitoring. In the hospital, the patient can receive immediate medical attention, nutritional support, and psychological intervention to address underlying issues. Outpatient programs (B) may not offer sufficient supervision, while day treatment programs (C) may not provide round-the-clock care. Home with weekly nursing visits (D) is not appropriate for a patient with such severe eating regulation issues.
Inappropriate, life-threatening or challenging behaviours may be inadvertently maintained by reinforcement from others in the environment. Which of the following is a process that can be carried out in order to help identify the factors maintaining the behaviour?
- A. Functional analysis
- B. Statistical analysis
- C. Behavioural analysis
- D. Procedural analysis
Correct Answer: A
Rationale: Functional Analysis: Using operant conditioning principles to identify rewarding or reinforcing factors maintaining behavior.
A Hispanic woman comes to the mental health center at the urging of her adult children. The patient has lost 5 pounds since her husband's death 6 months ago and says, "My husband comes to visit me in the night but I cannot understand what he says." How should the nurse analyze this situation? The patient is:
- A. Experiencing auditory and visual hallucinations.
- B. At high risk for imbalanced nutrition.
- C. Grieving the husband's death.
- D. Denying the husband's death.
Correct Answer: C
Rationale: The correct answer is C: Grieving the husband's death. The patient's statement about her deceased husband visiting her in the night and her weight loss following his death indicate a strong possibility of experiencing grief. This is a common manifestation of bereavement, where individuals may have difficulty accepting the reality of the loss and experience hallucinations or illusions involving the deceased. The patient's symptoms are more aligned with the normal process of grieving rather than psychosis. Choices A and B are incorrect because the patient's experiences are likely related to grief rather than auditory and visual hallucinations or imbalanced nutrition. Choice D is incorrect as the patient's statements suggest she is aware of her husband's death but is struggling to cope with it emotionally.