Nokea
Which of the following interventions is most appropriate for a patient with bulimia nervosa?
- A. Encourage regular weight monitoring and restriction of food intake.
- B. Offer emotional support and focus on healthy coping mechanisms.
- C. Provide medications to induce vomiting after meals.
- D. Focus on achieving weight loss and reducing food intake.
Correct Answer: B
Rationale: The correct answer is B because offering emotional support and focusing on healthy coping mechanisms are crucial in treating bulimia nervosa. This approach addresses the psychological aspects of the disorder and helps the patient develop healthier behaviors. Regular weight monitoring and food restriction (choice A) can exacerbate the disorder by reinforcing a focus on weight and food. Medications to induce vomiting (choice C) can be harmful and do not address the underlying issues. Focusing on weight loss and reducing food intake (choice D) may worsen the patient's disordered eating behaviors and contribute to a cycle of restriction and bingeing.
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A client is admitted to a day hospital following an episode in which he purchased a gun to use while standing guard over his property to prevent a neighbor from erecting a boundary fence. His wife describes him as distrustful of the motives of others and often interpreting others' motives as threats. She mentions that one time he accused her of having an affair with a neighbor with whom she chatted occasionally. The care plan will list the priority outcome as 'Client will:
- A. admit his action was excessive based on the circumstance.
- B. write the neighbor a letter of apology.
- C. demonstrate trust in the nurse.
- D. identify positive role models.'
Correct Answer: C
Rationale: The correct answer is C: demonstrate trust in the nurse. This is the priority outcome because the client's lack of trust and tendency to perceive threats need to be addressed first. By demonstrating trust in the nurse, the client can begin to develop a therapeutic relationship, which is essential for addressing his distrustful behavior and interpreting threats. This outcome focuses on building rapport and establishing a foundation for therapeutic interventions.
Choice A is incorrect because admitting his action was excessive may not address the underlying issues of distrust and misinterpretation of motives. Choice B is incorrect as it does not address the client's core issues and may not be appropriate in this context. Choice D is also incorrect as identifying positive role models is not a priority when the client's trust and perception issues need immediate attention.
Which of the following is the main neurological birth syndrome caused by anoxia?
- A. Down Syndrome
- B. Fragile X syndrome
- C. Cerebral palsy
- D. Cerebral Vascular accident
Correct Answer: C
Rationale: Cerebral Palsy: The main neurological birth syndrome caused by anoxia, characterized by motor symptoms affecting strength and coordination.
A 34-year-old male admitted with catatonic schizophrenia has been mute and motionless for several days while at home prior to admission. He still appears stuporous in the hospital. Which nursing intervention would be an initial priority?
- A. Orienting the client to the unit
- B. Assessing the client for physical problems
- C. Establishing a nonthreatening relationship
- D. Reinforcing reality with the client
Correct Answer: B
Rationale: The correct answer is B: Assessing the client for physical problems. This is the initial priority because the client's muteness and motionless state could be due to an underlying physical issue that needs immediate attention, such as dehydration, malnutrition, or infection. By assessing for physical problems first, the nurse can rule out any urgent medical concerns before addressing the client's mental health needs.
A: Orienting the client to the unit - While important, this can be done after addressing any physical problems.
C: Establishing a nonthreatening relationship - Also essential, but assessing physical health takes precedence.
D: Reinforcing reality with the client - Not the immediate priority; physical assessment should come first.
A rape victim tells the nurse, "I should not have been out on the street alone."Â Select the nurse's most helpful response.
- A. Rape can happen anywhere.
- B. Blaming yourself increases your anxiety and discomfort.
- C. You are right. You should not have been alone on the street at night.
- D. You feel as though this would not have happened if you had not been alone.
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the victim's feelings without placing blame or judgment. By reflecting the victim's feelings back to them, the nurse validates their experience and shows empathy. This response encourages the victim to express their emotions and helps in building trust with the nurse.
Other choices are incorrect:
A: This choice does not address the victim's feelings of self-blame and does not provide the needed support.
B: While this choice acknowledges the negative impact of self-blame, it does not directly address the victim's statement.
C: This choice may be perceived as dismissive or blaming, which can further harm the victim's emotional well-being.
The psychiatric-mental health nurse knows that the patient's spouse clearly understands the adverse effects of lithium carbonate (Eskalith), when they say:
- A. I should call the doctor if my spouse shakes badly'
- B. I should make sure my spouse drinks as much water as possible'
- C. My spouse must remain on a salt-free diet'
- D. When the lithium level is 1.6mEq\L, my spouse can go back to work'
Correct Answer: A
Rationale: Tremors are a common lithium side effect requiring medical attention; other options reflect misunderstanding (e.g., salt-free diet increases toxicity risk, 1.6mEq\L is toxic).