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 14-year-old client on the eating disorders unit refuses to eat her meals and says to the nurse on the unit, 'You can't make me eat! There is nothing wrong with me.' The nurse will assess this as use of which defense mechanism?
- A. Repression.
- B. Rationalization.
- C. Sublimation.
- D. Denial.
Correct Answer: D
Rationale: The correct answer is D: Denial. Denial is a defense mechanism where an individual refuses to acknowledge reality to avoid discomfort. In this scenario, the client is denying the seriousness of their situation by refusing to eat and claiming there is nothing wrong. Repression (A) involves unconsciously blocking out unpleasant thoughts or feelings. Rationalization (B) is creating logical explanations to justify behavior. Sublimation (C) is redirecting negative impulses into positive behaviors. In this case, denial is the most fitting defense mechanism as the client is refusing to accept the reality of their eating disorder.
According to statistical research data, which of these children currently being followed by the pediatric nurse practitioner is at the greatest risk for fatal abuse?
- A. A child who is 2 years old and has cerebral palsy
- B. A child who is 5 years old and has measles
- C. A child who is 8 years old and has appendicitis
- D. A child who is 11 years old and has a fractured humerus
Correct Answer: A
Rationale: The correct answer is A because young children with disabilities, like cerebral palsy, are at the highest risk for fatal abuse based on statistical research. These children may be more vulnerable due to their dependency on caregivers and communication challenges. Choice B is incorrect as measles, although serious, is not associated with fatal abuse. Choice C is incorrect as appendicitis is a medical condition and not a risk factor for abuse. Choice D is incorrect as a fractured humerus, while concerning, does not indicate a higher risk for fatal abuse compared to a child with cerebral palsy.
Which disorder is associated with persons with a body weight that is normal or even slightly above average?
- A. Pica.
- B. Bulimia.
- C. Obesity.
- D. Anorexia nervosa.
Correct Answer: B
Rationale: The correct answer is B: Bulimia. Individuals with bulimia nervosa typically have a normal or slightly above average body weight due to the cycle of binge eating and purging behaviors. This is because they consume large amounts of food during binges but then engage in compensatory behaviors such as vomiting or excessive exercise to prevent weight gain. In contrast, choices A (Pica) and D (Anorexia nervosa) are associated with low body weight. Choice C (Obesity) is characterized by excess body weight. Bulimia is the only disorder in the list where individuals can have a normal or slightly above average body weight due to the nature of their eating behaviors.
Serious mental illness is characterized as:
- A. any mental illness of more than 2 weeks duration
- B. a major long-term mental illness marked by significant functional impairments
- C. a mental illness accompanied by physical impairment and severe social problems
- D. a major mental illness that cannot be treated to prevent deterioration of cognitive and social abilities
Correct Answer: B
Rationale: Serious mental illness has replaced the term chronic mental illness. Global impairments in function are evident particularly social. Physical impairments may be present. Serious mental illness can be treated, but remissions and exacerbations are part of the course of the illness.
After being raped, a woman was told by her aunt, 'I'm not surprised that happened to you. You were asking for it.' A few days later, a friend told her, 'Well after all, he took you to dinner. He expected something in return.' The victim states, 'I can't believe that people can think that way.' The rape crisis nurse correctly hypothesizes that the client is:
- A. Experiencing cognitive dissonance.
- B. In denial about the rape.
- C. Seeking validation from others.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Experiencing cognitive dissonance. Cognitive dissonance refers to the mental discomfort or conflict that occurs when a person's beliefs or attitudes are inconsistent with their actions or experiences. In this scenario, the woman is facing conflicting beliefs - she knows she did not ask for or deserve to be raped, yet the comments from her aunt and friend suggest otherwise. This leads to the woman feeling disbelief and distress.
Summary:
B: In denial about the rape - This choice does not address the conflicting beliefs the woman is experiencing.
C: Seeking validation from others - While seeking validation may be a natural response, it does not capture the essence of cognitive dissonance in this context.