Which of the following is a common emotional response for patients with anorexia nervosa?
- A. Fear of gaining weight and loss of control over eating.
- B. Lack of concern about food intake and weight.
- C. Excessive joy and pride in achieving weight loss.
- D. Denial of the need for treatment and weight restoration.
Correct Answer: A
Rationale: The correct answer is A because fear of gaining weight and loss of control over eating are core features of anorexia nervosa. Patients with anorexia often have an intense fear of gaining weight, leading to restrictive eating behaviors. This fear is accompanied by a sense of loss of control over their eating habits.
Choice B is incorrect because lack of concern about food intake and weight is not a common emotional response in anorexia nervosa. Choice C is incorrect as excessive joy and pride in achieving weight loss are more characteristic of other eating disorders like bulimia nervosa or orthorexia. Choice D is incorrect because denial of the need for treatment and weight restoration may be present in some cases but is not a common emotional response in anorexia nervosa.
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When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?
- A. Evidence of spasticity or flaccidity
- B. The patient's level of motor activity
- C. Medications the patient has recently taken
- D. Level of preoccupation with somatic symptoms
Correct Answer: C
Rationale: The correct answer is C: Medications the patient has recently taken. This information is crucial because certain medications can cause delirium in elderly patients. By reviewing the patient's recent medications, healthcare providers can identify potential drug-induced delirium and adjust treatment accordingly. Spasticity or flaccidity (choice A) is more indicative of neurologic conditions, not delirium. The patient's level of motor activity (choice B) may provide some insight but is not as specific to delirium as medication history. The level of preoccupation with somatic symptoms (choice D) is more relevant to other psychiatric conditions and does not directly help in distinguishing delirium.
A 14-year-old female comes into clinic for a medical certificate once a week for multiple complaints of chest pain and abdominal pain. The complaints are non-specific, and her physical examination is normal. She is quiet with poor eye contact. She states the pain is worse on school days. Her mother is concerned that her daughter is being bullied but won't talk to her. Her mother is also worried that her complaints represent an undiagnosed medical condition. The next best step in management is:
- A. Referral to tertiary hospital to rule out organic cause
- B. HEADSS or other psychosocial screening
- C. Referral for counselling
- D. Reassurance that nothing is wrong
Correct Answer: B
Rationale: HEADSS screening assesses psychosocial factors (e.g., bullying, stress) that may underlie somatic complaints, making it the best next step before referral or reassurance.
In a sad voice, an elderly patient tells the nurse of the recent deaths of a spouse and close friend. The patient has no other family and only a few acquaintances in the community. The nurses priority is to determine whether which nursing diagnosis applies to this patient?
- A. Risk for suicide related to recent deaths of significant others
- B. Anxiety related to sudden and abrupt lifestyle changes
- C. Social isolation related to loss of existing family
- D. Spiritual distress related to anger with God
Correct Answer: A
Rationale: The patient appears to be experiencing normal grief related to the loss of her family, but because of age and social isolation, the risk for suicide should be determined and has high priority. No defining characteristics exist for the diagnoses of anxiety or spiritual distress. The patients social isolation is important, but the risk for suicide has higher priority.
What is the priority nursing intervention when caring for a patient with bulimia nervosa who has a history of purging?
- A. Provide emotional support and assist with stress management.
- B. Monitor vital signs and electrolyte levels closely.
- C. Encourage the patient to exercise regularly to prevent weight gain.
- D. Help the patient identify triggers for binge eating and purging behaviors.
Correct Answer: B
Rationale: The correct answer is B because monitoring vital signs and electrolyte levels closely is crucial in managing a patient with bulimia nervosa who has a history of purging. Purging can lead to electrolyte imbalances and dehydration, which can have serious consequences such as cardiac arrhythmias and electrolyte disturbances. By closely monitoring vital signs and electrolyte levels, nurses can quickly identify and intervene in case of any abnormalities, preventing potential life-threatening complications.
Choice A is incorrect because emotional support and stress management are important but not the priority when dealing with physical complications from purging. Choice C is incorrect because encouraging exercise may exacerbate the patient's unhealthy behaviors and should be approached cautiously. Choice D is incorrect because identifying triggers is important but not as immediate as monitoring vital signs and electrolyte levels in this situation.
A young patient diagnosed with schizophrenia is standing naked after showering and appears to be both dazed and indecisive. The nursing intervention that will be most helpful to promote dressing would be:
- A. saying, 'These are your clothes. Please get dressed.'
- B. saying, 'These are your underpants. I'll help you put them on.'
- C. asking, 'Which of these two outfits would you like to wear now?'
- D. asking, 'Is something the matter with your clothes that makes you not want to dress?'
Correct Answer: B
Rationale: The correct answer is B. By saying, "These are your underpants. I'll help you put them on," the nurse provides clear guidance and offers assistance, which can help the patient feel more comfortable and supported in the dressing process. This approach acknowledges the patient's need for help while respecting their autonomy.
Choice A is too directive and may make the patient feel pressured or overwhelmed. Choice C involves too many options, which can be confusing for a patient experiencing indecisiveness. Choice D assumes a problem with the clothes rather than focusing on the patient's needs and feelings. Overall, choice B is the most appropriate and supportive intervention in this situation.