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Which of the following is a critical aspect of nursing care for patients with anorexia nervosa?
- A. Encouraging weight loss to avoid complications from obesity.
- B. Promoting normalization of eating habits and nutritional rehabilitation.
- C. Restricting fluid intake to reduce risk of water retention.
- D. Avoiding any pressure for the patient to gain weight rapidly.
Correct Answer: B
Rationale: The correct answer is B: Promoting normalization of eating habits and nutritional rehabilitation. This is critical in anorexia nervosa treatment to address malnutrition and restore a healthy relationship with food. Encouraging weight loss (A) is inappropriate as these patients are already underweight. Restricting fluid intake (C) can worsen dehydration and electrolyte imbalances. Avoiding pressure for rapid weight gain (D) is important, but the primary focus should be on promoting healthy eating habits and gradual weight restoration. By focusing on normalization of eating habits and nutritional rehabilitation, nurses can help patients with anorexia nervosa recover physically and mentally.
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A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales. Today, he argued with several office mates and threatened to kill one of them. The police were called, and he was brought to the mental health center for evaluation. He has had previous admissions to the unit for stabilization of paranoid schizophrenia. When the nurse meets him, he points at staff in the nursing station and states loudly, 'They're all plotting to destroy me. Isn't that true?' Which would be the most appropriate response?
- A. No, that is not true. People here are trying to help you if you will let them.'
- B. Let's think about it: what reason would people have to want to destroy you?'
- C. Thinking that people want to destroy you must be very frightening.'
- D. That doesn't make sense; staff are health care workers, not murderers.'
Correct Answer: C
Rationale: The correct answer is C because it demonstrates empathy and validates the patient's feelings without agreeing with the delusion. By acknowledging the patient's fear, the nurse can establish trust and rapport, which are crucial in therapeutic communication. This response shows understanding and compassion, helping to de-escalate the situation and provide a supportive environment for the patient.
Choice A is incorrect as it denies the patient's belief and may lead to increased agitation. Choice B is incorrect as it challenges the patient's delusion, which can worsen the situation and lead to further confrontation. Choice D is incorrect as it dismisses the patient's feelings and may cause the patient to become defensive or feel misunderstood.
A nurse and social worker co-lead a reminiscence group for eight young-old adults. Which activity is most appropriate to include in the group?
- A. Mild aerobic exercise
- B. Singing a song from World War II
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in today's newspaper
Correct Answer: C
Rationale: The correct answer is C. Discussing national leadership during the Vietnam War is most appropriate as it aligns with the reminiscence therapy goal of recalling past experiences to promote social interaction and cognitive stimulation. It is relevant to the age group of young-old adults who may have lived through that era, sparking meaningful discussions. Choice A does not directly relate to reminiscence therapy. Choice B may not resonate with all group members. Choice D focuses on negative news, which is not conducive to the therapeutic purpose.
Marie is 16 years old. She has been referred to the clinic by the nurse at her school because she started a fight with a younger girl and hurt her badly. The school nurse reports that Marie has been troublesome beforeskipping school, bullying, and smoking on school grounds on several occasions. Of the following, which diagnosis is most likely?
- A. Bipolar depression
- B. Paranoid schizophrenia
- C. Conduct disorder
- D. Dysthymic disorder
Correct Answer: C
Rationale: Conduct disorder is characterized by a pattern of aggressive behavior and violating the rights of others, including defiance and rule breaking. The other responses are psychiatric disorders that would not be the most likely diagnosis given Maries behavior.
The nurse is interviewing a client who presents with a dislocated shoulder. She demonstrates signs of anxiety and poor eye contact and turns to her partner for answers, allowing him to answer for her. Bruises on her breast and upper arm are visible. The nurse asks the partner to go to the admitting office to give insurance information. While the partner is out of the room, which question is most important to ask?
- A. Have you been with your partner long?'
- B. Have you ever been physically or emotionally hurt by someone?'
- C. Are you an abused woman?'
- D. Shall I notify the police that you would like to press charges?'
Correct Answer: B
Rationale: The correct answer is B: "Have you ever been physically or emotionally hurt by someone?" This question is important as it directly addresses the potential abuse the client may be experiencing. It allows the nurse to assess for any history of abuse, which could be contributing to the client's anxiety and behavior. It also opens up an opportunity for the client to disclose any abuse they may be facing.
Choice A is incorrect because the length of the relationship with the partner is not as crucial as addressing the potential abuse. Choice C is also incorrect because it is too direct and may not encourage the client to open up about their experiences. Choice D is incorrect as it assumes the client wants to press charges without first assessing the situation and the client's wishes.
Which of the following is characteristic of a dissociative disorder?
- A. phobic disorder
- B. amnesia
- C. paranoia
- D. depression
Correct Answer: B
Rationale: Dissociative disorders feature disruptions like amnesia, distinguishing them from phobias or paranoia.