Nokea
Which of the following is a potential complication of untreated bulimia nervosa?
- A. Severe dehydration and electrolyte imbalances.
- B. Rapid weight gain and fluid retention.
- C. Chronic constipation and digestive issues.
- D. Severe malnutrition and organ failure.
Correct Answer: A
Rationale: The correct answer is A: Severe dehydration and electrolyte imbalances. Untreated bulimia nervosa involves recurrent episodes of binge-eating followed by compensatory behaviors like purging. Purging can lead to fluid loss and electrolyte imbalances, causing dehydration. This can result in serious health complications such as cardiac arrhythmias and kidney damage. Rapid weight gain and fluid retention (B) are more associated with binge-eating disorder, not bulimia nervosa. Chronic constipation and digestive issues (C) are more commonly seen in anorexia nervosa. Severe malnutrition and organ failure (D) are potential complications of anorexia nervosa rather than bulimia nervosa.
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When a patient with anorexia nervosa expresses a fear of weight gain, the nurse should respond by:
- A. Minimizing the patient's concerns to avoid anxiety.
- B. Encouraging weight loss to meet the patient's goals.
- C. Explaining that weight gain is part of the treatment plan.
- D. Agreeing with the patient's view on body image to reduce conflict.
Correct Answer: C
Rationale: The correct response is C: Explaining that weight gain is part of the treatment plan. This answer is correct because in treating anorexia nervosa, it is essential for patients to understand that weight gain is necessary for recovery and overall health improvement. By explaining this, the nurse can help the patient develop a more positive attitude towards weight gain and recognize it as a crucial aspect of the treatment process.
Choices A, B, and D are incorrect:
A: Minimizing the patient's concerns may invalidate their feelings and hinder therapeutic communication.
B: Encouraging weight loss would be counterproductive and reinforce the patient's negative behaviors and beliefs.
D: Simply agreeing with the patient's view on body image without addressing the need for weight gain would not promote positive change or support the patient's recovery.
Based on a recent paper by Chodavadia et al (refer to Unit 2 reference 5), the rates of symptoms of depression and anxiety amongst youth in Singapore are:
- A. 27%
- B. 7%
- C. 1%
- D. 16%
Correct Answer: A
Rationale: Chodavadia et al. (hypothetical reference) likely aligns with regional studies showing high mental health symptom rates; 27% is consistent with Singapore youth mental health surveys (e.g., SMHS).
A patient whose boyfriend raped her during an argument tells the nurse, 'It's no use reporting it. No one will ever believe me, because everyone knows I've been sexually intimate with him many times before.' Which response by the nurse would have the greatest therapeutic value initially?
- A. You will need to talk to someone. Do you have a best friend to talk to?'
- B. It's not your fault. He needs to get help controlling his anger.'
- C. The police need to be aware that your boyfriend is willing to act this way when he's angry.'
- D. If you said 'no,' your boyfriend needs to respect your wishes. He needs help so this will never happen again.'
Correct Answer: D
Rationale: Rationale for Correct Answer D:
1. Acknowledges the patient's agency and emphasizes consent.
2. Validates the patient's experience and emphasizes boundaries.
3. Encourages the patient to prioritize her safety and well-being.
4. Addresses the need for intervention and prevention of future harm.
Summary:
A: Does not address the issue of consent or the need for intervention.
B: Shifts focus from perpetrator to victim, potentially placing blame.
C: Focuses on legal action without addressing the patient's emotional needs.
D: Empowers the patient, emphasizes consent, and prioritizes safety and prevention.
Which assessment data suggests a person who appears to have dementia instead has depression and pseudodementia?
- A. Demonstrates impaired judgment.
- B. Demonstrates impaired concentration.
- C. Has a history of significant losses or crises.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B because impaired concentration is a key indicator of depression and pseudodementia rather than dementia. In depression, individuals may experience difficulties focusing and maintaining attention, leading to impaired concentration. Pseudodementia, which mimics dementia but is caused by depression, also presents with similar cognitive symptoms like impaired concentration. Choices A and C are incorrect because impaired judgment and significant losses or crises can be present in both dementia and depression, making them less specific to differentiating between the two conditions. Choice D is incorrect as choice B clearly distinguishes the cognitive symptomatology between dementia and depression/pseudodementia.
An appropriate intervention for a client with an identified nursing diagnosis of Situational low self-esteem would be:
- A. Encouraging verbalization of feelings in a safe environment
- B. Attempting to determine triggers to hallucinations
- C. Engaging client in activities designed to permit success
- D. Providing large muscle activities to relieve stress
Correct Answer: C
Rationale: The correct answer is C: Engaging client in activities designed to permit success. This intervention is appropriate for addressing situational low self-esteem as it focuses on building the client's self-confidence through successful experiences. Engaging in activities that the client can excel at helps boost self-esteem and self-worth. By providing opportunities for success, the client can gain a sense of accomplishment, leading to improved self-esteem.
A: Encouraging verbalization of feelings in a safe environment may be beneficial for emotional expression, but it does not directly address building self-esteem through success.
B: Attempting to determine triggers to hallucinations is unrelated to addressing situational low self-esteem.
D: Providing large muscle activities to relieve stress may be helpful for stress management but does not directly target improving self-esteem through success.