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Which of the following is a priority for a nurse caring for a patient with anorexia nervosa during the refeeding phase?
- A. Providing a high-calorie diet immediately to speed up weight gain.
- B. Monitoring the patient closely for signs of refeeding syndrome.
- C. Promoting the patient's independence in meal choices.
- D. Encouraging exercise to improve physical health.
Correct Answer: B
Rationale: The correct answer is B: Monitoring the patient closely for signs of refeeding syndrome. Refeeding syndrome is a potentially life-threatening condition that can occur when a malnourished individual is fed too quickly. Monitoring for signs such as electrolyte imbalances, fluid shifts, and organ dysfunction is crucial to prevent complications. Providing a high-calorie diet immediately (A) can exacerbate refeeding syndrome. Promoting independence in meal choices (C) may not be appropriate if the patient needs close monitoring. Encouraging exercise (D) can be harmful during the refeeding phase as the body needs time to recover and regain strength.
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According to the Diagnostic and Statistical Manual, 5th Edition (DSM-5), how many symptoms should be present for at least two weeks before a diagnosis of adolescent depression is made?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: D
Rationale: DSM-5 requires 5 symptoms (including depressed mood or loss of interest) for at least 2 weeks for a Major Depressive Disorder diagnosis.
An 85-year-old has difficulty walking after a knee replacement. The patient tells the nurse, 'Its awful to be old. Every day is a struggle. No one cares about old people.' Select the nurses best response.
- A. Everyone here cares about old people. Thats why we work here.'
- B. It sounds like youre having a difficult time. Tell me about it.'
- C. Lets not focus on the negative. Tell me something good.'
- D. You are still able to get around, and your mind is alert.'
Correct Answer: B
Rationale: The nurse uses empathetic understanding to permit the patient to express frustration and clarify her struggle for the nurse. The distracters block communication.
A patient with anorexia nervosa in outpatient treatment has begun refeeding. Between the first and second appointment, the patient gained 8 pounds. The nurse should:
- A. Praise the weight gain.
- B. Assess lung sounds and extremities.
- C. Suggest implementation of an exercise program.
- D. Establish a higher target for weight gain for the next week.
Correct Answer: B
Rationale: The correct answer is B because assessing lung sounds and extremities is crucial after significant weight gain in a patient with anorexia nervosa to monitor for potential complications like refeeding syndrome. Praise in choice A may reinforce unhealthy behaviors. Choice C suggesting an exercise program may be harmful. Choice D could lead to excessive weight gain.
A child, aged 11 years, stays home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The home is cluttered and dirty when the community mental health nurse visits to investigate the child's school absences. When the parents arrive home from work, the child's father behaves angrily. He orders his wife and son about. He finds fault with the son, asking him twice, 'Why are you such a stupid kid?' The wife tells the nurse she has difficulty disciplining the children and gets frustrated easily. The nurse desires to build some trust and continue to gather assessment data. The remark or question that would interfere with the nurse's goals is:
- A. Tell me what happens when the children misbehave.'
- B. When your baby cries, how do you get him to stop?'
- C. Caring for three young children must be difficult.'
- D. Do you or your husband ever beat the children?'
Correct Answer: D
Rationale: The correct answer is D. Asking about physical abuse can be perceived as accusatory, defensive, or judgmental, hindering trust-building and data collection. It may lead to denial or termination of communication. Choices A and B are relevant to understanding parenting skills, while C shows empathy. These questions align with the nurse's goal of assessing the family's dynamics without inciting defensiveness or shutting down communication.
Which situation is consensual sex rather than rape?
- A. A husband forces vaginal sex when he comes home intoxicated from a party. The wife objects.
- B. A woman's lover pleads with her to have oral sex. She gives in but then regrets the decision.
- C. A person is beaten, robbed, and forcibly subjected to anal penetration by an assailant.
- D. A dentist gives anesthesia for a procedure and then has intercourse with the unconscious patient.
Correct Answer: B
Rationale: The correct answer is B because, although the woman initially gave in to her lover's plea for oral sex, she later regretted the decision. Consent must be freely given without coercion or manipulation. In this scenario, the woman's regret indicates that her initial agreement was not genuine consent. Choice A involves force and lack of consent. Choice C depicts a violent and non-consensual act. Choice D involves taking advantage of a vulnerable and unconscious individual, which is also non-consensual.