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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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Anorexia nervosa is very common in teenage girls
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Anorexia nervosa is prevalent among teenage girls due to societal pressures and developmental factors.
A 19-year-old client is admitted for the second time in 9 months and is acutely psychotic with a diagnosis of undifferentiated schizophrenia. The client sits alone rubbing her arms and smiling. She tells the nurse her thoughts cause earthquakes and that the world is burning. The nurse assesses the primary deficit associated with the client's condition as:
- A. Altered mood states
- B. Disturbed thinking
- C. Social isolation
- D. Poor impulse control
Correct Answer: B
Rationale: The correct answer is B: Disturbed thinking. In this scenario, the client's belief that her thoughts cause earthquakes and the world is burning are examples of delusions, which are a key symptom of schizophrenia. This demonstrates a disturbance in the client's thought process, indicating a primary deficit in thinking. Altered mood states (A) may be present as well but are not the primary deficit in this case. Social isolation (C) is a consequence of the client's symptoms rather than the primary deficit. Poor impulse control (D) is not the primary issue presented in the scenario.
A nurse leads a staff development session about ageism among health care workers. What information should the nurse include about the consequences of ageism? Select one tha does not apply.
- A. Failure of the elderly to receive necessary medical information
- B. Development of public policy that discriminates against the elderly
- C. Staff shortages because caregivers prefer working with younger adults
- D. The perception that elderly consume a smaller share of medical resources
Correct Answer: D
Rationale: Because of society's negative stereotyping, elderly patients often receive less information (A) and fewer treatment options, public policy discriminates against them (B), and staff shortages occur as some prefer younger patients (C). The elderly are seen to consume more resources (not D), and discrimination spans all staff (not E).
The wife of a client who is being seen in the sleep clinic states that her husband snores terribly at night and that she has to shake him to get him to stop. The client complains of a headache upon wakening and often falls asleep during the day when he sits for long periods. This client is exhibiting signs and symptoms characteristic of:
- A. narcolepsy.
- B. parasomnia.
- C. sleep apnea.
- D. primary hypersomnia.
Correct Answer: C
Rationale: The correct answer is C: sleep apnea. The client's symptoms of loud snoring, need to be shaken to stop snoring, morning headache, daytime sleepiness, and falling asleep during the day are all classic signs of sleep apnea. Sleep apnea is a disorder characterized by pauses in breathing or shallow breathing during sleep, leading to poor sleep quality and daytime symptoms. Narcolepsy (choice A) involves excessive daytime sleepiness and sudden muscle weakness, which are not mentioned here. Parasomnia (choice B) refers to abnormal behaviors during sleep, such as sleepwalking or night terrors, which are not described in the scenario. Primary hypersomnia (choice D) is characterized by excessive daytime sleepiness without a clear cause, which is not consistent with the client's symptoms.
A 45-year-old man develops weakness and wasting of the right hand. Which one of the following is least likely to be the cause?
- A. Old injury to the elbow joint.
- B. Bronchogenic carcinoma of the right upper lobe.
- C. Multiple sclerosis.
- D. Syringomyelia.
Correct Answer: C
Rationale: Multiple sclerosis (C) typically causes sensory and motor symptoms but rarely isolated hand wasting, which is more characteristic of peripheral nerve or motor neuron issues. Old injury (A), lung cancer (B, via brachial plexus), syringomyelia (D), and motor neurone disease (E) are more directly linked to such symptoms.