Age Specific Patient Care

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Which of the following is a priority intervention for a patient with bulimia nervosa who is experiencing electrolyte imbalances?

  • A. Encourage the patient to drink fluids and increase food intake.
  • B. Monitor the patient's heart rate and electrolyte levels closely.
  • C. Provide high-protein foods to help restore energy.
  • D. Instruct the patient to avoid any form of physical exercise.
Correct Answer: B

Rationale: The correct answer is B. Monitoring the patient's heart rate and electrolyte levels closely is crucial in managing electrolyte imbalances in patients with bulimia nervosa. Electrolyte imbalances, often caused by purging behaviors, can lead to serious complications like cardiac arrhythmias. Close monitoring allows for timely interventions such as electrolyte replacement therapy to prevent cardiac issues.

A: Encouraging the patient to drink fluids and increase food intake is not the priority when dealing with electrolyte imbalances as it may worsen the imbalance.
C: Providing high-protein foods may be beneficial for overall nutrition but does not address the immediate need to correct electrolyte imbalances.
D: Instructing the patient to avoid physical exercise is not directly related to managing electrolyte imbalances and may not address the underlying issue effectively.

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A newly admitted patient diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment. He states that he saw two doctors talking in the hall and knows they were plotting to kill him. When charting, how should the nurse identify this behavior?

  • A. Idea of reference
  • B. Delusion of infidelity
  • C. Auditory hallucination
  • D. Echolalia
Correct Answer: A

Rationale: The correct identification for the behavior described is "A: Idea of reference." This term refers to the belief that neutral events are directed at oneself. In this case, the patient's belief that the doctors were plotting to kill him is an example of a false idea of reference. Delusion of infidelity (choice B) involves false beliefs about a partner's unfaithfulness, not relevant here. Auditory hallucination (choice C) pertains to false perceptions of hearing sounds, not applicable. Echolalia (choice D) is the repetition of words spoken by others, not seen in this scenario. Identifying the behavior as an idea of reference helps the nurse understand the patient's distorted perception of reality.

A patient is hospitalized for severe depression. Of the medications listed below, the nurse can expect to provide the patient with teaching about:

  • A. Chlordiazepoxide (Librium).
  • B. Clozapine (Clozaril).
  • C. Sertraline (Zoloft).
  • D. Tacrine (Cognex).
Correct Answer: C

Rationale: Rationale:
1. Severe depression is typically treated with antidepressants like Sertraline (Zoloft).
2. Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression.
3. The nurse should provide teaching on how to take the medication, potential side effects, and monitoring for effectiveness.
4. Other choices (A, B, D) are not typically used as first-line treatment for severe depression and may not be appropriate for this patient.

The single most common symptom of autism is:

  • A. Inability to grasp reality
  • B. Impaired social interaction
  • C. Acting out behaviors
  • D. Diminished affect
Correct Answer: B

Rationale: Though all of these behaviors may occur at some time in autism, impaired social interaction is the overriding symptom that occurs in this disorder.

A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2G sodium diet, Restraint as needed, Limit fluids to 1800~mL daily, Continue antihypertensive medication, Milk of magnesia 30~mL PO once if no bowel movement for 3 days. The nurse should:

  • A. question the fluid restriction
  • B. question the order for restraint
  • C. transcribe the prescriptions as written
  • D. assess the residents bowel elimination
Correct Answer: B

Rationale: Restraints may be imposed only on a written order of the health care provider that specifies the duration during which the restraints can be used. The Joint Commission guidelines and Omnibus Budget Reconciliation Act regulations also mandate a number of other conditions that must be considered and documented before restraints are used. The other prescriptions are appropriate.

Statistical approaches to abnormality define as 'abnormal' those who

  • A. show evidence of loss of contact with reality
  • B. are unhappy, withdrawn, and depressed
  • C. deviate from typical or average patterns of behavior
  • D. are disabled by anxiety
Correct Answer: C

Rationale: Statistical definitions label behavior abnormal if it deviates significantly from the norm, regardless of specific symptoms.

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