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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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When analyzing the behaviors of a 23-year-old who meets the criteria for antisocial personality disorder, the nurse recognizes that the following nursing diagnosis would be pertinent to his care:
- A. Risk for self-mutilation
- B. Disturbed personal identity
- C. Impaired social interaction
- D. Social isolation
Correct Answer: C
Rationale: Step-by-step rationale for choice C (Impaired social interaction) being the correct answer:
1. Antisocial personality disorder is characterized by a lack of regard for others and a pattern of violating their rights.
2. Individuals with this disorder often have difficulty forming and maintaining healthy relationships.
3. Impaired social interaction reflects the challenges the individual faces in relating to others.
4. This nursing diagnosis would address the core issue of social dysfunction in individuals with antisocial personality disorder.
Summary of why the other choices are incorrect:
A. Risk for self-mutilation - Not typically associated with antisocial personality disorder, more common in other mental health conditions.
B. Disturbed personal identity - Not a primary concern in antisocial personality disorder, which is more about behavior than identity.
D. Social isolation - While individuals with antisocial personality disorder may isolate themselves, impaired social interaction is a more direct and specific issue to address in their care.
A 45-year-old patient shows marked cognitive impairment that has developed progressively over several months. A family member reports that the patient's father also had early-onset dementia. What research-based information can be given to the family in response to their concerns about the patient developing early-onset dementia?
- A. The risk for developing the condition is about 50% only if both parents were affected.
- B. The greatest risk exists for relatives of individuals diagnosed with Alzheimer disease before age 55 years.
- C. Added risk is present only for people with Down syndrome, so relatives without Down syndrome are essentially "safe."Â
- D. Results of the research on genetic predisposition and its effect on the development of early-onset dementia are still unclear.
Correct Answer: B
Rationale: The correct answer is B because individuals with a family history of early-onset dementia, particularly Alzheimer's disease before age 55, are at a higher risk of developing the condition themselves. This is supported by research showing a strong genetic component in the development of early-onset dementia. Choice A is incorrect because the risk is not solely dependent on both parents being affected. Choice C is incorrect as early-onset dementia is not limited to individuals with Down syndrome. Choice D is incorrect because research has shown a clear link between genetic predisposition and early-onset dementia.
Which of these nursing communications would be most effective in teaching a patient about abusive behavior?
- A. So when your husband says he needs other women because you aren't sexually satisfying his needs, do you believe what he is telling you is true?'
- B. You say that your son has been pulling the neighbor's pigtails and you are worried he's becoming violent and abusive like your brother?'
- C. You say that you placed your son on an allowance but that you also want to regulate everything he spends and saves?'
- D. I noticed that when your mother paid you a compliment about your new hairstyle, you seemed skeptical.'
Correct Answer: A
Rationale: The correct answer is A because it directly addresses the issue of abusive behavior in a clear and non-judgmental manner. By framing the question around a specific scenario of abusive behavior and asking for the patient's perspective, it encourages self-reflection and critical thinking. This approach empowers the patient to recognize and acknowledge the abusive behavior, which is crucial for initiating change.
Choices B, C, and D are incorrect because they do not specifically address abusive behavior. Choice B focuses on a different type of behavior (childhood aggression), Choice C addresses financial control rather than abuse, and Choice D discusses skepticism in response to a compliment, which is unrelated to abusive behavior. These choices do not effectively target the issue at hand and may lead to confusion or misinterpretation.
A nurse is educating a patient with anorexia nervosa about nutrition. What should the nurse focus on?
- A. Encouraging rapid weight gain through a high-calorie diet.
- B. Promoting gradual weight gain and nutritional rehabilitation.
- C. Providing a low-calorie diet to maintain a healthy weight.
- D. Focusing on weight maintenance without discussing food intake.
Correct Answer: B
Rationale: The correct answer is B because promoting gradual weight gain and nutritional rehabilitation is essential in treating anorexia nervosa. Rapid weight gain can lead to medical complications and mental distress. Providing a low-calorie diet (C) contradicts the goal of weight gain. Focusing on weight maintenance without discussing food intake (D) neglects the importance of nutrition in recovery.
For those family members who desire to care at home for loved ones who have been given a diagnosis of Alzheimer's disease, it is important for the nurse to ensure that the family is aware of which caregiver skills and responsibilities will be necessary. What is one of the responsibilities of the caregiver during the middle stage of the disease?
- A. Helping the loved one with memory and communication problems
- B. Providing a stable, routine environment
- C. Providing complete assistance with physical care
- D. Adapting to the changing personality and behavior of the loved one
Correct Answer: D
Rationale: The correct answer is D: Adapting to the changing personality and behavior of the loved one. During the middle stage of Alzheimer's disease, individuals may experience significant changes in personality and behavior. Caregivers need to adapt to these changes by being patient, understanding, and flexible. This responsibility is crucial for maintaining a positive and supportive relationship with the loved one.
A: Helping the loved one with memory and communication problems is important, but it is more relevant in the early stages of the disease when these issues are more prominent.
B: Providing a stable, routine environment is essential throughout all stages of Alzheimer's disease, not just the middle stage.
C: Providing complete assistance with physical care may become necessary in the later stages of the disease when the individual's physical abilities decline significantly.