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Which of the following is a priority nursing intervention for a patient with anorexia nervosa during the refeeding process?
- A. Encourage the patient to engage in physical activity to stimulate appetite.
- B. Monitor vital signs and electrolyte levels to avoid refeeding syndrome.
- C. Offer high-calorie snacks to speed up weight gain.
- D. Focus on the patient's body image concerns before addressing nutrition.
Correct Answer: B
Rationale: The correct answer is B because monitoring vital signs and electrolyte levels is crucial during the refeeding process to prevent refeeding syndrome, a potentially life-threatening complication. This intervention ensures early detection of any electrolyte imbalances or cardiac complications that may arise as the body readjusts to increased food intake. Encouraging physical activity (A) can be harmful due to the patient's compromised state. Offering high-calorie snacks (C) may lead to rapid weight gain and increase the risk of refeeding syndrome. Focusing on body image concerns (D) is important but should not take precedence over addressing the patient's immediate medical needs.
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A nurse wants to assess for suicidal ideation in an elderly patient. Select the best question to begin this assessment.
- A. Are there any things going on in your life that would cause you to consider suicide?'
- B. What are your beliefs about a persons right to take his or her own life?'
- C. Do you think you are vulnerable to developing a depressed mood?'
- D. If you felt suicidal, would you tell someone about your feelings?'
Correct Answer: B
Rationale: This question is clear, direct, and respectful. It will produce information relative to the acceptability of suicide as an option to the patient. If the patient deems suicide unacceptable, no further assessment is necessary. If the patient deems suicide as acceptable, the nurse can continue to assess intent, plan, means to carry out the plan, lethality of the chosen method, and so forth. The other options are less direct, may produce responses that may be unclear, or are appropriate for later in this discussion.
The Freudian explanation of anxiety disorders emphasizes
- A. the avoidance paradox
- B. learned habits of self-defeating behavior
- C. forbidden impulses that threaten a loss of control
- D. the development of a faulty or inaccurate self-image and distorted self-perceptions
Correct Answer: C
Rationale: Freud viewed anxiety as stemming from repressed impulses threatening to surface, disrupting control.
Which of the following medications would NOT be recommended for prescription by a Family Doctor for a depressed adolescent who also has panic attacks?
- A. Sertraline
- B. Amitriptyline
- C. Propranolol
- D. Lorazepam
Correct Answer: D
Rationale: Lorazepam, a benzodiazepine, is not recommended for adolescents due to dependency risks; SSRIs like Sertraline are preferred.
A patient remanded by the court after his wife had him jailed for battery told the judge how sorry he was and suggested he needed psychiatric help. His history reveals acting-out behaviors as an adolescent and several adult arrests. The nurse interviews him about his relationship with his wife. Which statement by the patient is most consistent with a diagnosis of antisocial personality disorder?
- A. I've done some stupid things in my life, but I've learned a lesson.'
- B. I'm feeling terrible about the way my behavior has hurt my family.'
- C. I have a quick temper, but I can usually keep it under control.'
- D. I hit her because she nags at me. She deserves it when I beat her up.'
Correct Answer: D
Rationale: The correct answer is D because it demonstrates a lack of remorse, empathy, and justification for violent behavior, which are key characteristics of antisocial personality disorder. The statement indicates a pattern of blaming others for his actions and a sense of entitlement to use violence as a means of control.
Choice A is incorrect because it shows acknowledgment of past mistakes and a willingness to learn from them, which is not typical of individuals with antisocial personality disorder. Choice B is incorrect as it reflects genuine regret and concern for the impact of his actions, which is inconsistent with the disorder. Choice C is incorrect because it implies an ability to control his temper, whereas individuals with antisocial personality disorder often struggle with impulsivity and aggression.
Trends that have contributed to the recent increase in eating disorders in the United States include a(n):
- A. more competitive workplace.
- B. increase in the number of divorces.
- C. focus on being thin as a measure of attractiveness.
- D. increase in the number of nonnutritional foods consumed.
Correct Answer: C
Rationale: The correct answer is C: focus on being thin as a measure of attractiveness. This is because societal pressures and media influence have placed a strong emphasis on thinness as the ideal body type, leading to increased body dissatisfaction and disordered eating behaviors. Option A (more competitive workplace) and B (increase in the number of divorces) are not directly linked to eating disorders, while option D (increase in the number of nonnutritional foods consumed) may contribute to health issues but not specifically to eating disorders. In conclusion, the societal focus on thinness has a significant impact on the rise of eating disorders in the United States.