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Which of the following is an appropriate nursing intervention for a patient with anorexia nervosa?
- A. Promote gradual weight gain through a structured meal plan.
- B. Encourage the patient to restrict calorie intake to avoid weight gain.
- C. Offer emotional support without addressing food-related behaviors.
- D. Focus on daily exercise to improve physical fitness.
Correct Answer: A
Rationale: The correct answer is A because promoting gradual weight gain through a structured meal plan is essential in treating anorexia nervosa. This intervention helps the patient restore their nutritional status and physical health. By providing a structured meal plan, the patient can slowly increase their caloric intake, leading to healthy weight gain. This approach also helps address the underlying psychological and emotional issues associated with the eating disorder. Encouraging the patient to restrict calorie intake (B) is harmful as it perpetuates the cycle of malnutrition. Offering emotional support without addressing food-related behaviors (C) neglects the crucial aspect of nutritional rehabilitation. Focusing on daily exercise (D) may exacerbate the patient's physical health and reinforce unhealthy behaviors.
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An adolescent claims to have been physically abused by a parent. The adolescent's other parent angrily tells the nurse, 'It's ridiculous for our child to accuse my spouse, who's a prominent doctor and is respected by the community.' Which of these nursing communications would be most effective for the parent?
- A. You believe that abuse does not exist in well-respected, professional families?'
- B. Your spouse seems to have a very stressful, demanding practice. That can be a risk factor for losing your temper when angry.'
- C. I know that it is difficult to believe what your child is saying about your spouse, but abuse has occurred.'
- D. I know your spouse from working in the emergency room. Your spouse is always kind to patients, but that can be misleading.'
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. This response challenges the parent's belief that abuse does not exist in respected families, highlighting the misconception that abuse can happen in any family.
2. It addresses the parent's disbelief directly, encouraging them to reconsider their assumptions and beliefs about abuse.
3. It promotes critical thinking and reflection on the parent's part, fostering a more open-minded and empathetic approach towards the adolescent's disclosure.
Summary of Other Choices:
B: This choice focuses on the stress of the accused parent, deflecting from the issue of abuse and potentially excusing their behavior.
C: This choice acknowledges the difficulty of the situation but does not effectively challenge the parent's disbelief or misconceptions about abuse.
D: This choice uses a positive characteristic of the accused parent to deflect from the allegations of abuse, which does not address the parent's denial or the seriousness of the situation.
A depressed patient is to have his first electroconvulsive therapy (ECT) session tomorrow morning. Which intervention would routinely be implemented in preparing the patient for treatment?
- A. Explaining that 20 or more treatments will be needed
- B. Advising the patient that memory loss is usually transient
- C. Preparing the patient to be restrained during the procedure
- D. Educating the patient about how ECT will end his depression
Correct Answer: B
Rationale: The correct answer is B: Advising the patient that memory loss is usually transient. This is because memory loss is a common side effect of ECT, but it is typically temporary and resolves after treatment. It is important to prepare the patient for potential memory issues to reduce anxiety and manage expectations. Choices A, C, and D are incorrect because explaining the number of treatments needed, preparing for restraint, or suggesting ECT will end depression are not standard interventions in preparing a patient for ECT.
Discharge planning begins for an elderly patient hospitalized for 2 weeks diagnosed with major depression. The patient needs ongoing assessment and socialization opportunities as well as education about medication and relapse prevention. The patient lives with a daughter, who works during the week. Select the best referral for this patient.
- A. Behavioral health home care
- B. A skilled nursing facility
- C. Partial hospitalization
- D. A halfway house
Correct Answer: C
Rationale: Partial hospitalization will provide services the patient needs as well as give supervision and meals to the patient while the daughter is at work. Home care would not provide socialization. The patient does not need the intensity of a skilled nursing facility. A halfway house provides 24-hour care and usually expects involvement in off-campus programs.
All of the following are ways that you can reduce your contributions to ground ozone pollution except
- A. Conserving energy at home and at school
- B. Carpooling more to reduce pollution
- C. Use low VOC paints
- D. Stop smoking
Correct Answer: D
Rationale: Stopping smoking reduces personal health risks but has minimal direct impact on ground-level ozone, unlike the other options.
A patient tells the nurse, "My doctor prescribed Paxil (paroxetine) for my depression. I assume I'll have side effects like I had when I was taking Tofranil (imipramine)." The nurse's reply should be based on the knowledge that paroxetine is a:
- A. Selective norepinephrine reuptake inhibitor.
- B. Tricyclic antidepressant.
- C. MAO inhibitor.
- D. SSRI
Correct Answer: D
Rationale: The correct answer is D: SSRI. Paroxetine belongs to the class of selective serotonin reuptake inhibitors (SSRIs), which work by primarily increasing the levels of serotonin in the brain. This mechanism differs from tricyclic antidepressants like Tofranil (imipramine) and MAO inhibitors. SSRIs are known for having fewer side effects compared to tricyclic antidepressants and MAO inhibitors. Therefore, the nurse should inform the patient that the side effects experienced with Tofranil are not necessarily indicative of what they will experience with Paxil due to the different drug classes.