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Which of the following is characteristic of a dissociative disorder?
- A. phobic disorder
- B. amnesia
- C. paranoia
- D. depression
Correct Answer: B
Rationale: Dissociative disorders feature disruptions like amnesia, distinguishing them from phobias or paranoia.
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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.
A common nursing diagnosis for a patient with antisocial personality disorder is:
- A. chronic low self-esteem, related to poor self-image and excessive fear of failure
- B. disturbed thought processes, related to sensory-perceptual alterations
- C. impaired social interaction, related to manipulative behaviors
- D. social isolation, related to anxiety in social situations
Correct Answer: C
Rationale: Impaired social interaction due to manipulation reflects the interpersonal challenges of antisocial personality disorder.
The nurse caring for a school-age child who has been sexually abused by a close family member realizes that the child may resist disclosing the experience of being sexually abused because the child:
- A. Realizes that repeated questioning by others will occur
- B. Fears being blamed or disbelieved
- C. Fears becoming an object of pity at school
- D. Is embarrassed about facing family members
Correct Answer: B
Rationale: The correct answer is B: Fears being blamed or disbelieved. This is because children who have been sexually abused often fear that they will not be believed or may be blamed for what happened. This fear can prevent them from disclosing the abuse. Choice A is incorrect because repeated questioning may not be the primary reason for the child's resistance. Choice C is incorrect because the child's fear of being pitied at school is not typically a main concern when disclosing sexual abuse. Choice D is incorrect because embarrassment about facing family members may be a factor, but the fear of blame or disbelief is usually a more significant barrier to disclosure in cases of sexual abuse.
What is an important aspect of managing refeeding syndrome in patients with anorexia nervosa?
- A. Refeeding the patient with high-calorie foods immediately.
- B. Monitoring electrolytes closely during the refeeding process.
- C. Allowing the patient to eat whatever they want without restrictions.
- D. Restricting fluid intake to avoid water retention.
Correct Answer: B
Rationale: The correct answer is B because monitoring electrolytes closely during refeeding is crucial to prevent life-threatening complications such as electrolyte imbalances. Refeeding syndrome can lead to shifts in electrolytes, particularly phosphorus, potassium, and magnesium, which may result in cardiac arrhythmias, respiratory failure, or even death. Close monitoring allows for timely interventions to maintain electrolyte balance.
Choice A is incorrect because refeeding a patient with high-calorie foods immediately can actually exacerbate refeeding syndrome by overwhelming the body's metabolic and electrolyte regulation processes. Choice C is incorrect because allowing the patient to eat whatever they want without restrictions can lead to rapid and uncontrolled weight gain, which may worsen medical complications. Choice D is incorrect because restricting fluid intake can also contribute to electrolyte imbalances and dehydration during refeeding.
A patient, aged 82 years, has Alzheimer's disease. She lives with her daughter's family and goes to a day care facility on weekdays. The nurse at the day care center noticed the patient was unkempt and had multiple bruises. When the daughter arrived to pick her up, the nurse discussed her observations. The daughter became defensive and said that her mother was very difficult to manage. She stated, "My mother is not my mother anymore. She is confused, and she wanders all night. We have to watch her constantly. Last night I fell asleep, and she fell down the stairs. Sometimes I just cannot bear to care for her."Â Which nursing diagnosis would be most important to address for this patient?
- A. Risk for injury related to impaired cognition, judgment, and coordination and lack of caregiver supervision
- B. Nonadherence related to confusion and disorientation, as evidenced by lack of cooperation
- C. Anxiety related to increasing disorientation, as evidenced by the patient wandering at night
- D. Impaired verbal communication related to brain impairment, as evidenced by the patient's confusion
Correct Answer: A
Rationale: The correct answer is A: Risk for injury related to impaired cognition, judgment, and coordination and lack of caregiver supervision. The rationale is that the patient's Alzheimer's disease has led to impaired cognitive function, making her at risk for injury due to wandering and falls. The daughter's lack of supervision and inability to manage the patient's needs further exacerbate this risk. Choices B, C, and D are incorrect because they do not directly address the immediate safety concern of the patient being at risk for injury. Nonadherence, anxiety, and impaired communication are important issues but do not take precedence over the patient's safety in this context.