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Which situation would be most likely to serve as a trigger to a catastrophic reaction in a client with stage 2 Alzheimer's disease?
- A. Participating in singing 'Happy Birthday' to another client at dinner
- B. Being scolded by an aide for spilling a glass of milk
- C. Listening to Big Band music from the 1940s
- D. Eating cupcakes in the activities room
Correct Answer: B
Rationale: The correct answer is B because being scolded for spilling milk can trigger feelings of shame, embarrassment, and confusion in a person with Alzheimer's stage 2. This negative interaction can lead to heightened agitation, aggression, or emotional distress due to the client's impaired ability to process and regulate emotions. In contrast, choices A, C, and D involve positive or neutral activities that are less likely to evoke such strong negative emotions or reactions in someone with Alzheimer's disease.
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A psychiatric clinical nurse specialist uses cognitive therapy with a patient with anorexia nervosa. Which statement by the nurse supports this type of therapy?
- A. What are your feelings about not eating foods you prepare?
- B. You seem to feel much better about yourself when you eat something.
- C. It must be difficult to talk about private matters to someone you just met.
- D. Being thin doesn't seem to solve problems. You're thin now but still unhappy.
Correct Answer: D
Rationale: The correct answer is D because it reflects a key principle of cognitive therapy, which is challenging distorted thoughts and beliefs. In this statement, the nurse is helping the patient recognize that being thin has not resolved their underlying unhappiness. This challenges the patient's belief that thinness equals happiness, promoting insight and cognitive restructuring.
A: This statement focuses on emotions related to food and preparation, not directly challenging distorted thoughts.
B: This statement focuses on self-esteem related to eating, not directly challenging distorted thoughts.
C: This statement addresses the difficulty of sharing personal information, not directly challenging distorted thoughts.
What is an appropriate goal for a nurse working with a patient who has bulimia nervosa?
- A. The patient will engage in daily exercise to control weight.
- B. The patient will eliminate purging behaviors and establish healthy eating habits.
- C. The patient will maintain a low weight and avoid binge episodes.
- D. The patient will adopt a restrictive diet to manage their eating behaviors.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Eliminating purging behaviors addresses the primary symptom of bulimia nervosa.
2. Establishing healthy eating habits promotes long-term recovery and overall well-being.
3. Focusing on behavior change rather than weight control aligns with evidence-based treatment.
4. This goal is client-centered, prioritizing the patient's mental and physical health.
Summary:
A: Focusing solely on exercise does not address the root cause of bulimia.
C: Emphasizing weight maintenance may reinforce unhealthy body image and behaviors.
D: Adopting a restrictive diet can exacerbate disordered eating patterns and harm health.
Which neighborhood in Boston had the highest rates of Chlamydia in 2006?
- A. Allston/Brighton
- B. Roxbury
- C. Jamiaca Plain
- D. Roslindale
Correct Answer: B
Rationale: Roxbury, a historically underserved area, had higher Chlamydia rates in 2006, likely due to socioeconomic factors and limited healthcare access.
Which of the following is an expected finding for a patient with anorexia nervosa?
- A. Increased appetite and food cravings.
- B. A body mass index (BMI) in the normal range.
- C. Bradycardia and hypotension.
- D. Elevated blood pressure and rapid pulse.
Correct Answer: C
Rationale: The correct answer is C. Patients with anorexia nervosa often have bradycardia and hypotension due to the physiological effects of severe malnutrition. Explanation: Severe restriction of food intake leads to decreased energy stores, causing the body to slow down its metabolic processes, including heart rate and blood pressure. Bradycardia and hypotension are common findings in individuals with anorexia nervosa.
Summary:
A: Increased appetite and food cravings are not expected findings in anorexia nervosa as patients typically have a decreased appetite.
B: A body mass index (BMI) in the normal range is not expected in anorexia nervosa, as patients often have a low BMI due to significant weight loss.
D: Elevated blood pressure and rapid pulse are not typical findings in anorexia nervosa; rather, patients may present with low blood pressure and bradycardia.
A client who has been diagnosed as having bulimia nervosa is hospitalized for treatment of electrolyte imbalance. Just before lunch is finished, the client leaves the table and walks quickly in the direction of the bathroom. The nurse should say:
- A. No one is allowed to leave the dining room during meals.'
- B. I must accompany you when you go to the bathroom.'
- C. I think I understand your plan, and I cannot permit you to carry it out.'
- D. Wouldn't it be preferable to exercise rather than vomit?'
Correct Answer: B
Rationale: The correct answer is B because accompanying the client to the bathroom is essential to prevent purging behavior associated with bulimia nervosa. By doing so, the nurse can provide support, monitor the client, and intervene if necessary to ensure the client's safety. Choice A is incorrect as it may come across as punitive and restrictive. Choice C is incorrect as it may escalate the situation and lead to confrontation. Choice D is incorrect as it suggests an alternative behavior without addressing the immediate concern of potential purging. Accompanying the client to the bathroom is the most appropriate and therapeutic response in this situation.