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Which statement by a parent of a teen with anorexia nervosa suggests a need for further education?
- A. I will make sure my teen eats three meals a day.
- B. It is important to monitor my teen's weight regularly.
- C. I should encourage my teen to keep a food journal.
- D. I should allow my teen to skip meals if she feels full.
Correct Answer: D
Rationale: The correct answer is D because allowing the teen to skip meals if she feels full can reinforce unhealthy eating behaviors associated with anorexia nervosa. This statement contradicts the essential goal of promoting regular and adequate meal intake to support recovery. Encouraging the teen to eat when not hungry may be necessary to restore normal eating patterns. Choices A, B, and C align with supporting the teen's nutritional needs and recovery process.
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A patient receiving risperidone (Risperdal) reports severe muscle stiffness midmorning. During lunch he has difficulty swallowing food and speaking, and when vital signs are taken 30 minutes later, he is noted to be stuporous and diaphoretic, with a temperature of 38.8° C, pulse of 110 beats/min, and blood pressure of 150/90 mm Hg. The nurse should suspect _____ and should _____.
- A. Neuroleptic malignant syndrome"¦place him in a cooling blanket and transfer to ICU
- B. Anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
- C. Relapse of his psychosis"¦administer PRN antipsychotic drugs and notify his physician
- D. Agranulocytosis"¦hold his antipsychotic and draw blood for a complete blood count
Correct Answer: A
Rationale: The correct answer is A: Neuroleptic malignant syndrome. The patient is exhibiting symptoms consistent with NMS, a rare but serious side effect of antipsychotic medications like risperidone. The severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, elevated temperature, and vital sign changes are classic signs of NMS. Treatment includes immediate cooling to lower the body temperature and transfer to the intensive care unit for close monitoring and supportive care.
Choice B: Anticholinergic toxicity does not fit the patient's presentation as there are no specific signs of anticholinergic toxicity such as dry mucous membranes, dilated pupils, or tachycardia.
Choice C: Relapse of psychosis is unlikely to present with the same constellation of symptoms, including altered mental status, fever, and vital sign changes.
Choice D: Agranulocytosis is characterized by a severe drop in white blood cells, leading to increased risk of infection, but it does
A woman tells the nurse, 'My partner is frustrated with me. I don't have any natural lubrication when we have sex.' What type of sexual disorder is evident?
- A. Genito-pelvic pain/penetration disorder
- B. Female sexual interest/arousal disorder
- C. Hypoactive sexual desire disorder
- D. Female orgasmic disorder
Correct Answer: B
Rationale: The correct answer is B: Female sexual interest/arousal disorder. The woman's complaint of lack of natural lubrication during sex indicates a difficulty in arousal, which falls under this disorder category. This is because arousal difficulties can lead to inadequate lubrication, impacting sexual satisfaction. Genito-pelvic pain/penetration disorder (A) involves pain during intercourse, not lack of lubrication. Hypoactive sexual desire disorder (C) refers to low libido, not lubrication issues. Female orgasmic disorder (D) pertains to difficulties reaching orgasm, not lubrication problems.
A client who is hospitalized with anorexia nervosa states during a one-to-one session with the nurse, 'I'm freaking out. I'm losing it.' Which nurse response would be most therapeutic at this time?
- A. Would you feel better if I called your parents?'
- B. Just sit here and relax and maintain control.'
- C. Let me sit with you for a while.'
- D. Tell me what thoughts are going through your head.'
Correct Answer: D
Rationale: The correct answer is D because it encourages the client to express their thoughts and feelings, aiding in the therapeutic process. This response promotes open communication and allows the nurse to assess the client's mental state. Choice A may not address the client's immediate distress and could potentially escalate anxiety. Choice B dismisses the client's feelings and does not address the issue. Choice C offers support but does not actively encourage the client to verbalize their thoughts, which is crucial in addressing underlying issues.
A nurse works a rape telephone hotline. Communication should focus on:
- A. Explaining immediate steps victims should take;
- B. Providing callers with a sympathetic listener.
- C. Obtaining information for law enforcement.
- D. Arranging long-term counseling.
Correct Answer: A
Rationale: The correct answer is A because in cases of sexual assault, immediate steps such as seeking medical attention, preserving evidence, and contacting authorities are crucial. Providing sympathy (B) is important but secondary to ensuring victims' safety. Obtaining information for law enforcement (C) should only be done if victims consent, as their safety and well-being are the priority. Long-term counseling (D) is important but not the immediate focus on a hotline call.
A type of delusion in which a patient claims that her genitals have disappeared without her knowledge is called
- A. Hypochondriacal
- B. Amorous
- C. Reference
- D. Nihilistic
Correct Answer: D
Rationale: Nihilistic delusions involve beliefs that parts of the body or the self have ceased to exist or are destroyed.