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Which statement by a patient with an eating disorder reflects a correct understanding of the condition?
- A. Gaining 1 pound is as much of a disaster as gaining 100 pounds.
- B. I was happy when I was a size 4, so I must diet to that size.
- C. I've been coping with my feelings by overeating.
- D. Binging is the only way I can soothe myself.
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the emotional aspect of eating disorders. Coping with feelings by overeating indicates insight into using food to manage emotions, a common characteristic of eating disorders. This understanding is crucial for addressing the underlying issues contributing to the disorder.
A: Incorrect. This statement suggests an extreme and distorted view of weight gain, which is not reflective of a healthy understanding of an eating disorder.
B: Incorrect. This statement implies a fixation on a specific size for happiness, which may perpetuate disordered eating behaviors.
D: Incorrect. This statement indicates reliance on binging as the sole coping mechanism, overlooking the emotional aspect of the disorder.
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A newly admitted patient with schizophrenia approaches the unit nurse and says, 'The voices are bothering me. They are yelling and telling me stuff. They are really bad.' Which response by the nurse would be most appropriate?
- A. Do you hear these voices very often?'
- B. Do you have a plan for getting away from the voices?'
- C. I'll stay with you. Tell me what you are hearing.'
- D. Try to ignore them and play cards with the others.'
Correct Answer: C
Rationale: The correct answer is C because it demonstrates active listening and empathy, which can help establish trust and rapport with the patient. By saying, "I'll stay with you. Tell me what you are hearing," the nurse acknowledges the patient's distress and offers support. This response can help the patient feel heard and understood, which is crucial in managing symptoms of schizophrenia.
Choice A is incorrect as it focuses more on the frequency rather than addressing the immediate distress. Choice B is incorrect as it assumes the patient has a plan to escape the voices, which may not be the case and can escalate the situation. Choice D is incorrect as it dismisses the patient's experience and suggests distraction rather than addressing the underlying issue.
What is an appropriate goal for a nurse working with a patient with anorexia nervosa?
- A. The patient will gain weight rapidly to restore nutritional balance.
- B. The patient will express satisfaction with their body image by the end of treatment.
- C. The patient will eat three meals daily and demonstrate healthy eating behaviors.
- D. The patient will be able to resume normal physical activities without fatigue.
Correct Answer: C
Rationale: The correct answer is C because setting a goal for the patient to eat three meals daily and demonstrate healthy eating behaviors is a more realistic and achievable target for someone with anorexia nervosa. This goal focuses on establishing regular eating habits and promoting a healthy relationship with food, which are crucial in the treatment of anorexia nervosa. Choices A and D are incorrect as rapid weight gain and resuming normal physical activities may not be safe or sustainable goals for someone with anorexia nervosa. Choice B is also incorrect because body image satisfaction is a complex issue that may not be directly addressed solely through treatment for anorexia nervosa.
A client with anorexia nervosa engages in manipulative behavior. She tells the nurse, 'I can't get weighed this morning, because I drank a glass of juice a few minutes before breakfast.' The best approach by the nurse would be:
- A. I'm pleased that you took in some calories.'
- B. We can get around this, if you'll eat a doughnut, too.'
- C. The rule is 'weigh before eating'; now we have to put it off until tomorrow.'
- D. This is weight day. Please step on the scale.'
Correct Answer: D
Rationale: Step 1: The correct answer is D because it sets clear boundaries and enforces consistency by reminding the client of the established protocol.
Step 2: By stating "This is weight day. Please step on the scale," the nurse maintains the structure and accountability in the treatment plan.
Step 3: This response avoids reinforcing manipulative behavior and emphasizes the importance of following the agreed-upon rules for accurate monitoring.
Step 4: Other choices like A may inadvertently validate the manipulation, B suggests giving in to the client's avoidance tactic, and C delays the weighing without addressing the manipulation directly.
For patients diagnosed with serious mental illness, what is the major advantage of case management?
- A. The case manager can modify traditional psychotherapy
- B. With one coordinator of services, resources can be more efficiently used
- C. The case manager can focus on social skills training and esteem building
- D. Case managers bring groups of patients together to discuss common problems
Correct Answer: B
Rationale: The case manager coordinates the care and multiple referrals that so often confuse the seriously mentally ill patient and the patients family. Case management promotes efficient use of services. The other options are lesser advantages or are irrelevant.
The medication donepezil (Aricept) frequently is used to treat the early-stage symptoms of Alzheimer's disease. When administering this particular medication, the nurse should be especially alert to assess the client for:
- A. Weight changes
- B. Tremors
- C. Increased sweating
- D. Alterations in blood pressure
Correct Answer: D
Rationale: The correct answer is D: Alterations in blood pressure. Donepezil can cause changes in blood pressure as a side effect. Nurses should monitor for orthostatic hypotension and changes in blood pressure to prevent adverse effects. Weight changes (A), tremors (B), and increased sweating (C) are not commonly associated with donepezil and are less likely to be significant concerns when administering this medication for Alzheimer's disease.