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Which statement by a patient with bulimia nervosa indicates a need for further education?
- A. I understand that purging can damage my body in the long term.
- B. I feel better after purging, but I know it's not a healthy behavior.
- C. I believe I can control my eating and purging behaviors without help.
- D. I know I need therapy to address my unhealthy relationship with food.
Correct Answer: C
Rationale: Rationale:
Choice C indicates a need for further education because it suggests the patient believes they can manage bulimia without help. Patients with bulimia often require professional intervention for successful treatment. Choices A, B, and D acknowledge the need for therapy, understanding of long-term consequences, and recognition of unhealthy behaviors, respectively.
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In refeeding syndrome that develops during nutritional rehabilitation of a patient with eating disorder, what is the most important biochemical change?
- A. Hypomagnesemia
- B. Hypophosphatemia
- C. Hypokalaemia
- D. Hypoglycaemia
Correct Answer: B
Rationale: Hypophosphatemia is the most critical biochemical change in refeeding syndrome, as it can lead to severe complications like cardiac arrest.
Which disorder is associated with persons with a body weight that is normal or even slightly above average?
- A. Pica.
- B. Bulimia.
- C. Obesity.
- D. Anorexia nervosa.
Correct Answer: B
Rationale: The correct answer is B: Bulimia. Individuals with bulimia nervosa typically have a normal or slightly above average body weight due to the cycle of binge eating and purging behaviors. This is because they consume large amounts of food during binges but then engage in compensatory behaviors such as vomiting or excessive exercise to prevent weight gain. In contrast, choices A (Pica) and D (Anorexia nervosa) are associated with low body weight. Choice C (Obesity) is characterized by excess body weight. Bulimia is the only disorder in the list where individuals can have a normal or slightly above average body weight due to the nature of their eating behaviors.
A nurse is providing care for a patient diagnosed with bulimia nervosa. What is a priority nursing intervention?
- A. Encourage regular exercise to promote weight loss.
- B. Provide a calm, structured environment with consistent mealtimes.
- C. Focus on weight loss as the most important goal.
- D. Offer the patient a high-protein diet to restore health.
Correct Answer: B
Rationale: The correct answer is B: Provide a calm, structured environment with consistent mealtimes. This is the priority intervention because individuals with bulimia nervosa benefit from a stable and supportive environment to establish regular eating patterns and reduce anxiety around mealtimes. This intervention helps promote a sense of safety and predictability, which are crucial for managing the eating disorder. Encouraging regular exercise (Choice A) may exacerbate compulsive behaviors related to bulimia. Weight loss (Choice C) should not be the focus as it can worsen the patient's condition. Offering a high-protein diet (Choice D) may not address the underlying psychological issues associated with bulimia.
A client has just been diagnosed with mild Alzheimer's disease. A family member asks what medications are used for treatment. The nurse knows that which of the following medications are the ones most used for mild to moderate Alzheimer's disease? (Select all that apply.)
- A. Haloperidol (Haldol)
- B. Donepezil (Aricept)
- C. Rivastigmine (Exelon)
- D. Nonsteroidal antiinflammatory drugs
Correct Answer: B
Rationale: The correct answer is B: Donepezil (Aricept). Donepezil is a cholinesterase inhibitor commonly used to treat mild to moderate Alzheimer's disease by improving cognitive function. It is considered a first-line medication for Alzheimer's. Haloperidol (A) is an antipsychotic drug and not used for Alzheimer's treatment. Rivastigmine (C) is another cholinesterase inhibitor like donepezil, but it is more commonly used for moderate to severe Alzheimer's. Nonsteroidal anti-inflammatory drugs (D) are not typically used for Alzheimer's treatment. In summary, Donepezil is the preferred medication for mild to moderate Alzheimer's due to its effectiveness in improving cognitive symptoms.
An adult patient tells the case manager, 'I dont have bipolar disorder anymore, so I dont need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now Im bored and dont have any friends.' Where should the nurse refer the patient? Select one tha does not apply.
- A. Psychoeducational classes
- B. Vocational rehabilitation
- C. Social skills training
- D. A homeless shelter
Correct Answer: D
Rationale: The patient does not understand the illness and need for adherence to the medication regimen. Psychoeducation for the patient (and family) can address this lack of knowledge. The patient, who considers himself friendless, could also profit from social skills training to improve the quality of interpersonal relationships. Many patients with serious mental illness have such poor communication skills that others are uncomfortable interacting with them. Interactional skills can be effectively taught by breaking the skill down into smaller verbal and nonverbal components. Work gives meaning and purpose to life, so vocational rehabilitation can assist with this aspect of care. The nurse case manager will function in the role of crisis stabilizer, so no related referral is needed. The patient presently has a home and does not require a homeless shelter.