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Your pregnant patient has a history of major depression. Which of the following is she most likely to be at risk for?
- A. She is at risk for development of manic episodes.
- B. She is at risk for recurrence of depression after the birth of the baby.
- C. She is more likely to have an autistic child.
- D. She has no higher risk for emotional problems than other patients.
Correct Answer: B
Rationale: History of major depression (B) is the biggest risk factor for postpartum depression, increasing the likelihood of recurrence post-delivery.
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An 18-year-old referred to the mental health center often cooks gourmet meals but eats only tiny portions. The patient wears layers of loose clothing saying, "I like the style." The patient's weight dropped from 130 to 95 pounds. She has amenorrhea. Which diagnosis is most likely?
- A. Eating disorder not otherwise specified
- B. Anorexia nervosa
- C. Bulimia nervosa
- D. Binge eating
Correct Answer: B
Rationale: The correct diagnosis is B: Anorexia nervosa. This patient exhibits key symptoms such as restrictive eating leading to significant weight loss, wearing layers of clothing to hide body shape, and amenorrhea. These symptoms align with the diagnostic criteria for anorexia nervosa. The other choices are incorrect because they do not fully capture the combination of symptoms present in this case. Choice A (Eating disorder not otherwise specified) is too broad and does not specify the severity of the symptoms. Choice C (Bulimia nervosa) typically involves binge eating followed by compensatory behaviors, which is not indicated in this case. Choice D (Binge eating) focuses solely on overeating without the restrictive eating and weight loss seen in anorexia nervosa.
What is the primary goal for a nurse treating a patient with anorexia nervosa?
- A. To help the patient achieve optimal body weight quickly.
- B. To restore the patient's nutritional balance and weight.
- C. To involve the patient in daily exercise routines to improve physical health.
- D. To encourage the patient to undergo intensive psychotherapy.
Correct Answer: B
Rationale: The primary goal for a nurse treating a patient with anorexia nervosa is to restore the patient's nutritional balance and weight. This is because individuals with anorexia nervosa often have severe malnutrition and weight loss, which can lead to serious health complications. By focusing on restoring nutritional balance and weight, the nurse can help improve the patient's physical health and overall well-being. Encouraging the patient to achieve optimal body weight quickly (choice A) may not be realistic or safe, as rapid weight gain can have negative consequences. Involving the patient in daily exercise routines (choice C) may exacerbate the patient's compulsive behaviors around food and exercise. Encouraging the patient to undergo intensive psychotherapy (choice D) is important, but it is not the primary goal in the initial treatment of anorexia nervosa.
The nurse working with a client whose diagnosis is bulimia asks the client to recall a time in her life when eating was a positive experience and she enjoyed small amounts of food without purging. The purpose of this intervention is to:
- A. gain additional information about the client's bulimic condition.
- B. emphasize that the client is capable of engaging in eating without purging.
- C. incorporate specific foods into the meal plan to reflect pleasant memories.
- D. assist the client to become more compliant with the treatment plan.
Correct Answer: B
Rationale: The correct answer, B, emphasizes that the client is capable of engaging in eating without purging. By asking the client to recall a positive experience with food, the nurse is helping the client recognize that they can enjoy food without the need to purge. This intervention aims to challenge the client's negative beliefs about food and eating, promoting a healthier relationship with food.
Choice A is incorrect as the purpose is not solely to gain additional information about the client's condition but rather to shift the client's perspective on food. Choice C is incorrect as the intervention focuses on emotional aspects rather than specific foods. Choice D is incorrect as the goal is to address the psychological aspect of the client's behavior, not just compliance with the treatment plan.
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 family cares for her during the evening and at night. Noting the patient had several bruises, the nurse discussed her observations with the daughter, who became defensive and said that her mother was very difficult to manage because she is confused and wanders all night. She says the bruises resulted from a fall down stairs. The daughter states, "I have lost my mother, and I cannot bear it anymore. It is wrecking my family."Â The nursing intervention that should take priority is:
- A. Teaching the daughter more about the effects of Alzheimer's disease.
- B. Identifying two options for caregiver respite and care assistance at night.
- C. Supporting the daughter to grieve the loss of her mother's ability to function.
- D. Teaching the family how to give physical care more effectively and efficiently.
Correct Answer: B
Rationale: The correct answer is B: Identifying two options for caregiver respite and care assistance at night. This is the priority intervention because it addresses the immediate need to ensure the patient's safety and well-being while also supporting the daughter who is struggling to cope. By identifying options for caregiver respite and care assistance at night, the daughter can get the help she needs to manage her mother's care effectively without feeling overwhelmed. This intervention promotes both the patient's safety and the daughter's mental well-being.
Choices A, C, and D are incorrect:
A: Teaching the daughter more about the effects of Alzheimer's disease. While education is important, in this scenario, the immediate need is to address caregiver respite and care assistance.
C: Supporting the daughter to grieve the loss of her mother's ability to function. While supporting the daughter emotionally is important, ensuring the patient's safety should take priority.
D: Teaching the family how to give physical care more effectively and efficiently. While this is important
An emergency department nurse prepares to assist with evidence collection for a sexual assault victim. Prior to photographs and pelvic examination, what documentation is important?
- A. The patient's vital signs
- B. Consent signed by the patient
- C. Supervision and credentials of the examiner
- D. Storage location of the patient's personal effects
Correct Answer: B
Rationale: The correct answer is B: Consent signed by the patient. This is crucial as it ensures the patient's autonomy and willingness to undergo evidence collection. Without proper consent, the procedure would be unethical and potentially illegal. Vital signs (A) may be important for overall assessment but are not directly related to evidence collection. Supervision and credentials of the examiner (C) are necessary but not the most important documentation. The storage location of personal effects (D) is relevant for patient safety but not essential for evidence collection.