Nokea
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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What is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors?
- A. Monitor for signs of electrolyte imbalances and dehydration.
- B. Assess for any weight gain and increase exercise habits.
- C. Encourage the patient to express feelings about food and body image.
- D. Monitor for compulsive eating behaviors and binge episodes.
Correct Answer: A
Rationale: The correct answer is A: Monitor for signs of electrolyte imbalances and dehydration. This is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors because purging can lead to electrolyte imbalances and dehydration, which can result in serious health complications such as cardiac arrhythmias and renal issues. Monitoring electrolyte levels and hydration status is crucial for the patient's safety and well-being.
Summary:
- Choice B is incorrect because focusing on weight gain and exercise habits is not the priority when dealing with the immediate health risks of electrolyte imbalances and dehydration.
- Choice C is incorrect as expressing feelings about food and body image is important for therapy but not the priority in this acute situation.
- Choice D is incorrect as monitoring for compulsive eating behaviors and binge episodes is more relevant for patients with binge eating disorder rather than bulimia nervosa with frequent purging behaviors.
The caregiver for a client with moderate to severe dementia tells the nurse, 'I'm exhausted. He wanders at night instead of sleeping, so I get no rest. I'm afraid to leave him during the day, so I have to take him to the grocery store and to the laundromat. When I'm busy there, he often wanders off. Still, I have to do it all.' The nurse recognizes the need to provide teaching for this caregiver. An appropriate outcome is that the caregiver will:
- A. Feel justified in putting the client in a nursing home
- B. Verbalize realistic self-expectations
- C. Cease abusive interactions with the client
- D. Feel comfortable leaving the client alone one morning a week
Correct Answer: B
Rationale: The correct answer is B: Verbalize realistic self-expectations. This is the most appropriate outcome to address the caregiver's situation. By verbalizing realistic self-expectations, the caregiver can understand the importance of self-care and setting boundaries. This outcome promotes the caregiver's well-being while still providing care for the client.
Choice A is incorrect because putting the client in a nursing home may not be the best solution without exploring other options first. Choice C is incorrect as there is no mention of abusive interactions in the scenario. Choice D is incorrect because feeling comfortable leaving the client alone without addressing the caregiver's exhaustion and concerns may not be the most appropriate approach.
A common form of mental disorder afflicting 10-20\% of the population is
- A. schizophrenia
- B. senile dementia
- C. depression
- D. delusional disorder
Correct Answer: C
Rationale: Depression affects 10-20\% of people at some point, making it far more common than schizophrenia or delusional disorders.
The nurse is evaluating a patient with bulimia nervosa. The most appropriate action is to:
- A. Assign a strict dietary plan to prevent weight gain.
- B. Monitor the patient for physical symptoms of starvation.
- C. Encourage the patient to avoid purging after meals.
- D. Provide emotional support without focusing on food-related behaviors.
Correct Answer: C
Rationale: The correct answer is C: Encourage the patient to avoid purging after meals. This is the most appropriate action because it addresses the harmful purging behavior associated with bulimia nervosa. By encouraging the patient to avoid purging, the nurse can help prevent serious health consequences such as electrolyte imbalances and damage to the esophagus.
Option A is incorrect because assigning a strict dietary plan may exacerbate the patient's unhealthy relationship with food and contribute to feelings of guilt and shame. Option B is incorrect as monitoring for physical symptoms of starvation may not directly address the underlying issue of purging behavior. Option D is also incorrect as providing emotional support alone may not effectively address the harmful purging behavior.
A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:
- A. Appropriately express angry feelings.
- B. Verbalize two positive things about self.
- C. Verbalize the importance of eating a balanced diet.
- D. None of the above.
Correct Answer: D
Rationale: Rationale:
1. Patient's diagnosis indicates coping issues, not anger expression or self-esteem.
2. Patient's coping mechanism involves overeating and vomiting, not diet.
3. Outcome should focus on coping skills improvement, not unrelated goals.
4. None of the choices address the root issue of coping with loneliness and isolation.
5. Thus, the correct answer is D, as none of the options directly address the patient's ineffective coping mechanism.