A 15-year-old female is admitted for treatment of anorexia nervosa. Which is
characteristic of anorexia nervosa?
Body weight less than normal for age, height, and overall physical health
Amenorrhea for at least two cycles
Absence of hunger feelings
Anorexia nervosa is a life-threatening eating disorder characterized by the client's
refusal or inability to maintain a minimally normal body weight, intense fear of gaining
weight or becoming fat, significantly disturbed perception of the shape or size of the
body, and steadfast inability or refusal to acknowledge the seriousness of the problem or
even that one exists. Clients with anorexia have a body weight that is less than the
minimum expected weight, considering their age, height, and overall physical health. In
addition, clients have a preoccupation with food and food-related activities and can have
a variety of physical manifestations. Physical problems or anorexia nervosa include
amenorrhea, constipation, overly sensitive to cold, lanugo hair on body, hair loss, dry
skin, dental caries, pedal edema, bradycardia, enlarged parotid glands, hypothermia, and
electrolyte imbalance. These clients do not lose their appetites. They still experience
hunger but ignore it and signs of physical weakness and fatigue. Dental erosion is
characteristic of bulimia nervosa.
The nurse is assessing a client with bulimia nervosa. Which of the following symptoms
would the nurse expect to find? Select all that apply.
The weight of clients with bulimia usually is in the normal range, although some clients
are overweight or underweight. Recurrent vomiting destroys tooth enamel, and
incidence of dental caries and ragged or chipped teeth increases in these clients.
Metabolic alkalosis often results from vomiting. Cold intolerance and hypotension are
symptoms associated with emaciation seen in anorexia nervosa.
The nurse is assessing a client with bullimia nervosa. Which of the following symptoms would the nurse expect to find? SATA.
Normal weight for height. Dental erosion. Metabolic alkalosis.
Which eating disorder is charecterized by consuming an amount of food much larger than a person would normally eat & of near-normal weight? Afterward the client may purge the food or exercise excessively, an between binges, the client may eat low-calorie foods or fast?
When working with a family of a client with anorexia, which of the following issues must be addressed?
While assessing the family dynamics of a client with an eating disorder, which of the following does the nurse most likely discover?
The nurse understand that which biologic factors may influence the development of an eating disorder? SATA.
Family history of eating disorders. Dysfunction of the hypothalamus. Norepinephrine imbalances. Decreased serotonin levels.
Which factors may contribute to the frequency of eating disorders in adolescents? SATA.
Media portrayal of slimness. Body disatisfaction in adolescent females. Body image disturbance. Seeking autonomy. Seeking to develop a unique identity.
Several meds are prescribed to a client with anorexia. Which med may be prescribed to help treat the client's distorted body image?
The nurse uses cognitive behavioral approaches to assist the client with bulimia toward recovery. Which statement by the nurse would be consistent of this approach?
"Is there anyway you can look at that sandwich as fuel for your body?"
Which may help a person to overcome an eating disorder that causes weight gain?
Believing that gaining weight is a side effect of unhealthy lifestyle behaviors & losing weight is a side effect of healthy lifestyle behaviors.
The nurse is assessing a client with an eating disorder. which personality charecteristic would the nurse expect to detect when interacting with the client?
The nurse is teaching a client with bulimia to use self-monitoring techniques. Which client statement would let the nurse know that this has been effective?
"I am learning to recognize events & emotions that trigger my binges and am working on responses other than binging & purging."
When preparing a client with bulimia for discharge, the nurse suggest that the client & family continue with family therapy on an outpatient basis. Which of the following is a rationale for this suggestion?
Family members often need to learn role independence & autonomy.
Which of the following interventions would be appropriate for a client with anorexia?
Having the client for view of staff for 90 minutes after each meal.
Which is the primary objective for nursing interventions in the care of a client with anorexia?
Restoring nutritional status to normal
Which nursing statement is most effective in communicating a positive expectation in a client?
"I will sit here quielty with you, while you eat."
The nurse has been teaching the client's family about the clients eating disorder, anorexia. Which statement would indicate that teaching was effective?
"We will negotiate resolutions to family conflicts."
A client who has an eating disorder is becoming dependent on the nurse for direction of food choices. Which approach by the nurse would demonstrate the nurse's self-awareness?
Approach the client with adult-like-objectivity.
A community health nurse is planning a substance abuse prevention program. Which group would be the best target audience for the nurse to plan a program?
school-aged children in an after-school program
Which statement are important reasons for why the problem for substance abuse must be addressed? SATA.
Increasing number of infants are suffering the physiologic & emotional consequences of prenatal exposure to alcohol or drugs. Chemical abuse results in increased violence. Drug abuse costs business & industry an estimated costs of $102 billion annually. Alcohol abuse is too frequent cause of or contribute to death.,
When interviewing the family members of a client being treated for substance abuse problems, which behavior would alert the nurse to the possibility of codependency?
Blaming themselves' for the family's problems
The nurse is assessing the drinking history of a client being admitted for alcohol abuse. Which statement would the nurse expect the client to make?
"I don't really have a problem with alcohol. I've just been having a streak of bad luck lateley."
A client for treatment for drug abuse makes the statement, "I am a winner. You all are the losers because I cant beat this on my own." What common charecteristic of persons addicted to drugs is revealed in this statement?
Defending against a negative self-concept
A nurse is exploring treatment options of a client addicted to heroin. Which information regarding the use of Methadone is important for the nurse to include?
Methadone will meet the physical needs of opiates wihtout producing cravings for more.
A client with a history of heavy alcohol use, whose last drink was 24-hours ago, is seen in the ER. The client is oriented but tremulous, weak, & sweaty & has some GI symptoms. Which of the following is typical of these symptoms?
Alcohol Withdrawal Syndrome
A client with alcohol dependence is admitted to the hospital with pancreatitis. Which intervention should be included in the client's plan of care?
The nurse is coleading a family therapy group with a client addicted to alcohol. Which statement made by the wife indicates a need for additional education regarding alcoholism as a family illness?
"I have to call in sick for my husband when he is too hungover to go to work."
A nurse is working with a couple who is seeking counseling for marital discord. The history indicates the husband was treated for substance abuse 4 years ago & attends AA meeting occasionally. Which statement made by the recovering husband should alert the nurse for the need of further education?
"She gets upset when I hang out with my old buddies n the weekends."
The nurse is co-leading a family therapy group for clients & families of drug-addicted individuals. the family of a cocaine addict is angry and can not understand why the client can not stop using. The nurse guides the group to discuss their understanding of the nature of addiction. Which staements would the nurse identify as the accurate understanding of the nature of addiction? SATA.
It is a medical illness that is progressive. Relapses & remissions are part of the illness.
A peer reports to work looking unkempt & disshelvled. her movement are uncoordinated, and her breath smells like mouthwash. Another nurse suspects this peer is intoxicated. What should be the action of the nurse who suspects that a peer is intoxicated?
Ask the peer if she feels alright & express concern.
Which reasons make it necessary for the nurse to examine his or her beliefs & attitudes about substance abuse? SATA.
The nurse may be overly harsh & critical of the client. The nurse may unknowingly act out old family roles & engage in enabling behaviors. The nurse or close friends & family of the nurse may abuse substances. The nurse may have different attitudes about various substances of abuse.
Which would most likely be a type of behavior that would be manifested by a client who has histrionic personality disorder?
Having a tantrum if not getting enough attention
Which term describes the extent to which a person considers himself to be an integral part of the universe?
The nurse is teaching a client with paranoid personality disorder to validate ideas with another person before taking action on him. which is the best rationale for this intervention?
Teach the client to make necessary requests in writing or over the phone.
Which of the following is a realistic outcome for the care of a person with a personality disorder?
Outcomes that focus on change in behavior
A client wiht anitsocial personality disorder is begging to use the phone to call his wife, even though it is against the unit rules. The client begs, "It is just this once, and she will be so hurt if i don't call her." Which would be the most appropriate response by the nurse?
"you may not use the phone to call your wife."
When planning care for a client with passive-aggressive personality disorder, the nurse will need to include interventions for which personality behavior?
Procrastination & intentional inefficiency
Which nursing interventions are most important in a plan of care for a client with histrionic personality disorder? SATA.
Teach social skills. Try to meet the client's needs for attention.
A client with dependent personality disorder has a goal to increase her problems-solving skills. Which client behavior would indicate progress toward meeting that goal?
Which are important in the limit-setting technique to deal with manipulative behavior? SATA.
Stating the behavioral limit. Identifying consequences if the limit is exceeded. Identifying the expected or desired behavior.
the nurse teaches an anti-social client to take a time-out in his room when challenged by another person instigating an argument. What is the main reason for the time-out?
It allows an opportunity for the client to regain control of emotions.
A nurse is teaching a client with borderline personality disorder to reshape thinking patterns. Which is an example of a cognitive restructuring technique that would be helpful for this client?
Recognize negative thoughts & replace them with positive ones.
Upon admission, a client with a personality disorder identified the following as areas of concern for which the client would like to help. According to studies, which will most likely be addressed to the healthcare team?
A female client with borderline personality was formerly cooperative with the treatment regimen . Suddenly, the client believes the staff is working against her & is refusing all interaction & participation in treatment. The nurse feels very frustrated with this client's behavior. What is the best action for the nurse to take regarding personal frustration with this client?
Discuss the frustration with a colleague or supervisor in a private setting.
Which challenges are posed when working with clients with personality disorders? SATA.
It can take a long time to change their behaviors, attitudes, or coping skills. The nurse can easily but mistakingly believe the client simply lacks motivation or the willingness to make changes. Clients with personality disorders challenge the ability of therapeutic staff to work as a team. Team members may have differing opinions about individual clients.
Which techniques are important for nurses caring for clients with personality disorders to use in order to effectively provide care? SATA.
Discuss feelings of anger or frustration with colleagues to help them recognize & cope with their own feelings. Employ ongoing communication with team members to remain firm & consistent about expectations for clients.
which best explains the neurochemical processes responsible for depression?
Decreased serotonin & norepinephrine activity
Which statements about the etiology of bipolar disorder do most psychoanalytical theories subscribe to? SATA.
Manic episodes are a "defense" against udnerlying depression. The id takes over the ego and acts as an undisciplined hedonistic being (child).
Which variables represent the highest risk for developing major depressive disorder? SATA.
Mood-disorder in first degree relatives. Older adult.
A concerned family member tells the nurse, "I am concerned about my brother. He has been acting very different lately." Knowing the family has a history of bipolar disorder, the nurse inquires further about this. Which behavior during the past week might indicate that the brother has bipolar disorder?
A client is admitted for major depression. At which time would the nurse expect the client to be at highest risk for self-harm?
Approxiamtley 2 weeks after starting antidepressant medication
A client who is depressed begins to cry and states, "I'm just really sick of feeling this way. nothing ever seems to go right in my life." Which would be the most appropriate response by the nurse?
"You are feeling really sad right now. It's a hard time."
A client who is manic threatens others on the unit. Which would be the intial nursing action in response to this behavior?
Setting limits on aggressive & intimidating behavior
The nursing instructor is conducting a preconference with a group of nursing students on a psychiatric unit. Which statement made by the students reflects the greatest barrier to being able to provide professional care to the client who is suicidal?
"I think suicide is wrong & selfish."