WEEK 2 [BSN 340] "FEEDING, EATING AND PERSONALITY DISORDERS"

The community health nurse has been asked to give a presentation to a local group focused on healthy body image in teenage girls. Which statement by one of the teenagers indicates the need for additional​ teaching? -"My confidence should be based on my value as a human​ being, not the size of my clothes." -"I learned a lot about healthy eating and healthy portions today." -"I need to eat enough calories to meet the nutritional needs of my body." -"No matter​ what, it is important to be healthy by staying thin."

"No matter​ what, it is important to be healthy by staying thin."

The nurse is providing care for a client who may have a personality disorder. Which question will be most appropriate for the nurse to include in the client interview to help diagnose the client​'s personality​ disorder? -"Are you having trouble ​sleeping?" -"Have you recently experienced weight ​loss?" -"Have you had thoughts of​ violence?" -"Do you ever experience feelings of ​mania?"

-"Have you had thoughts of​ violence?"

The school nurse becomes concerned about a potential eating disorder when a member of the cheerleading squad is brought to the office following a syncopal episode during practice. Once the client has​ rested, the nurse inquires about the time she last had something to eat. The client​ responds, "I only eat dinner at night because I don​'t want to get fat." The nurse calculates the client​'s body mass index​ (BMI) as 19 and gathers additional information. Which client statement contributes to the nurse​'s concern that the client has anorexia​ nervosa? Select all that apply. -"If I eat too​ much, I use laxatives to balance it out." -"I know I need extra calories when I​'m training extensively." -"I don​'t think it​'s a big deal if I don​'t eat three meals a day. It​'s healthier to be skinny." -"I eat only 800 calories per day." -"I feel fat."

-"If I eat too​ much, I use laxatives to balance it out." -"I don​'t think it​'s a big deal if I don​'t eat three meals a day. It​'s healthier to be skinny." -"I eat only 800 calories per day." -"I feel fat."

Which statement by the nurse indicates an understanding of eating disorders and organ​ function? Select all that apply. -"Cardiovascular side effects of anorexia nervosa include tachycardia and hypertension." -"The client with an eating disorder may present with jaundiced skin tone." -"Easily bruised skin is a normal finding in a healthy individual." -"The client with bulimia nervosa will have no abnormal dental findings." -"An eating disorder can affect the integumentary​ system, leading to dry​ skin, brittle​ hair, and brittle nails."

-"The client with an eating disorder may present with jaundiced skin tone." -"An eating disorder can affect the integumentary​ system, leading to dry​ skin, brittle​ hair, and brittle nails."

The nurse is caring for a client who is suffering from extremely low​ self-esteem. In trying to assess the specific factors that are affecting the​ client's self-esteem, what factors would the nurse​ consider? Select all that apply. -Ethnicity -Gender -Age -Socioeconomic status -Level of education

-Age -Socioeconomic status -Level of education

The nurse is caring for a client diagnosed with a personality disorder. Which intervention is not appropriate for this​ client? -Allowing the client to keep a disposable razor at the bedside -Establishing a contract to attend one group therapy session per day -Refusing to share confidential information with another client -Identifying manipulative traits during free time

-Allowing the client to keep a disposable razor at the bedside

The nurse is caring​ for17-year-old Michelle Appleton at an outpatient pediatric clinic. Michelle requires a complete physical prior to joining the high school cheerleading squad. Upon​ assessment, Michelle's nurse notes that Michelle has areas of decay on several teeth and​ Michelle's weight is less than​ 85% of normal.​ Michelle's mother privately tells the nurse that she is concerned because she suspects that her daughter is vomiting after meals and that she is not eating very much during the day.The nurse would consider that Michelle might be experiencing which alteration of​ self? -Rumination disorder -Anorexia nervosa -Pica -​Binge-eating disorder

-Anorexia nervosa

The nurse is completing an intake health questionnaire with a​ 20-year-old professional ballerina. The client has a body mass index of​ 17.5, blood pressure of​ 95/45 mmHg, and an irregular apical pulse. For which eating disorder should this client be​ screened? -Anorexia nervosa -Overexercising ​-Binge-eating disorder -Bulimia nervosa

-Anorexia nervosa

The nurse is performing the initial physical exam of a client who presented with a complaint of "feeling faint" when standing up. During the​ exam, the nurse notes​ emaciation, dry​ skin, and lanugo on the client​'s arms and shoulders. Which diagnosis should the nurse consider based on these​ findings? -Anorexia nervosa -Hyperthyroidism -Bulimia nervosa ​-Binge-eating disorder

-Anorexia nervosa

Through an assessment screening the nurse observes that a client is obsessed with​ weight, has an extreme fear of gaining​ weight, and admits to using laxatives and diuretics to lose weight. The nurse would consider that the client has which eating or feeding​ alteration? -Anorexia nervosa -Rumination disorder -Prader-Willi syndrome -Bulimia nervosa

-Anorexia nervosa

The nurse is working with a team of healthcare professionals to care for a client with a personality disorder. The team has collaboratively decided on pharmacologic therapy for the client. Which types of medications would the nurse expect to provide to treat the​ client's condition? Select all that apply. -Antidepressant -Anxiolytic -Anticonvulsant -Antipsychotic -Antispasmodic

-Antidepressant -Anxiolytic -Antipsychotic

The nurse is working with a team of healthcare professionals to care for a client with a personality disorder involving hallucinations. The team has collaboratively decided on pharmacologic therapy for the client. Which type of medication would the nurse expect to provide to treat the​ client's condition? -Antipsychotic -Anxiolytic -Antidepressant -Antispasmodic

-Antipsychotic

The nurse is providing care to a client who reads hidden meanings or threatening meanings in benign comments. Which treatment does the nurse anticipate for this​ client? -Anxiolytic therapy -Psychodynamic therapy ​-family-focused therapy ​-Anger-management therapy

-Anxiolytic therapy

Mary​ Cooper, a​ 45-year-old female​ client, has been diagnosed with anxiety. The nurse understands that collaborative treatment may be required to help treat​ Mary's anxiety. The nurse is preparing to provide Mary with education regarding the medication​ Mary's healthcare provider just prescribed. The nurse would expect to discuss which type of medication with​ Mary? -Antispasmodics -Antipsychotics -Anticholinergics -Anxiolytics

-Anxiolytics

The nurse is completing an assessment for a client who has manifestations of a personality disorder. Which assessment approach is most appropriate for this​ client? -Asking questions that allow the client to describe aspects about self -Asking questions about the Final Four game last evening -Asking questions that allow the client to describe aspects about the client​'s family -Asking questions that allow the nurse to speak more than the client

-Asking questions that allow the client to describe aspects about self

Takeisha is a​ 17-year-old African American female who came to the health care providers office with a complaint of amenorrhea for the past 4 months. She is accompanied by her​ mother, who tells the nurse that Takeisha is a straight A student who plays softball for her high school. Takeisha hopes to become a model for athletic clothes and participates in many local modeling events. She runs 5 miles before school each​day, and 3-4 times a week she stays after softball practice and runs another 5 miles. Takeisha is 58 and was last weighed 5 months ago at her annual​ physical, which was recorded as 120 lbs. She now weighs 25 lbs less. Takeisha quickly interjects that her schedule is too busy for her to eat balanced meals. She eats most of her meals away from​ home, and they consist primarily of energy bars and sports drinks. Her mother adds that she is a single mom and does not make many meals at home. Neither Takeisha nor her mother seems concerned at this time about the weight loss. They are more concerned about the amenorrhea. Takeisha states that she is not sexually active and has no time or interest in establishing relationships with boys. She is working very hard to get a​ full-time modeling job after she graduates. When the nurse asks Takeisha about her​appearance, Takeisha states that she feels and looks athletic rather than considering that she is rather thin compared with others girls on her team. When asked about her​ friends, Takeisha states that it is hard for her to make and keep friends because she does not have much time outside her sports interest and studying. Until about a year​ ago, Takeisha spent most of her free time with her mom. Takeisha tells you that her mom has a new​ boyfriend, and that she resents the time he spends with her mom that they used to spend together. He also teases her constantly that African American girls are too fat to be models. While taking Takeishas history you note which risk factors for anorexia​ nervosa? Select all that apply. -Athlete -Adolescent -Perfectionist -Female -African American

-Athlete -Adolescent -Perfectionist -Female

Which component is required in a nursing assessment of a client diagnosed with an eating​ disorder? Select all that apply. -Attitude toward food -Current medication list -Condition of the teeth -Cognitive functioning tests -Body mass index

-Attitude toward food -Current medication list -Condition of the teeth -Body mass index

The community health nurse is preparing a seminar on preventive methods to decrease risk factors for developing personality disorders. Which resource is appropriate for the nurse to include in the​ presentation? Select all that apply. -The Boys and Girls Club -Big Brothers Big Sisters Program -YMCA -The Nurse-Family Partnership Program -Incredible Years Program

-Big Brothers Big Sisters Program -The Nurse-Family Partnership Program -Incredible Years Program

The nurse is assessing a client who reports eating to the point of discomfort at least two times a week for the past year. The client denies use of​ laxatives, self-induced​ vomiting, ipecac​ syrup, or​ enemas, and feels unable to control the behavior. The client feels embarrassed and has stopped going out with friends. Which eating disorder should the nurse suspect this client​ has? -Anorexia nervosa ​-Binge-eating disorder -Bulimia nervosa -Purging

-Binge-eating disorder

​Hanna, a​ 48-year-old woman, has been admitted for treatment of anorexia nervosa following a heart arrhythmia and presyncopal episode. Which health care​ provider's order should cause the nurse to ask for​ clarification? -Blood glucose monitoring -Thyroid function tests -Electrocardiography -Urinalysis

-Blood glucose monitoring

A client is discussing her feelings regarding her eating disorder with the nurse. The client shares that when she looks in a​ mirror, she sees herself as "fat" even though her body mass index is 18. This statement is consistent with which thought​ pattern? -Body image distortion -Deception -Therapeutic relationship -Purging

-Body image distortion

You are preparing to perform your daily evaluation of Takeishas progress in meeting her goals as listed on the nursing care plan. Which nursing diagnoses will you​ evaluate? Select all that apply. -Client has a disturbed body image. -Client has chronic low​ self-esteem. -Client has deficient fluid volume. -Clients nutrition is less than body requirements. -Clients coping skills are ineffective.

-Client has a disturbed body image. -Client has chronic low​ self-esteem. -Clients nutrition is less than body requirements. -Clients coping skills are ineffective.

The nurse is evaluating a client who is showing behaviors of being​ dramatic, emotional, and erratic. Based on these assessment​ findings, which cluster of personality disorders will the nurse document for this​ client? -Cluster D -Cluster A -Cluster B -Cluster C

-Cluster B

Which form of intervention is the primary treatment used with clients who have feeding and eating​ disorders? -Pharmacologic therapy -Cognitive-behavioral therapy​ (CBT) ​-Schema-focused therapy -Dialectical behavioral therapy

-Cognitive-behavioral therapy​ (CBT)

A nurse is reviewing the medical record for a client who was admitted following a cardiac arrhythmia related to an eating disorder. Which of the abnormal clinical findings is common in clients with eating​ disorders? Select all that apply. -Concentrated urine -Electrolyte imbalance -Increased urine output -Dehydration -Hypotension

-Concentrated urine -Electrolyte imbalance -Dehydration -Hypotension

During group therapy one​ morning, Ann tells the group that she loves to date a lot of men and really enjoys it when they fight over her. She tells them different stories to get their attention and enjoys watching them get angry at each other just so she'll get the attention she deserves and wont be alone. You document which signs of unstable interpersonal​ relationships? Select all that apply.​ -Controlling and demanding behavior -Clinging and exploitive behavior -Intense empathy with everyone she is dating -Pitting individuals against each other -Multiple relationships to avoid being alone

-Controlling and demanding behavior -Clinging and exploitive behavior -Pitting individuals against each other -Multiple relationships to avoid being alone

Which specific independent interventions would the nurse provide to a client who is diagnosed with alteration of​ self? Select all that apply. -Creating a safe environment for the client to talk -Promoting adequate nutrition to the client -Helping the client identify strengths and weaknesses -Providing cognitive-behavioral therapy to the client -Providing pharmacologic therapy to the client

-Creating a safe environment for the client to talk -Promoting adequate nutrition to the client -Helping the client identify strengths and weaknesses

Which behavior that places the client at risk of injury is not usually associated with an eating​ disorder? -Inadequate caloric intake -Excessive exercise -Purging -Cutting

-Cutting

As part of her plan of​ care, you prepare to teach Ann about impulsive behaviors and how she can monitor and learn to control them. Which behaviors will you include in her teaching​ plan? Select all that apply. -Cutting her arms and other acts of​ self-injury -Extreme rage in response to unimportant events -Disregard for the consequences of her behavior -Indifference to others feelings -Unwillingness to take responsibility for her actions

-Cutting her arms and other acts of​ self-injury -Disregard for the consequences of her behavior -Indifference to others feelings -Unwillingness to take responsibility for her actions

The nurse is assessing a client who​ states, "My family often says that I am​ clingy, that I hate being separated from​ them, and that I go to great lengths to be accepted by them." Based on the client​'s statement during the​ assessment, with which personality disorder does the nurse anticipate this client will be diagnosed by the healthcare​ provider? -Antisocial -Dependent -Paranoid -Avoidant

-Dependent

The nurse is working with a team of healthcare professionals to care for a client with a personality disorder. The team has collaboratively decided on psychiatric therapy for the client. Which specific types of therapies are most commonly used to treat the​ client's condition? Select all that apply. -Dialectical behavioral therapy -Expressive therapy -Collaborative therapy -Cognitive-behavioral therapy​ (CBT) ​-Schema-focused therapy

-Dialectical behavioral therapy -Expressive therapy -Cognitive-behavioral therapy​ (CBT) ​-Schema-focused therapy

According to​ Freud's Psychosexual Theory of​ Development, what are the three primary elements of the human​ personality? Select all that apply. -Real self -Ideal self -Ego -Id -Superego

-Ego -Id -Superego

Which statement should the nurse include in a presentation regarding eating​ disorders? Select all that apply. -Electrolyte imbalance is a common problem associated with eating disorders. -Eating disorders can cause malnutrition. -Excessive exercise can be associated with an eating disorder. -Diet pills and laxatives are not used by people with eating disorders. -Teenagers are the only age group with eating disorders.

-Electrolyte imbalance is a common problem associated with eating disorders. -Eating disorders can cause malnutrition. -Excessive exercise can be associated with an eating disorder.

A nurse treating a client for anorexia nervosa​ (AN) is concerned that the primary disorder has caused other health issues. Which test would the nurse consider for the​ client? -Thematic apperception test -Personality diagnostic questionnaire -Head CT -Electrolyte study

-Electrolyte study

Helping Ann learn to control her manipulative behavior requires strict limit setting. Which goals for limit setting should be included in her plan of​ care? Select all that apply. -Control the risk for suicide -Establish personal and professional boundaries -Prevent escalation of negative behavior -Decrease the risk of depression -Counteract resistance from the client

-Establish personal and professional boundaries -Prevent escalation of negative behavior -Counteract resistance from the client

The nurse encounters a client who has trust issues with others and is not being open to treatment. The client often sits in a corner away from everyone else in the room. Which nursing intervention is appropriate for this​ client? -Discharging the client from the hospital -Establishing a nurse-client relationship -Making the client sit with the rest of the group -Leaving the client in the corner of the room

-Establishing a nurse-client relationship

The nurse is preparing to perform a nursing assessment on a client diagnosed with a personality disorder. Which action by the nurse would ensure an effective​ assessment? -Establishing an authoritative environment -Asking​ detailed, personal questions -Asking questions related to family​ members' mental health -Establishing a therapeutic environment

-Establishing a therapeutic environment

The nurse is caring for an adolescent client who is diagnosed with a personality disorder. Which assessment finding supports this​ diagnosis? -Experiencing manic highs -Exhibiting narcissism -Feelings of anxiety -Hearing voices

-Exhibiting narcissism

Which critical clinical manifestation does Takeisha exhibit that supports a diagnosis of anorexia​ nervosa? -Extreme weight loss -Compulsive exercising -Serum electrolytes -Thought distortions

-Extreme weight loss

Which is a risk factor for developing a personality disorder​ (PD)? Select all that apply. -Family life -Genetics -Low socioeconomic status -Minimal physical activity -Childhood abuse

-Family life -Genetics -Low socioeconomic status -Childhood abuse

What are the risk factors for the development of mood​ disorders? Select all that apply. -Family member with depression -Childhood sexual abuse -Female gender -Male gender -Caucasian ethnicity

-Family member with depression -Childhood sexual abuse

You are preparing a teaching plan for Takeisha about her anorexia. You know you must build in areas to emphasize in repeat sessions during her hospital stay. Which are the key areas of teaching you will build into your​ plan? Select all that apply. -How to recognize situations and events that trigger anxiety. -Food is necessary in​ life, but moderation must be learned. -Feelings are normal and there is no need to fear them. -Expressing​ love, affection, and​ appreciation, verbally and​ physically, are important to recovery. -Avoid arguments about food and eating behaviors.

-Food is necessary in​ life, but moderation must be learned. -Feelings are normal and there is no need to fear them. -Expressing​ love, affection, and​ appreciation, verbally and​ physically, are important to recovery. -Avoid arguments about food and eating behaviors.

Which are types of psychotherapy used in the treatment of personality​ disorders? Select all that apply. -Group therapy ​-Schema-focused therapy -Cognitive-behavioral therapy -Dialectical behavioral therapy -Physical therapy

-Group therapy ​-Schema-focused therapy -Cognitive-behavioral therapy -Dialectical behavioral therapy

​Mary, a​ 23-year-old client, is seen for an annual​ OB/GYN check-up. The nurse is reviewing​ Mary's medical record prior to the health care​ provider's physical examination and notes that Mary has lost 50 pounds since her last visit.​ Mary's last recorded weight was 145​ pounds; she now weighs 95 pounds. While Mary was overweight for her height at the previous​ visit, she is now underweight. The nurse suspects that Mary may be anorexic. Which assessment finding would support this​ suspicion? -Stained teeth -Hypotension -Hypokalemia -Scars on fingers

-Hypotension

The nurse suspects that the client she is caring for is suffering from Prader-Willi syndrome. During the​ assessment, which specific signs or symptoms would the nurse look​ for? Select all that apply. -Incessant desire to eat -Poor muscle tone -Consumption of nonfood items -Regurgitation of food -Mental retardation

-Incessant desire to eat -Poor muscle tone -Mental retardation

The nurse is reviewing laboratory results for a client diagnosed with anorexia nervosa. Which result is not consistent with the client​'s ​diagnosis? -Decreased serum potassium -Ketones present in the urine -Urine specific gravity of 1.030 -Increased level of ferritin

-Increased level of ferritin

Which psychosocial nursing diagnosis is appropriate for a client with an eating​ disorder? Select all that apply. -Increased risk of anxiety -Alterations in body image -Potential for injury -Decreased​ self-esteem -Impaired nutrition

-Increased risk of anxiety -Alterations in body image -Decreased​ self-esteem

What are important nursing actions when performing a nursing assessment of a client with a suspected alteration of​ self? Select all that apply. -Interview the client. -Assess the​ client's role mastery. -Assess the​ client's personal identity. -Establish a safe environment. -Establish a therapeutic relationship.

-Interview the client. -Establish a safe environment. -Establish a therapeutic relationship.

You are reviewing and revising your nursing care plan for Ann. Which interventions designed to control her manipulative behavior will you​ include? Select all that apply. -Involving her in assertiveness training to reduce the risk for aggressive behavior -Assigning one staff member as the primary resource person to consistently reduce opportunities for splitting the staff -Removing limits from the treatment plan on a scheduled basis -Setting limits that are realistic with enforceable consequences to control and reduce negative behavior -Modeling​ respect, honesty,​ openness, and assertive behavior to demonstrate expected and acceptable behavior

-Involving her in assertiveness training to reduce the risk for aggressive behavior -Assigning one staff member as the primary resource person to consistently reduce opportunities for splitting the staff -Setting limits that are realistic with enforceable consequences to control and reduce negative behavior -Modeling​ respect, honesty,​ openness, and assertive behavior to demonstrate expected and acceptable behavior

Ann tries to cut herself one night with a plastic knife. She tells you that she just had to cut myself. Theres no other way I can feel anything. Which would be the best​ response? -Thats a pretty misguided way to feel anything. -I guess you would feel something. It must​ hurt! -You seem to feel a lot because of the way youre always angry at everyone. -Lets talk about what led up to your cutting yourself.

-Lets talk about what led up to your cutting yourself.

During an interdisciplinary team​ meeting, Anns case is discussed and a therapeutic plan is formulated. Which strategies or approaches will the team include in the therapeutic​ plan? -Making sure team members are in constant communication with each other to ensure consistent client interactions. -Providing Ann with a daily schedule of activities. -Implementing strategies to promote sleep. -Allowing Ann to select preferred caregivers to accelerate personal growth.

-Making sure team members are in constant communication with each other to ensure consistent client interactions.

Takeisha continues her treatment at the adolescent treatment facility. She comes to you in tears one evening and begs not to go to dinner. Shes been eating and has gained five pounds over the last week. You have engaged in a personal​ self-assessment to gauge your own reactions to clients with anorexia. You know that you identify with clients with weight concerns because you are trying to control your own weight after the recent delivery of your first child. Your​ self-awareness helps you recognize that Takeishas request is a reflection of which type of behavior common to clients with​ anorexia? ​-Self-absorption -Pleading -Manipulation -Pleasing others

-Manipulation

The nurse is providing care to a client diagnosed with a personality disorder who often reports feelings of anxiety. The client would like to explore alternative forms of therapy. About which therapy that is known to be helpful in the treatment of personality disorders would the nurse educate the​ client? -FFT -SSRI therapy -Meditation therapy -DBT

-Meditation therapy

A client has come to the mental hospital. The nurse​'s assessment has shown clinical manifestations of perfectionism interfering with task completion and excessive devotion to work. Which diagnosis does the nurse anticipate based on the assessment​ findings? -Avoidance personality disorder -Dependent personality disorder -Histrionic personality disorder -Obsessive-compulsive personality disorder

-Obsessive-compulsive personality disorder

The nurse is providing care to a newly admitted client tentatively diagnosed with schizotypal personality disorder​ (Cluster A). Which assessment finding supports this client​'s ​diagnosis? -Paranoia -Panic -Impulsivity -Irritability

-Paranoia

Which components form​ self-concept? Select all that apply. -Global​ self-esteem -Personal identity ​-Self-awareness -Role performance -Body image

-Personal identity -Role performance -Body image

During an​ examination, a client admits that he cannot control his urge to eat paper. The nurse suspects the client is suffering from an eating or feeding disorder. Which specific disorder would the nurse​ consider? ​-Binge-eating disorder ​-Avoidant/restrictive food intake disorder -Pica -Nocturnal​ sleep-related eating disorder

-Pica

During the admitting​ assessment, you observed that Ann withdrew from her parents and kept her eyes averted. You document that there needs to be​ follow-up about which possible precursor to borderline personality​ disorder? -Possible childhood physical or sexual abuse -History of trouble with authority -Possible severe childhood illness -History of oppositional defiance

-Possible childhood physical or sexual abuse

After a thorough outpatient​ evaluation, Takeisha is admitted to an adolescent treatment center specializing in eating disorders. As you begin to develop a nursing care​ plan, you recognize that the plan must be holistic to take into account multiple etiological factors. Which of the multiple etiologies are reflected in Takeishas​ history? -Psychological and sociologic ​-biologic, sociologic, and psychological -Psychological and biologic -Biologic and sociologic

-Psychological and sociologic

A client presents to the urgent care clinic with complaints that "my heart feels like it is skipping beats." The client reports always feeling​ cold, and the body mass index is calculated at 18. What other clinical manifestation should the nurse watch for if the client is suspected of having anorexia​ nervosa? Select all that apply. -Rigidity and the need to control situations -Extreme perfectionism -Feelings of euphoria -Strenuous exercising -Obsession over body shape

-Rigidity and the need to control situations -Extreme perfectionism -Strenuous exercising -Obsession over body shape

The nurse is caring for a client who is a young mother and is putting herself through college by working a​ full-time job. The client seems anxious and​ fatigued, and the nurse suspects she is experiencing an alteration of self. Which specific element of​ self-concept would the nurse​ consider? -Role conflict -Personal identity conflict -Introspection conflict ​-Self-awareness conflict

-Role conflict

Which pharmacologic therapy is used for a client diagnosed with a personality disorder​ (PD)? -Anticholinergics ​-Beta-blockers -Selective serotonin reuptake inhibitors -Antihypertensives

-Selective serotonin reuptake inhibitors

The nurse is caring for a client who is attractive and athletic. The client reveals that he is very disappointed in his own academic abilities and feels embarrassed around his​ well-educated friends. Which specific element of​ self-concept would the nurse recognize as affecting the​ client? ​-Self-awareness -Global​ self-esteem -Public self -Specific​ self-esteem

-Specific​ self-esteem

Ann Callahan is a​ 28-year-old-female who is admitted to your unit with a diagnosis of borderline personality disorder. She presents with a history of alcohol​ abuse, marijuana ​use, and a recent suicide attempt by overdosing on her antidepressant. She has small cuts on her arms where she has used a knife to feel alive. Her parents tell you that she was feeling depressed because she recently got fired from her fourth job in two years as a receptionist. The latest job she had was at a local beauty salon where she worked with other women. Ann accused them of trying to steal her boyfriends and talking badly about her to all the customers just because she was prettier than any of them. As you observe her interactions with her parents in the interview​ room, you see that Ann withdraws when they begin to talk and keeps her eyes downcast and averted from her father. Based on Ann's health history and your​ observations, you document which signs and symptoms of borderline personality disorder​ (BPD)? Select all that apply.​ -Dissociation -Substance abuse -Impulsivity -Unstable relationships -Depression

-Substance abuse -Impulsivity -Unstable relationships

Ann has several scars on her arms from cutting herself. She tells you that it helps her to feel alive. You also note her prior overdose of antidepressants. You revise your nursing care plan to include which​ assessment? -Suicide risk assessment -Neurologic risk assessment -Manipulative behavior assessment -Medication adherence assessment

-Suicide risk assessment

Takeisha's mother is participating in a family education group in order to help prepare for Takeisha's discharge. Which key teaching points are important for Takeisha's mother to know and to teach other people who are important in Takeisha's​ life? Select all that apply. -Takeisha must want to make herself better and be willing to change her behaviors. -Takeisha will take positive steps forward and a few steps backward in her recovery. -Takeisha is learning to eat in moderation and should not be forced to eat. -Takeisha should be encouraged to participate in support groups to learn from others. -Takeisha must be watched closely for returning signs of binging and purging.

-Takeisha must want to make herself better and be willing to change her behaviors. -Takeisha will take positive steps forward and a few steps backward in her recovery. -Takeisha is learning to eat in moderation and should not be forced to eat. -Takeisha should be encouraged to participate in support groups to learn from others.

You are spending time with Takeisha after she sees the health care provider. Takeisha​ says, My doctor says I have to eat and gain​ weight, but I still have this fat little tummy. What is your best​ response? -Yes, you mustl-you are way too​ thin! -Its important you do what the doctor tells you. -Tell me what you are feeling right now. -What little​ tummy? I dont see any fat.

-Tell me what you are feeling right now.

The nurse is reviewing the plan of care for a client who causes harm to himself by​ self-mutilation. Which evaluation statement indicates that the plan of care has been​ successful? -The client has remained free from injury during the hospital stay. -The client has not been violent toward others during the hospital stay. -The client exhibits fear of new people. -The client is scheduled for discharge in 2 days.

-The client has remained free from injury during the hospital stay.

The nurse is reviewing a questionnaire completed by an adolescent client. Which predisposing factor may increase the client​'s risk of an eating​ disorder? Select all that apply. -The client lists alprazolam​ (Xanax) on the home medication list. -The client reports a history of childhood abuse. -The client​'s mother has a history of bulimia nervosa. -The client lists "checkout clerk in a grocery store" as the occupation. -The client reports good family support and a healthy friendship network.

-The client lists alprazolam​ (Xanax) on the home medication list. -The client reports a history of childhood abuse. -The client​'s mother has a history of bulimia nervosa.

A nurse has admitted a​ 43-year-old woman whose anorexia nervosa is complicated by dehydration and a cardiac arrhythmia. Which is a positive outcome for this​ client? Select all that apply. -The client stated that she liked how she looked in the new dress. -The client had a​ 24-hour fluid intake of 600 mL. -The client remained free of injury. -The client attended therapy sessions as scheduled. -The client increased nutritional intake by​ 20%.

-The client stated that she liked how she looked in the new dress. -The client remained free of injury. -The client attended therapy sessions as scheduled. -The client increased nutritional intake by​ 20%.

The nurse and a client with an eating disorder have set up a behavioral contract to guide the client toward healthier eating patterns. Which goal should be incorporated in the​ contract? Select all that apply. -The client will attend and participate in therapy. -The client will not engage in purging behaviors. -The client will stop compulsive thinking about weight. -The client will maintain adequate caloric intake. -The client will limit exercise to 30 minutes per day.

-The client will attend and participate in therapy. -The client will not engage in purging behaviors. -The client will maintain adequate caloric intake. -The client will limit exercise to 30 minutes per day.

A client has attended and completed her inpatient therapy for bulimia nervosa. She has been making healthy choices in her daily​ meals, has not​ overeaten, and has not made herself vomit. She reports she is feeling in control of her weight. Which priority goal has the client​ achieved? -The client will remain free of injury. -The client will not demonstrate purging behaviors. -The client will not deny presyncopal episodes. -The client will maintain serum electrolytes within normal limits.

-The client will not demonstrate purging behaviors.

Although Takeisha's weight at 100 pounds is not yet life​ threatening, her resistance to participating in her care causes you concern. When you discuss this with​Takeisha, she tells you that she has never had time to eat well and her mother didn't cook often enough for her to know what was good or not good. She wants to control what she eats so she doesn't gain too much weight. You consult with the dietitian to plan a menu for Takeisha and include Takeisha in the planning. Which is the best rationale for including​ Takeisha? -This approach enlists Takeisha as an active participant in her treatment. -This approach reassures Takeisha that she still has all the control over her nutrition. -This approach conveys your acceptance of Takeisha and your confidence. -This approach plans for a slow introduction of food to Takeishas system.

-This approach enlists Takeisha as an active participant in her treatment.

Which laboratory test indicates the nutritional deficiency of anemia in a client with anorexia​ nervosa? -Hormone studies -Urinalysis -Comprehensive metabolic panel​ (CMP) -Transferrin

-Transferrin

Which complementary therapy may be considered in the treatment of a client with an eating​ disorder? Select all that apply. -Herbs -Yoga -Chamomile tea -Acupuncture -Biofeedback

-Yoga -Chamomile tea -Acupuncture -Biofeedback

A new staff nurse is caring for​ 22-year-old Sara, who has been diagnosed with an eating disorder. Implementing which nursing intervention indicates that the nurse requires additional​ education? -Allowing the client to eat her meals in private -Initiating a behavioral contract -Supervising the client in the clinical setting -Encouraging the client to participate in therapy sessions

Allowing the client to eat her meals in private

Which is included in the health history portion of the nursing assessment for a client diagnosed with a personality​ disorder? -Vital sign assessment -Focused system assessment -Assessment for symptoms of cutting -Assessment for history of drug or alcohol use

Assessment for history of drug or alcohol use

Which is a goal of the nursing assessment for a client diagnosed with a personality​ disorder? -Drug identification -Family identification -Behavior identification -Work identification

Behavior identification

You know that one successful therapeutic strategy for clients with eating disorders is a behavioral contract. Which element of a behavioral contract is essential for Takeishas​ treatment? -Taking all medications as prescribed and scheduled. -Refraining from purging by vomiting or laxative use. -Attending all group therapy sessions as scheduled. -Consuming all scheduled nutritional supplements as listed.

Consuming all scheduled nutritional supplements as listed.

The nurse is conducting a group therapy session for the clients diagnosed with borderline personality disorder. Which additional therapy may be beneficial for the nurse to facilitate during the group therapy​ session? -Wound therapy -Hydrotherapy -Expressive therapy -Massage therapy

Expressive therapy

Sheila is a​ 32-year-old client who exhibits symptoms of provocative​ behavior, exhibits use of physical appearance to draw attention to​ herself, and is very theatrical. She has been diagnosed with histrionic personality disorder. Which collaborative therapy is not appropriate for Shelia based on her​ diagnosis?

Group therapy

Which behavior should a nurse least expect while assessing a client with a suspected eating​ disorder? -Secrecy -Deceit -Denial -Healthy body image

Healthy body image

A nursing administrator is creating a form to be used in the focused assessment of a client​'s nutritional status. Which component is not appropriate to include on the​ form? ​-Height, weight, and body mass index​ (BMI) -Diagnostic test results -Client interview -Interview of the client​'s family

Interview of the client​'s family

The nurse is providing care to a client diagnosed with a personality disorder. Which behaviors would categorize this client with​ antagonism? Select all that apply. Exhibiting​ risk-taking behaviors Lying to parents Avoiding intimacy Feelings of grandiosity Being manipulative with friends

Lying to parents Feelings of grandiosity Being manipulative with friends

The nurse is caring for a client who is suspicious of all activities that occur during psychotherapy sessions because of to the paranoia associated with the diagnosed personality disorder. Which intervention is the priority for this​ client? -Suggesting group interactivity -Sharing personal information -Identifying manipulative tactics -Maintaining confidentiality

Maintaining confidentiality

The nurse is caring for a client who is suffering from an eating or feeding​ disorder, but the nurse is having difficulty establishing a therapeutic relationship with the client. Which specific factor may be making it difficult for the nurse to establish this​ relationship? -Recovery rates are poor for clients with eating disorders. -Clients may not be capable of​ self-awareness. -Creating a safe environment for the client is exceptionally difficult. -Providing nutrition counseling may be perceived as an attempt at control.

Providing nutrition counseling may be perceived as an attempt at control.

Which intervention is not specific to the nursing care provided to a client diagnosed with a personality​ disorder? -Maintaining confidentiality -Establishing a behavioral contract -Removing harmful items from the client environment -Recommending a​ disease-specific diet

Recommending a​ disease-specific diet

Which evaluation statement indicates successful treatment for a client diagnosed with a personality​ disorder? -The client continues to exhibit manifestations of anxiety. -The client remains free from injury. -The client remains free from airway disturbances. -The client refuses to adhere to rules and guidelines.

The client remains free from injury.

Which is an example of the appropriate goal statement for a client diagnosed with a personality​ disorder? -The client​'s blood pressure will be normal before discharge. -The client will remain free from injury. -The client will refrain from violent behaviors. -The client will verbalize emotions to staff. -The client will actively participate in​ one-on-one and/or group therapy sessions.

The client will verbalize emotions to staff.

Michael is a​ 23-year-old client who is seen for treatment of a personality disorder. Which finding during the nursing assessment supports this​ diagnosis?

Weak sense of self

During an​ examination, the nurse suspects that the client may be in the beginning stages of an eating or feeding alteration. Which question would the nurse ask the client during the personal identity portion of the psychosocial​ assessment? ​-"In one or two​ words, how do you feel about your​ body?" ​-"How do you describe​ yourself?" ​-"What do you think when you look at your body in a​ mirror?" -​"How important is physical appearance to​ you?"

​-"How do you describe​ yourself?"

A client confesses that she secretly eats large amounts of food and then feels guilty about it afterward. Which response would the nurse give to this​ client? ​-"Do you regularly eat nonfood items and regurgitate​ them?" ​-"You might have Prader-Willi ​syndrome, which is a chromosomal​ disorder." ​-"It sounds as though you may be suffering from what is called​ binge-eating disorder." ​-"Have you noticed any insomnia or weight loss associated with your​ behavior?"

​-"It sounds as though you may be suffering from what is called​ binge-eating disorder."

The nurse is caring for​ 16-year-old Lucia​ Morales, who is slightly overweight. Lucia tells the nurse that she has not been swimming this summer because she does not want to go to a public place in a swimsuit. Which response would the nurse give to​ Lucia? -​"The mental picture you have of your physical self is completely​ inaccurate, and I am recommending​ cognitive-behavioral therapy." ​-"Society promotes unrealistic images of the ideal​ body, and you should embrace the positive aspects of​ yourself." ​-"You are​ obese, and you should consult with a nutritionist and personal​ trainer." ​-"Your perceived body image is​ accurate, but you should focus more on your health and not on your actual​ weight."

​-"Society promotes unrealistic images of the ideal​ body, and you should embrace the positive aspects of​ yourself."

The nurse is caring for​ 15-year-old Taylor Moore at an outpatient pediatric office.​ Taylor's father is concerned that his daughter is developing an eating disorder.​ Taylor's father asks the​ nurse, "Are there any laboratory tests that would diagnose an eating disorder in​ Taylor?" Which response would the nurse give to​ Taylor's father? -​"A urinalysis test can tell us if Taylor is developing an eating​ disorder." ​-"We can run a complete blood count test to see if Taylor has an eating​ disorder." ​-"A liver-function test can determine whether Taylor has an eating​ disorder." ​-"Unfortunately, there are no laboratory tests to diagnose eating​ disorders."

​-"Unfortunately, there are no laboratory tests to diagnose eating​ disorders."

A client reveals that she feels guilty about her thoughts of leaving her husband and that it is causing her a lot of emotional distress. If applying​ Freud's psychoanalytic theory to the​ issue, which response would the nurse give to the​ client? -​"You would benefit from​ psychoanalysis, and I am referring you to a​ specialist." ​-"While those thoughts may seem​ disturbing, it means that you have reached a level of​ self-awareness." ​-"You may feel guilty because your desires are in conflict with what​ everyone, including​ yourself, expects from​ you." -​"You may be feeling guilty because of an interrole conflict that is affecting your​ self-concept."

​-"You may feel guilty because your desires are in conflict with what​ everyone, including​ yourself, expects from​ you."

Ann comes up to you after the team meeting and​ says, Youre so helpful. I know you can help me get a pass to go home this weekend. Which response to her comment is the most​appropriate? ​-Ann, that is so​ sweet! Ill talk to the team and do what I can to get you a pass to go home. I know its important. ​-Ann, when you compliment me to get what you​ need, you just make me angry and I dont want to help you. ​-Ann, when you compliment people to get something from​ them, they will quickly learn not to trust anything you say. ​-Ann, thats​ nice, but compliments will get you nowhere with me. Go try another nurse.

​-Ann, when you compliment people to get something from​ them, they will quickly learn not to trust anything you say.

The nurse is performing a psychosocial assessment of a client. Which specific behavioral elements would the nurse​ observe? Select all that apply. ​-Client's spiritual affiliations and practices ​-Client's current roles and role conflicts ​-Client's ability to follow a conversation ​-Client's verbal expression of emotion ​-Client's nonverbal cues

​-Client's ability to follow a conversation ​-Client's verbal expression of emotion ​-Client's nonverbal cues

Which components should be included in all nursing interviews of clients with suspected alterations of​ self? Select all that apply. -Specific​ self-image -Global ideal self ​-Self-awareness ​-Self-concept ​-Self-esteem

​-Self-awareness ​-Self-concept ​-Self-esteem

Which alterations of the components of self can cause the development of personality​ disorders? Select all that apply. -Public self ​-Self-awareness ​-Self-esteem ​-Self-concept -Real self

​-Self-awareness ​-Self-esteem ​-Self-concept

​Nina, a​ 32-year-old woman, presents to the clinic with a history of bulimia nervosa.​ Nina's body mass index is 18. Which finding during the physical examination represents a positive outcome for this​ client? -Deteriorating enamel on the​ client's teeth -Bruises ​-Strong, shiny hair -Poor skin turgor

​Strong, shiny hair