Mental Health Module 29
A patient with an eating disorder (ED) calls the nurse to discuss her fears concerning the outcome of her recent pregnancy. A friend has told her that the baby could die in utero or be delivered prematurely because of the ED. How should the nurse respond to address the patient's concern? A. "Eating disorders can affect pregnancy, and preterm delivery is certainly something that can occur. Let's discuss this when you come in for your initial visit." B. "There are really no documented issues that occur consistently with eating disorders in pregnancy." C. "Unfortunately, your friend is right: An eating disorder can cause a baby to die in utero as a result of a lack of adequate nutritional support during pregnancy." D. "You're right to be concerned. It's important to get you referred and admitted as soon as possible for intensive inpatient treatment of your eating disorder."
A. "Eating disorders can affect pregnancy, and preterm delivery is certainly something that can occur. Let's discuss this when you come in for your initial visit."
The nurse is assessing a patient in the clinic for treatment of a personality disorder (PD). Which statement should the nurse expect from this patient? A. "I don't know why they made me come here. I didn't do anything wrong. It is not my fault." B. "I don't know why I am here; I can't remember much of anything." C. "I am hoping coming here will help me understand why I continue to act like I do." D. "I am hearing voices telling me what I should do."
A. "I don't know why they made me come here. I didn't do anything wrong. It is not my fault."
The nurse is describing the process of cognitive-behavioral therapy (CBT) with a patient. Which statement should indicate to the nurse that the patient understands the goal of this type of therapy? A. "I will learn how to change problematic thoughts and behaviors." B. "We will discuss skills training and problem solving." C. "The therapist will direct how I progress to the next level." D. "Exposure therapy will help with identity issues."
A. "I will learn how to change problematic thoughts and behaviors."
A public health nurse is teaching a group of school nurses about eating disorders. Which statement concerning pathophysiological changes that occur in patients with feeding and eating disorders should be included in the discussion? A. "People with feeding or eating disorders experience blunted or attenuated function in both short-and long-acting signaling processes for weight and appetite regulation." B. "The sensitivity of the short-term satiation signal increases during food deprivation, so smaller amounts of food are necessary to generate the signal to terminate a meal, resulting in a vicious circle." C. "Hormones affected in individuals with feeding and eating disorders will return to normal once the eating-disordered behaviors cease." D. "A low level of the neurotransmitter 5-HT increases a person's satiety and decreases nutrient intake, contributing to eating disorders such as anorexia."
A. "People with feeding or eating disorders experience blunted or attenuated function in both short-and long-acting signaling processes for weight and appetite regulation."
A daycare provider asks the nurse how to differentiate "picky" eating from more serious eating disorders, such as avoidant/restrictive food intake disorder (ARFID), in this age group. How should the nurse respond? A. "Picky eating does not generally result in persistent failure to meet the child's nutritional or energy needs, whereas ARFID does." B. "ARFID is characterized by rejection of foods of a particular consistency or texture, whereas picky eating involves limitations of the variety of foods eaten." C. "Eating disorders in very young children are rare and difficult to discern because many of the behaviors seen truly just reflect picky eating." D. "Neophobia and aberrant eating behaviors reflect ARFID, whereas picky eating mainly involves an unwillingness to try new foods."
A. "Picky eating does not generally result in persistent failure to meet the child's nutritional or energy needs, whereas ARFID does."
The nurse is caring for a young client at an outpatient pediatric office. The client's father is concerned that his daughter is developing an eating disorder and inquires if there is any laboratory test to diagnose this. How should the nurse respond? A. "Unfortunately, there are no laboratory tests to diagnose eating disorders." B. "A urinalysis test can tell us if your daughter is developing an eating disorder." C. "We can run a complete blood count test to see if she has an eating disorder." D. "A liver-function test can determine whether your daughter has an eating disorder."
A. "Unfortunately, there are no laboratory tests to diagnose eating disorders."
The nurse is completing a psychosocial assessment for an adolescent. Which question by the nurse assesses the adolescent's perception of their body image? A. "What do you see when you look in a mirror?" B. "What do you like most about yourself?" C. "How satisfied are you with yourself?" D. "How do you describe yourself?"
A. "What do you see when you look in a mirror?"
The nurse is caring for a client who is exhibiting extremely low self-esteem. Which factor should the nurse assess that could be affecting the client's self-esteem? (Select all that apply.) A. Age B. Sex C. Ethnicity D. Level of education E. Socioeconomic status
A. Age D. Level of education E. Socioeconomic status
The nurse is working with a team of healthcare professionals to care for a patient diagnosed with a personality disorder who also has a co-occurring mental health disorder accompanied by hallucinations. Which type of medication should the nurse anticipate the healthcare provider to prescribe? A. Antipsychotic B. Antispasmodic C. Antidepressant D. Anxiolytic
A. Antipsychotic
A patient who was recently incarcerated for robbing a convenience store twice has been assigned to mental health treatment as a part of probation. Which personality disorder (PD) should the nurse suspect that may be consistent with this patient's behaviors? A. Antisocial personality disorder B. Avoidant personality disorder C. Obsessive-compulsive personality disorder D. Borderline personality disorder
A. Antisocial personality disorder
The nurse is working with a team of healthcare professionals to care for a client with a personality disorder. Which type of medication that might be prescribed by the healthcare provider should the nurse expect? (Select all that apply.) A. Anxiolytic B. Antipsychotic C. Antispasmodic D. Antidepressant E. Antihypertensive
A. Anxiolytic B. Antipsychotic D. Antidepressant
The nurse is completing an assessment with a patient demonstrating symptoms of a personality disorder (PD). Which assessment approach should the nurse use with this patient? A. Asking questions that allow the patient to describe aspects about themselves B. Asking questions that allow the patient to describe aspects about the patient's family C. Asking questions that allow the nurse to speak more than the patient D. Asking questions about the basketball game last evening
A. Asking questions that allow the patient to describe aspects about themselves
The nurse performs the admission assessment of a child who is severely underweight. The child's mother states that the child has lost much weight in the last month and refuses to eat at meals. Which disorder should the nurse suspect that the child is experiencing? A. Avoidant/restrictive food intake disorder B. Rumination disorder C. Pica D. Prader-Willi syndrome
A. Avoidant/restrictive food intake disorder
The nurse cares for a client who has issues with self-concept. Which component of self-concept should the nurse assess in the client? (Select all that apply.) A. Body image B. Self-awareness C. Personal identity D. Role performance E. Global self-esteem
A. Body image C. Personal identity D. Role performance
The nurse is evaluating the treatment plan for a client with anorexia nervosa. Which behavior by the client demonstrates that the treatment plan was successful? (Select all that apply.) A. Eats meals with the family. B. Skin on arms and legs is dry and pale. C. Gained 2 pounds in the past two weeks. D. Lacks concentration when answering questions. E. Has an albumin blood level within normal limits.
A. Eats meals with the family. C. Gained 2 pounds in the past two weeks. E. Has an albumin blood level within normal limits.
The nurse discusses Erik Erikson's theory of psychosocial development with colleagues. Which should the nurse recognize as an overriding theme in Erikson's theory? (Select all that apply.) A. Establishing trust in others B. Developing a sense of identity in society C. Viewing life experiences as isolated events D. Helping the next generation prepare for the future E. Identifying relationships that connect actions to self
A. Establishing trust in others B. Developing a sense of identity in society D. Helping the next generation prepare for the future
The nurse performs a nursing assessment of a client with a suspected alteration of self. Which nursing action should the nurse include in the assessment? (Select all that apply.) A. Interview the client. B. Establish a safe environment. C. Assess the client's role mastery. D. Establish a therapeutic relationship. E. Assess the client's personal identity.
A. Interview the client. B. Establish a safe environment. D. Establish a therapeutic relationship.
The mental health nurse is reviewing personality disorders (PD) with a group of new nurses. Which information should the nurse provide that explains why the etiology of PD difficult to discern? A. Lack of diagnostic uniformity B. An abundance of samples C. Sample sizes being too small D. Lack of data
A. Lack of diagnostic uniformity
The nurse is performing a psychosocial assessment of a client. The nurse should assess for which specific behavioral element? (Select all that apply.) A. Nonverbal cues B. Verbal expression of emotion C. Current roles and role conflicts D. Ability to follow a conversation E. Spiritual affiliations and practices
A. Nonverbal cues B. Verbal expression of emotion D. Ability to follow a conversation
The nurse admits a patient to the mental health unit. The patient states, "I don't know why they made me come here. I didn't do anything wrong. It is not my fault." Which disorder should the nurse suspect? A. Personality disorder B. Rumination disorder C. Eating disorder D. Schizophrenia
A. Personality disorder
The nurse suspects a client has Prader-Willi syndrome. Which specific manifestation has led to the nurse's suspicion? (Select all that apply.) A. Poor muscle tone B. Mental retardation C. Regurgitation of food D. Incessant desire to eat E. Consumption of nonfood items
A. Poor muscle tone B. Mental retardation D. Incessant desire to eat
The nurse is caring for a patient who is attractive and athletic. The patient reveals disappointment in their academic abilities and feels embarrassed around well-educated friends. The nurse should recognize that which specific element of self-concept is affecting the patient? A. Specific self-esteem B. Global self-esteem C. Self-awareness D. Public self
A. Specific self-esteem
The nurse is developing a behavioral contract for a patient with severe anorexia nervosa (AN) to prevent injury. Which possible negative outcome of this type of approach should the nurse keep in mind while developing the contract? A. The patient's inability to adhere to the contract may result in increased shame and decreased self-esteem. B. The patient may be unwilling to follow the contract. C. Such contracts can be difficult to develop because of the complexity of eating disorders. D. The patient may become more depressed when seeing the disorder outlined so clearly in black and white in the contract.
A. The patient's inability to adhere to the contract may result in increased shame and decreased self-esteem.
The nurse is completing a health questionnaire with a young patient who has a BMI of 17.5, blood pressure of 95/45 mmHg, and an irregular apical pulse. For which disorder should the patient be screened? A. Overexercise B. Anorexia nervosa C. Bulimia nervosa D. Binge-eating disorder
B. Anorexia nervosa
The nurse is providing care to a patient who believes benign comments contain hidden meanings or threatening messages. Which treatment should the nurse anticipate for this patient? A. Family-focused therapy B. Anxiolytic therapy C. Psychodynamic therapy D. Anger-management therapy
B. Anxiolytic therapy
A patient is admitted to an inpatient care facility for the treatment of anorexia nervosa with purging behaviors. Which intervention is most appropriate for the nurse to implement? A. Allow access to the bathroom after meals. B. Begin an individualized diet as prescribed by a nutritionist. C. Divide the daily calories over three meals a day. D. Set a goal of a weight gain of 2 pounds a week.
B. Begin an individualized diet as prescribed by a nutritionist.
A patient seeking treatment for bulimia nervosa of the binge eating/purging type reports being worried about the bloating she is experiencing. How should the nurse respond? A. Not using the bathroom after meals causes bloating. B. Bloating is not an unusual symptom in BN. C. Setting a goal of a weight gain of 2 lb/week causes bloating. D. Dividing the daily calorie intake over three meals a day causes bloating.
B. Bloating is not an unusual symptom in BN.
The nurse is discussing self-concept with colleagues. Which item should the nurse include as a component of self-concept? A. Physical performance B. Body image C. Personality traits D. Cognitive development
B. Body image
The nurse is preparing to perform a nursing assessment on a client diagnosed with a personality disorder. Which action by the nurse should ensure an effective assessment? A. Establishing an authoritative environment B. Establishing a therapeutic environment C. Asking detailed, personal questions D. Asking questions related to family members' mental health
B. Establishing a therapeutic environment
The nurse explains the role of family in the development of healthy self-esteem to a group of parents. Which action should the nurse explain may contribute to lowered self-esteem in children? (Select all that apply.) A. Loss of a pet B. Interfamilial violence C. Authoritative parenting D. Overprotective parenting E. Movement to a new neighborhood
B. Interfamilial violence C. Authoritative parenting D. Overprotective parenting
A patient with anorexia nervosa is being hospitalized for medical stabilization. Which nursing intervention can best help determine the patient's food and fluid intake? A. Weighing the patient twice daily (morning and night) B. Monitoring the patient directly during meals C. Observing the patient for signs of fluid overload, which may indicate re-feeding syndrome D. Checking the patient's room after meals for any hoarded food
B. Monitoring the patient directly during meals
The nurse is assessing a patient who complains of insomnia, sleepwalking, and consumption of unusual foods or nonfood items during sleepwalking. Which eating disorder should the nurse suspect in the patient? A. Rumination disorder B. Nocturnal sleep-related eating disorder C. Pica D. Prader-Willi syndrome
B. Nocturnal sleep-related eating disorder
A patient demonstrates perfectionism that interferes with task completion and excessive devotion to work. Which diagnosis should the nurse anticipate? A. Dependent personality disorder B. Obsessive-compulsive personality disorder C. Histrionic personality disorder D. Avoidant personality disorder
B. Obsessive-compulsive personality disorder
The nurse is meeting with the family of a patient who has been diagnosed with anorexia nervosa. Which behavior should the nurse anticipate while discussing family behaviors and patterns of interaction that might develop after the diagnosis? A. A focus on conflict resolution within the family B. Preoccupation with food, eating, and rituals involving food C. Maintenance of clearly defined boundaries between the family and the patient D. Isolation of family members from one another
B. Preoccupation with food, eating, and rituals involving food
The nurse is discussing interventions associated with patients who are diagnosed with personality disorders (PDs) with a group of new nurses. Which intervention should be emphasized throughout the teaching session? A. Encouraging interpersonal relationships B. Promoting patient safety C. Promoting comfort D. Adhering to medication therapy
B. Promoting patient safety
The nurse is planning care for a patient diagnosed with an eating disorder. Which intervention should the nurse include in the plan of care to promote positive self-esteem? A. Help the patient set long-term goals for weight gain. B. Provide positive reinforcement when the patient adheres to the treatment plan. C. Help the patient to manage disruptive behaviors. D. Assess the patient for suicidal ideations.
B. Provide positive reinforcement when the patient adheres to the treatment plan.
The nurse is caring for a young mother going through college as a full-time student. The patient seems anxious and fatigued, and the nurse suspects the patient is experiencing an alteration of self. Which specific element of self-concept should the nurse consider? A. Introspection conflict B. Role conflict C. Personal identity conflict D. Self-awareness conflict
B. Role conflict
A patient has attended outpatient therapy and completed their treatment for bulimia nervosa. The patient has been making healthy choices in their daily meals, has not overeaten, and has not made themselves vomit. The patient reports feeling in control of their weight. Which priority goal has the patient achieved? A. The patient will not deny presyncopal episodes. B. The patient will not demonstrate purging behaviors. C. The patient will remain free from injury. D. The patient will maintain serum electrolytes within normal limits.
B. The patient will not demonstrate purging behaviors.
The nurse is using the DSM-5 as a diagnostic tool to identify personality disorders. Which should the nurse identify as a challenge of using this tool? A. Guidelines are very general. B. There is an overlap of symptoms across disorders. C. Not enough information can be collected. D. It is only valuable when used on children.
B. There is an overlap of symptoms across disorders.
The nurse is caring for a 3-year-old child who has characteristic features of mental retardation, obesity, and poor muscle tone. The patient's mother tells the nurse that the child has an incessant desire to eat. Which disorder does the nurse suspect in the patient? A. Pica B.Prader-Willi syndrome C. Nocturnal sleep-related eating disorder D.Rumination disorder
B.Prader-Willi syndrome
The nurse reviews diagnostic testing for personality disorders (PDs) with a new nurse. Which statement should indicate to the nurse a need for further teaching? A. "The Thematic Apperception Test (TAT) is used to identify personality traits." B. "The Personality Diagnostic Questionnaire (PDQ) is commonly used to identify narcissistic personality disorder." C. "A single interview is usually sufficient to make a definitive diagnosis of a PD." D. "Interpreting subjective descriptions of patient symptoms poses challenges to healthcare providers."
C. "A single interview is usually sufficient to make a definitive diagnosis of a PD."
Which statement by the nurse indicates an understanding of eating disorders and organ function? A. "A patient with bulimia nervosa will have no abnormal dental findings." B. "Cardiovascular side effects of anorexia nervosa include tachycardia and hypertension." C. "An eating disorder can affect the integumentary system, leading to dry skin and brittle hair and nails." D. "Easily bruised skin is a normal finding in a healthy individual."
C. "An eating disorder can affect the integumentary system, leading to dry skin and brittle hair and nails."
The mother of an adolescent girl tells the nurse that she is concerned because her daughter "keeps trying new things." How should the nurse respond? A. "By trying new things, your daughter is attempting to win your approval." B. "By trying new things, your daughter is attempting to stress you out." C. "By trying new things, your daughter is attempting to form her personal identity." D. "By trying new things, your daughter is exhibiting signs of stress herself."
C. "By trying new things, your daughter is attempting to form her personal identity."
A patient is being evaluated for a personality disorder (PD). Which question should the nurse include in the patient interview? A. "Are you having trouble sleeping?" B. "Do you ever experience feelings of mania?" C. "Have you had thoughts of violence toward yourself or others?" D. "Have you recently experienced weight loss?"
C. "Have you had thoughts of violence toward yourself or others?"
The nurse is admitting a patient to the mental health unit for treatment of a personality disorder. Which statement should the nurse expect from this patient? A. "I am hoping this admission will help me to understand why I continue to act like I do." B. "I am hearing voices telling me what I should do." C. "I don't know why they made me come here. I didn't do anything wrong. It is not my fault." D. "I am unsure why I am here; I can't remember much of anything."
C. "I don't know why they made me come here. I didn't do anything wrong. It is not my fault."
The nurse gave a presentation to a local group focused on healthy body image in teenage girls. Which statement by one of the teen participants indicates the need for additional teaching? A. "I learned a lot about healthy eating and healthy portions today." B. "My confidence should be based on my value as a human being, not the size of my clothes." C. "No matter what, I've got to stay thin." D. "I need to eat enough calories to meet my body's nutritional needs."
C. "No matter what, I've got to stay thin."
A family caregiver is concerned that an older adult parent has an eating disorder because the parent has no energy and no appetite. How should the nurse respond? A. "As a result of changes in muscle tone and skin elasticity, it sometimes seems like older people are losing weight when they actually aren't. This is probably not an eating disorder." B. "This is common as a result of sensory changes. There's no need to be concerned. Please don't worry." C. "This is referred to as physiological anorexia of aging and is common in older adults. We can schedule an appointment if you'd like to get an assessment done." D. "It's a valid concern. Eating disorders can happen in older adults, and anorexia nervosa is the most common."
C. "This is referred to as physiological anorexia of aging and is common in older adults. We can schedule an appointment if you'd like to get an assessment done."
The healthcare provider has ordered the antidepressant fluoxetine (Prozac) for a patient with bulimia nervosa (BN). Which information about the medication and its use should the nurse provide to the patient? A. "Fluoxetine can be helpful in treating bulimia nervosa but it can cause some serious side effects, including blood dyscrasias and cancer." B. "This drug is only approved for use to treat depression and anxiety by the Food & Drug Administration, but sometimes it helps in bulimia." C. "This medication will help lessen bingeing and purging behaviors and improve your attitude toward eating." D. "Fluoxetine can help with some of the behaviors of bulimia nervosa but it doesn't have any impact on relapse, so you'll have to constantly be aware of this possibility."
C. "This medication will help lessen bingeing and purging behaviors and improve your attitude toward eating."
The nurse suggests to a teen patient that reconnecting with the activities that the patient once enjoyed is a way of helping deal with an eating disorder. Which outcome would the nurse most likely expect if the patient were to implement this action? A. A decrease in ordered eating behaviors B. A decrease in anxiety and relief of tension C. Beginning to re-experience positive emotions D. An enhanced ability to communicate effectively
C. Beginning to re-experience positive emotions
The nurse is reviewing personality disorders (PDs) with a new nurse. Which risk factor for the development of PD should the nurse include? A. Caucasian American ethnicity B. Male gender C. Childhood sexual abuse D. Female gender
C. Childhood sexual abuse
The nurse conducts an admission assessment for a female patient admitted to the mental health unit. When asked about medications, the patient informs the nurse about routinely taking diuretics and laxatives. Which disorder should the nurse associate with the patient's condition? A. Personality disorder B. Binge-eating disorder C. Eating disorder with purging D. Avoidant/restrictive food intake disorder
C. Eating disorder with purging
The nurse is discussing care with the parents of a teenage patient who has expressed a willingness to stop some maladaptive behaviors, which include excessive exercising, consumption of several energy drinks a day, refusal to eat more than one small meal a day, purging, and use of diuretics. Which dietary intervention should the nurse initially encourage to ease anxiety and address a maladaptive behavior? A. Asking a parent to oversee trips to the bathroom to help prevent purging B. Keeping a daily log of food and fluids ingested C. Eliminating caffeine and other stimulants D. Encouraging the patient and parents to consider inpatient care for parenteral feeding
C. Eliminating caffeine and other stimulants
Which risk factor has the strongest influence on development of a personality disorder (PD)? A. Poverty B. Personality characteristics of anxiety, fear, and aggression C. Genetics D. Experience of a childhood trauma
C. Genetics
The nurse is caring for a pregnant patient previously diagnosed with obsessive-compulsive personality disorder. Which symptom should the nurse identify that may be associated with the patient's diagnosis? A. Hypertension B. Edema of the legs C. Intractable nausea and vomiting D. Elevated blood glucose
C. Intractable nausea and vomiting
The nurse conducts a support group for families of clients diagnosed with personality disorders. Which risk factor should the nurse include in the teaching? (Select all that apply.) A. Older age B. Male sex C. Loss of a spouse D. History of sexual abuse E. History of childhood trauma
C. Loss of a spouse D. History of sexual abuse E. History of childhood trauma
Which manifestations should the nurse expect in a patient diagnosed with anorexia nervosa? A. Repeated regurgitation of food outside the presence of a medical condition B. Mental retardation, poor muscle tone, and an incessant desire to eat C. Low body weight, fear of gaining weight, purging behaviors D. Frequent and recurrent episodes of eating large amounts of food and then purging by self-induced vomiting or laxative use
C. Low body weight, fear of gaining weight, purging behaviors
The nurse is caring for a patient diagnosed with an eating disorder. Which nursing intervention is most important regarding this patient's physiological assessment? A. Only a psychologic assessment is necessary. B. Ask the patient about the presence of hallucinations. C. Monitor vital signs and laboratory studies. D. Monitor for lack of exercise.
C. Monitor vital signs and laboratory studies
During an examination, a patient admits to not being able to control the urge to eat paper. The nurse should associate the patient's behavior with which specific eating disorder? A. Avoidant/restrictive food intake disorder B. Binge-eating disorder C. Pica D. Nocturnal sleep-related eating disorder
C. Pica
The nurse is having difficulty establishing a therapeutic relationship with a patient who has an eating disorder. Which specific factor can make it difficult for the nurse to establish this relationship? a. Recovery rates are poor for patients with eating disorders. B. Creating a safe environment for the patient is exceptionally difficult. C. Providing nutrition counseling may be perceived as an attempt at control. D. The patient may not be capable of self-awareness.
C. Providing nutrition counseling may be perceived as an attempt at control.
The nurse in a mental health clinic is teaching a newly hired nurse about the priority action when performing a nursing assessment for a patient with a personality disorder (PD). Which response by the newly hired nurse is appropriate? A. "I should ask the patient detailed, personal questions." B. "I should establish an authoritative environment for the patient." C. "I should ask the patient about their family's mental health issues." D. "I should help establish a therapeutic environment for the patient."
D. "I should help establish a therapeutic environment for the patient."
The nurse reviews the treatment plan with a patient with obsessive-compulsive personality disorder who will begin taking an antidepressant. Which statement should indicate to the nurse that the patient understands the plan? A. "I can expect that the medication will make me feel better after the first week." B. "There are few side effects to the medication I will be taking." C. "The medication will only be a part of my plan for the first 30 days." D. "Medication is only a part of my plan."
D. "Medication is only a part of my plan."
The nurse reviews the characteristics of obsessive-compulsive personality disorder with the parents of a 20-year-old patient diagnosed with the disorder. Which statement by the parents should indicate to the nurse that teaching was effective? A. "Our son will eventually grow out of this phase." B. "This disorder is uncommon in males." C. "Our son is fully aware of his actions toward others." D. "Our son will struggle with making friends."
D. "Our son will struggle with making friends."
The nurse reviews the characteristics of borderline personality disorder (BPD) with a group of new nurses. Which statement indicates to the nurse that teaching was effective? A. "Patients with BPD are structured and emotionless." B. "Patients with BPD experience chronic paranoia." C. "Patients with BPD do not experience splitting." D. "Patients with BPD often self-mutilate as a release of pain."
D. "Patients with BPD often self-mutilate as a release of pain."
The nurse is reviewing the characteristics of borderline personality disorder (BPD) with a group of new nurses. Which statement should indicate to the nurse that the group understands the content? A. "Young adults with BPD generally do not show symptoms of the disorder." B. "Young adults with BPD have more impulse control than do older adults with BPD." C. "Young adults with BPD generally seek treatment on their own." D. "Young adults with BPD are at a higher risk for suicide than are other age groups."
D. "Young adults with BPD are at a higher risk for suicide than are other age groups."
A patient reports "feeling faint" when standing up. During the exam, the nurse notes emaciation, dry skin, and lanugo on the patient's arms and shoulders. In light of these findings, which diagnosis should the nurse suspect? A. Binge-eating disorder B. Hyperthyroidism C. Bulimia nervosa D. Anorexia nervosa
D. Anorexia nervosa
While assessing a client, the nurse notes that the client has areas of decay on several teeth and her weight is less than 85% of normal. The client's mother privately tells the nurse her daughter is vomiting after meals and not eating very much during the day. Which alteration of self does the nurse suspect the client to be experiencing? A. Binge-eating disorder B. Pica C. Rumination disorder D. Anorexia nervosa
D. Anorexia nervosa
A patient with bulimia nervosa (BN) asks the healthcare provider whether any medications can be prescribed to treat the disorder. Which medication should the nurse anticipate will be prescribed for the patient? A. Antianxiety agent, lorazepam B. H2 antagoist, famotidine C. Progesterone megestrol D. Antidepressant agent, fluoxetine
D. Antidepressant agent, fluoxetine
The nurse admits a patient diagnosed with a feeding and eating disorder. Which clinical therapy should the nurse expect to be ordered for this patient? A. Pharmacologic therapy B. Schema-focused therapy C. Dialectic behavioral therapy D. Cognitive-behavioral therapy
D. Cognitive-behavioral therapy
An older adult patient is seeking medical care for new symptoms of a personality disorder (PD). Which factor should the nurse suspect contributed to this patient's health problem? A. Lack of sleep B. Physical impairments C. Medication side effects D. Death or loss of a support person
D. Death or loss of a support person
The family of a teen patient with long-standing issues related to anorexia nervosa brings the patient to the emergency department after the patient exhibits even more weight loss, trouble thinking, and feeling faint. Which other signs and symptoms should the nurse anticipate as possible complications of anorexia nervosa? A. Weakness and leg cramps B. Body mass index >18.5 C. Rapid, shallow breathing and dizziness D. Decreased pulse and blood pressure, irregular heart rhythm
D. Decreased pulse and blood pressure, irregular heart rhythm
The nurse is attempting to develop a trusting therapeutic relationship with a patient with borderline personality disorder (BPD). What should the nurse keep in mind when caring for this patient? A. Relying solely on medication to reduce the incidence of paranoia B. Getting another therapist involved in this treatment C. Discussing abnormal behaviors D. Establishing boundaries
D. Establishing boundaries
The nurse is completing an admission history on a teenage patient admitted for treatment of anorexia. Which factor noted in the patient's history may have played a role in the development of this disorder? A. Increased serotonin level B. High endorphin levels C. Recent episode of mild anxiety over final exams at school D. History of eating disorders in mother and one aunt
D. History of eating disorders in mother and one aunt
While meeting with the mother and a young adult patient, the nurse learns that the patient engages in hyperjealousy, mistrust, and suspicious behavior with family members. Which personality disorder should the nurse keep in mind during the initial asessment? A. Borderline personality disorder B. Schizotypal personality disorder C. Schizoid personality disorder D. Paranoid personality disorder
D. Paranoid personality disorder
A patient reports anxiety when going to sleep at night and asks about complementary approaches to reduce the symptoms. Which action should the nurse encourage the patient to take? A. Calling the nurse to talk them through the issue B. Taking medications at night C. Having a breathing treatment D. Performing deep-breathing exercises
D. Performing deep-breathing exercises
The nurse admits a patient to the mental health unit, who has been admitted numerous times over the past 2 years. The nurse notes that the patient has difficulty relating to others, poor impulse control, and thinks differently from others in the cultural group. Which disorder should the nurse expect to be listed as a diagnosis in the patient's medical record? A. Binge-eating disorder B. Avoidant/restrictive food intake disorder C. Purging disorder D. Personality disorder
D. Personality disorder
A client presents at the urgent care clinic and states, "My heart feels like it's skipping beats." The client also reports always feeling cold, and has a BMI of 18. The nurse suspects anorexia. Which other clinical manifestation should the nurse assess? (Select all that apply.) A. Strenuous exercise B. Feelings of euphoria C. Extreme perfectionism D. Obsession over body shape E. Rigidity and the need to control situations
A. Strenuous exercise C. Extreme perfectionism D. Obsession over body shape E. Rigidity and the need to control situations
The nurse is finalizing a plan of care for a patient with an eating disorder. Which information should the nurse include? A. Teaching the patient methods of self-soothing such as watching television or reading a book B. Encouraging the patient to limit daily alcohol intake to two drinks or less C. Creating a contract with the patient to control compulsive eating behaviors D. Discussing the patient's long-term goals regarding nutrition and weight
A. Teaching the patient methods of self-soothing such as watching television or reading a book
The nurse is reviewing a questionnaire completed by an adolescent client. Which predisposing factor may increase the client's risk for an eating disorder? (Select all that apply.) A. The client reports a history of childhood abuse. B. The client's mother has a history of bulimia nervosa. C. The client lists alprazolam (Xanax) on the home medication list. D. The client lists "checkout clerk in a grocery store" as the occupation. E. The client reports good family support and a healthy friendship network.
A. The client reports a history of childhood abuse. B. The client's mother has a history of bulimia nervosa. C. The client lists alprazolam (Xanax) on the home medication list.
The nurse is reviewing the plan of care for a patient who practices self-mutilation. Which evaluation statement indicates that the plan of care has been successful? A. The patient has remained free from injury during the hospital stay. B. The patient exhibits fear of new people. C. The patient is scheduled for discharge in 2 days. D. The patient has not been violent toward others during the hospital stay.
A. The patient has remained free from injury during the hospital stay.
A disheveled patient displays abnormal behavior and believes someone is following them and planning to do harm. Which laboratory test should the nurse anticipate to rule out factors that may be causing these behaviors? A. Toxicology screening B. WBC with differential C. Plasma breakdown D. Peak and trough medication levels
A. Toxicology screening
The nurse is reviewing Erikson's theory on psychosocial development in humans with colleagues. Which statement should the nurse include? A. "Erikson's theory is grounded in the human response to impulses." B. "Erikson's theory focuses on society and conflicts that influence personality." C. "Erikson's theory is the earliest framework for personality development." D. "Erikson's theory focuses mostly on internal conflicts that influence personality."
B. "Erikson's theory focuses on society and conflicts that influence personality."
The nurse suspects that a patient may be in the beginning stages of developing an eating disorder. Which question should the nurse ask during the personal identity portion of the psychosocial assessment? A. "In one or two words, how do you feel about your body?" B. "How do you describe yourself?" C. "How important is physical appearance to you?" D. "What do you think when you look at your body in a mirror?"
B. "How do you describe yourself?"
A client confesses to secretly eating large amounts of food and then feeling guilty about it afterward. Which response by the nurse is appropriate? A. "Have you noticed any insomnia or weight loss associated with your behavior?" B. "It sounds as though you may be suffering from binge-eating disorder." C. "Do you regularly eat nonfood items and regurgitate them?" D. "You might have Prader-Willi syndrome, which is a chromosomal disorder."
B. "It sounds as though you may be suffering from binge-eating disorder."
During assessment, a patient with anorexia nervosa (AN) tells the nurse, "My thighs are huge." Which response by the nurse represents the use of a cognitive-behavioral approach to treatment? A. "I don't think you have large thighs, but it would be good if you did." B. "Let's talk about how we can work on perceiving your body proportionally." C. "Your thighs are no larger than they were yesterday." D. "How do you feel about the possibility of gaining some weight?"
B. "Let's talk about how we can work on perceiving your body proportionally."
The nurse working in a pediatric surgical unit cares for patients who are undergoing surgical amputations of limbs. Which age group should the nurse expect to have the most problems following recovery from these procedures? A. Toddlers B. Adolescents C. Preschoolers D. School-age children
B. Adolescents
A patient with attention deficit/hyperactivity disorder (ADHD) has been admitted for treatment of anorexia nervosa. Which healthcare provider's order should the nurse clarify? A. Mood stablizer B. Central nervous system stimulant for ADHD C. Antipsychotic drug D. Antidepressant drug
B. Central nervous system stimulant for ADHD
The nurse is conducting a group therapy session for patients with borderline personality disorder (BPD). Which additional therapy should the nurse consider facilitating during the group therapy session? A. Wound therapy B. Expressive therapy C. Hydrotherapy D. Massage therapy
B. Expressive therapy
The nurse is assessing a client who is obese and reports eating to the point of discomfort at least twice a week for the past year. The client denies the use of laxatives, self-induced vomiting, ipecac syrup, or enemas and reports feeling unable to control the behavior. The client feels embarrassed and has stopped going out with friends. Which eating disorder should the nurse suspect? A. Anorexia nervosa B. Bulimia nervosa C. Binge-eating disorder D. Purging
C. Binge-eating disorder
The nurse cares for a client who has undergone an amputation of the right leg. The nurse is concerned the client might experience issues with self-concept. Which component of self-concept should the nurse assess in the client? A. Role performance B. Self-esteem C. Body image D. Personal identity
C. Body image
The nurse is working with an interprofessional team to care for a client with a personality disorder. The team has collaboratively decided on therapies that might benefit the client. Which specific type of therapy should the nurse anticipate might be used to treat the client's condition? (Select all that apply.) A. Expressive therapy B. Collaborative therapy C. Schema-focused therapy D. Cognitive-behavioral therapy E. Dialectical behavioral therapy
C. Schema-focused therapy D. Cognitive-behavioral therapy E. Dialectical behavioral therapy
The nurse teaches a client to engage in a personal exploration and evaluation of thoughts, emotions, and values. Which component of self-concept is the nurse teaching? A. Role performance B. Personal identity C. Self-awareness D. Self-esteem
C. Self-awareness
The nurse conducts a support group for families of clients diagnosed with personality disorders and discusses the components of self that can cause the development of personality disorders. Which component should the nurse include? (Select all that apply.) A. Real self B. Public self C. Self-esteem D. Self-concept E. Self-awareness
C. Self-esteem D. Self-concept E. Self-awareness
The nurse suspects a patient with a weight change from 145 lb to 95 lb in the last 6 months of having anorexia nervosa. Which additional assessment finding supports the suspected diagnosis? A. Scars on fingers B. Potassium of 4.0 mEq/L C. Skin covered with a fine layer of hair D. Blood pressure of 210/124 mmHg
C. Skin covered with a fine layer of hair
The nurse is admitting a patient diagnosed with a personality disorder. Which nursing intervention is most important for this patient? A. Teach coping behaviors. B. Establish a therapeutic relationship. C.Establish a safe environment. D. Eliminate stressors.
C.Establish a safe environment.
An adolescent patient who has been diagnosed with a personality disorder has been admitted to the hospital after a suicide attempt. The patient's mother asks, "What will you do for my son first?" How should the nurse respond? A. "Eliminate all stressors on your son." B. "Teach your son coping behaviors." C. "Establish a therapeutic relationship with your son." D. "Ensure that your son is safe here."
D. "Ensure that your son is safe here."
A patient with schizotypal personality disorder reports that the delusions and hallucinations of another patient are the work of evil spirits. How should the nurse respond to this patient? A. "Why would you think that the patient is possessed by evil spirits when they have a mental health disorder?" B. "There is no such thing as an evil spirit, and that kind of thinking isn't helpful." C. "That's an interesting perspective, but let's keep religion out of this." D. "I'd like to understand more about your religious views to better guide your treatment."
D. "I'd like to understand more about your religious views to better guide your treatment."
While reviewing lab results for a patient with anorexia nervosa, the nurse notes a low hemoglobin level. Which complication should the nurse suspect based on the lab result? A. Dehydration B. Metabolic alkalosis C. Osteoporosis D. Anemia
D. Anemia
A teen patient with an eating disorder confides to the nurse of being in a volatile relationship and often feels that their partner thinks that they are fat or not pretty. Which intervention should the nurse include in this patient's plan of care to help address the eating disorder? A. Asking whether a meeting could be scheduled with the patient, their partner, and the counselor to discuss ways of developing a healthy relationship B. Encouraging the patient to sever the relationship with this individual because it is likely a trigger for the disordered eating C. Telling the patient that there is no potential connection between the relationship and the eating disorder D. Discussing this relationship with the teen patient and helping them determine whether it serves as a trigger for disordered eating behaviors
D. Discussing this relationship with the teen patient and helping them determine whether it serves as a trigger for disordered eating behaviors
The nurse is counseling a patient with an eating disorder (ED) at the initial prenatal visit. Which risk should the nurse discuss with the patient? A. Infant mortality B. Congenital disorders C. Failure to thrive D. Preterm delivery
D. Preterm delivery
The nurse prepares to interview a client with suspected alterations of self. Which component should the nurse include in the assessment? (Select all that apply.) A. Self-esteem B. Self-concept C. Self-awareness D. Global ideal self E. Specific self-image
A. Self-esteem B. Self-concept C. Self-awareness
