Nursing Elites

1. In managing a patient with anorexia nervosa, which initial treatment goal is most important?

• A. Addressing distorted body image
• B. Restoring nutritional status
• C. Resolving family conflicts
• D. Increasing social interactions

Correct answer: B

Rationale: The most crucial initial treatment goal for anorexia nervosa is restoring nutritional status. This is essential to prevent life-threatening complications associated with severe malnutrition, such as organ damage and cardiac issues. Addressing distorted body image, resolving family conflicts, and increasing social interactions are important aspects of treatment, but they are secondary to the critical need of restoring the patient's nutritional status to ensure their physical well-being and recovery.

2. A healthcare provider is evaluating the effectiveness of medication therapy for a client diagnosed with bipolar disorder. Which outcome should indicate that the medication has been effective?

• A. The client reports a decrease in manic episodes.
• B. The client experiences fewer mood swings.
• C. The client sleeps for 8 hours each night.
• D. The client maintains a stable weight.

Correct answer: A

Rationale: A decrease in manic episodes is a key indicator of the effectiveness of medication therapy for bipolar disorder. Manic episodes are a hallmark of bipolar disorder, and a decrease in their frequency or intensity suggests that the medication is helping to stabilize the client's mood and manage their symptoms. While choices B, C, and D are important aspects of overall health and well-being, they are not specific indicators of the effectiveness of medication therapy for bipolar disorder. Choice B focuses on mood swings in general, which may include depressive episodes as well, while choice C addresses sleep patterns and choice D relates to weight stability, which can be influenced by various factors unrelated to bipolar disorder treatment.

3. A client is being assessed by a nurse after being diagnosed with anorexia nervosa. Which of the following findings should the nurse expect?

• A. Weight gain and increased appetite
• B. Lanugo on the face and back
• C. Increased body temperature and tachycardia
• D. Hyperactivity and distractibility

Correct answer: B

Rationale: In anorexia nervosa, individuals often develop lanugo, fine soft hair, on the face and back. This is a physiological response to the body's attempt to conserve heat due to a lack of subcutaneous fat. It is a common physical finding in clients with anorexia nervosa and can be a sign of severe malnutrition. Choices A, C, and D are incorrect because weight gain and increased appetite, increased body temperature and tachycardia, and hyperactivity and distractibility are not typically associated with anorexia nervosa. In fact, weight loss, decreased appetite, hypothermia, and bradycardia are more commonly seen in individuals with anorexia nervosa.

4. During cognitive-behavioral therapy, a 12-year-old patient reports to the nurse practitioner:

• A. I was so mad I wanted to hit my mother.
• B. I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd.
• C. I forgot that you told me to breathe when I become angry.
• D. I scream as loud as I can when the train goes by the house.

Correct answer: B

Rationale: In cognitive-behavioral therapy, recognizing and challenging negative thoughts is crucial for progress. Choice B demonstrates the patient's ability to identify and correct distorted thoughts, indicating positive advancement in therapy. This cognitive restructuring is a key component of cognitive-behavioral therapy, helping individuals develop healthier thinking patterns and coping strategies.

5. A client has been prescribed bupropion (Wellbutrin) for depression. Which instruction should the nurse provide during discharge?

• A. Take the medication with a full glass of water.
• B. Stop taking the medication if you feel better.
• C. Avoid drinking alcohol while taking this medication.
• D. Double the dose if you miss a dose.

Correct answer: C

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid drinking alcohol while taking bupropion (Wellbutrin) due to the increased risk of side effects like seizures. Alcohol can interact with bupropion and worsen its side effects, making it important to abstain from alcohol consumption during the treatment. Option A is incorrect because taking the medication with a full glass of water is a general instruction for medications and not specific to bupropion. Option B is incorrect as abruptly stopping bupropion can lead to withdrawal symptoms and should only be done under medical supervision. Option D is incorrect as doubling the dose of bupropion is dangerous and should not be done, even if a dose is missed.

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