A 14-year-old client on the eating disorders unit refuses to eat her meals and says to the nurse on the unit, 'You can't make me eat! There is nothing wrong with me.' The nurse will assess this as use of which defense mechanism?

Correct Answer: D

Rationale: The correct answer is D: Denial. Denial is a defense mechanism where an individual refuses to acknowledge reality to avoid discomfort. In this scenario, the client is denying the seriousness of their situation by refusing to eat and claiming there is nothing wrong. Repression (A) involves unconsciously blocking out unpleasant thoughts or feelings. Rationalization (B) is creating logical explanations to justify behavior. Sublimation (C) is redirecting negative impulses into positive behaviors. In this case, denial is the most fitting defense mechanism as the client is refusing to accept the reality of their eating disorder.

Correct Answer: B

Rationale: The correct answer is B: Bulimia. Individuals with bulimia nervosa typically have a normal or slightly above average body weight due to the cycle of binge eating and purging behaviors. This is because they consume large amounts of food during binges but then engage in compensatory behaviors such as vomiting or excessive exercise to prevent weight gain. In contrast, choices A (Pica) and D (Anorexia nervosa) are associated with low body weight. Choice C (Obesity) is characterized by excess body weight. Bulimia is the only disorder in the list where individuals can have a normal or slightly above average body weight due to the nature of their eating behaviors.

Correct Answer: C

Rationale: Step 1: Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image. Step 2: Patients often use strict control over food intake as a way to cope with underlying emotional issues. Step 3: Maintaining a sense of control is crucial in managing anorexia nervosa as it addresses the core psychological aspects driving the disorder. Step 4: Managing weight gain (A) is not the primary focus as patients may resist gaining weight due to their fear. Step 5: Controlling personal stressors (B) may be important but does not address the underlying issue of control related to food and body. Step 6: Avoiding social interactions (D) does not address the core psychological need for control and can further isolate the patient.

Correct Answer: C

Rationale: In this question focusing on red flags for a communication disorder, option C is the correct choice. The red flags listed in option C - lack of pointing to show interests or needs, poor eye contact, and reduced joint attention - are commonly associated with communication disorders in children. Lack of pointing to show interests or needs can indicate a difficulty in expressing oneself, poor eye contact might suggest challenges in social communication, and reduced joint attention can impact the ability to engage and interact with others effectively. These signs are crucial for early identification and intervention in children with communication disorders. Analyzing the incorrect options: - Option A includes speech onset at 24 months, lack of pointing, and poor eye contact. While these can be potential concerns, they are not comprehensive enough to cover a range of communication issues. - Option B mentions short attention, odd intonation of speech, and poor pretend play. These are more related to cognitive or behavioral aspects rather than communication specifically. - Option D lists weak vocabulary, reduced joint attention, and poor interaction with peers. While these are relevant factors, they do not directly address the core communication indicators highlighted in option C. Educational Context: Understanding red flags for communication disorders is vital for educators, caregivers, and healthcare professionals to identify potential issues early and provide appropriate support. By recognizing these signs, interventions can be implemented to enhance communication skills, social interactions, and overall development in children. This knowledge equips professionals to collaborate effectively with families and specialists to create tailored interventions for children with communication challenges.

Correct Answer: B

Rationale: Refeeding syndrome is a potentially life-threatening condition that can occur when severely malnourished individuals, such as those with eating disorders, are aggressively fed after a period of starvation. In this context, the most important biochemical change to monitor is hypophosphatemia (Option B). Phosphate is essential for energy metabolism, cell signaling, and the formation of nucleic acids. During refeeding, insulin release is stimulated, which leads to increased cellular uptake of phosphate and other electrolytes. If phosphate replacement is inadequate, it can result in a sudden drop in serum phosphate levels, leading to cardiac and respiratory failure. Hypomagnesemia (Option A) is also common in refeeding syndrome due to increased renal magnesium excretion, but it is not the most critical change. Hypokalemia (Option C) and hypoglycemia (Option D) can also occur but are secondary to the risk posed by hypophosphatemia. Educationally, understanding the biochemical changes in refeeding syndrome is crucial for healthcare providers involved in the care of patients with eating disorders. Prompt recognition and appropriate management of these electrolyte imbalances are essential to prevent serious complications and improve patient outcomes. By prioritizing the correction of hypophosphatemia, healthcare providers can mitigate the risks associated with refeeding syndrome and ensure safe nutritional rehabilitation for these vulnerable patients.