A 72-year-old female patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. A nurse planning discharge care must consider the need to teach the family to be alert for maladaptive cognitive symptoms because:

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Question 1 of 5

A 72-year-old female patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. A nurse planning discharge care must consider the need to teach the family to be alert for maladaptive cognitive symptoms because:

Correct Answer: D

Rationale: The correct answer is D because slower metabolism in the elderly can lead to medication toxicity, including anticholinergic toxicity causing delirium. As people age, their metabolism slows down, making them more susceptible to drug accumulation and toxicity. This can result in cognitive symptoms like delirium. A: Delirium is not a hypersensitivity reaction; it is an acute state of confusion. B: Denial of cognitive changes is not directly related to the risk of medication toxicity in the elderly. C: Gender is not a significant factor in medication toxicity leading to delirium; it is more related to individual metabolism and drug interactions.

Question 2 of 5

A 16-year-old client has anorexia nervosa. She has lost 50 pounds during the past 3 months and is about 20 pounds under the weight that is normal for her height. She has dry skin with poor turgor, hair breakage, and brittle nails. The nurse can anticipate that when giving information about her menstrual history, the client is likely to report:

Correct Answer: B

Rationale: The correct answer is B: amenorrhea. In anorexia nervosa, severe weight loss can disrupt the hormonal balance, leading to the cessation of menstruation, known as amenorrhea. This is due to the body conserving energy and prioritizing essential functions over reproductive processes. The client's significant weight loss and physical symptoms indicate a state of malnutrition, further supporting the likelihood of amenorrhea. The other choices (heavy menstrual flow, premenstrual syndrome, dysmenorrhea) are less likely because they are not typically associated with anorexia nervosa and severe weight loss. Amenorrhea is a common manifestation of anorexia nervosa and reflects the impact of malnutrition on reproductive health.

Question 3 of 5

A pediatric nurse at the clinic interviews a 14-year-old client who is dressed in baggy clothes and two sweaters on a warm day. The client admits to not having had her period for 4 months. The nurse notes fine downy hair along the client's cheeks. Vital signs are T, 36.6; P, 64; and BP, 84/50. Which additional objective sign would best support the nurse's assessment that the client has anorexia nervosa?

Correct Answer: A

Rationale: The correct answer is A: Weight 15% below normal for her height. In anorexia nervosa, individuals have a fear of gaining weight leading to severe weight loss. A weight 15% below normal for her height indicates significant weight loss, a hallmark feature of anorexia nervosa. This is supported by the client's baggy clothes, two sweaters on a warm day, and absence of menstrual periods, which are common signs of anorexia nervosa. Choice B: Eroded dental enamel is a sign of bulimia nervosa, not anorexia nervosa. Choice C: Parotid gland enlargement is seen in bulimia nervosa due to frequent vomiting, not anorexia nervosa. Choice D: Dehydration is a general sign and not specific to anorexia nervosa.

Question 4 of 5

Which disorder is often difficult to detect and consequently often goes untreated?

Correct Answer: B

Rationale: The correct answer is B: Bulimia. Bulimia is often difficult to detect as individuals may engage in secretive binge eating and purging behaviors. Unlike anorexia nervosa where visible weight loss may be noticeable, individuals with bulimia may maintain a normal weight, making it harder to identify. Bulimia also tends to be associated with feelings of shame and guilt, leading individuals to hide their behaviors. Pica (A) involves eating non-food items and can be more easily observed. Obesity (C) is often noticeable due to visible weight gain. Anorexia nervosa (D) is also easier to detect as individuals may exhibit extreme weight loss and visible physical symptoms.

Question 5 of 5

The coping mechanism that patients with anorexia nervosa use maladaptively is:

Correct Answer: A

Rationale: The correct answer is A: denial. Patients with anorexia nervosa often deny the seriousness of their low weight, distorted body image, or the potential health consequences of their eating behaviors. This denial helps them avoid facing their underlying issues and enables them to continue harmful behaviors. Choice B (projection) involves attributing one's own thoughts or feelings onto others, not relevant to anorexia. Choice C (introjection) involves internalizing external beliefs or values, not a common maladaptive coping mechanism in anorexia. Choice D (rationalization) involves creating logical explanations to justify inappropriate behaviors, not the primary defense mechanism in anorexia.

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