A patient has recently been under significant stress and worked long hours. At home, the patient watches television and eats until going to bed. The patient is too tired to exercise and has gained 25 pounds in 1 month. A desired outcome for the patient is to recognize anxiety that precedes binge eating and reduce it. Which intervention addresses the outcome?

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Teaching stress-reduction techniques (relaxation, imagery) helps patient identify anxiety triggers leading to binge eating. 2. By recognizing anxiety, patient can interrupt pattern of mindless eating and address root cause. 3. Relaxation techniques empower patient to cope effectively without turning to food. 4. Encouraging exercise (choice B) may not directly address underlying anxiety and binge eating triggers. 5. Exploring control over the environment (choice C) does not necessarily address emotional aspects of binge eating. 6. Attending a support group (choice D) may provide peer support but doesn't focus on recognizing and reducing anxiety triggers.

Correct Answer: C

Rationale: Rationale: Choice C is correct because seeking out a trusted person when feeling the need to purge can help the client establish a supportive and healthy coping mechanism. It encourages open communication, emotional support, and accountability. This approach addresses the underlying issues contributing to the purging behavior, fostering long-term positive change. Choices A, B, and D are incorrect as they do not directly address the need for seeking support and establishing healthier coping strategies.

Correct Answer: B

Rationale: The correct answer is B (17 years old) because anorexia nervosa typically manifests during adolescence, around ages 15-19. This age range coincides with the developmental stage where body image concerns and societal pressures are heightened. Choice A (13 years old) is too young for the typical onset. Choices C (33 years old) and D (40 years old) are too late for onset, as anorexia nervosa usually begins earlier in life.

Correct Answer: A

Rationale: The correct answer is A: formulation of a nurse-patient contract. This is because establishing a clear agreement outlining the roles, responsibilities, and boundaries between the nurse and patient is crucial in building trust and collaboration. It sets the foundation for a therapeutic alliance by promoting mutual understanding and shared goals. Summary: B: Resolving conflicts with family members may be important for overall well-being but is not the first step in creating a therapeutic alliance. C: Agreeing on the patient's body perception is important but does not address the fundamental establishment of trust through a contract. D: Specifying means of stabilizing nutritional status is essential but comes after the initial agreement on roles and responsibilities.

Correct Answer: B

Rationale: The best step in managing this situation is option B) HEADSS or other psychosocial screening. This approach is crucial in adolescent care as it aims to assess various aspects of the adolescent's life that may contribute to their presenting complaints. In this case, the girl's symptoms, along with her behavior and poor eye contact, suggest underlying psychosocial issues such as possible bullying or emotional distress. Conducting a HEADSS assessment can help uncover any stressors or mental health concerns that may be impacting her health. Referring her to a tertiary hospital to rule out an organic cause (option A) is premature at this stage since her symptoms are non-specific and her physical examination is normal. Jumping to this step without exploring psychosocial factors first may not address the root cause of her symptoms. Referral for counseling (option C) could be beneficial but should come after a comprehensive psychosocial assessment to determine the most appropriate intervention. Counseling alone may not address the underlying issues if they are related to social stressors or bullying. Reassuring her that nothing is wrong (option D) without further investigation could dismiss her concerns and potentially worsen her distress. It is important to validate her experiences and conduct a thorough assessment to provide appropriate support and intervention. Educationally, understanding the importance of psychosocial assessments in adolescent care is crucial for healthcare providers to provide holistic and patient-centered care. Teaching students to use tools like HEADSS can help them gather relevant information to better support adolescent patients facing various challenges. It also highlights the significance of addressing mental health and social factors in overall health management.