A student transfers from a hometown college to a university 200 miles away after breaking up with her boyfriend of 2 years. She was slow to make friends at the university. The history shows a close relationship with her mother and sister. She began eating large quantities when she felt sad, and then she induced vomiting. When the student's schoolwork declined, she sought help. During the initial interview, what priority issue should the nurse address?

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Question 1 of 5

A student transfers from a hometown college to a university 200 miles away after breaking up with her boyfriend of 2 years. She was slow to make friends at the university. The history shows a close relationship with her mother and sister. She began eating large quantities when she felt sad, and then she induced vomiting. When the student's schoolwork declined, she sought help. During the initial interview, what priority issue should the nurse address?

Correct Answer: A

Rationale: The correct answer is A: Losses. The priority issue the nurse should address is the student's losses, such as the breakup with her boyfriend and the difficulty in making friends at the new university. This is important because these losses may be contributing to her emotional distress and maladaptive coping mechanisms like binge-eating and induced vomiting. The nurse needs to explore these losses to understand the root cause of the student's behavior and provide appropriate support. Choice B: Sleep patterns, and Choice C: School activities are not the priority issues in this scenario. While sleep patterns and school activities are important aspects of the student's life, the primary concern here is addressing the emotional impact of the losses she has experienced. Choice D: None of the above is incorrect because losses are indeed the priority issue that needs to be addressed in this situation. Ignoring the emotional impact of the student's losses could hinder the effectiveness of any interventions or support provided.

Question 2 of 5

Which of the following is a critical aspect of nursing care for patients with anorexia nervosa?

Correct Answer: B

Rationale: The correct answer is B: Promoting normalization of eating habits and nutritional rehabilitation. This is critical in anorexia nervosa treatment to address malnutrition and restore a healthy relationship with food. Encouraging weight loss (A) is inappropriate as these patients are already underweight. Restricting fluid intake (C) can worsen dehydration and electrolyte imbalances. Avoiding pressure for rapid weight gain (D) is important, but the primary focus should be on promoting healthy eating habits and gradual weight restoration. By focusing on normalization of eating habits and nutritional rehabilitation, nurses can help patients with anorexia nervosa recover physically and mentally.

Question 3 of 5

A nurse is caring for a patient with bulimia nervosa who has not eaten for 24 hours. The nurse should first:

Correct Answer: B

Rationale: The correct answer is B because assessing vital signs and hydration status is crucial in identifying potential complications from prolonged fasting in a patient with bulimia nervosa. This step helps determine the patient's immediate needs for intervention and guides further care planning. Encouraging the patient to eat a full meal immediately (Choice A) may lead to refeeding syndrome due to electrolyte imbalances. Providing a menu for the next meal (Choice C) is not the priority when the patient has not eaten for 24 hours. Contacting the physician for a medication prescription (Choice D) is not necessary at this point without first assessing the patient's current physical status.

Question 4 of 5

A patient with an eating disorder states, 'I heard people laughing behind me in the check-out line at the department store. I bet they thought it was hysterically funny that I gained a pound in the last few days.' The nurse documents that the patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?

Correct Answer: B

Rationale: The correct answer is B: Personalization. Personalization is a cognitive distortion where an individual takes responsibility for events that are not entirely their fault. In this scenario, the patient is attributing the laughter of people in the check-out line to being about them and their weight gain, when in reality, the laughter may have had nothing to do with them. This distortion can contribute to feelings of guilt, shame, and self-blame. A: Magnification involves exaggerating the importance or meaning of an event, which is not evident in the scenario. C: Overgeneralization involves making broad negative conclusions based on a single event, which is not demonstrated here. D: Dichotomous thinking is the tendency to view situations in black and white terms, with no middle ground, which is not present in the patient's statement.

Question 5 of 5

A client with obsessive-compulsive personality disorder seeks treatment for depression after the recent breakup of a relationship. The client constantly procrastinated about proposing marriage and said his girlfriend complained that he did not show her affection and that he was too controlling. Now he describes inability to sleep, poor concentration, and loss of energy since the breakup. Which outcome is a priority for the client? The client will:

Correct Answer: C

Rationale: Rationale: The correct answer is C: Identify feelings of sadness related to the failed relationship. This is the priority outcome because the client is experiencing symptoms of depression following the breakup, such as insomnia, poor concentration, and loss of energy. By identifying and processing the feelings of sadness related to the failed relationship, the client can begin to work through the grief and start the healing process. Summary: A: Demonstrating assertive behavior may be beneficial for the client in the long term but is not the priority at this stage when dealing with depression. B: Expressing hope for a new relationship may provide temporary relief but does not address the underlying issues of depression and unresolved feelings from the breakup. D: Listing new ways to reduce stress is important for overall well-being but does not address the primary concern of processing feelings of sadness and grief related to the failed relationship.

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