Larry is a 50-year-old man who works about 60 hours per week. He arrives at the clinic seeking assistance with a weight gain of 50 pounds over the past year. Larry admits to sleeping 4 to 5 hours a night. The nurse recognizes that the weight gain may be related to:

Correct Answer: C

Rationale: Rationale for Choice C (Correct Answer): 1. Hormones like leptin and ghrelin regulate appetite and energy balance. 2. Lack of sleep disrupts these hormones, leading to increased appetite. 3. Larry's sleep deprivation may have dysregulated his appetite hormones. 4. This dysregulation could result in increased food intake and subsequent weight gain. Summary of Incorrect Choices: A. Diabetes: No information suggests Larry has diabetes symptoms. B. Cardiovascular disease: Weight gain may be a risk factor, but sleep deprivation's direct impact on hormones is more likely. D. Depression: While depression can contribute to weight gain, there's no indication of comorbidity in Larry's case.

Correct Answer: D

Rationale: The correct action for the nurse to take first is to tell the AP to discontinue their conversation (Choice D). This is because addressing the issue directly with the individuals involved is the most immediate and effective way to stop the breach of client confidentiality. Reporting to the supervisor (Choice A) can be done after addressing the immediate situation. Completing an incident report (Choice B) should come after resolving the issue in real-time. Providing written documentation (Choice C) may be necessary for education but is not the most immediate response to stop the confidentiality breach.

Correct Answer: C

Rationale: Rationale: - Option C is correct because middle-aged adults are most likely to be married, reflecting a common life stage where many individuals have already established long-term relationships or families. - Option A is incorrect because the peak marriage age can vary and is not a universal range. - Option B is incorrect as marrying in one's teens does not necessarily predict divorce rates for all individuals. - Option D is incorrect as there is no direct correlation between marrying between the ages of 23 to 27 years and divorce rates.

Correct Answer: D

Rationale: The correct answer is D because bibliotherapy involves using books to help individuals understand and cope with emotional or psychological problems. This form of therapy encourages patients to read specific books that address their issues, providing insights and strategies for personal growth and healing. Option A is incorrect as it focuses on listing books rather than actual reading for therapeutic purposes. Option B is incorrect as it misrepresents bibliotherapy as a shopping-related coping technique. Option C is incorrect as it suggests the therapist imparts knowledge rather than utilizing books as the main therapeutic tool.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Giving advice can create dependency on the advisor. 2. It may hinder the individual's ability to think for themselves. 3. Encouraging self-reliance and problem-solving is more effective. 4. Therefore, giving advice is rarely helpful in promoting independence and personal growth. Summary of other choices: B. Fostering independence would involve guiding individuals to make their own decisions. C. Lifting the burden of decision-making could lead to reliance on external opinions rather than self-reflection. D. Developing feelings of personal adequacy is better achieved through self-discovery and empowerment rather than being told what to do.

Correct Answer: B

Rationale: The correct answer is B: Crisis is a time-limited event. This is correct because a crisis is typically a temporary situation that occurs when an individual is unable to cope with a stressful event or situation. It is characterized by a sense of urgency and the need for immediate action to restore stability. Understanding that a crisis is time-limited helps individuals focus on problem-solving and coping strategies to navigate through the difficult period. Incorrect Choices: A: Crisis triggers maladaptive responses - This is incorrect because not everyone responds to a crisis in a maladaptive way. Individuals may exhibit a range of responses, including adaptive coping mechanisms. C: Chronic crisis is a real situation - This is incorrect as a crisis, by definition, is an acute, time-limited event. Chronic stressors may lead to ongoing challenges, but these are typically not considered crises. D: Events causing a crisis are similar for everyone - This is incorrect because the events leading to a crisis can vary greatly among individuals, depending on their unique

Correct Answer: C

Rationale: The correct answer is C: A lower dosage. This adjustment is appropriate for maintenance therapy in bipolar I disorder to prevent toxicity and maintain therapeutic levels. Lowering the dose reduces the risk of adverse effects while still providing the necessary benefits. Increasing the dosage (choice A) may lead to toxicity. Once a week dosing (choice B) is not standard for lithium. Switching to a different drug (choice D) is not necessary if the patient has been responding well to lithium.

Correct Answer: B

Rationale: The correct answer is B: Major depressive disorder. Following a major stroke, individuals often experience feelings of grief, sadness, and hopelessness due to the significant life changes and disabilities. This can lead to the development of major depressive disorder. Depression is common post-stroke due to neurobiological changes and psychosocial factors. The other choices are incorrect because bipolar I disorder is characterized by distinct episodes of mania and depression, which are not directly related to stroke. Generalized anxiety disorder and posttraumatic stress disorder are also not directly associated with the typical emotional response following a stroke.

Correct Answer: C

Rationale: Rationale for Choice C (Correct Answer): 1. Hormones like leptin and ghrelin regulate appetite and energy balance. 2. Lack of sleep disrupts these hormones, leading to increased appetite. 3. Larry's sleep deprivation may have dysregulated his appetite hormones. 4. This dysregulation could result in increased food intake and subsequent weight gain. Summary of Incorrect Choices: A. Diabetes: No information suggests Larry has diabetes symptoms. B. Cardiovascular disease: Weight gain may be a risk factor, but sleep deprivation's direct impact on hormones is more likely. D. Depression: While depression can contribute to weight gain, there's no indication of comorbidity in Larry's case.