The average age for onset of anorexia nervosa is:

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: 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.

Correct Answer: C

Rationale: The correct answer is C) Post-Traumatic Stress Disorder (PTSD). PTSD is not typically associated with oppositional behavior in children. A) Attention Deficit/Hyperactivity Disorder (ADHD) is commonly linked to oppositional behavior due to impulsivity and difficulty with self-regulation. B) Conduct Disorder is characterized by persistent patterns of violating societal norms and the rights of others, often exhibiting oppositional behaviors. D) Autism Spectrum Disorder (ASD) can sometimes present with oppositional behaviors, stemming from challenges in communication and social interaction rather than intentional defiance. Educationally, understanding the different psychiatric conditions associated with oppositional behaviors in children is crucial for nurses providing care. Recognizing these distinctions helps in accurate assessment, planning appropriate interventions, and fostering effective communication with healthcare teams and families. It also aids in promoting a therapeutic environment that meets the specific needs of each child based on their diagnosis.

Correct Answer: B

Rationale: The most appropriate intervention for a male client who develops orthostatic hypotension while taking amitriptyline (Elavil) is advising the client to sit up for 1 minute before getting out of bed (Option B). This intervention helps prevent a sudden drop in blood pressure that can occur when changing positions, which is a common side effect of amitriptyline. Option A, consulting with the physician about substituting a different type of antidepressant, may be a consideration in some cases. However, it is not the most immediate or necessary intervention for orthostatic hypotension. Option C, instructing the client to double the dosage until the problem resolves, is incorrect and dangerous. Increasing the dosage without medical supervision can lead to adverse effects and complications. Option D, instructing the client to stop medication immediately, is also incorrect. Abruptly stopping amitriptyline can lead to withdrawal symptoms and potential worsening of the client's condition. In an educational context, it is essential for nurses to understand the side effects of medications and appropriate interventions to manage them effectively. Educating clients on strategies to prevent orthostatic hypotension can improve patient safety and outcomes. Monitoring for side effects and collaborating with healthcare providers are crucial aspects of providing age-specific nursing care.

Correct Answer: D

Rationale: The correct answer to the question is D) Nihilistic. In the context of age-specific nursing care, it is crucial for healthcare providers to understand and recognize different types of delusions that may be observed in elderly patients. A nihilistic delusion is characterized by a belief that a part of the body, or the self as a whole, does not exist or is ceasing to exist. In this case, the patient claiming that her genitals have disappeared fits the description of a nihilistic delusion. Option A) Hypochondriacal is incorrect because hypochondriacal delusions typically involve a preoccupation with having a serious illness or disease despite medical reassurance. This does not align with the scenario described in the question. Option B) Amorous is incorrect as it refers to delusions involving romantic or sexual themes, which is not reflective of the situation where the patient believes her genitals have disappeared. Option C) Reference is also incorrect as reference delusions involve the belief that events, objects, or people in the environment have a particular and unusual significance to the individual. This type of delusion does not match the scenario provided in the question. Understanding different types of delusions is essential for nurses caring for older adults, as delusions can impact a patient's behavior, emotions, and overall well-being. Being able to identify and interpret delusional beliefs accurately can guide appropriate interventions and enhance the quality of care provided to elderly patients experiencing cognitive changes.