The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:

Correct Answer: A

Rationale: The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things in extremes of either all good or all bad. In this scenario, the client initially idealizes the psychiatrist as the best doctor, then suddenly devalues and hates him for taking a vacation, indicating a shift from all good to all bad. This extreme change in perception is characteristic of splitting. B: Projective identification involves projecting one's own feelings onto another person and then identifying with those projected feelings. This choice does not fit the scenario as the client is not projecting their feelings onto the psychiatrist. C: Isolation of affect refers to the separation of feelings from ideas and events. The client's strong emotions towards the psychiatrist do not demonstrate a lack of emotional expression or detachment from feelings. D: Dissociation is a defense mechanism where thoughts, feelings, and experiences are separated from conscious awareness. The client's reaction does not suggest a disconnection from reality or consciousness.

Correct Answer: B

Rationale: The correct answer is B because individuals with a family history of early-onset dementia, particularly Alzheimer's disease before age 55, are at a higher risk of developing the condition themselves. This is supported by research showing a strong genetic component in the development of early-onset dementia. Choice A is incorrect because the risk is not solely dependent on both parents being affected. Choice C is incorrect as early-onset dementia is not limited to individuals with Down syndrome. Choice D is incorrect because research has shown a clear link between genetic predisposition and early-onset dementia.

Correct Answer: A

Rationale: The correct answer is A: Head trauma. Adolescents are less likely to develop dementia due to age-related neurodegenerative diseases. Head trauma can lead to cognitive impairment and memory loss, mimicking symptoms of dementia. Neurosyphilis is a sexually transmitted infection affecting the brain, not common in adolescents. Pick disease is a rare neurodegenerative disorder more commonly seen in older adults. Hypothyroidism can cause cognitive symptoms but is not typically associated with dementia in adolescents.

Correct Answer: A

Rationale: The correct answer is A because it focuses on assisting the client to identify the problems causing her concern. By helping the client explore the underlying issues driving her desire to lose weight, the nurse can address the root cause of her behavior. This intervention promotes self-awareness and insight, enabling the client to better understand her motivations and make informed choices. Option B is incorrect because while determining what the client hopes to gain from the behavior is important, it does not directly address the immediate concern of identifying underlying problems. Option C is incorrect because simply explaining the risks of becoming ill may not effectively address the client's belief that losing weight will lead to fewer problems and increased popularity. Option D is incorrect because sending a physical report to college officials without the client's consent may violate confidentiality and trust, and it does not address the client's psychological needs.

Correct Answer: B

Rationale: The correct answer, B, emphasizes that the client is capable of engaging in eating without purging. By asking the client to recall a positive experience with food, the nurse is helping the client recognize that they can enjoy food without the need to purge. This intervention aims to challenge the client's negative beliefs about food and eating, promoting a healthier relationship with food. Choice A is incorrect as the purpose is not solely to gain additional information about the client's condition but rather to shift the client's perspective on food. Choice C is incorrect as the intervention focuses on emotional aspects rather than specific foods. Choice D is incorrect as the goal is to address the psychological aspect of the client's behavior, not just compliance with the treatment plan.