The first step in the creation of a therapeutic alliance between a nurse and a patient with a maladaptive response to eating regulation is:

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: 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.

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.