The nurse in the emergency department tells the daughter of a patient that her 86-year-old mother has had a stroke. The daughter tearfully asks the nurse, 'Who will take care of me now?' When the nurse explores this query, the daughter mentions that her mother always tells her what job to take, what clothes to buy and wear, and what to have for lunch. The daughter states that she needs someone to direct her and reassure her when she gets anxious. With which personality disorder is this presentation most consistent?

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Question 1 of 5

The nurse in the emergency department tells the daughter of a patient that her 86-year-old mother has had a stroke. The daughter tearfully asks the nurse, 'Who will take care of me now?' When the nurse explores this query, the daughter mentions that her mother always tells her what job to take, what clothes to buy and wear, and what to have for lunch. The daughter states that she needs someone to direct her and reassure her when she gets anxious. With which personality disorder is this presentation most consistent?

Correct Answer: B

Rationale: The correct answer is B: Dependent. This presentation is most consistent with dependent personality disorder because the daughter is displaying excessive need for someone to take care of her and make decisions for her, as well as seeking reassurance and guidance when anxious. Individuals with dependent personality disorder often lack self-confidence and rely heavily on others for emotional and physical needs. Choice A: Histrionic personality disorder is characterized by attention-seeking behavior and excessive emotions, which do not match the daughter's presentation. Choice C: Narcissistic personality disorder involves a grandiose sense of self-importance and a lack of empathy for others, which is not evident in the daughter's behavior. Choice D: Borderline personality disorder is characterized by unstable relationships, self-image, and emotions, as well as impulsive behaviors, which are not reflected in the daughter's need for constant direction and reassurance.

Question 2 of 5

What is the priority nursing intervention for a patient with bulimia nervosa who is engaging in purging behaviors?

Correct Answer: A

Rationale: The correct answer is A. The priority nursing intervention for a patient with bulimia nervosa engaging in purging behaviors is to monitor electrolyte levels and cardiac function. This is crucial due to the potential electrolyte imbalances and cardiac complications resulting from purging behaviors. Monitoring these parameters helps prevent life-threatening conditions such as hypokalemia and arrhythmias. Option B is incorrect as self-monitoring of food intake may not address the immediate health risks associated with purging behaviors. Option C is also incorrect as emotional support and body image acceptance are important but not the immediate priority in this case. Option D is incorrect as focusing on weight loss through diet control can exacerbate the patient's eating disorder behaviors and does not address the urgent medical concerns associated with purging.

Question 3 of 5

Which statement by a patient with anorexia nervosa indicates a need for further education?

Correct Answer: B

Rationale: The correct answer is B because feeling good about their body and not recognizing the need to gain weight is a common symptom of anorexia nervosa. This statement indicates a lack of insight into the seriousness of their condition and the necessity to restore a healthy weight. The other choices (A, C, D) demonstrate an understanding of the importance of weight gain, collaboration with healthcare professionals, and the need for increased food intake to improve health, indicating a willingness to engage in treatment and recovery.

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 attributes external events to themselves without any evidence. In this case, the patient is assuming that people laughing were directed at them and related to their weight gain, which is a distorted belief. A: Magnification involves blowing things out of proportion, which is not evident in this scenario. C: Overgeneralization involves drawing broad conclusions based on a single incident, which is not happening here. D: Dichotomous thinking involves seeing things in black and white terms, which is not demonstrated in the patient's statement. In summary, the patient's attribution of others' laughter to their weight gain without evidence aligns with the cognitive distortion of personalization, making it the correct choice.

Question 5 of 5

A patient tells a nurse, 'The others won't give me my pain meds early, but you are more understanding, you know what it's like to be in pain, and you don't want to see your patients suffer. Could you find a way to get me my pill now? I won't tell anyone.' Which response by the nurse would be most therapeutic?

Correct Answer: D

Rationale: Step 1: Acknowledge the patient's pain and show understanding. Step 2: Emphasize the importance of safety in medication administration. Step 3: Set clear boundaries by explaining why giving medicine too soon is unsafe. Step 4: Reiterate empathy for the patient's pain while prioritizing safety. Summary: Answer D is correct as it acknowledges the patient's pain, emphasizes safety, sets clear boundaries, and maintains empathy. Other choices either ignore the patient's request, defer responsibility, or solely focus on safety without empathy.

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