Which of the following is the most important initial intervention for a patient with bulimia nervosa?

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Question 1 of 5

Which of the following is the most important initial intervention for a patient with bulimia nervosa?

Correct Answer: A

Rationale: The correct answer is A: Provide a structured mealtime environment with supervision. This is the most important initial intervention for a patient with bulimia nervosa because it addresses the immediate health concern of disordered eating behavior. By providing a structured mealtime environment with supervision, the patient can establish regular eating patterns, learn healthier eating habits, and reduce the risk of purging behaviors. This intervention also helps in restoring proper nutrition and addressing any underlying issues related to food and eating. Choice B is incorrect because support groups may be beneficial but are not the most critical initial intervention. Choice C is incorrect as antianxiety medications do not directly address the disordered eating behavior. Choice D is also incorrect as assessing family dynamics and home environment is important but not as crucial as addressing the immediate eating disorder symptoms.

Question 2 of 5

A nurse is providing care for a patient diagnosed with bulimia nervosa. What is a priority nursing intervention?

Correct Answer: B

Rationale: The correct answer is B: Provide a calm, structured environment with consistent mealtimes. This is the priority intervention because individuals with bulimia nervosa benefit from a stable and supportive environment to establish regular eating patterns and reduce anxiety around mealtimes. This intervention helps promote a sense of safety and predictability, which are crucial for managing the eating disorder. Encouraging regular exercise (Choice A) may exacerbate compulsive behaviors related to bulimia. Weight loss (Choice C) should not be the focus as it can worsen the patient's condition. Offering a high-protein diet (Choice D) may not address the underlying psychological issues associated with bulimia.

Question 3 of 5

Which of the following interventions is most appropriate for a patient with bulimia nervosa?

Correct Answer: B

Rationale: The correct answer is B because offering emotional support and focusing on healthy coping mechanisms are crucial in treating bulimia nervosa. This approach addresses the psychological aspects of the disorder and helps the patient develop healthier behaviors. Regular weight monitoring and food restriction (choice A) can exacerbate the disorder by reinforcing a focus on weight and food. Medications to induce vomiting (choice C) can be harmful and do not address the underlying issues. Focusing on weight loss and reducing food intake (choice D) may worsen the patient's disordered eating behaviors and contribute to a cycle of restriction and bingeing.

Question 4 of 5

A client is admitted to a day hospital following an episode in which he purchased a gun to use while standing guard over his property to prevent a neighbor from erecting a boundary fence. His wife describes him as distrustful of the motives of others and often interpreting others' motives as threats. She mentions that one time he accused her of having an affair with a neighbor with whom she chatted occasionally. The care plan will list the priority outcome as 'Client will:

Correct Answer: C

Rationale: The correct answer is C: demonstrate trust in the nurse. This is the priority outcome because the client's lack of trust and tendency to perceive threats need to be addressed first. By demonstrating trust in the nurse, the client can begin to develop a therapeutic relationship, which is essential for addressing his distrustful behavior and interpreting threats. This outcome focuses on building rapport and establishing a foundation for therapeutic interventions. Choice A is incorrect because admitting his action was excessive may not address the underlying issues of distrust and misinterpretation of motives. Choice B is incorrect as it does not address the client's core issues and may not be appropriate in this context. Choice D is also incorrect as identifying positive role models is not a priority when the client's trust and perception issues need immediate attention.

Question 5 of 5

A patient with borderline personality disorder has been making steady progress but one day gets a phone call from her boyfriend, who breaks off their relationship. Although she has not self-injured in over 2 months, she makes repeated lacerations on her forearm. Which statement about this and most maladaptive behaviors seen in personality disorders is most accurate?

Correct Answer: B

Rationale: The correct answer is B: However dysfunctional, most behavior is the person's best effort to cope. Rationale: 1. People with borderline personality disorder often struggle with intense emotions and unstable relationships. 2. Self-injury is a maladaptive coping mechanism used to manage overwhelming emotions or distress. 3. In this scenario, the patient resorts to self-injury as a coping strategy after the breakup triggers intense emotional pain. 4. Despite being maladaptive, the behavior serves as a coping mechanism to regulate emotions. 5. Understanding that maladaptive behaviors are often the individual's best attempt to cope helps in providing non-judgmental support and promoting healthier coping strategies. Summary: A: Incorrect. People with personality disorders can make progress with appropriate treatment and support. C: Incorrect. While external factors may trigger behaviors, individuals with personality disorders have agency in their actions. D: Incorrect. Improvement in behavior should not always be viewed as manipulation; it can indicate genuine progress in coping skills.

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