You would expect to include all of the following nursing interventions in Lily's plan of care EXCEPT:

Involve family in treatment

Encourage secrecy to maintain trust

Refer for dialectical behavior therapy (DBT)

Teach alternative coping strategies

Answer and Explanation

The Correct Answer is B

A. Involve family in treatment: Family involvement helps address relational stressors and improves communication and support systems. Education and collaboration with caregivers can reduce triggers for self-harm and reinforce healthy coping strategies. Inclusion is guided by safety, consent, and therapeutic goals.

B. Encourage secrecy to maintain trust: Encouraging secrecy can increase risk by limiting safety planning and preventing appropriate monitoring. Nursing care emphasizes transparency, safety, and appropriate information sharing when self-harm is present. Trust is built through honest communication and protective collaboration.

C. Refer for dialectical behavior therapy (DBT): DBT is an evidence-based approach for adolescents who engage in self-injury. It focuses on emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness. Referral supports development of safer coping skills.

D. Teach alternative coping strategies: Teaching skills such as grounding, journaling, sensory modulation, or reaching out for support provides practical alternatives to self-harm. These strategies target emotional regulation and reduce reliance on injurious behaviors.

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Correct Answer is B

Explanation

A. Lack of distress: While some older adults may minimize or mask emotional distress, depression in the elderly often presents with noticeable changes in mood, motivation, and behavior rather than complete absence of emotional expression. Distress can still be present but may manifest differently than in younger adults.

B. Improvement in symptoms as the day progresses: Elderly individuals with depression frequently experience diurnal variation, with mood and energy lowest in the morning and improving throughout the day. Early-morning awakening and fatigue are common, reflecting biological and circadian rhythm changes associated with depression.

C. Disorientation: Disorientation is more indicative of delirium or neurocognitive disorders rather than depression alone. Cognitive impairment may occur secondary to depression, but primary disorientation is not a defining feature of depressive episodes.

D. Slow progression: Depressive symptoms in the elderly can develop gradually or appear suddenly depending on life stressors, medical conditions, or medication effects. A slow progression is not a universal characteristic and may vary between individuals.

A. "Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not." B. "Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not." C. "Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not." D. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not."

Correct Answer is D

Explanation

A. "Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not.": Hypotension and lanugo are more characteristic of anorexia nervosa due to severe malnutrition. Edema may appear in both conditions depending on fluid shifts.

B. "Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not.": Tooth enamel erosion is primarily associated with bulimia nervosa due to repeated vomiting. Anorexia nervosa may cause malnutrition-related oral changes but not the classic enamel erosion from purging.

C. "Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not.": Amenorrhea is more commonly observed in anorexia nervosa because of severe weight loss and hormonal disruption. Bulimia may or may not cause menstrual irregularities depending on nutritional status.

D. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not.": Severe nutritional deficits are hallmark features of anorexia nervosa due to prolonged restriction. Bulimia nervosa involves bingeing and purging, which maintains near-normal weight and reduce severity of nutrient depletion.

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You would expect to include all of the following nursing interventions in Lily's plan of care EXCEPT:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Depression in the elderly is often characterized by:

Correct Answer is B

Explanation

A nursing instructor is teaching students about the differences between the symptoms of Anorexia Nervosa and the symptoms of Bulimia Nervosa. Which student statement indicates that learning has occurred?

Correct Answer is D

Explanation

The nurse is preparing educational materials for a patient diagnosed with binge eating disorder. Which FDA approved medication should the nurse anticipate discussing with the patient?

A physician orders mixed amphetamine salts (Adderall) for a child diagnosed with attention deficit-hyperactivity disorder (ADHD). Which information about this medication should the nurse provide to the parents?

The nurse suspects a client is experiencing delirium. Which specific assessment information would support this suspicion?

A family asks why their father is attending activity groups at the long-term care facility. The son states, "My father worked hard all of his life. He just needs some rest at this point." Which is the appropriate nursing reply?

After an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10 pounds in a 2-month period. What is the best explanation for this weight loss?

A parent describes a 3-year-old child in constant motion and is unable to sit still during story time. The parent is concerned about this behavior. Which nursing response indicates an appropriate evaluation of the situation?

Which of the following physical manifestations would you expect to assess in a patient suffering with Anorexia Nervosa?