Deck 29: Self

Question 1

A clinic nurse is providing care for several clients. Which client is at the highest risk for anorexia nervosa?

A)A 16-year-old Hispanic female client
B)A 21-year-old Hispanic male client
C)A 16-year-old non-Hispanic White female client
D)A 22-year-old non-Hispanic White male client

Answer 1

A 16-year-old non-Hispanic White female client

Question 2

To evaluate a client's personal identity, the nurse should consider what three aspects of the client's self?

A)Ideal self, private self, and public self
B)Ideal self, real self, and public self
C)Authentic self, presented self, and perceived self
D)Real self, goal self, and private self

Answer 2

Ideal self, real self, and public self

Question 3

Which of the following questions would best help the nurse assess a client's global self-esteem?

A)"What do you consider your greatest personal strength?"
B)"What do you like least about yourself?"
C)"How satisfied are you with yourself and your life so far?"
D)"Do you consider yourself a hard-working person?"

Answer 3

"How satisfied are you with yourself and your life so far?"

Question 4

A nurse who works in the emergency department is assessing a client with bulimia nervosa. Which assessment findings indicate that the client is dehydrated? Select all that apply.

A)Dry mouth
B)Hypertension
C)Concentrated urine
D)General weakness
E)Poor skin turgor

Question 5

During an assessment, a client tells the nurse that she "can't stand her mother." The client also says she does "whatever Mom wants me to do" because the client "can't do anything right anyway." The nurse should use this information when determining which of the following items during the client assessment?

A)Personal identity
B)Role performance
C)Self-esteem
D)Body image

Question 6

The nurse is providing care to a preadolescent client who was recently diagnosed with bulimia nervosa. The client's mother states, "I am very weight and exercise conscious, and I try to ensure my children stay in shape and eat well so that they can succeed in life. I have no idea how my daughter developed bulimia. She must have inherited a genetic tendency for bulimia from her birth mother." Based on this data, which conclusion by the nurse is the most appropriate?

A)The mother's focus on diet, exercise, and achievement fostered the client's eating disorder.
B)The client must have inherited a genetic predisposition for eating disorders.
C)The client must have a neurotransmitter abnormality.
D)The mother is setting a good example for the client with her eating and exercise habits.

Question 7

A nurse is teaching the father of a 2-year-old client about steps he can take to foster his child's self-esteem. Which statement by the father indicates that more education is needed?

A)"At this stage, my most important job as a parent is to ensure that my child does not fail at completing new tasks."
B)"I should provide my child with an environment that is safe yet still allows for active exploration."
C)"My child needs to be permitted to learn from her mistakes."
D)"Toddlers who feel confident about their ability to act independently are more likely to develop healthy self-esteem."

Question 8

A student nurse is asked to recall the questions included in the SCOFF questionnaire. Which questions identified by the student nurse are appropriate? Select all that apply.

A)Do you believe yourself to be fat when others say you are too thin?
B)Would you say that food dominates your life?
C)Do you worry you have lost control over how much you eat?
D)Do you make yourself sick because you feel uncomfortably full?
E)Have you recently lost more than 1 pound in a 3-month period?

Question 9

The nurse is providing care to a client diagnosed with bulimia. The healthcare provider has prescribed medication to help decrease the client's binging and purging behavior. Which medication classification should the nurse include in the teaching plan for this client?

A)Mood stabilizers
B)Antidepressants
C)Antipsychotics
D)Anxiolytics

Question 10

An older adult client recognizes the need for help with personal care at home yet does not want to move to a nursing home or assisted living facility. Which action by the nurse would best assist this client?

A)Reminding the client that his physical strength will grow weaker at home until a nursing home is required
B)Suggesting that the client move in with his adult children
C)Recommending to the physician that the client be admitted to a nursing home immediately
D)Referring the client to a personal care assistant who can help with activities of daily living

Question 11

A client tells the nurse that the thought of eating makes her anxious and nervous, so she just avoids eating altogether. Which of the following actions would be highest priority when planning care for this client?

A)Providing instruction on the role of nutrition in normal menstruation
B)Providing instruction on the importance of nutrition for vital signs and muscle tone
C)Undertaking interventions to address anxiety and feelings of being in control
D)Providing instruction on appropriate nutritional intake

Question 12

The nurse is providing care to a client who is diagnosed with bulimia. Which clinical manifestations does the nurse anticipate when conducting the client's physical assessment? Select all that apply.

A)Increased urine output
B)Hoarseness when speaking
C)Poor skin turgor
D)Low body temperature
E)Elevated blood pressure

Question 13

During a routine physical examination, a preadolescent client tells the nurse, "I am too fat, and I'm going to do whatever I can to look like the girls on the cover of fashion magazines." The nurse should plan care for this client based on which risk factor for eating disorders?

A)A desire for a long-term profession
B)Societal influences on body weight
C)Unrealistic expectations
D)Family influences on body weight

Question 14

A client explains that she is experiencing high stress levels because her mornings are so hectic. She tells the nurse that before she arrives at work each morning, she needs to dress and feed her children, drop them off at daycare, and begin preparations for that evening's dinner. Based on this information, the nurse should anticipate that the client will require care related to which of the following issues?

A)Self-esteem
B)Role mastery
C)Role conflict
D)Role ambiguity

Question 15

A client tells the nurse that he feels pressure to spend every Sunday with his parents. However, the client's wife does not participate and stays at home waiting for the client to return. Which of the following elements is determining the client's self-concept?

A)Family and culture
B)History of successes and failures
C)Stressors
D)Resources

Question 16

The nurse is providing care to an adolescent client who has a history of vomiting after eating. Which diagnostic tests should the nurse anticipate when providing care to this client? Select all that apply.

A)Complete blood count
B)Serum electrolytes
C)Blood urea nitrogen (BUN)and creatinine
D)Urine drug screen
E)Barium enema

Question 17

The nurse is providing care to a client who has been diagnosed with anorexia nervosa. Which assessment findings indicate that the client has met some of the treatment goals related to the disease process? Select all that apply.

A)The client is observed wearing wrinkled clothes, listening to a portable music device, and staring out the window.
B)The client states that her menstrual cycle is regular and she is learning to prepare meals.
C)The client's vital signs are within normal limits.
D)The client's current weight is 75% of normal after 2 years of treatment.
E)The client is overheard telling her mother that she will eat dinner if her mother buys her new jeans.

Question 18

An adult client tells the nurse, "No matter what I do, I never can make my parents happy." Which action by the nurse may enhance the client's self-concept?

A)Suggesting that the client reduce the amount of time spent with her parents
B)Reminding the client that she is educated and has a great career and good marriage
C)Suggesting that the client turn the tables by expressing the same dissatisfaction with her parents
D)Telling the client that she is too old to be listening to her parents

Question 19

A client who has been admitted with an eating disorder tells the nurse, "No matter what I do, I continue to be fat." Which of the following is the priority nursing diagnosis when planning care for this client?

A)Ineffective Coping
B)Disturbed Body Image
C)Impaired Tissue Integrity
D)Deficient Knowledge

Question 20

An adolescent client who currently weighs 50% of expected body weight tells the nurse, "I get upset and can't eat because my mother is constantly forcing food on me." Which treatments are indicated for this client? Select all that apply.

A)Family-based psychotherapy
B)Hospitalization
C)Behavior modification
D)Medication to increase appetite
E)Placement with a foster family

Question 21

A client is admitted with behavior consistent with borderline personality disorder. Which of the following interventions should the nurse anticipate for this client?

A)Exercise therapy
B)Vitamin B₁₂ injections
C)Occupational therapy
D)Dialectical behavior therapy

Question 22

Why is the presence of dental caries and enamel erosion more suggestive of bulimia nervosa than of anorexia nervosa?

A)Unlike clients with anorexia nervosa, clients with bulimia nervosa are unlikely to consume sufficient amounts of calcium and other bone-building nutrients due to their restricted food intake.
B)Unlike clients with anorexia nervosa, clients with bulimia nervosa tend to eat large amounts of sugar, which promotes tooth decay.
C)Unlike clients with anorexia nervosa, clients with bulimia nervosa often purge by vomiting, which means their teeth are frequently exposed to the highly acidic contents of the stomach.
D)Unlike clients with anorexia nervosa, clients with bulimia nervosa tend to consume large amounts of laxatives, which can damage the oral cavity.

Question 23

A client who was admitted for treatment of a personality disorder is observed pulling another client's hair and pushing clients out of their chairs. What is the priority nursing intervention for this client?

A)Removing the client from the room and addressing the behavior privately
B)Establishing a therapeutic nurse-client relationship
C)Placing the client in a jacket restraint
D)Asking the client what purpose is served by disrupting others

Question 24

A client who has been diagnosed with a personality disorder tells the nurse, "Sometimes I daydream that I go home and kill my family." Which of the following is the priority nursing diagnosis for this client?

A)Ineffective Coping
B)Deficient Knowledge
C)Risk for Other-Directed Violence
D)Dysfunctional Family Processes

Question 25

A nurse working on the behavioral health unit is developing a plan of care for a client. The client does not interact with others, refuses to attend group sessions, and has a history of throwing things at other clients. Which of the following is the priority nursing diagnosis for this client?

A)Ineffective Coping
B)Risk for Other-Directed Violence
C)Social Isolation
D)Impaired Social Interaction

Question 26

Which of the following manifestations would the nurse least likely observe in a client with a Cluster B personality disorder?

A)Dramatic behavior
B)Erratic behavior
C)Extreme fearfulness
D)Extremely emotionality

Question 27

A nurse is caring for a pregnant client who has a history of bulimia nervosa. Which of the following statements should the nurse include when counseling this client about the potential effects of pregnancy on eating disorder?

A)"In some women with a history of eating disorders, pregnancy can lead to new or renewed onset of binge eating."
B)"Only a tiny fraction of women with bulimia continue to engage in disordered eating during pregnancy."
C)"Women with a history of bulimia or anorexia are at increased risk for pica during pregnancy."
D)"Engaging in disordered eating while pregnant can harm you, but it is unlikely to affect the health of your fetus."

Question 28

An experienced nurse is teaching a student nurse about personality disorders in the older adult population. Which of the following statements by the student nurse would indicate a need for further education?

A)"In some older adults, borderline personality disorder remits with age."
B)"In older adults, loss of a significant support person sometimes exacerbates symptoms and leads individuals to seek treatment."
C)"Antisocial personality disorder tends to worsen as a person moves from middle age into older adulthood."
D)"Among older adults with personality disorders, the risk of suicide tends to decline with age."

Question 29

An adolescent client tells the nurse that she plans to fight recent charges of shoplifting because she was just taking what was rightfully hers. Which trait associated with personality disorders is this client exhibiting?

A)Lying
B)Narcissism
C)Projection
D)Manipulation

Question 30

The nurse is planning care for a client who has been diagnosed with antisocial personality disorder. Which goals address the client's antisocial behavior? Select all that apply.

A)The client will share meals with others in the community dining area.
B)The client will interact socially with others.
C)The client will engage in individual therapy without disruptions.
D)The client will take all medications as prescribed.
E)The client will refrain from attention-seeking behavior.

Question 31

A college student tells the nurse about being "out of control" with eating. The client states, "I am trying to keep my weight down so my mom doesn't call me fat. Usually, I make myself throw up after eating." Based on this data, the nurse should plan on providing care for which of the following disorders?

A)Binge-eating disorder
B)Anorexia nervosa
C)Bulimia nervosa
D)Purging disorder

Question 32

An experienced nurse practitioner is teaching a student nurse about feeding and eating disorders in the pediatric population. Which of the following statements from the student nurse indicates that more education is necessary?

A)"Avoidant/restrictive food intake disorder, or ARFID, is the most common eating disorder among children."
B)"In recent years, eating disorders have become more common in the pediatric population."
C)"Many children are picky eaters, but few of them satisfy the diagnostic criteria for ARFID."
D)"Eating disorders are overdiagnosed in children because providers often fail to distinguish picky eating from true ARFID."

Question 33

The nurse is providing care to a client who has been diagnosed with a personality disorder. Which treatment options should the nurse anticipate for this client? Select all that apply.

A)Antipsychotic medication
B)Antidepressant medication
C)Cognitive-behavioral therapy
D)Nutritional counseling
E)Weight management program

Question 34

Which of the following personality disorders is characterized by an inability to trust others; a rigid worldview that often conspiratorial in nature; and the belief that other people's actions are based on ulterior motives?

A)Obsessive-compulsive personality disorder
B)Paranoid personality disorder
C)Schizoid personality disorder
D)Schizotypal personality disorder

Question 35

A nurse working on the behavioral health unit is caring for a client with histrionic personality disorder. Which types of behaviors should the nurse anticipate when assessing this client? Select all that apply.

A)Flamboyant behaviors
B)Dramatic behaviors
C)Competitive behaviors
D)Arrogant behaviors
E)Manipulative behaviors

Question 36

A client tells the nurse, "My mother spent many years in a mental institution, and my father would abuse me when my mother was not around." Based on this information, the client is at greatest risk for developing which of the following conditions?

A)A personality disorder
B)Poor relationships with individuals of the opposite sex
C)An eating disorder
D)Substance abuse

Question 37

The parents of an adolescent client tell the nurse that their daughter is very shy, exhibits intense anxiety about new people and situations, and tends to internalize negative comments from her peers. They ask the nurse whether they should be concerned about this behavior. What is the nurse's best response?

A)"All of these behaviors are strongly associated with avoidant personality disorder. I'd suggest you take your daughter to a psychologist as soon possible."
B)"Your daughter may be exhibiting signs of dependent personality disorder, but this condition can't be formally diagnosed until she is an adult."
C)"This behavior is normal for adolescents, and your daughter will eventually grow out of it."
D)"A lot of these behaviors are developmentally appropriate to some degree, but if they persist or severely impair your daughter's ability to function, they may be suggestive of a personality disorder."

Question 38

The nurse is providing care to a client who has been diagnosed with a personality disorder. Which finding indicates that the treatment plan has been beneficial for this client?

A)The client has ceased self-mutilating behavior and bathes once a week.
B)The client eats sporadically and reports being told she does not deserve to eat.
C)The client asks others for money because the client's money was stolen.
D)The client sits with others in the lounge area conversing about current affairs.

Question 39

In an adult client, the presence of lanugo and dry, brittle nails is suggestive of which of the following conditions?

A)Bulimia nervosa
B)Binge-eating disorder
C)Pica
D)Anorexia nervosa