89 Item Psychiatric Nursing Exam II : Substance Abuse, Eating disorders andImpulse control disorders Correct Answers and RationaleTopic: Substance Abuse, Eating disorders, Impulse control disorders.
http://www.pinoybsn.tk 1. An unemployed woman, age 24, seeks help because she feels depressed andabandoned and doesn't know what to do with her life. She says she has quit her last five jobs because her coworkers didn't like her and didn't train her adequately. Last week, her boyfriend broke up with her after she drove his car into a tree after an argument. Theclient's initial diagnosis is borderline personality disorder. Which nursing observationssupport this diagnosis?A. Flat affect, social withdrawal, and unusual dressB. Suspiciousness, hypervigilance, and emotional coldness
C. Lack of self-esteem, strong dependency needs, and impulsive behavior
D. Insensitivity to others, sexual acting out, and violenceRationale: Borderline personality disorder is characterized by lack of self-esteem, strongdependency needs, and impulsive behavior. Instability in interpersonal relationships,mood, and poor self-image also is common. Typically, the client can't tolerate beingalone and expresses feelings of emptiness or boredom. Flat affect, social withdrawal, andunusual dress are characteristic of schizoid personality disorder. Suspiciousness,hypervigilance, and emotional coldness are seen in paranoid personality disorders. Inantisocial personality disorder, clients are usually insensitive to others and act outsexually; they may also be violent2.In a toddler, which of the following injuries is most likely the result of child abuse?A. A hematoma on the occipital region of the headB. A 1-inch forehead laceration
C. Several small, dime-sized circular burns on the child's back
D. A small isolated bruise on the right lower extremityRationale: Small circular burns on a child's back are no accident and may be fromcigarettes. Toddlers are injury prone because of their developmental stage, and falls arefrequent because of their unsteady gait; head injuries aren't uncommon. A small area of ecchymosis isn't suspicious in this age-group.3. A client is admitted to the emergency department after being found unconscious. Her blood pressure is 82/50 mm Hg. She is 5
4" (1.6 m) tall, weighs 79 lb (35.8 kg), andappears dehydrated and emaciated. After regaining consciousness, she reports that shehas had trouble eating lately and can't remember what she ate in the last 24 hours. Shealso states that she has had amenorrhea for the past year. She is convinced she is fat andrefuses food. The nurse suspects that she has:A. bulimia nervosa.
B. anorexia nervosa.