A nurse is assessing an adolescent client who has anorexia nervosa. Which of the following client statements is a sign of cognitive distortion?

"I really need to get into shape."

"If I eat one piece of candy, I may as well eat ten."

"I can't afford to gain weight."

"I like to cut my food into small pieces."

Answer and Explanation

The Correct Answer is B

A.   It reflects a desire to improve physical fitness, which is a common and generally positive goal. However, if this statement were accompanied by an excessive focus on weight loss or extreme measures to achieve fitness, it could indicate a problem, but on its own, this statement is not clearly indicative of cognitive distortion.
B.   It reflects "all-or-nothing thinking," a common cognitive distortion in eating disorders. This pattern of thinking involves seeing things in black and white, where a small lapse in diet is perceived as a complete failure, leading to excessive and irrational behavior, such as consuming more than intended.
C.   It shows a strong fear of gaining weight, which is typical in anorexia nervosa. However, it is more a sign of extreme concern about body image rather than a specific cognitive distortion pattern. Cognitive distortions often involve faulty logic or irrational beliefs, and this statement is more about an emotional response to weight gain.
D.   Cutting food into small pieces can be a behavioral characteristic or ritual for someone with anorexia nervosa, but it does not necessarily reflect a cognitive distortion on its own. It might be a way to control portions or prolong the eating process, but it is not a direct example of distorted thinking.

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Correct Answer is B

Explanation

A. This option is not the best source of protein. While avocados are nutritious and contain healthy fats, they are low in protein. One cup of pureed avocado contains approximately 3 grams of protein, which is relatively low compared to other protein-rich foods. It’s better for providing healthy fats rather than substantial protein needed for wound healing.
B. This is the best source of protein among the choices. Lentils are an excellent source of plant-based protein, providing about 18 grams of protein per cup. They are also rich in fiber, vitamins, and minerals. For someone on a vegan diet, lentils can effectively support protein needs essential for wound healing and overall recovery.
C. This option is not the best source of protein. Brown rice is a good source of carbohydrates and provides about 5 grams of protein per cup, but it is not as protein-dense as lentils. While brown rice can be part of a balanced diet, it does not provide as much protein as lentils or other high-protein vegan foods.
D. This option does not provide significant protein. Orange juice is rich in vitamin C, which is important for wound healing, but it contains negligible protein. It's not a protein source and should not be relied upon for meeting protein needs.

A. The nurse allows the client to rest in a supine position during feeding. B. The nurse initiates the feeding after aspirating 50 mL of gastric residual. C. The nurse irrigates the NG tube with tap water after feeding. D. The nurse administers the feeding through a syringe barrel by gravity.

Correct Answer is A

Explanation

A. The supine position increases the risk of aspiration, where food or liquid could enter the airway and potentially cause aspiration pneumonia. To minimize this risk, the client should be positioned in a semi- Fowler’s position (head of the bed elevated at 30-45 degrees) during feedings.
B. Aspirating gastric residual volumes is a standard practice to check for proper digestion and tolerance of the feeding. Generally, a residual of up to 250-500 mL can be acceptable depending on institutional policy and client condition. This action does not necessarily require intervention unless specific guidelines indicate otherwise.
C. Irrigating the NG tube with tap water is a common practice to ensure the tube remains patent and to help clear any residual feeding material from the tube. Tap water is generally considered acceptable for this purpose, though some facilities may use sterile or distilled water to avoid any potential infections.
D. Administering the feeding through a syringe barrel by gravity is a standard method for intermittent tube feedings. This technique allows the feeding to flow slowly into the stomach without excessive pressure, which can help prevent complications such as nausea or cramping.

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A nurse is assessing an adolescent client who has anorexia nervosa. Which of the following client statements is a sign of cognitive distortion?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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