A nurse is reviewing the purpose of advance directives with a client. Which of the following statements should the nurse make?

"It expresses your wishes regarding health care when you can no longer communicate."

"It specifies your choices regarding funeral arrangements."

"It defines the criteria for the distribution of your assets."

"It appoints a health care provider to speak for you with power of attorney for health care."

Answer and Explanation

The Correct Answer is A

Rationale:

A. "It expresses your wishes regarding health care when you can no longer communicate.": Advance directives are legal documents that state a client's preferences for medical care if they become unable to communicate those decisions themselves. This includes choices about life-sustaining treatments, resuscitation, and organ donation.

B. "It specifies your choices regarding funeral arrangements.": Funeral arrangements are typically addressed in a will or separate personal document, not in advance directives. Advance directives focus on medical decisions, not postmortem planning.

C. "It defines the criteria for the distribution of your assets.": The distribution of assets is handled through a last will and testament or estate planning documents, not through an advance directive. The directive is solely for healthcare-related decisions.

D. "It appoints a health care provider to speak for you with power of attorney for health care.": An advance directive may include the appointment of a health care proxy or agent, but it does not appoint a health care provider. It designates a trusted individual—not a clinician to make decisions if the client is incapacitated.

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Correct Answer is D

Explanation

Rationale:

A. Paranoid personality disorder: This disorder is marked by distrust and suspicion of others, but it is not closely associated with the development of anorexia nervosa. It does not typically involve the rigid control over food and body image seen in eating disorders.

B. Schizotypal personality disorder: While schizotypal personality disorder involves social anxiety and eccentric behaviors, it is more aligned with psychotic spectrum disorders than with the rigid and perfectionistic traits commonly seen in anorexia nervosa.

C. History of attention deficit hyperactivity disorder: ADHD may be more associated with impulsive eating behaviors and a higher risk for binge eating or bulimia nervosa, rather than the restrictive and perfectionistic traits seen in anorexia nervosa.

D. History of obsessive-compulsive disorder: OCD is a significant risk factor for anorexia nervosa due to the overlap in obsessive thoughts and compulsive behaviors. Individuals with OCD often display rigid routines, perfectionism, and intrusive thoughts about food, body image, and control—all of which are common features in anorexia.

A. Administer disulfiram B. Encourage participation in exposure therapy. C. Administer memantine D. Recommend client join a self-help group.

Correct Answer is D

Explanation

Rationale:

A. Administer disulfiram: Disulfiram is used to deter alcohol consumption by causing unpleasant effects when alcohol is consumed. It has no therapeutic use in the treatment of gambling disorders and would not address the behavioral or psychological components involved.

B. Encourage participation in exposure therapy: Exposure therapy is typically used for anxiety disorders, such as phobias or post-traumatic stress disorder. It is not a standard treatment for gambling disorder, which requires cognitive and behavioral interventions tailored to impulse control.

C. Administer memantine: Memantine is primarily used to manage symptoms of Alzheimer’s disease and is not an approved or evidence-based treatment for gambling disorder. Its mechanism of action is unrelated to the neurobiology of behavioral addictions like gambling.

D. Recommend client join a self-help group: Self-help groups like Gamblers Anonymous provide peer support and structured recovery programs that address compulsive gambling behaviors. Participation can foster accountability, emotional support, and behavioral change, making this a relevant and effective nursing intervention.

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