A nurse in an inpatient psychiatric unit is setting short-term goals for a client who was admitted for treatment of anorexia nervosa. Which of the following is an appropriate short-term goal the nurse should set?
The client will reach an appropriate body weight.
The client will gain 2 to 3 lb weekly.
The client will verbalize a realistic body image.
The client will develop a personalized meal plan.
The Correct Answer is B
Choice A reason: Reaching an appropriate body weight is a long-term goal, not a short-term one. Clients with anorexia nervosa require gradual weight restoration to avoid complications such as refeeding syndrome. Setting this as a short-term goal is unrealistic and potentially unsafe.
Choice B reason: Gaining 2 to 3 lb weekly is the correct short-term goal because it is measurable, realistic, and safe. This gradual increase helps stabilize the client’s nutritional status while minimizing medical risks. It also provides a tangible benchmark for progress during inpatient treatment.
Choice C reason: Verbalizing a realistic body image is important but represents a long-term psychosocial goal. Distorted body image is a core feature of anorexia nervosa and requires extended therapy and counseling. It cannot be expected as a short-term outcome during initial hospitalization.
Choice D reason: Developing a personalized meal plan is a collaborative long-term strategy involving dietitians and therapists. While important, it is not the immediate short-term focus. The priority is safe, gradual weight gain.
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Correct Answer is C
Explanation
Choice A reason: Encouraging the client to rest during the day is not appropriate. Daytime rest can worsen nighttime wakefulness and wandering. Clients with Alzheimer’s benefit from structured daytime activity to promote nighttime sleep.
Choice B reason: Asking the client why they continue to get out of bed is ineffective. Clients with Alzheimer’s often cannot provide logical explanations due to cognitive decline. This approach does not enhance safety.
Choice C reason: Moving the mattress to the floor is correct because it reduces the risk of injury if the client attempts to get out of bed or falls. This is a practical safety intervention for clients who wander or are restless at night.
Choice D reason: Keeping a television on at night introduces noise and light, which can increase agitation and confusion. It disrupts sleep and does not prevent wandering.
Correct Answer is D
Explanation
Choice A reason: Asking why the client thinks their life is not worth it is too broad and may come across as challenging or judgmental. It does not directly assess the client’s risk of harm and may not provide the nurse with the critical information needed to ensure safety.
Choice B reason: Telling the client they can trust the nurse is supportive, but it is vague and does not directly address the immediate risk of suicide. While building trust is important, the priority is to assess the client’s intent and plan.
Choice C reason: Asking what the client means by misery explores feelings but does not assess the immediate risk of suicide. While understanding the client’s emotional state is valuable, the nurse must first determine if the client has a plan, which indicates the level of risk.
Choice D reason: Asking if the client has a plan to end their life is the most appropriate response because it directly assesses suicide risk. The presence of a plan indicates a higher level of danger and guides the nurse in determining the urgency of interventions. This is the correct answer because it prioritizes safety and risk assessment.
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