A nurse in an outpatient setting is caring for a client.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
The Correct Answer is []
Potential Condition
Bulimia nervosa: The client has a BMI of 18.5, which is on the lower end of normal, indicating possible weight issues, but not the severe underweight typical of anorexia nervosa. The client describes cycles of binge eating followed by compensatory behaviors such as purging (using laxatives), which are characteristic of bulimia nervosa. The client expresses a preoccupation with food and body weight, and feelings of embarrassment about their eating habits, which align with bulimia nervosa.
Actions to Take
1. Assess binging and purging patterns: It's crucial to understand the frequency, triggers, and methods of binging and purging to tailor interventions effectively and to monitor the severity and progression of bulimia.
2. Encourage client to identify triggers for overeating: Identifying triggers for binging can help the client develop healthier coping mechanisms and reduce the occurrence of binge eating episodes.
Parameters to Monitor
1. Electrolyte levels: Frequent use of laxatives and purging behaviors can lead to electrolyte imbalances, which are potentially life-threatening and must be monitored regularly.
2. Frequency of compensatory behaviors: Tracking the frequency of purging behaviors (such as laxative use) helps assess the effectiveness of interventions and the client’s progress in reducing harmful behaviors.
Incorrect answers:
Actions to Take:
- Assess for and discourage provocative or seductive behaviour: This is more relevant to histrionic personality disorder, not bulimia nervosa.
- Weigh daily for the first week: While weighing the client can be part of the monitoring process, daily weigh-ins can increase anxiety and may not directly address the core issues of bulimia.
- Assess for consumption of right food items: While dietary intake is important, focusing solely on food items without addressing the psychological aspects may not be effective for treating bulimia.
Parameters to Monitor:
- Attention-seeking behaviours: More relevant to histrionic personality disorder than bulimia nervosa.
- Signs of infection: Not directly relevant unless there is evidence of a related health issue or a compromised immune system, which is not indicated in the provided information.
- Presence of lanugo: Lanugo is more commonly associated with anorexia nervosa due to severe malnutrition, not bulimia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E","F"]
Explanation
Findings Consistent with Antisocial Personality Disorder (ASPD)
1. Experience with the legal system since teenage years: Individuals with ASPD often exhibit a pattern of behavior that violates societal norms and legal codes, leading to frequent encounters with the legal system. The client has a history of criminal behavior, including shoplifting, auto theft, and resisting arrest, which aligns with the diagnostic criteria for ASPD.
2. Substance use: Substance abuse is common among individuals with ASPD. The client's history of driving under the influence of alcohol and possession and sale of marijuana demonstrates a disregard for the law and social norms, which is characteristic of ASPD.
3. Acceptance of responsibility: A key feature of ASPD is a lack of remorse or responsibility for one’s actions. The client’s statement, "That car wreck was not my fault! That judge just has it out for me," indicates a refusal to accept responsibility for their actions and a tendency to blame others, which is consistent with ASPD.
4. Relationship with family: Estrangement from family members is often seen in individuals with ASPD due to their manipulative, deceitful, or exploitative behavior, which can damage personal relationships. The client's estrangement from their family supports this pattern of unstable and problematic relationships.
Findings Not Consistent with ASPD
5. Adhering to financial responsibilities: The client does not adhere to financial responsibilities, as evidenced by their eviction for failure to pay rent. This behavior is consistent with ASPD, where individuals often exhibit irresponsibility, particularly in financial matters.
6. Employment status: Employment status alone is not a definitive indicator of ASPD. While the client is currently employed by a food delivery service, which suggests some level of functional ability, it does not provide enough context regarding their overall adherence to social norms or work behavior.
7. Compassion toward others: The client displays a lack of compassion toward others, which is a hallmark of ASPD. They refer to other clients in a derogatory manner ("losers") and show disdain for their feelings. This behavior reflects the lack of empathy and disregard for others typical in ASPD.
8. Rechanneling anger with physical activity: While engaging in physical activity to manage anger is generally a positive coping strategy, it does not specifically relate to the diagnostic criteria for ASPD. The client's use of physical activity to mitigate anger does not negate the presence of other antisocial traits.
Correct Answer is D
Explanation
. Use physical restraints during severe outbursts to ensure safety. Physical restraints are not appropriate for managing behavioural issues in children with ODD. They can escalate the situation, cause physical harm, and damage the trust between the child and caregivers.
B. Assign daily chores that are challenging to encourage discipline. While chores can teach responsibility, assigning challenging tasks is not appropriate for managing ODD and could lead to frustration and further defiance.
C. Encourage solitary play to reduce social stressors. Solitary play might reduce social stress but does not address the underlying behavioural issues of ODD. Social skills and interactions need to be improved rather than avoided.
D. Put into practice consistent consequences for rule-breaking behaviour. Consistent consequences help the child understand the link between behaviour and outcomes, which is crucial for managing ODD. It provides structure and clear expectations, which are essential for children with behavioral issues.
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