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 D
Explanation
A. Permanent short-term memory loss: While certain substances, particularly chronic alcohol use, can lead to memory impairment, permanent short-term memory loss is not a typical complication of heroin use. Heroin primarily affects the respiratory system and can lead to other health risks such as overdose and infection. Therefore, this choice is incorrect.
B. Nasal septum perforation: Nasal septum perforation is typically associated with the intranasal use of substances like cocaine, which can damage the nasal tissues. Heroin is more commonly injected or smoked, and nasal perforation is not a primary health risk associated with its use. Therefore, this choice is incorrect.
C. Acute pancreatitis: Acute pancreatitis is commonly associated with excessive alcohol consumption rather than heroin use. Heroin primarily affects the central nervous and respiratory systems rather than the pancreas. Therefore, this choice is incorrect.
D. Respiratory depression/arrest: Heroin use poses a significant risk of respiratory depression and arrest, which can be fatal. It depresses the central nervous system and slows down breathing, potentially leading to severe hypoxia and death, especially in the case of overdose. This choice is correct.
Correct Answer is B
Explanation
A. "Why did you feel you needed to do that at this time?": This response might come off as insensitive or judgmental. It could imply that the parents made an inappropriate decision without acknowledging their difficult situation.
B. "It must be frustrating for you to have to cancel an activity your son enjoyed.": This response validates the parents' feelings and acknowledges the emotional difficulty of making such a decision. It shows empathy and understanding of their situation.
C. "You never know. He could be ready for baseball by the spring.": This response offers false hope and may not be realistic given the child’s terminal illness. It could undermine the parents’ acceptance of the situation.
D. "Baseball can be a dangerous sport for children anyway.": This response dismisses the parents' feelings and does not acknowledge the real reason for canceling the activity. It is insensitive to the gravity of their situation.
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