A nurse is assessing a client who has a new diagnosis of anorexia nervosa. Which of the following findings should the nurse expect?
Bradycardia
Hyperactive bowel sounds
Dental erosion
Hypertension.
The Correct Answer is A
Choice A rationale: Bradycardia
Bradycardia, or an abnormally slow heart rate, is a common cardiovascular manifestation in individuals with anorexia nervosa. It is often a result of the body’s adaptive response to conserve energy due to severe malnutrition and reduced caloric intake. This is because the body is trying to conserve as much energy as possible, and one way it does this is by slowing down the heart rate. This can be dangerous, however, as it can lead to fainting, heart failure, or even death if not properly managed.
Choice B rationale: Hyperactive bowel sounds
Hyperactive bowel sounds are not typically associated with anorexia nervosa. Instead, individuals with this disorder often experience constipation and other gastrointestinal issues due to inadequate food intake. The lack of food intake can slow down the digestive process, leading to these symptoms.
Choice C rationale: Dental erosion
Dental erosion can be a consequence of anorexia nervosa, but it is more commonly associated with bulimia nervosa due to the frequent vomiting that characterizes this disorder. The stomach acid that comes into contact with the teeth during vomiting can cause the enamel to erode. However, it’s important to note that not all individuals with anorexia nervosa will experience this symptom.
Choice D rationale: Hypertension
Hypertension, or high blood pressure, is not typically associated with anorexia nervosa. In fact, low blood pressure (hypotension) is more common due to the decreased volume of blood in the body from insufficient nutrition.
Hypertension is more commonly associated with conditions such as obesity and metabolic syndrome.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
While the client's statement might seem like other defense mechanisms, here's why Denial is the most fitting choice: Denial:
Involves refusing to acknowledge a painful or threatening reality.
The client attributes their cough, a potential symptom of lung cancer, to a common cold, dismissing the possibility of their condition worsening.
This allows them to avoid the emotional distress associated with facing their illness. Other options and their rationales:
Reaction formation (Choice A): This involves expressing the opposite of what one truly feels or desires. The client doesn't show any outward signs of expressing emotions opposite to their actual feelings about their health.
Suppression (Choice C): This involves consciously pushing unpleasant thoughts or feelings out of awareness. While the client might downplay the cough, they haven't completely pushed the thought of their illness away.
Regression (Choice D): This involves reverting to an earlier stage of development in response to stress. There's no indication of the client displaying behaviors characteristic of an earlier developmental stage.
Addressing other potential mechanisms:
Displacement: Redirecting emotions towards a less threatening target is not evident in the scenario.
Rationalization: Justifying behavior in a way that avoids facing the true reasons is not seen in the client's explanation. Projection: Attributing one's own feelings or desires to others is not present in the client's statement.
Remember:
Denial is a common coping mechanism for dealing with difficult realities like illness.
It's crucial for the nurse to assess the extent of the client's denial and offer support without judgment.
The goal is to help the client acknowledge their illness while providing emotional support and resources for managing their condition.
Correct Answer is D
Explanation
Choice A rationale: A 13-year-old girl worrying about a pimple on her face is a common concern at this age. Adolescence is a time of significant physical changes, including the onset of acne. While this can cause distress and affect self-esteem, it is not as immediate a concern as some of the other options.
Choice B rationale: Menarche, or the onset of menstruation, typically occurs around the age of 12-14, but it can vary widely. Some girls may start their periods as early as 9 or as late as 16. This girl’s concern about not having started her period yet, while valid, is not unusual or immediately concerning given her age.
Choice C rationale: Feeling like one’s parents are treating them like a baby is a common sentiment among adolescents who are striving for more independence. It’s a normal part of the developmental process and, while it can cause conflict and frustration, it is not an immediate concern.
Choice D rationale: This statement indicates that the girl is feeling socially isolated, which can be a sign of social problems or mental health issues such as depression or anxiety. Social relationships and a sense of belonging are crucial for mental health, particularly during adolescence. This should be the nurse’s priority to address.
Please note that these rationales are based on general knowledge and understanding of adolescent development and mental health. For a more accurate and detailed explanation, it would be best to consult with a healthcare professional or refer to trusted health resources.
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