A nurse is caring for a client in an emergency department (ED).

Exhibits

For each assessment finding, click to specify if the finding is consistent with bulimia nervosa or anorexia nervosa. Each finding may support more than one disease process or none at all. There must be at least 1 selection In every column. There does not need to be a selection in every row. (Note: Each category must have at least 1 response option selected)

Parotid glands

Potassium level

Weight

Sodium level

Hand findings

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A,B"},"E":{"answers":"A"}}

Rationale:

Parotid glands: Parotid gland enlargement is a typical finding in clients with bulimia nervosa due to repeated episodes of self-induced vomiting. The recurrent stimulation of salivary glands leads to painless swelling, often bilateral, and may also contribute to facial puffiness or a rounded appearance.
Potassium level: A potassium level of 3.0 mEq/L is low and may result from either bulimia nervosa or anorexia nervosa. In bulimia, this is typically due to purging through vomiting or laxative use; in anorexia, it stems from prolonged restriction, dehydration, and possible diuretic misuse. Both conditions increase the risk of cardiac complications.
Weight: The client’s weight of 61.8 kg with a BMI of 20.7 falls within the normal range and is more consistent with bulimia nervosa. Individuals with anorexia nervosa usually present with a significantly lower body weight and BMI, typically below 18.5, due to extreme caloric restriction and prolonged starvation.
Sodium level: A sodium level of 134 mEq/L is slightly low and can occur in both bulimia nervosa and anorexia nervosa. In bulimia, frequent vomiting may cause sodium loss, while in anorexia, hyponatremia can develop from malnutrition, dehydration, or excessive water intake in attempts to suppress appetite or manipulate weight.
Hand findings: Calluses on the index and middle fingers, known as Russell’s sign, are associated with bulimia nervosa. These result from repeated trauma during induced vomiting episodes, as the hand comes into contact with the teeth. This finding is a classic physical sign of chronic purging behavior.

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Free Nursing Study Resources

Correct Answer is ["A","B","C","E"]

Explanation

Rationale:

A. Limit visitors to 30 min per day: Time restrictions help minimize radiation exposure to visitors. Short visits reduce the cumulative dose received, which is especially important for non-staff individuals who are not regularly monitored for radiation exposure.

B. Instruct visitors who are pregnant to remain 3 feet from the client: Pregnant individuals should avoid close contact with radiation sources due to fetal sensitivity. Maintaining a 3-foot distance helps reduce exposure to scattered radiation from the sealed implant.

C. Wear a lead apron when providing care: A lead apron provides protection against scatter radiation, particularly during direct, prolonged care. Nurses should also stand as far away from the source as possible and work efficiently to limit time near the implant.

D. Place the client in a semi-private room: Clients with sealed radiation implants require a private room to protect others from radiation exposure. A semi-private room would place another patient at unnecessary risk and violates radiation safety protocols.

E. Close the door to the client's room: Keeping the door closed helps contain radiation within the room, thereby protecting other individuals in the surrounding area. It is a standard precaution for clients receiving internal radiation therapy.

A. Expresses pain freely and loudly B. Prefers foods that maintain a balance of hot and cold within the body. C. Prefers to make direct eye contact with health care personnel D. Tends to be very expressive with gestures and body language

Correct Answer is B

Explanation

Rationale:

A. Expresses pain freely and loudly: Many Chinese American clients may view overt pain expression as a loss of control or dignity. Cultural norms often encourage stoicism, and clients may underreport pain unless directly asked in a sensitive and respectful manner.

B. Prefers foods that maintain a balance of hot and cold within the body: Traditional Chinese medicine emphasizes balance, particularly of hot and cold elements, especially during the postpartum period. Clients may prefer warm foods and drinks to restore balance and promote healing after childbirth.

C. Prefers to make direct eye contact with health care personnel: In Chinese cultural contexts, direct eye contact can be considered disrespectful or confrontational, especially toward authority figures. Avoiding eye contact may be a sign of respect rather than disinterest.

D. Tends to be very expressive with gestures and body language: Chinese American clients may communicate in a more reserved and controlled manner, often minimizing the use of expressive gestures. Nonverbal communication may be subtle, requiring attentive observation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has lung cancer and has a sealed radiation implant. Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is planning care for a client who is Chinese American and reports adhering to Chinese cultural postpartum practices. Which of the following should the nurse anticipate?

Correct Answer is B

Explanation

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