A nurse is caring for a client who has anorexia nervosa. Which of the following findings requires immediate intervention by the nurse?

Lanugo covering the body

+2 edema of the lower extremities

BUN 21 mg/dL

Blood pH 7.60

Answer and Explanation

The Correct Answer is D

A blood pH of 7.60 indicates alkalosis, which is a life-threatening condition that can result from vomiting, laxative abuse, or diuretic use in clients who have anorexia nervosa. Alkalosis can cause cardiac arrhythmias, seizures, coma, and death if not corrected promptly. The nurse should notify the provider and prepare to administer IV fluids and electrolytes as ordered. The other findings are also concerning, but they are not as urgent as alkalosis.

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Correct Answer is D

Explanation

Referring the client to a self-help group, such as Alcoholics Anonymous (AA), is an effective strategy to promote sobriety and prevent relapse after discharge. Self-help groups provide peer support, education, and coping skills for clients who have alcohol use disorder. Systematic desensitization is a behavioral therapy technique that is used to treat phobias, not alcohol use disorder. Contacting a close relative of the client may be helpful, but it is not a recommendation that the nurse can make without the client's consent and involvement. Buprenorphine is a medication that is used to treat opioid use disorder, not alcohol use disorder.

A. The client states that he is unable to eat more than once a day. B. The client frequently recalls negative experiences that occurred during his marriage. C. The client relates that he is angry that the provider did not save his partner's life. D. The client says he feels guilty about not spending more time with his partner.

Correct Answer is A

Explanation

The nurse's priority is to address the client's physical needs, such as nutrition and hydration, which are essential for survival and recovery. The client who is unable to eat more than once a day is at risk for malnutrition, dehydration, and electrolyte imbalance, which can lead to serious complications. The other findings indicate emotional distress and grief, which are also important to address, but not as urgent as the client's physical health.

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A nurse is caring for a client who has anorexia nervosa. Which of the following findings requires immediate intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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