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 B

Explanation

The nurse should collaborate with the client to set realistic and achievable goals for weight gain and recovery. This can help increase the client's sense of control and motivation. The other options are not appropriate because they do not involve the client in the decision-making process, and they may increase the client's resistance or anxiety.

A. "Ask a family member to check the locks for you at night." B. "Focus on abdominal breathing whenever you go to check the locks." C. "Keep a journal of how often you check the locks each night." D. "Snap a rubber band on your wrist when you think about checking the locks."

Correct Answer is D

Explanation

Thought stopping technique is a cognitive-behavioral intervention that aims to interrupt and replace unwanted thoughts with more adaptive ones. Snapping a rubber band on the wrist is a form of aversive conditioning that creates a negative association with the obsessive thought and reduces its frequency and intensity.

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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

A nurse is planning care for a newly admitted client who has anorexia nervosa. Which of the following interventions should the nurse include in the plan?

Correct Answer is B

Explanation

A nurse is providing behavioral therapy for a client who has obsessive-compulsive disorder. The client repeatedly checks that the doors are locked at night. Which of the following instructions should the nurse give the client when using thought stopping technique?

Correct Answer is D

Explanation

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