A nurse is caring for a client who has bulimia nervosa.
Which of the following actions should the nurse take first?

Observe the client during and after meals.

Suggest that the client assist with meal planning.

Instruct the client about effective coping strategies.

Refer the client to a support group for clients who have eating disorders.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

The nurse's first action when caring for a client with bulimia nervosa should be to observe the client during and after meals. This is essential to monitor for signs of binge-eating followed by compensatory behaviors such as vomiting or the misuse of laxatives. Timely observation can help ensure the client's safety and provide an opportunity for immediate intervention if necessary.

Choice B rationale:

Suggesting that the client assist with meal planning can be a beneficial intervention, but it should not be the first action. Clients with bulimia nervosa often have complex emotional and psychological issues related to their eating habits, so it's crucial to address the immediate risks of binge-purge episodes before moving on to meal planning.

Choice C rationale:

Instructing the client about effective coping strategies is important for long-term recovery, but it should not be the first action. Immediate safety concerns, such as monitoring for binge-purge behaviors, take precedence in the initial care of a client with bulimia nervosa.

Choice D rationale:

Referring the client to a support group is a valuable intervention in the long-term management of bulimia nervosa, but it should not be the first action. The immediate priority is to assess and address any acute risks associated with the disorder, such as binge-purge episodes.

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Correct Answer is B

Explanation

Choice A rationale:

Sarcoptes scabiei is the causative agent of scabies, a contagious skin infestation. While scabies is a communicable disease, it is typically not a reportable disease to the state health department. Scabies is usually treated at the individual or community level, and reporting to the state health department is not required.

Choice B rationale:

Neisseria gonorrhoeae is the bacterium responsible for gonorrhea, a sexually transmitted infection. Gonorrhea is a notifiable disease, and healthcare providers are required to report cases of gonorrhea to the state health department. This is because gonorrhea is a significant public health concern due to its potential complications and the need for contact tracing and prevention.

Choice C rationale:

Human papillomavirus (HPV) is a very common sexually transmitted infection, but it is typically not a reportable disease to the state health department. HPV can lead to various health issues, including genital warts and certain types of cancer. However, reporting HPV cases is not a standard practice because it is highly prevalent and usually managed at the individual level through screening and vaccination programs.

Choice D rationale:

Impetigo contagiosa is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes. While it is contagious, impetigo is not typically a reportable disease to the state health department. Like scabies, impetigo is usually managed at the individual or community level, and reporting is not a standard requirement.

A. Sore throat B. Disorientation C. Blood pressure changes D. Tachycardia E. High fever F. Agranulocytosis

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

Explanation

Condition	Definition	Causes	Symptoms	Treatment
Agranulocytosis	A severe and potentially life-threatening reduction in the number of white blood cells (neutrophils) that fight infection.	Can be caused by some antipsychotic medications, such as clozapine, olanzapine, and quetiapine.	Sore throat, fever, chills, mouth ulcers, infections, bleeding, and fatigue.	Discontinuation of the offending medication, antibiotics, antifungals, and granulocyte colony-stimulating factor (G-CSF) injections to stimulate the bone marrow to produce more white blood cells.
Neuroleptic Malignant Syndrome (NMS)	A rare but serious reaction to antipsychotic medications, especially the older ones, such as haloperidol, fluphenazine, and chlorpromazine.	Can be triggered by high doses, rapid dose changes, or switching of antipsychotic medications.	High fever, muscle rigidity, altered mental status, autonomic instability (blood pressure changes, tachycardia, sweating, etc.), and elevated creatine kinase levels.	Discontinuation of the offending medication, supportive care, cooling measures, hydration, and medications such as dantrolene, bromocriptine, or amantadine to counteract the effects of dopamine blockade.
Serotonin Syndrome	A potentially life-threatening condition caused by excessive levels of serotonin in the brain.	Can be caused by taking too much of a serotonin-enhancing medication, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), or other drugs that affect serotonin levels, such as tramadol, linezolid, or St. John’s wort. Can also be caused by combining two or more serotonin-enhancing medications.	Agitation, confusion, disorientation, anxiety, hallucinations, muscle spasms, tremors, shivering, hyperreflexia, incoordination, diarrhea, nausea, vomiting, blood pressure changes, tachycardia, and hyperthermia.	Discontinuation of the offending medication(s), supportive care, hydration, and medications such as benzodiazepines, cyproheptadine, or serotonin antagonists to reduce serotonin levels.

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A nurse is caring for a client who has bulimia nervosa.Which of the following actions should the nurse take first?

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Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is caring for a group of clients who have communicable diseases.Which of the following infections should the nurse report to the state health department?

Correct Answer is B

Explanation

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

Explanation

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A nurse is caring for a client who has bulimia nervosa.
Which of the following actions should the nurse take first?