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

Prepare the client for electroconvulsive therapy.

Weigh the client twice per day.

Encourage the client to participate in family therapy.

Set a weight gain goal of 2.2 kg (4.9 lb) per week.

Answer and Explanation

The Correct Answer is C

A. Prepare the client for electroconvulsive therapy:
Electroconvulsive therapy (ECT) is not a standard or appropriate treatment for anorexia nervosa. ECT is primarily used for severe depression, bipolar disorder, and certain other mental health conditions. Anorexia nervosa is typically managed through psychotherapy, nutritional counseling, and medical monitoring, often in an outpatient or inpatient setting, depending on the severity of the disorder.

B. Weigh the client twice per day:
Frequent weighing is generally discouraged in the treatment of anorexia nervosa. Individuals with this disorder often have an unhealthy fixation on their weight. Frequent weigh-ins can exacerbate anxiety, foster an unhealthy relationship with food and body image, and reinforce obsessive thoughts about weight and appearance. Healthcare providers should monitor weight and nutritional status regularly, but the frequency should be determined based on the individual's specific needs and in a manner that does not worsen their anxiety.

C. Encourage the client to participate in family therapy:
This is the appropriate choice. Family therapy is often a crucial component of the treatment plan for anorexia nervosa. It helps address family dynamics, communication patterns, and any dysfunctional relationships that might contribute to the eating disorder. Family therapy provides a supportive environment for both the individual with anorexia and their family members, aiding in understanding, coping, and healing.

D. Set a weight gain goal of 2.2 kg (4.9 lb) per week:
Setting specific weight gain goals can be counterproductive and potentially harmful for individuals with anorexia nervosa. Rapid or arbitrary weight gain goals may lead to unhealthy eating behaviors, excessive exercise, or other dangerous practices in an attempt to meet the goal quickly. Instead, healthcare providers focus on a more individualized and gradual approach to weight restoration, ensuring that it is safe, sustainable, and in line with the client's overall health and well-being.

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Correct Answer is B

Explanation

A. "I will learn how to voluntarily control my blood pressure and heart rate."
This statement indicates the client might be referring to techniques such as biofeedback or relaxation exercises that involve controlling physiological responses consciously. While these are relaxation techniques, they are not specifically cognitive reframing. Cognitive reframing focuses on changing negative thought patterns.

B. "I will practice replacing negative thoughts with positive self-statements."
This statement accurately reflects the concept of cognitive reframing. It involves identifying negative or unhelpful thoughts and consciously replacing them with positive, empowering, or rational thoughts. This technique is widely used in cognitive-behavioral therapy (CBT) to help individuals manage stress, anxiety, and various mental health issues.

C. "I will focus on a mental image while concentrating on my breathing."
This statement describes a relaxation technique where individuals visualize a calming image and synchronize their breathing with this mental image. While this practice is beneficial for relaxation, it is not cognitive reframing. Cognitive reframing specifically deals with changing the content of thoughts, not necessarily focusing on mental imagery.

D. "I will progressively relax each of my muscle groups when feeling stressed."
This statement describes a relaxation technique known as progressive muscle relaxation. It involves tensing and then relaxing different muscle groups to reduce physical tension and stress. While this technique is excellent for relaxation, it is not cognitive reframing. Cognitive reframing pertains to changing thoughts, not physical sensations.

A. Takes advantage of others for her own benefit B. Believes that others are deceiving her C. Shows exaggerated expression of emotions D. Demonstrates detachment from others

Correct Answer is B

Explanation

A. Takes advantage of others for her own benefit:
This behavior is not specific to paranoid personality disorder. Instead, it may be seen in individuals with antisocial personality disorder, who disregard the rights of others and exploit them for personal gain. People with paranoid personality disorder are more characterized by a pervasive distrust of others and a belief that others are out to harm or deceive them.

B. Believes that others are deceiving her:
This is a hallmark symptom of paranoid personality disorder. Individuals with this disorder often exhibit extreme distrust and suspicion, believing that others have hidden motives or are deliberately trying to deceive, harm, or manipulate them. This suspiciousness and belief in the untrustworthiness of others are key features of paranoid personality disorder.

C. Shows exaggerated expression of emotions:
Exaggerated expression of emotions is not a defining characteristic of paranoid personality disorder. People with this disorder tend to display a guarded and suspicious demeanor rather than exaggerated emotional expressions. Their interpersonal interactions are often marked by skepticism and wariness.

D. Demonstrates detachment from others:
Detachment from others is more characteristic of schizoid personality disorder, not paranoid personality disorder. Individuals with schizoid personality disorder tend to be emotionally detached and have limited interest in social interactions. In contrast, individuals with paranoid personality disorder are highly suspicious and tend to assume that others are hostile or malevolent, leading to interpersonal difficulties rooted in their intense distrust.

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

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