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. Clients who are involuntarily committed do not maintain access to legal counsel.
This statement is incorrect. Clients who are involuntarily committed generally do have the right to legal counsel. They can challenge their commitment in a court of law, and legal representation is often provided to them if they cannot afford it.

B. Clients must be informed of the risks of treatment.
This statement is correct. Informed consent is a fundamental principle in healthcare, including mental health treatment. Clients have the right to be fully informed about the risks and benefits of any treatment or procedure before giving consent.

C. Clients who have a severe mental illness cannot request a psychiatric advance directive.
This statement is incorrect. Clients with severe mental illness can, and should, create psychiatric advance directives. These directives allow individuals to specify their preferences regarding mental health treatment in advance, ensuring their wishes are respected even if they are not able to communicate them at a later time due to their mental condition.

D. Clients who are violent can refuse chemical restraint.
This statement is generally incorrect. In emergency situations where a client poses an immediate danger to themselves or others, chemical restraint might be administered without the client's consent to ensure safety. However, there are strict guidelines and regulations surrounding the use of chemical restraints, and they should only be used in specific situations and as a last resort. In non-emergency situations, clients generally have the right to refuse any treatment, including chemical restraint, unless it is court-ordered due to their condition posing an imminent risk.

A. "Why did you feel like giving away your belongings?" B. "You should find a support group to attend." C. "Everyone feels a little down sometimes." D. "Can you tell me how you have been feeling lately?"

Correct Answer is D

Explanation

A. "Why did you feel like giving away your belongings?"
This response is empathetic and invites the client to explore their feelings and motivations. It shows understanding and can help the nurse comprehend the client's emotional state better.

B. "You should find a support group to attend."
This response suggests a proactive step to seek support, which can be helpful. However, it might be premature in this context as the nurse hasn't fully assessed the client's situation yet. It's important to understand the client's feelings and circumstances before recommending specific interventions.

C. "Everyone feels a little down sometimes."
This response minimizes the client's feelings and can be invalidating. It doesn't acknowledge the seriousness of the client's statement, which might discourage them from opening up further.

D. "Can you tell me how you have been feeling lately?"
As previously explained, this response is empathetic and open-ended, encouraging the client to share their emotions and thoughts. It's a good starting point for a therapeutic conversation, allowing the nurse to assess the client's current mental state.

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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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