A nurse is planning care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?
Offer the client a selection of beverages at each meal.
Inform the client that a weight gain of 2.3 kg (5 lb) per week is expected.
Arrange for someone to remain with the client for 30 min after meals.
Encourage the client to participate in developing dietary goals.
The Correct Answer is D
A. Offer the client a selection of beverages at each meal: Providing a variety of beverages may offer hydration and a sense of control, but clients with anorexia nervosa often use fluids to avoid calorie-dense solid foods. This approach can reinforce avoidance behaviors and does not contribute meaningfully to nutritional rehabilitation or psychological recovery.
B. Inform the client that a weight gain of 2.3 kg (5 lb) per week is expected: A weight gain goal of 2.3 kg per week is too aggressive and may provoke anxiety or resistance from the client. A slower, more gradual goal of 0.5 to 1 kg (1 to 2 lb) per week is considered safer and more psychologically tolerable. Unrealistic expectations can harm rapport and may lead to nonadherence or relapse.
C. Arrange for someone to remain with the client for 30 min after meals: Monitoring after meals is essential to prevent purging or other compensatory behaviors. The standard is 60 to 90 minutes post-meal observation to address delayed attempts at purging or exercising. Thus, while well-intentioned, this time frame is insufficient.
D. Encourage the client to participate in developing dietary goals: Involving the client in setting dietary goals promotes a sense of autonomy, collaboration, and ownership in the recovery process. This approach is therapeutic, reduces power struggles, and helps build trust between the nurse and the client.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Grapefruit: Grapefruit inhibits the cytochrome P450 3A4 enzyme in the liver, which is responsible for metabolizing atorvastatin. When this enzyme is blocked, the levels of atorvastatin in the blood can rise increasing the risk of serious side effects such as muscle toxicity and liver damage. Clients taking statins should completely avoid grapefruit to ensure the medication is processed safely and effectively.
B. Coffee: Coffee does not interact with atorvastatin in a clinically significant way. While excessive caffeine intake can have other health implications, it does not affect the metabolism or effectiveness of atorvastatin. Clients with hyperlipidemia may still consume coffee in moderation unless otherwise advised based on other health conditions.
C. Milk: Milk does not interfere with atorvastatin's absorption or metabolism. It is safe to consume while on the medication. In fact, low-fat dairy products can be part of a heart-healthy diet aimed at lowering cholesterol, making milk an acceptable food choice for clients with hyperlipidemia.
D. Oatmeal: Oatmeal is beneficial for clients with hyperlipidemia because it contains soluble fiber, which helps to lower LDL (bad) cholesterol levels. There are no known interactions between oatmeal and atorvastatin. Including oatmeal in the diet supports the therapeutic goals of atorvastatin by promoting heart health.
Correct Answer is A
Explanation
A. Eggs: Eggs are one of the most common food allergens in toddlers and young children. They contain proteins, particularly in the whites, that frequently trigger allergic reactions. Reactions can range from mild skin irritations to severe anaphylaxis. Because of this high risk, eggs are often introduced cautiously and monitored closely during early childhood.
B. Milk: While cow's milk is also a common allergen in infants and toddlers, it is often introduced earlier than eggs, typically when infants transition from breast milk or formula. Some children do outgrow milk allergies as they age. However, compared to eggs, milk is slightly less likely to cause first-time allergic reactions in toddlers once it has been safely introduced during infancy.
C. Citrus fruits: Citrus fruits may cause irritation or mild sensitivities in some toddlers due to their acidity, leading to rashes around the mouth or digestive discomfort. However, they are not among the top food allergens. The proteins in citrus fruits rarely trigger true allergic reactions compared to common allergens like eggs or milk.
D. Bananas: Bananas are generally well-tolerated and are among the first fruits introduced to infants due to their low allergenic potential. While rare allergies to bananas can occur—especially in those with latex allergies—they are not typically considered a high-risk food for allergies in toddlers.
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