A nurse is providing care for a client who has anorexia nervosa. Which of the following nursing interventions should the nurse take?

Schedule regular weigh-in times.

Allow the client to eat at any time.

Provide privacy when friends visit.

Compliment the client for weight gain.

Answer and Explanation

The Correct Answer is A

A. Schedule regular weigh-in times: Monitoring the client's weight on a regular schedule is important in managing anorexia nervosa. It helps track progress and any potential complications related to weight loss.

B. Allow the client to eat at any time: For individuals with anorexia nervosa, there is typically a structured meal plan that is carefully monitored by healthcare professionals. Allowing the client to eat at any time might disrupt the planned nutritional intake.

C. Provide privacy when friends visit: Privacy is important, but it should be balanced with ensuring the client's safety and adherence to the treatment plan. Visitors might need to be supervised to prevent any behaviors that could exacerbate the disorder.

D. Compliment the client for weight gain: While support and encouragement are important, complimenting a client for weight gain might inadvertently reinforce a focus on body image and reinforce disordered eating behavior. It's crucial to provide positive reinforcement for adherence to the treatment plan and progress in recovery, rather than emphasizing weight changes.

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Correct Answer is C

Explanation

A. Regression: Incorrect

Regression is a defense mechanism in which a person reverts to an earlier stage of development in response to stress or anxiety. For example, an adult might start behaving like a child when faced with a difficult situation. In this case, the student berating the teacher doesn't demonstrate a return to an earlier developmental stage, so regression is not the correct choice.

B. Conversion: Incorrect

Conversion refers to the conversion of emotional distress into physical symptoms, such as experiencing physical pain without any apparent physical cause. This mechanism is often seen in conditions like conversion disorder. The student berating the teacher is not exhibiting physical symptoms as a response to emotional distress, so conversion is not the correct choice.

C. Projection: Correct

Projection is the act of attributing one's own unacceptable feelings or thoughts to another person. In this scenario, the student is projecting their own failure onto the teacher and the course by blaming them for the failure. They are unable to accept their own role in the failure and are instead placing the blame on external factors. This aligns with the behavior described in the scenario.

D. Undoing: Incorrect

Undoing involves trying to compensate for or negate an unacceptable action or thought with a contrary action. For instance, someone who had angry thoughts might engage in excessive acts of kindness to "undo" those thoughts. The student berating the teacher is not engaging in actions to negate their negative feelings or thoughts; they are expressing their frustration directly.

A. Remain with the client. B. Give the client a PRN sleeping medication. C. Encourage the client to go back to bed. D. Explore alternatives to pacing the floor with the client

Correct Answer is A

Explanation

Remaining with the client provides support and ensures their safety. The client's behavior indicates distress, and having a nurse nearby can help the client feel more comfortable and secure.

B. Give the client a PRN sleeping medication:

Explanation: Administering a sleeping medication should not be the first response, especially if the client is agitated. It's important to address the underlying cause of the agitation and consider other interventions before resorting to medication.

C. Encourage the client to go back to bed:

Explanation: Encouraging the client to go back to bed might not be effective if they are experiencing significant distress or anxiety. It's better to address their emotional state first before suggesting any changes in activity.

D. Explore alternatives to pacing the floor with the client:

Explanation: This is a reasonable course of action. Exploring alternatives to the client's current behavior can help address their distress and find ways to manage their emotions more effectively.

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A nurse is providing care for a client who has anorexia nervosa. Which of the following nursing interventions should the nurse take?

Nursing Test Bank

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