A nurse is reinforcing discharge teaching with a client who states, "I don't feel confident driving to my follow-up appointments." The nurse should obtain a referral for which of the following members of the health care team?

Choice A Reason:

Suggesting that the client assist with meal planning may be appropriate, but it's not the first priority. Monitoring the client's eating behaviors and safety during meals takes precedence.

Choice B Reason:

Observe the client during and after meals. When caring for a client with bulimia nervosa, the initial priority is to monitor the client during and after meals to assess their eating behaviors and the potential for purging or other disordered eating habits. This helps ensure the client's safety and can provide valuable information for the treatment team. Once immediate safety concerns are addressed, the nurse can proceed with other aspects of care, such as assisting with meal planning, providing education on coping strategies, and referring the client to support groups as appropriate.

Choice C Reason:

Instructing the client about effective coping strategies is an important part of the treatment plan, but it's not the immediate priority. Ensuring the client's safety during meals is more critical initially.

Choice D Reason:

Referring the client to a support group can be a valuable part of long-term treatment, but it's not the first step. Monitoring and addressing immediate eating behaviors and safety come first.

Choice A Reason:

The client wanting to talk about the diagnosis with nursing staff indicates a desire for communication and support, which may be an expression of hope or a way to cope with the diagnosis.

Choice B Reason:

Requesting a second opinion suggests that the client is actively seeking more information and exploring potential treatment options, which is not indicative of hopelessness.

Choice C Reason:

Having a decreased energy level can be a common physical and emotional response to a terminal illness but does not directly indicate hopelessness on its own. It may reflect the physical and emotional toll of the diagnosis and its treatment.

Choice D Reason:

The client makes funeral arrangements is correct. Making funeral arrangements is often seen as an indication of hopelessness in the context of a recent terminal illness diagnosis. It suggests that the client has accepted the inevitability of their death and is preparing for it. While making arrangements can be a practical and important step, it may also indicate a sense of hopelessness or resignation.