A nurse on a mental health unit is reinforcing teaching with a client who has anorexia nervosa. Which of the following statements by the client indicates an understanding of the teaching?

"I should gain half of a pound per week to meet my treatment goal’

"The staff will watch me closely for 1 hour after each meal’

"The treatment goal is to be within 60 percent of my ideal body weight."

"The staff will weigh me every night before I go to bed."

Answer and Explanation

The Correct Answer is B

Rationale:

A. "I should gain half of a pound per week to meet my treatment goal": Weight gain goals for clients with anorexia nervosa are typically more aggressive, often around 1 to 3 pounds per week, to restore healthy weight timely and prevent complications of prolonged malnutrition.

B. "The staff will watch me closely for 1 hour after each meal": Monitoring clients after meals is essential to prevent purging behaviors, such as vomiting or excessive exercise. The one-hour observation period helps ensure safety and supports recovery.

C. "The treatment goal is to be within 60 percent of my ideal body weight.": Treatment aims to restore clients to at least 85 to 90 percent of their ideal body weight to improve physical and psychological health; 60 percent is dangerously low and not an appropriate goal.

D. "The staff will weigh me every night before I go to bed.": Weighing is typically done once in the morning before breakfast and after voiding, to ensure consistency and accuracy. Nighttime weighing is not standard practice and may contribute to anxiety.

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Correct Answer is B

Explanation

Rationale:

A. The client needs strict measurement of intake and output: This task can be delegated to assistive personnel as it involves routine data collection without complex clinical judgment.

B. The client develops a postoperative fever: A postoperative fever may indicate infection or other complications requiring assessment, clinical judgment, and intervention by a registered nurse.

C. The client is experiencing a therapeutic effect from their treatment: Monitoring expected therapeutic effects is routine and can often be overseen by licensed practical nurses or assistive personnel, depending on policy.

D. The client needs routine wound care performed: Routine wound care is generally a delegated nursing task that does not require the advanced assessment or clinical decision-making of an RN unless complications arise.

A. Open the side flap of the sterile kit, allowing it to lie flat on the work surface B. Open the flap on the sterile kit nearest to the nurse and place the flap on the work surface. C. Apply sterile gloves. D. Open the outermost flap of the sterile kit away from the nurse's body.

Correct Answer is D

Explanation

Rationale:

A. Open the side flap of the sterile kit, allowing it to lie flat on the work surface: This step comes later in the process of opening a sterile field. Side flaps should be opened after the top (farthest) flap to prevent reaching over the sterile field and contaminating it.

B. Open the flap on the sterile kit nearest to the nurse and place the flap on the work surface: Opening the closest flap first risks contaminating the sterile field by reaching over it. This flap should be opened last, after the top and side flaps are already secured.

C. Apply sterile gloves: Sterile gloves are applied after the sterile field is prepared and all supplies are organized within the sterile area. Putting them on too early may lead to contamination during field setup.

D. Open the outermost flap of the sterile kit away from the nurse's body: The first step in establishing a sterile field is to open the flap away from the body. This minimizes contamination by preventing the nurse from leaning over the sterile surface.

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A nurse on a mental health unit is reinforcing teaching with a client who has anorexia nervosa. Which of the following statements by the client indicates an understanding of the teaching?

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