A nurse on an inpatient eating disorder unit is caring for a client who has anorexia nervosa.
A nurse on an inpatient eating disorder unit is assessing a client. Which of the following assessment findings indicate a therapeutic response to the treatment plan?
Select all that apply.
ECG report
Respiratory assessment
Temperature
Weight
Sodium level
Creatinine level
Correct Answer : B,D,E,F
A. The ECG shows persistent sinus bradycardia on both December 1 and December 15. While sinus bradycardia is common in anorexia nervosa, its persistence may not necessarily reflect a therapeutic response.
B. The respiratory rate improved from 24/min to 20/min and the respirations are described as even and unlabored on December 15. This indicates a positive response to treatment.
C. The temperature data for December 15 is not provided. However, an increase toward normal temperature would indicate a therapeutic response, but without this data, we cannot confirm.
D. The weight increased from 34.5 kg (76 lb) to 37.2 kg (82 lb), which is a significant therapeutic improvement, reflecting progress in treatment.
E. The sodium level improved from 128 mEq/L to 130 mEq/L. Although the level is still slightly below normal, the upward trend indicates improvement.
F. The creatinine level decreased from 1.2 mg/dL to 0.9 mg/dL, showing improvement in kidney function and response to treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Awareness of potential for self-harm is the priority as it directly impacts the safety and immediate well-being of the client with borderline personality disorder.
B. Medication compliance is important but secondary to immediate safety concerns.
C. Information about insurance coverage is relevant but does not address the immediate psychological safety needs.
D. Resources for group therapy are helpful but not as urgent as ensuring the family is aware of and can respond to self-harm risks.
Correct Answer is D
Explanation
Rationale:
A. This statement may indicate prolonged grief or depression but does not specifically point to the guilt or distress seen in traumatic grief.
B. This describes a physiological response to flashbacks, which is more indicative of post-traumatic stress disorder (PTSD) rather than traumatic grief.
C. This statement reflects emotional suppression, which can be common in military culture but does not directly indicate traumatic grief.
D. Expressing survivor's guilt, as in feeling that they should have died instead of their friend, is a hallmark of traumatic grief and indicates the client is struggling with the loss in a deeply distressing way.
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