A nurse is assessing an adolescent female client who has anorexia nervosa. Which of the following findings should the nurse expect?

Choice A rationale: Refusal of medication due to paranoia is not typically associated with conversion disorder. Paranoia is more commonly seen in disorders such as schizophrenia or paranoid personality disorder.

Choice B rationale: Preoccupation with manifestations of various illnesses is a characteristic of somatic symptom disorder, not conversion disorder. In somatic symptom disorder, individuals are excessively worried about having a serious illness, despite having no or only mild symptoms.

Choice C rationale: Frequent manic episodes are a hallmark of bipolar disorder, not conversion disorder. Manic episodes involve periods of extreme high energy or mood.

Choice D rationale: Conversion disorder, also known as functional neurological symptom disorder, is characterized by the presence of neurological symptoms, such as the loss of a sensory or motor function, that cannot be explained by medical evaluation. Symptoms can include seizures, weakness or paralysis, or reduced input from one or more senses. Therefore, an involuntary loss of a sensory function or a motor function with no underlying neurologic pathology is an expected finding in a client diagnosed with conversion disorder.

The correct answer/s is Choice/s A, E, and G.

Choice A rationale: Administering 0.9% sodium chloride IV is a common practice in emergency departments to ensure the patient is well-hydrated. This is particularly important for patients experiencing acute mania, as they may have neglected their physical health, including hydration, during their manic episode.

Choice B rationale: Flumazenil is an antagonist for benzodiazepines and is typically used to reverse the sedative effects of benzodiazepines. It is not typically used in the treatment of bipolar disorder or acute mania.

Choice C rationale: Preparing the client for intubation is usually reserved for situations where the patient is unable to maintain their own airway or adequate ventilation. This is not typically necessary in cases of acute mania unless there are other complicating factors.

Choice D rationale: Beginning chest compressions is a response to cardiac arrest. There is no indication in the that the patient is experiencing cardiac arrest, so this would not be a typical anticipation for a patient experiencing acute mania.

Choice E rationale: Administering IV naloxone is done in cases of suspected opioid overdose. While it’s not directly related to treating acute mania, it’s possible that the patient could have comorbid substance use issues, given the high rate of comorbidity between bipolar disorder and substance use disorders.

Choice F rationale: Administering activated charcoal is done in cases of certain types of poisoning or drug overdose. It is not typically used in the treatment of bipolar disorder or acute mania.

Choice G rationale: Preparing the client for electroconvulsive therapy (ECT) could be an appropriate anticipation for a patient experiencing acute mania. ECT is considered a highly effective treatment for severe mania, particularly when other treatments have failed or when rapid stabilization is required.