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The nurse is aware that the major health complication associated with anorexia nervosa is:

Cardiac dysrhythmia resulting in cardiac arrest

Endocrine imbalance causing amenorrhea

Decreased metabolism causing cold intolerance

Glucose intolerance resulting in hypoglycemia

Answer and Explanation

The Correct Answer is A

a. Cardiac dysrhythmia resulting in cardiac arrest

Explanation of Choices

Choice A Reason: Cardiac Dysrhythmia Resulting in Cardiac Arrest

Cardiac dysrhythmias, or irregular heartbeats, are a significant health complication associated with anorexia nervosa. These dysrhythmias can result from electrolyte imbalances, particularly low potassium levels (hypokalemia), which are common in individuals with anorexia due to malnutrition and purging behaviors. Severe dysrhythmias can lead to cardiac arrest, making this one of the most critical and potentially fatal complications of anorexia nervosa. The heart muscle can weaken due to prolonged malnutrition, leading to a condition known as myocardial atrophy, which further increases the risk of cardiac complications.

Choice B Reason: Endocrine Imbalance Causing Amenorrhea

Amenorrhea, or the absence of menstruation, is a common endocrine complication in females with anorexia nervosa. This condition occurs due to the body’s response to severe weight loss and malnutrition, which disrupts the normal production of reproductive hormones. While amenorrhea is a significant health issue, it is not as immediately life-threatening as cardiac dysrhythmias. Amenorrhea can lead to long-term complications such as infertility and osteoporosis but does not typically result in acute medical emergencies.

Choice C Reason: Decreased Metabolism Causing Cold Intolerance

Decreased metabolism and cold intolerance are common symptoms in individuals with anorexia nervosa. The body reduces its metabolic rate in response to prolonged starvation to conserve energy. This can lead to a lower body temperature and increased sensitivity to cold. While uncomfortable and indicative of severe malnutrition, decreased metabolism and cold intolerance are not as immediately dangerous as cardiac dysrhythmias. These symptoms reflect the body’s adaptation to a state of energy deficiency but do not pose an immediate threat to life.

Choice D Reason: Glucose Intolerance Resulting in Hypoglycemia

Hypoglycemia, or low blood sugar, can occur in individuals with anorexia nervosa due to inadequate food intake. However, glucose intolerance and hypoglycemia are less common and less severe complications compared to cardiac dysrhythmias. Hypoglycemia can cause symptoms such as dizziness, confusion, and fainting, but it is typically manageable with appropriate nutritional support. It does not carry the same immediate risk of fatality as cardiac dysrhythmias.

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Correct Answer is ["A","C","D"]

Explanation

Choice A Reason: Perform a neurological assessment on a patient in seclusion to compare the nurse’s findings

This task is an example of overdelegation. Performing a neurological assessment requires specialized knowledge and skills that are beyond the scope of practice for unlicensed assistive personnel. Such assessments should be conducted by a licensed nurse or healthcare provider to ensure accuracy and appropriate clinical judgment.

Choice B Reason: Play cards with 3 patients during unstructured time

This task is appropriate for a PCT. Engaging patients in recreational activities like playing cards does not require specialized clinical skills and falls within the scope of practice for unlicensed assistive personnel. It helps in providing social interaction and can be beneficial for the patients’ mental health.

Choice C Reason: Review follow-up care with a patient about to be discharged

This task is an example of overdelegation. Reviewing follow-up care involves providing important information about the patient’s ongoing treatment and care plan, which requires clinical knowledge and the ability to answer any questions the patient may have. This responsibility should be handled by a licensed nurse or healthcare provider.

Choice D Reason: Set a goal for the day for a patient with a borderline personality disorder

This task is also an example of overdelegation. Setting therapeutic goals for patients, especially those with complex mental health conditions like borderline personality disorder, requires clinical expertise and an understanding of the patient’s treatment plan. This should be done by a licensed nurse or mental health professional.

Choice E Reason: Obtain a weight on a patient with bipolar disorder in a hypomanic state

This task is appropriate for a PCT. Obtaining a patient’s weight is a routine task that does not require specialized clinical skills and falls within the scope of practice for unlicensed assistive personnel. It is a straightforward task that can be safely delegated.

A. 0.8 mEq/L B. 2.3 mEq/L C. 1.8 mEq/L D. 1.2 mEq/L

Correct Answer is B

Explanation

Choice A Reason: 0.8 mEq/L

The therapeutic range for lithium is typically between 0.6 and 1.2 mEq/L. A level of 0.8 mEq/L falls within this range and is considered normal. Therefore, it is unlikely that a client with this lithium level would present with symptoms such as mental confusion, frequent urination, and coarse tremors. These symptoms are more indicative of lithium toxicity, which occurs at higher levels.

Choice B Reason: 2.3 mEq/L

A lithium level of 2.3 mEq/L is significantly above the therapeutic range and indicates lithium toxicity. Symptoms of lithium toxicity include mental confusion, frequent urination, and coarse tremors, which match the client’s presentation. Severe toxicity can occur at levels above 2.0 mEq/L and can be life-threatening if not treated promptly. Therefore, this is the most likely lithium level for the client described.

Choice C Reason: 1.8 mEq/L

A lithium level of 1.8 mEq/L is above the therapeutic range but below the level typically associated with severe toxicity. While some symptoms of toxicity might appear at this level, they are generally less severe than those described in the scenario. The client’s symptoms suggest a more severe level of toxicity, making this choice less likely.

Choice D Reason: 1.2 mEq/L

A lithium level of 1.2 mEq/L is at the upper limit of the therapeutic range. While it is possible for some mild side effects to occur at this level, the severe symptoms described (mental confusion, frequent urination, and coarse tremors) are more indicative of a higher, toxic level of lithium. Therefore, this choice is also less likely.

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The nurse is aware that the major health complication associated with anorexia nervosa is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Psychiatric care technicians (PCTs) are unlicensed assistive personnel that are an integral part of the acute care mental healthcare team. Which of the following choices would be an example(s) of overdelegation by the nurse to a PCT? The nurse directs the PCT to (Select All that Apply):

Correct Answer is ["A","C","D"]

Explanation

A client prescribed lithium carbonate 300 mg twice daily a month ago comes to the Emergency Department with mental confusion, frequent urination in large amounts, and coarse tremors. Which lithium level would the nurse expect?

Correct Answer is B

Explanation

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