The nurse is developing a plan of care for a 16-year-old client with bulimia nervosa. Which interventions would be included in the plan of care? (Select all that apply.)
Observe the client for 1–2 hours after each meal in a central area.
Assess the client for electrolyte imbalances.
Allow the client to remain on current laxatives.
Do not allow the client to keep a food diary during hospitalization.
Be alert to hidden or discarded wrappers.
Correct Answer : A,B,E
Choice A reason: Monitoring after meals reduces opportunities for purging behaviors such as vomiting or excessive exercise, which are common in bulimia nervosa.
Choice B reason: Electrolyte disturbances, particularly hypokalemia, are common due to vomiting and laxative abuse. Ongoing assessment is critical for patient safety.
Choice C reason: Continuing laxative use perpetuates the disorder and poses health risks such as dehydration and bowel damage. This is contraindicated.
Choice D reason: Food diaries are sometimes used in therapy to help patients increase awareness of eating patterns. Outright prohibition may remove a useful therapeutic tool unless misused.
Choice E reason: Patients with bulimia may attempt to conceal evidence of binge eating. Being attentive to hidden or discarded wrappers is an important part of monitoring.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: The most critical teaching with MAOIs is to avoid foods containing tyramine. Eating these foods can trigger a hypertensive crisis, a potentially fatal complication.
Choice B reason: Cold medications with pseudoephedrine may also increase blood pressure and should be avoided, but dietary restrictions are more essential because food exposure is more common and life-threatening if overlooked.
Choice C reason: Taking the medication with food may reduce mild gastrointestinal side effects, but this is not the priority safety teaching.
Choice D reason: Avoiding hazardous activities until medication effects are known is general advice for many psychotropic drugs, but it is not specific or lifesaving for MAOI therapy.
Correct Answer is A
Explanation
Choice A reason: Redirecting the focus back to the patient in a therapeutic and nonjudgmental way ensures the conversation remains centered on the client’s needs. This maintains professional boundaries while being supportive.
Choice B reason: Stating that nurses direct interviews is authoritative and may come across as rigid. It does not encourage patient openness.
Choice C reason: Responding with a prohibition sounds harsh and judgmental. It could damage rapport and shut down communication.
Choice D reason: Asking "why" can make the patient feel defensive, which is not therapeutic. It shifts the focus to justification rather than reflection.
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