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 B
Explanation
Choice A reason: Enhancing dopamine transmission is not the mechanism of antipsychotics; excessive dopamine is implicated in schizophrenia’s positive symptoms, so reducing—not enhancing—dopamine activity is key.
Choice B reason: Blocking both dopamine and serotonin receptors is characteristic of second-generation (atypical) antipsychotics. This dual action reduces extrapyramidal side effects while still targeting positive and negative symptoms.
Choice C reason: First-generation antipsychotics primarily block dopamine D2 receptors, which increases the risk for extrapyramidal side effects such as dystonia and parkinsonism.
Choice D reason: Selective serotonin receptor blockade is not the defining mechanism of second-generation antipsychotics. These medications act on both dopamine and serotonin systems.
Correct Answer is C
Explanation
Choice A reason: Rationalization involves creating logical explanations to justify behavior or feelings. In this case, the client is not justifying but outright rejecting the diagnosis, so this does not apply.
Choice B reason: Regression occurs when an individual reverts to earlier developmental behaviors, such as childish actions, to cope with stress. The client is not reverting to earlier behaviors but refusing to accept reality.
Choice C reason: Denial is the refusal to accept reality or facts, blocking external events from conscious awareness. The client’s insistence that the diagnosis is a mistake demonstrates denial, making this the correct defense mechanism.
Choice D reason: Projection occurs when a person attributes their unacceptable thoughts or feelings to someone else. The client is not attributing their illness to others but rejecting its existence altogether.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.