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 C
Explanation
Choice A reason: Assigning leadership in a group setting may overwhelm a patient with schizoid personality disorder, as they are uncomfortable with close social interactions. This approach could increase withdrawal.
Choice B reason: Confrontation about avoidance behaviors is not therapeutic. It may heighten resistance and increase distress rather than encourage trust or engagement.
Choice C reason: Structured one-on-one interactions allow the nurse to build rapport while respecting the patient’s preference for limited emotional involvement. This is the most appropriate approach for schizoid personality disorder.
Choice D reason: Forcing daily group therapy participation may cause stress and withdrawal, as these patients are more comfortable with solitary activities. Gentle encouragement, not insistence, is better suited.
Correct Answer is ["A","B","D"]
Explanation
Choice A reason: Planning alternate escape routes is a core part of safety planning, ensuring the victim can exit safely even if blocked.
Choice B reason: Having an emergency bag ready allows quick departure and reduces risk of having to return to the abuser’s home.
Choice C reason: Giving the abuser information about location compromises safety and places the victim at greater risk.
Choice D reason: Establishing a signal with trusted individuals ensures the victim can get help quickly if violence escalates.
Choice E reason: Encouraging firearm purchase is not an appropriate nursing intervention due to safety risks and escalation potential. Safer protective strategies should be emphasized.
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