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The nurse reviews the Nurses' Notes from Day 1 at 1100.

Exhibits

Complete the following sentence by using the lists of options.

The nurse should first address the client's

followed by the client .
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}

Rationale for correct choices:

  • Electrolyte imbalance: The client’s potassium level of 3.0 mEq/L is critically low, contributing to premature ventricular contractions and orthostatic hypotension. These abnormalities place the client at immediate risk for cardiac dysrhythmias and require urgent correction to prevent life-threatening complications.
  • View of body: The client voices fear of gaining weight and fixates on food, which are indicators of distorted self-perception. This impaired view of the body is a central feature of bulimia nervosa and needs to be addressed during psychotherapy once the client is medically stabilized.

Rationale for incorrect choices:

  • Impaired body image: While body image concerns are common in eating disorders, this option is more general. “View of body” better captures the client’s psychological distortion and allows for more precise therapeutic interventions that address the cognitive roots of the disorder.
  • Impaired coping: The client engages in maladaptive coping strategies like bingeing and purging. However, these behaviors are secondary to deeper distortions in self-image and medical instability. Coping can be addressed later in the treatment process once safety is ensured.
  • History of anxiety: Anxiety is part of the client's long-standing history but is not causing the immediate physical risk. Addressing acute electrolyte disturbances and body image distortion takes precedence over chronic anxiety in this clinical setting.
  • Obsession with food: Although the client’s persistent thoughts about food are important, they are symptoms driven by distorted body perception. Treating the underlying belief system about body image is more foundational and effective in resolving food-related obsessions.


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Related Questions

Correct Answer is C

Explanation

Rationale:

A. "I should take this medication on an empty stomach.": Amitriptyline does not require administration on an empty stomach. It can be taken with or without food, although taking it with food may help reduce gastrointestinal discomfort in some individuals.

B. "I can continue to take St. John's wort while taking this medication.": St. John's wort can increase the risk of serotonin syndrome and reduce the effectiveness of amitriptyline due to drug interactions. Clients should avoid combining herbal supplements with antidepressants.

C. "I know it will be a couple of weeks before the medication helps me feel better.": Tricyclic antidepressants like amitriptyline take 2 to 4 weeks to show noticeable improvement in mood. Recognizing the delayed onset helps set realistic expectations and supports adherence.

D. "I expect this medication to raise my blood pressure.": Amitriptyline more commonly causes orthostatic hypotension, especially when therapy is initiated. Clients should be taught to change positions slowly to reduce the risk of dizziness and falls.

Correct Answer is B

Explanation

Rationale:

A. Butorphanol tartrate: This opioid analgesic can cause respiratory depression in the newborn if given too close to delivery. At 10 cm dilation and during pushing, it's generally too late to administer systemic opioids safely.

B. Pudendal block: A pudendal block provides localized perineal anesthesia and is safe for use during the second stage of labor when the client is fully dilated and pushing. It effectively reduces pain from stretching and pressure without affecting uterine contractions or fetal status.

C. Naloxone hydrochloride: Naloxone is not a pain-management measure; it is an opioid antagonist used to reverse opioid-induced respiratory depression. It does not provide analgesia and is not administered for pain relief during labor.

D. Spinal anesthesia: Spinal anesthesia is typically administered prior to a planned cesarean birth or late in the first stage of labor. It is not appropriate once the client is fully dilated and actively pushing, as it could delay delivery and complicate maternal positioning.

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