Which nursing intervention has priority as a patient diagnosed with anorexia nervosa begins to gain weight after initiating therapy?
Select one:
Assess for depression and anxiety every shift
Communicate empathy for the patient's feelings to increase rapport
Help the patient balance energy expenditure and caloric intake.
Observe for adverse effects of refeeding.
The Correct Answer is D
Refeeding syndrome is a potentially life-threatening condition that can occur when a person with anorexia nervosa begins to eat again after a period of starvation. It is important for the nurse to closely monitor the patient for signs of refeeding syndrome, such as electrolyte imbalances and fluid overload, as the patient begins to gain weight.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
In this scenario, the client has expressed a serious threat to harm someone, which triggers a healthcare provider's duty to warn law. The nurse appropriately informed the healthcare provider, who then informed their boss, to protect the potential victim from harm. This action is not a violation of privacy or confidentiality, as it is necessary for the safety and wellbeing of others.
Therefore, no disciplinary action is required for the nurse or the healthcare provider, as they acted in accordance with their professional and legal obligations to protect the safety of others.
Correct Answer is D
Explanation
This client is experiencing auditory hallucinations and may be at risk for self-harm or suicide. The nurse should prioritize visiting this client first to assess their safety and provide appropriate interventions.
Option a. A client who recently burned her arm by accident while using a hot iron at home may require wound care and education on safety, but this situation is not as urgent as the client experiencing auditory hallucinations.
Option b. A client who tells the nurse he experienced manifestations of severe anxiety before and during a job interview may benefit from interventions to manage anxiety, but this situation is not as urgent as the client experiencing auditory hallucinations.
Option c. A client who requests that her antipsychotic medication be changed due to some new adverse effects may require medication adjustment and monitoring for side effects, but this situation is not as urgent as the client experiencing auditory hallucinations.
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