While planning care for a client with anorexia nervosa, the nurse determines that a realistic outcome would be that the client will:
verbalize the importance of adequate nutrition within a few weeks.
eat 100% of the diet including snacks within two days.
gain 10 pounds by the end of the week.
consume a high-calorie diet in the first day.
The Correct Answer is A
a. Recovery from anorexia nervosa is a marathon, not a sprint. Setting small, achievable goals like understanding the importance of nutrition is crucial for initial progress.
b. Aiming for immediate, perfect dietary adherence is unrealistic and can be discouraging. Building healthy eating habits takes time and support.
c. Unrealistic weight gain goals can be demotivating and potentially harmful. Weight gain should be gradual and monitored by a healthcare professional.
d. A sudden high-calorie diet can be overwhelming for someone with a restricted eating pattern and could lead to gastrointestinal distress.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a. Client and staff safety: This is correct because ensuring the safety of both the client and staff is the top priority, especially in cases of reported aggression.
b. Medication compliance: While medication compliance is important, it is secondary to ensuring immediate safety in this scenario.
c. Client education: Client education is valuable but may not be the immediate priority when safety concerns are present.
d. Group participation: While group participation may be beneficial for the client's treatment, it is not the priority when safety issues are at stake.
Correct Answer is A
Explanation
a. "The voices must sound scary, but the devil is not talking to you. This is part of your illness." Validating the experience ("The voices must sound scary") shows empathy and avoids dismissing the client's reality. Explaining it as part of the illness ("This is part of your illness") provides a non-judgmental explanation.
b. "The devil only talks to people who are receptive to his influence." Denying the voices can be dismissive and make the client feel isolated.
c. "You are not going to hell. You are a good person." While offering reassurance might seem comforting, it doesn't address the specific hallucination.
d. "Did you take your medicine this morning?" Medication is important, but the immediate priority is to address the hallucination and provide support.
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