A 22-year-old female client is brought to the emergency department by her mother after the client became dizzy and fell. The mother says that the client has been away at college and is home for winter break. The client's mother is greatly concerned because while her daughter has always been thin and athletic, she has never seen her so skinny and emaciated. The client responds by telling her mother, "That is not true. You keep trying to force food down my throat even though it is obvious that I have so much weight to lose!"

Exhibits

The client is resting in bed and cooperative with her mother at her bedside.

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Answer and Explanation

The Correct Answer is []

Based on the information provided, the client is most likely experiencing anorexia nervosa. This is suggested by her significant weight loss, bradycardia, hypothermia, lanugo-type hair, and her expressed fear of gaining weight despite being underweight. However, this is a preliminary assessment and a definitive diagnosis should be made by a healthcare professional.

Actions the nurse should take to address this condition include:

Acknowledge anxious feelings: It’s important to validate the client’s feelings and fears about food and weight gain. This can help build trust and facilitate further discussion about her health.
Provide emotional support: Emotional support is crucial in managing eating disorders. The nurse can provide reassurance, listen empathetically, and encourage the client to express her feelings.

Parameters the nurse should monitor to assess the client’s progress include:

Nutritional intake: Monitoring the client’s food and fluid intake can help assess her nutritional status and response to treatment.
Weight and BMI: Regular monitoring of the client’s weight and BMI can provide objective measures of her nutritional status and response to treatment.

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Correct Answer is D

Explanation

Choice A rationale

Walking at least once an hour at work can be beneficial for overall health and can contribute to maintaining energy balance. However, it may not be the most effective action for maintaining energy balance for a person who already exercises 2 to 3 times per week.

Choice B rationale

Increasing exercise intensity can help burn more calories and can contribute to maintaining energy balance. However, it’s important to note that exercise alone may not be sufficient for maintaining energy balance if not combined with a balanced diet.

Choice C rationale

Avoiding foods with high carbohydrate levels is not necessarily an effective action for maintaining energy balance. Carbohydrates are a primary source of energy for the body. While it’s important to choose complex carbohydrates over simple ones, avoiding carbohydrates altogether is not recommended.

Choice D rationale

Selecting foods that are lower in caloric density is an effective action for maintaining energy balance. Foods that are lower in caloric density, such as fruits and vegetables, can provide essential nutrients without contributing excessive calories. This can help maintain energy balance and prevent weight gain.

Correct Answer is ["18"]

Explanation

Step 1 is to calculate the infusion rate. The prescription is for heparin 900 units/hr IV. The IV bag contains heparin 25,000 units in 500 mL of 0.45% normal saline.

So, the calculation would be (900 units ÷ 25,000 units) × 500 mL = 18 mL/hr.

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Naxlex Comprehensive Predictor Exams

A 33-year-old female client, who denies smoking, drinking, or using any illicit drugs, exercises 2 to 3 times per week and has an office job.She weighs 68 kg and is 156 cm tall.Which of the following actions would be effective in maintaining her energy balance?

Correct Answer is D

Explanation

A client receives a prescription for heparin 900 units/hr IV. The IV bag contains heparin 25,000 units in 500 mL of 0.45% normal saline. How many mL/hr should the nurse program the infusion pump to deliver?

Correct Answer is ["18"]

Explanation

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As a nurse, you are reviewing the orders and planning initial steps for caring for the same patient.Which interventions should you perform?

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