A client with a long history of bulimia nervosa is seen in the emergency department. The client is seeing things that others do not see, is restless, and has dry mucous membranes. Which is most likely the cause of this client's symptoms?

Binging, which causes abdominal discomfort

Vomiting, which may lead to dehydration and electrolyte imbalance

Mood disorders, which often accompany the diagnosis of bulimia nervosa

Nutritional deficits, which are characteristics of bulimia nervosa

Answer and Explanation

The Correct Answer is B

Choice A reason: Binging involves consuming large amounts of food, often leading to abdominal discomfort, bloating, or nausea. These symptoms are primarily gastrointestinal and do not directly cause hallucinations, restlessness, or dry mucous membranes, which are more indicative of systemic physiological imbalances, making this choice less likely as the primary cause.

Choice B reason: Frequent vomiting in bulimia nervosa causes significant dehydration and electrolyte imbalances, such as hypokalemia or hyponatremia. These disrupt neurological function, leading to hallucinations due to altered brain signaling, restlessness from nervous system irritability, and dry mucous membranes from fluid loss, making this the most likely cause of the symptoms.

Choice C reason: Mood disorders like depression or anxiety are common in bulimia nervosa and may contribute to emotional instability. However, they are less likely to directly cause hallucinations or physical symptoms like dry mucous membranes, which are more closely tied to physiological disruptions from dehydration or electrolyte imbalances.

Choice D reason: Nutritional deficits in bulimia nervosa result from purging or irregular eating, potentially causing fatigue or weakness. However, hallucinations and restlessness are more directly linked to acute electrolyte imbalances from vomiting rather than chronic nutritional deficiencies, which typically present with less acute neurological symptoms.

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Correct Answer is C

Explanation

Choice A reason: Impotence is a potential side effect of SSRIs due to serotonin’s effect on sexual function but is not a symptom of serotonin syndrome, a life-threatening condition involving excessive serotonin causing hyperthermia, agitation, and muscle rigidity, making this incorrect.

Choice B reason: Hypotension is not a primary symptom of serotonin syndrome, which involves serotonin excess leading to hyperthermia, tremors, and autonomic instability. Hypotension may occur secondary to severe cases but is not a hallmark symptom included in teaching.

Choice C reason: Fever is a key symptom of serotonin syndrome, caused by excessive serotonin stimulation leading to hyperthermia, muscle rigidity, and autonomic dysfunction. It’s a critical teaching point, as it signals a medical emergency requiring immediate intervention to prevent organ damage.

Choice D reason: Constipation is a side effect of some SSRIs due to serotonin’s effect on gastrointestinal motility but is not associated with serotonin syndrome. This condition involves acute neurological and autonomic symptoms, not chronic gastrointestinal issues, making this incorrect.

A. I will weigh myself daily and notify the healthcare provider if I gain 3 pounds in one day. B. I will notify the healthcare provider if I am becoming increasingly short of breath at rest. C. I will include lower sodium intake in my daily diet. D. I understand that I may need to sleep sitting up in a reclining chair.

Correct Answer is D

Explanation

Choice A reason: Daily weight monitoring and reporting a 3-pound gain in one day indicates fluid retention, a sign of worsening heart failure. This is correct and shows understanding of self-monitoring to prevent complications, requiring no further teaching.

Choice B reason: Notifying the provider about increasing shortness of breath at rest is appropriate, as it signals worsening heart failure due to reduced cardiac output or pulmonary edema. This reflects proper understanding of symptom monitoring, requiring no additional teaching.

Choice C reason: A low-sodium diet reduces fluid retention in heart failure by decreasing sodium-induced water retention, preventing worsening of edema or congestion. This statement is correct and demonstrates understanding of dietary management, requiring no further teaching.

Choice D reason: Sleeping in a reclining chair may occur in severe heart failure due to orthopnea, but it is not a standard recommendation. It suggests poor symptom control, requiring further teaching on optimizing medical management, such as medication adherence and fluid monitoring, to prevent this need.

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A client with a long history of bulimia nervosa is seen in the emergency department. The client is seeing things that others do not see, is restless, and has dry mucous membranes. Which is most likely the cause of this client's symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client was admitted to the inpatient unit for depression and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which sign or symptom would the nurse include in the teaching session about serotonin syndrome?

Correct Answer is C

Explanation

The nurse is teaching a client with heart failure how to avoid complications and future hospitalizations. Which of the following statements by the client requires additional teaching?

Correct Answer is D

Explanation

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