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A mental health nurse on an inpatient eating disorders unit is caring for a client who has anorexia nervosa and has a body mass index of 16.7. Which of the following actions should the nurse take? (Select all that apply.)

Monitor the client's weight daily

Allow the client to choose the meals she will eat

Allow the client to practice strenuous exercises

Stay with the client during meals and for 2 hrs after meals

Provide the client with small meals frequently.

Answer and Explanation

Correct Answer : A,E

The correct answer is choice A and E.

Choice A rationale:

Monitoring the client’s weight daily is crucial in managing anorexia nervosa. It helps track the client’s progress and ensures that any significant weight changes are promptly addressed.

Choice B rationale:

Allowing the client to choose their meals can be counterproductive. Clients with anorexia nervosa may make choices that do not support their nutritional needs, potentially exacerbating their condition.

Choice C rationale:

Allowing the client to practice strenuous exercises is not advisable. Strenuous exercise can further deplete the client’s already low energy reserves and exacerbate malnutrition.

Choice D rationale:

Staying with the client during meals and for 2 hours after meals is incorrect. The recommended practice is to stay with the client for 30 minutes after meals to monitor for any purging behaviors.

Choice E rationale:

Providing the client with small meals frequently is beneficial. It helps in managing their nutritional intake without overwhelming them, which can be more acceptable and manageable for clients with anorexia nervosa.

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Correct Answer is C

Explanation

Choice A rationale:

This response indicates anger, not denial. The client is expressing anger towards the doctor and their perceived lack of competence. While anger can be a component of the grief process, it does not specifically align with the denial phase, which is characterized by a refusal to accept the reality of a situation.

Choice B rationale:

This response indicates fatigue or depression, not denial. The client is acknowledging their physical and emotional state but is not expressing disbelief or refusal to accept their diagnosis.

Choice C rationale:

This response clearly demonstrates denial. The client is minimizing the severity of their diagnosis and attributing the doctor's statements to an ulterior motive. This is a classic example of denial, as it involves a distortion of reality to avoid facing a painful truth.

Choice D rationale:

This response indicates acceptance, not denial. The client is acknowledging the reality of their situation and expressing gratitude for the care they have received.

A. "Perhaps you should discuss this with your physician." B. "Of course, you aren't going to die, at least not in the immediate future." C. "I recommend you exercise daily and avoid smoking to decrease your risk." D. "Tell me more about these fears of dying from a heart attack.".

Correct Answer is D

Explanation

Choice A rationale:

Deflecting the client's concerns to the physician dismisses the client's immediate need for emotional support and therapeutic communication.

It can hinder the development of a trusting nurse-client relationship.

The nurse is responsible for addressing the client's psychosocial needs, not solely deferring them to other healthcare professionals.

Choice B rationale:

Offering false reassurance is inappropriate and potentially harmful. It can erode trust if the client's fears are later realized.

It minimizes the client's legitimate concerns and invalidates their emotional experience.

Choice C rationale:

While lifestyle modifications are essential for managing coronary artery disease, providing unsolicited advice at this moment disregards the client's emotional distress.

It prioritizes physical health over the client's psychological well-being. It can be perceived as dismissive of the client's fears and concerns.

Choice D rationale:

Inviting the client to elaborate on their fears demonstrates active listening and encourages therapeutic communication. It validates the client's concerns and shows empathy for their emotional experience.

It provides an opportunity to assess the client's understanding of their condition and identify specific fears or misconceptions. It establishes a foundation for exploring coping mechanisms and providing appropriate support and education.

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A mental health nurse on an inpatient eating disorders unit is caring for a client who has anorexia nervosa and has a body mass index of 16.7. Which of the following actions should the nurse take? (Select all that apply.)

Nursing Test Bank

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Correct Answer is D

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