A nurse in an acute care facility is caring for a client who has anorexia nervosa. During the first week of care, which of the following actions should the nurse take?

Observe the client for 1 hr after meals.

Obtain the client's vital signs every other day.

Weigh the client every 48 hr.

Allow the client to eat meals in their room.

Answer and Explanation

The Correct Answer is A

Observe the client for 1 hr after meals: This action is appropriate during the first week of care for a client with anorexia nervosa to monitor for signs of refeeding syndrome, such as electrolyte imbalances or hypoglycemia, which can occur after meals. Continuous observation allows for prompt intervention if complications arise.
B. Obtain the client's vital signs every other day: Vital signs should be monitored more frequently, especially during the initial phase of care, to assess for any physiological changes associated with refeeding or complications of anorexia nervosa.
C. Weigh the client every 48 hr: Weighing the client every 48 hours may not provide sufficient monitoring during the first week, as weight changes can occur rapidly in clients with anorexia nervosa. Daily weights are typically recommended during the initial phase of treatment.
D. Allow the client to eat meals in their room: Allowing the client to eat meals in their room may contribute to further isolation and avoidance of social interaction, which can exacerbate symptoms of anorexia nervosa. It's important to encourage meal consumption in a supportive environment, such as a dining area, where the client can receive encouragement and monitoring from staff and peers.

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Correct Answer is B

Explanation

A. "I will take the medication in the morning." - Metformin extended-release tablets are typically taken with the evening meal to minimize gastrointestinal side effects. Taking it in the morning may increase the risk of side effects during the day.
B. "I will avoid crushing this medication." - Metformin extended-release tablets should not be crushed, chewed, or broken, as doing so can disrupt the extended-release mechanism, leading to an increased risk of adverse effects or decreased efficacy.
C. "I will take the medication on an empty stomach." - While metformin can be taken with or without food, it is generally recommended to take it with meals to reduce gastrointestinal side effects. Taking it on an empty stomach may increase the risk of nausea or upset stomach.
D. "I will expect to gain weight." - Weight loss is a common side effect of metformin, particularly in individuals with type 2 diabetes. Therefore, expecting weight gain would indicate a misunderstanding of the medication's effects.

A. Hypertension B. Headache C. Insomnia D. Tinnitus

Correct Answer is B

Explanation

A. Hypertension:
Disulfiram does not typically cause hypertension as an adverse effect. However, consuming alcohol while taking disulfiram can lead to a range of cardiovascular effects, including hypotension rather than hypertension.

B. Headache:
Consuming alcohol while taking disulfiram can result in a severe and rapid onset of symptoms known as the disulfiram-alcohol reaction. Headache is a common symptom of this reaction, along with flushing, nausea, vomiting, and palpitations. Therefore, monitoring for headaches is essential in clients taking disulfiram who report alcohol ingestion.

C. Insomnia:
Insomnia is not a commonly reported adverse effect of disulfiram. The disulfiram-alcohol reaction primarily involves physical symptoms rather than disturbances in sleep patterns.

D. Tinnitus:
Tinnitus, or ringing in the ears, is not a typical adverse effect of disulfiram. However, disulfiram can cause a range of neurological symptoms as part of the disulfiram-alcohol reaction, but tinnitus is not commonly reported.

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A nurse in an acute care facility is caring for a client who has anorexia nervosa. During the first week of care, which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new prescription for metformin extended release tablets. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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