A nurse in an outpatient mental health clinic is caring for a client who has anorexia nervosa. The nurse is assessing the client during a follow-up visit.
Which of the following findings indicate a therapeutic response to the treatment plan? (Select all that apply.)

Choice A rationale:

Antipsychotic medications are a class of drugs commonly used to treat schizophrenia and other psychotic disorders. They work by blocking dopamine receptors in the brain. However, dopamine is also involved in motor control, and blocking its receptors can lead to extrapyramidal symptoms (EPS).

EPS are a group of movement disorders that can be caused by antipsychotic medications. They include: Akathisia: A feeling of restlessness and an inability to sit still.

Dystonia: Involuntary muscle contractions that can cause twisting or spasms.

Parkinsonism: Symptoms similar to Parkinson's disease, such as tremor, rigidity, and slowness of movement. Tardive dyskinesia: Involuntary, repetitive movements of the face, tongue, or other body parts.

The risk of developing EPS is higher with older antipsychotic medications, such as haloperidol and chlorpromazine. Newer antipsychotic medications, such as risperidone and olanzapine, are less likely to cause EPS, but they can still occur.

Clients who are taking antipsychotic medications should be monitored for EPS. If EPS develop, the medication may need to be changed or the dose reduced.

Choice B rationale:

Enzymes are not known to cause EPS. They are used to treat pancreatitis by helping the body to digest food.

Choice C rationale:

Insulin is not known to cause EPS. It is used to treat type 2 diabetes mellitus by helping the body to control blood sugar levels.

Choice D rationale:

Iron supplements are not known to cause EPS. They are often taken by pregnant women to prevent iron deficiency anemia.

Choice A rationale:

Avoids addressing the client's behavior: This response does not directly address the client's disrespectful tone of voice. It simply gives the client the schedule and expects them to comply. This could reinforce the client's belief that they can act out without consequences.

Misses an opportunity to set boundaries: Setting boundaries is essential when working with clients with BPD. This response does not establish a clear boundary regarding acceptable communication.

Does not promote therapeutic communication: This response does not encourage the client to share their feelings or explore the reasons behind their outburst. It shuts down communication rather than opening it up.

Choice B rationale:

Directly addresses the inappropriate behavior: This response assertively communicates to the client that their tone of voice is unacceptable. It sets a clear boundary regarding respectful communication.

Models appropriate communication: The nurse models respectful communication by using a calm and assertive tone of voice. This can help the client learn to communicate more effectively.

Promotes self-awareness: This response may prompt the client to reflect on their behavior and the impact it has on others. It can help them develop better self-awareness and emotional regulation skills.

Choice C rationale:

Focuses on the nurse's feelings: This response shifts the focus away from the client's behavior and onto the nurse's feelings. It can make the client feel defensive and less likely to engage in productive communication.

May escalate the situation: Asking "why" s can sometimes put clients on the defensive and lead to further conflict. It's generally more helpful to focus on the present behavior and its impact.

Choice D rationale:

Condescending and challenging: This response comes across as condescending and challenging. It's likely to make the client feel defensive and resentful.

Not therapeutic: This response does not promote a sense of trust or rapport between the nurse and the client. It's unlikely to lead to productive communication or behavior change.