A nurse in an outpatient setting is caring for a client.

Exhibits

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 []

Potential Condition

Bulimia nervosa: The client has a BMI of 18.5, which is on the lower end of normal, indicating possible weight issues, but not the severe underweight typical of anorexia nervosa. The client describes cycles of binge eating followed by compensatory behaviors such as purging (using laxatives), which are characteristic of bulimia nervosa. The client expresses a preoccupation with food and body weight, and feelings of embarrassment about their eating habits, which align with bulimia nervosa.

Actions to Take

1. Assess binging and purging patterns: It's crucial to understand the frequency, triggers, and methods of binging and purging to tailor interventions effectively and to monitor the severity and progression of bulimia.

2. Encourage client to identify triggers for overeating: Identifying triggers for binging can help the client develop healthier coping mechanisms and reduce the occurrence of binge eating episodes.

Parameters to Monitor

1. Electrolyte levels: Frequent use of laxatives and purging behaviors can lead to electrolyte imbalances, which are potentially life-threatening and must be monitored regularly.

2. Frequency of compensatory behaviors: Tracking the frequency of purging behaviors (such as laxative use) helps assess the effectiveness of interventions and the client’s progress in reducing harmful behaviors.

Incorrect answers:

Actions to Take:

Assess for and discourage provocative or seductive behaviour: This is more relevant to histrionic personality disorder, not bulimia nervosa.
Weigh daily for the first week: While weighing the client can be part of the monitoring process, daily weigh-ins can increase anxiety and may not directly address the core issues of bulimia.
Assess for consumption of right food items: While dietary intake is important, focusing solely on food items without addressing the psychological aspects may not be effective for treating bulimia.

Parameters to Monitor:

Attention-seeking behaviours: More relevant to histrionic personality disorder than bulimia nervosa.
Signs of infection: Not directly relevant unless there is evidence of a related health issue or a compromised immune system, which is not indicated in the provided information.
Presence of lanugo: Lanugo is more commonly associated with anorexia nervosa due to severe malnutrition, not bulimia.

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Correct Answer is D

Explanation

. Use physical restraints during severe outbursts to ensure safety. Physical restraints are not appropriate for managing behavioural issues in children with ODD. They can escalate the situation, cause physical harm, and damage the trust between the child and caregivers.

B. Assign daily chores that are challenging to encourage discipline. While chores can teach responsibility, assigning challenging tasks is not appropriate for managing ODD and could lead to frustration and further defiance.

C. Encourage solitary play to reduce social stressors. Solitary play might reduce social stress but does not address the underlying behavioural issues of ODD. Social skills and interactions need to be improved rather than avoided.

D. Put into practice consistent consequences for rule-breaking behaviour. Consistent consequences help the child understand the link between behaviour and outcomes, which is crucial for managing ODD. It provides structure and clear expectations, which are essential for children with behavioral issues.

A. "Why did you feel you needed to do that at this time?" B. "It must be frustrating for you to have to cancel an activity your son enjoyed." C. "You never know. He could be ready for baseball by the spring." D. "Baseball can be a dangerous sport for children anyway."

Correct Answer is B

Explanation

A. "Why did you feel you needed to do that at this time?": This response might come off as insensitive or judgmental. It could imply that the parents made an inappropriate decision without acknowledging their difficult situation.

B. "It must be frustrating for you to have to cancel an activity your son enjoyed.": This response validates the parents' feelings and acknowledges the emotional difficulty of making such a decision. It shows empathy and understanding of their situation.

C. "You never know. He could be ready for baseball by the spring.": This response offers false hope and may not be realistic given the child’s terminal illness. It could undermine the parents’ acceptance of the situation.

D. "Baseball can be a dangerous sport for children anyway.": This response dismisses the parents' feelings and does not acknowledge the real reason for canceling the activity. It is insensitive to the gravity of their situation.

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Naxlex Comprehensive Predictor Exams

A 9-year-old client with oppositional defiant disorder (ODD) has been referred to a child psychologist due to frequent outbursts and defiant behavior at home and school. Which of the following interventions should the nurse prioritize to help manage the child's behavior effectively?

Correct Answer is D

Explanation

A nurse is speaking with the parents of a 4-year-old child who has a terminal illness. The parents tell the nurse they have taken their son's name off the list for little league baseball next season. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

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