A nurse in an outpatient setting is caring for a client.
The client presents with feelings of anxiety and depression.
They recently started smoking marijuana as that is what their "new friends do all the time". They admit to using laxatives frequently and running for 1 hr after eating a very large meal, which happens at least 9 times a week.
They were recently arrested for stealing make-up from a local department store and acknowledge that this "is the first time I was caught". Complete the diagram by specifying 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.

Attention-seeking behaviors

Electrolyte levels

Presence of lanugo

Signs of infection

Frequency of compensatory behaviors.

Answer and Explanation

Correct Answer : B,C

Choice A rationale: Anorexia nervosa is an eating disorder characterized by relentless drive for thinness with a fear of gaining body weight associated with self-induced behaviors towards thinness. Symptoms include extreme weight loss, thin appearance, intense fear of gaining weight, bingeing and purging, abnormal blood counts, fatigue, insomnia, dizziness or fainting, bluish discoloration of the fingers, hair that thins, breaks or falls out, soft, downy hair covering the body, amenorrhea (absence of menstruation), constipation, dry or yellowish skin, intolerance of cold, irregular heart rhythms, low blood pressure, dehydration, osteoporosis, swelling of arms or legs. However, the client’s symptoms do not align with those of anorexia nervosa.

Choice B rationale: Bulimia nervosa is an eating disorder characterized by binge eating, followed by methods to avoid weight gain. Symptoms include binge eating, forceful vomiting, long-term fear of gaining weight, preoccupation with weight and body, a strong negative self-image, overuse of laxatives or diuretics, use of supplements or herbs for weight loss, excessive exercises, stained teeth (from stomach acid), calluses on the back of the hands, withdrawal from normal social activities. The client’s symptoms of using laxatives frequently and running for 1 hr after eating a very large meal, which happens at least 9 times a week, align with those of bulimia nervosa.

Choice C rationale: Histrionic personality disorder (HPD) is a mental health condition characterized by unstable emotions, a distorted self-image and a desire to be noticed. Symptoms include persistent attention seeking, dramatic behavior, rapidly shifting and shallow emotions, sexually provocative behavior, undetailed style of speech, and a tendency to consider relationships more intimate than they actually are. The client’s symptoms of feelings of anxiety and depression, starting smoking marijuana as that is what their “new friends do all the time”, and being recently arrested for stealing make-up from a local department store and acknowledging that this “is the first time I was caught” align with those of HPD.

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Correct Answer is ["10"]

Explanation

To calculate the amount of fluoxetine to administer, we can use the following steps:

Step 1: Identify the desired dose, which is 40 mg.

Step 2: Identify the available dose, which is 20 mg/5 mL.

Step 3: Set up the equation to solve for the unknown, which is the volume in mL. The equation is (Desired Dose ÷ Available Dose) × Volume = Volume to Administer.

Step 4: Substitute the known values into the equation: (40 mg ÷ 20 mg) × 5 mL = Volume to Administer. Step 5: Solve the equation: 2 × 5 mL = 10 mL.

So, the nurse should administer 10 mL of fluoxetine.

A. Agoraphobia B. Xenophobia C. Mysophobia D. Aerophobia.

Correct Answer is A

Explanation

Rationale:

A. Agoraphobia: This choice directly aligns with the client's presentation of being afraid to leave her home alone. Agoraphobia is a specific phobia characterized by an intense fear of situations that the individual perceives as inescapable or that might potentially lead to panic or embarrassment. Common triggers for agoraphobic individuals include crowded spaces, open spaces, public transportation, or being alone outside of the home. The client's inability to leave her home for weeks due to fear is a classic symptom of agoraphobia.

B. Xenophobia: This choice refers to the fear of strangers or foreigners. While the client may experience anxiety in unfamiliar situations, the primary focus of her fear is being outdoors alone rather than encountering unfamiliar people. Additionally, the daughter's description of the client's fear specifically mentions being alone, further supporting agoraphobia as the more likely diagnosis.

C. Mysophobia: This choice refers to an extreme or obsessive fear of germs or contamination. While anxiety related to cleanliness could coexist with agoraphobia, the primary presenting complaint in this case is the fear of being outdoors, not specifically germs or contamination.

D. Aerophobia: This choice refers to the fear of flying or being in high places. There is no indication in the scenario that the client's fear is specifically related to heights or flying, making this choice less likely.

Therefore, based on the specific nature of the client's fear and the limited information provided, agoraphobia is the most probable diagnosis and the one the nurse should anticipate planning care for.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer fluoxetine 40 mg PO daily. The amount available is fluoxetine 20 mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies.Do not use a trailing zero.).

Correct Answer is ["10"]

Explanation

A nurse in a mental health clinic is assessing a client who was brought in by her adult daughter stating that her mother has not been able to leave her home for weeks because she is afraid to be outdoors alone.The nurse should anticipate planning care for managing which of the following phobias?

Correct Answer is A

Explanation

A nurse is caring for a client following a suicide attempt.The client has a history of depression, substance abuse, and anorexia nervosa. Which of the following actions is the nurse's priority?

A mental health nurse is preparing a client who has chronic anxiety for discharge from the psychiatric unit. Which of the following instructions should the nurse include in the client's discharge plan?

A nurse is caring for a client following a recent suicide attempt. Which of the following actions should the nurse take?

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A nurse is caring for a client who has a mental illness.Which of the following actions by the nurse demonstrates the ethical concept of autonomy?

A nurse is performing a psychosocial assessment on an adolescent client. Which of the following should indicate to the nurse a potential risk for suicide? (Select all that apply)

A nurse is assessing a client who has a new diagnosis of anorexia nervosa. Which of the following findings should the nurse expect?

Which nursing intervention has priority as a client diagnosed with anorexia nervosa begins to gain weight after initiated therapy?