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A nurse is caring for a 22-year-old female client who has bulimia nervosa and frequently self-induces vomiting. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY)

Amenorrhea

Dental erosion

Dry oral mucosa

Icteric sclera

Presence of lanugo

Answer and Explanation

Correct Answer : A,B,C,E

The correct answer is

a. Amenorrhea

b. Dental erosion

c. Dry oral mucosa

e. Presence of lanugo

Choice A Reason:

Amenorrhea is the absence of menstruation. It is a common finding in individuals with bulimia nervosa due to hormonal imbalances caused by malnutrition and extreme weight loss. The body’s reproductive system can be significantly affected by the lack of essential nutrients, leading to disruptions in the menstrual cycle. Additionally, the stress and anxiety associated with bulimia can further contribute to amenorrhea. In clinical practice, amenorrhea is often used as an indicator of the severity of an eating disorder and the need for medical intervention.

Choice B Reason:

Dental erosion is another expected finding in clients with bulimia nervosa. Frequent self-induced vomiting exposes the teeth to stomach acid, which can erode the enamel and lead to significant dental problems. Over time, this acid exposure can cause the teeth to become sensitive, discolored, and more prone to cavities and decay. Dental erosion is often one of the first physical signs that healthcare providers notice in individuals with bulimia, and it can serve as a critical clue in diagnosing the disorder. Regular dental check-ups and proper oral hygiene are essential for managing this condition.

Choice C Reason:

Dry oral mucosa is a common symptom in individuals with bulimia nervosa. The frequent vomiting and dehydration associated with the disorder can lead to a dry mouth. Additionally, the use of diuretics and laxatives, which are sometimes abused by individuals with bulimia, can further contribute to dehydration and dry oral mucosa. This condition can cause discomfort, difficulty swallowing, and an increased risk of oral infections. Proper hydration and oral care are crucial for managing dry oral mucosa in clients with bulimia nervosa.

Choice D Reason:

Icteric sclera refers to the yellowing of the whites of the eyes, typically associated with liver dysfunction or jaundice. This is not a common finding in individuals with bulimia nervosa and is not directly related to the disorder. While bulimia can have various physical effects on the body, icteric sclera is not one of the expected findings. If a client with bulimia presents with icteric sclera, it would warrant further investigation to determine the underlying cause, which may be unrelated to the eating disorder.

Choice E Reason:

Presence of lanugo is the growth of fine, soft hair on the body, which is a common finding in individuals with eating disorders, including bulimia nervosa. Lanugo develops as the body’s response to extreme weight loss and malnutrition, as it attempts to conserve heat and energy. This fine hair can appear on the face, arms, and other areas of the body. The presence of lanugo is a sign of severe malnutrition and indicates the need for immediate medical intervention to address the underlying eating disorder and restore proper nutrition.

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Correct Answer is ["6.7"]

Explanation

Step 1: Convert the total daily dose from grams to milligrams. 1.2 grams × 1000 = 1200 milligrams Result: 1200 milligrams

Step 2: Divide the total daily dose by the number of doses per day to find the dose per administration. 1200 milligrams ÷ 3 = 400 milligrams per dose Result: 400 milligrams per dose

Step 3: Determine how many milliliters are needed for each dose. The medication is supplied as 300 mg/5 mL. 400 milligrams ÷ 300 milligrams = (400 ÷ 300) = 1.3333 Result: 1.3333

Step 4: Multiply the result by the volume (5 mL) to find the volume needed per dose. 1.3333 × 5 mL = 6.6665 mL Result: 6.6665 mL

Step 5: Round the result to the nearest tenth. 6.6665 mL rounded to the nearest tenth = 6.7 mL Result: 6.7 mL

The nurse will administer 6.7 mL per dose.

A. Is from another state and says they are here on a long vacation. B. Has a cell phone that is not working in the emergency department.

Correct Answer is C

Explanation

d. Speaks another language and is in need of an interpreter to translate.

The correct answer is…

c. Is accompanied by a family member who will not let the client answer questions.

Choice A Reason:

The statement that the client is from another state and says they are here on a long vacation could be a sign of human trafficking, but it is not definitive. People often travel for various reasons, and being from another state does not necessarily indicate trafficking. However, if combined with other suspicious behaviors, it could raise concerns. Traffickers often move victims to different locations to avoid detection, but this alone is not enough to suspect trafficking.

Choice B Reason:

Having a cell phone that is not working in the emergency department might be suspicious, but it is not a strong indicator of human trafficking. There could be many reasons for a non-functioning cell phone, such as technical issues or lack of service. While traffickers might control victims’ communication devices, this alone does not provide enough evidence to suspect trafficking.

Choice C Reason:

Being accompanied by a family member who will not let the client answer questions is a strong indicator of human trafficking. Traffickers often pose as family members or friends to maintain control over their victims and prevent them from speaking freely. This behavior is a red flag because it suggests that the accompanying person is trying to control the interaction and possibly hide something. Healthcare providers are trained to recognize this as a potential sign of trafficking.

Choice D Reason:

Speaking another language and needing an interpreter to translate is not a strong indicator of human trafficking. Many people who are not victims of trafficking may speak different languages and require translation services. While language barriers can complicate communication, they are not in themselves indicative of trafficking. However, if combined with other suspicious behaviors, it could contribute to the overall assessment.

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A nurse is caring for a 22-year-old female client who has bulimia nervosa and frequently self-induces vomiting. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY)

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A physician orders Lithium 1.2 grams/day in three divided doses PO for a client with bipolar disorder. The medication is supplied as 300 mg/5 mL. How much will the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["6.7"]

Explanation

A nurse is providing care for a client who is malnourished and appears exhausted. What data would cause the nurse to suspect the client is a victim of human trafficking? The client:

Correct Answer is C

Explanation

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