A nurse is caring for a client who has anorexia nervosa and expresses anxiety about the weight gain restoration program. Which of the following statements should the nurse make?
"You will need to accept that increasing weight is a natural part of the program."
"What are your feelings about the restoration process?"
"Why do you become so frightened about gaining weight?"
"Everyone feels better after they have completed the program."
The Correct Answer is B
Choice A reason: This statement is dismissive and confrontational. Telling a patient they "need to accept" a process they fear fails to validate their distress and creates a power struggle, which hinders the development of the therapeutic alliance necessary for effective treatment in patients with eating disorders.
Choice B reason: This is an open-ended, therapeutic communication technique. By inviting the client to express their feelings, the nurse demonstrates empathy and creates a safe space for the client to explore their fears. This approach encourages self-reflection and helps the nurse understand the patient's specific emotional barriers to recovery.
Choice C reason: Questions starting with "Why" are considered non-therapeutic as they can sound judgmental or accusatory, often making the patient feel defensive. Patients with anorexia often cannot logically articulate the deep-seated, irrational roots of their fear, making a "why" question unhelpful and potentially damaging to the relationship.
Choice D reason: This is an example of providing false reassurance and minimizing the patient's experience. It generalizes the recovery process, which ignores the individual's unique struggle and current anxiety. Such statements shut down further communication and can cause the patient to feel misunderstood or invalidated by the nurse.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: While some individuals may report a temporary reduction in anxiety during a binge, the subsequent purge is typically accompanied by profound distress, shame, and guilt. "Emotional high" is not a diagnostic criterion or a standard report associated with the pathological cycle of bulimia nervosa.
Choice B reason: This statement suggests appropriate medical use of laxatives. In the context of bulimia nervosa, laxative use is maladaptive, occurring in excessive, non-therapeutic quantities specifically intended for caloric elimination and weight control, rather than for the treatment of physiological gastrointestinal transit issues like constipation.
Choice C reason: The sensation of power through restriction is a hallmark psychological characteristic of anorexia nervosa. Patients with anorexia nervosa derive their sense of identity and self-control from rigid caloric restriction, whereas patients with bulimia nervosa feel a distinct loss of control during their binge-purge cycles.
Choice D reason: Bulimia nervosa is characterized by secrecy and social withdrawal surrounding the binge-purge behavior. Because the condition is often associated with intense shame, individuals frequently hide their actions from family and friends for years, which complicates early detection and diagnosis by healthcare professionals and support systems.
Correct Answer is A
Explanation
Choice A reason: Fluoxetine is the only selective serotonin reuptake inhibitor that has been specifically approved by the Food and Drug Administration for the treatment of bulimia nervosa. It functions by inhibiting the reuptake of serotonin at the presynaptic membrane, thereby increasing the concentration of serotonin in the synaptic cleft, which helps to decrease the frequency of binge-eating and purging episodes.
Choice B reason: Valproate is categorized as an anticonvulsant medication that also functions as a mood stabilizer. It is primarily utilized in the management of bipolar disorder or epilepsy. It does not belong to the selective serotonin reuptake inhibitor class and is not indicated for the primary pharmacological treatment of bulimia nervosa.
Choice C reason: Naltrexone is an opioid receptor antagonist primarily used in the management of alcohol and opioid dependence. While some research explores its use for impulse control disorders, it is not an selective serotonin reuptake inhibitor and is not the standard first-line pharmacological treatment for individuals diagnosed with bulimia nervosa.
Choice D reason: Olanzapine is an atypical antipsychotic medication often utilized for schizophrenia or bipolar disorder. In some clinical cases, it may be used off-label for severe anorexia nervosa to assist with weight gain and cognitive rigidity, but it is not a selective serotonin reuptake inhibitor, nor is it the primary pharmacological intervention for bulimia.
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