A nurse is caring for a client who has anorexia nervosa.

The client was admitted for medical stabilization due to a deteriorating condition that requires supervised refeeding. The client's weight is currently at 73% of ideal body weight.

Exhibits

Select the three findings that require immediate follow-up:

Magnesium level

Chloride level

Phosphate level

Potassium level.

Answer and Explanation

Correct Answer : A,C,D

Choice A rationale: The client’s magnesium level is 1.7 mg/dL, which is below the normal range of 1.8 to 2.4 mg/dL. Hypomagnesemia can cause neuromuscular irritability, muscle weakness, tremors, and even seizures or cardiac arrhythmias in severe cases.

It’s often associated with other electrolyte imbalances such as hypokalemia and hypocalcemia.

In the context of anorexia nervosa, this could be due to inadequate dietary intake, malabsorption, or excessive losses from the gastrointestinal tract.

Choice B rationale: The client’s chloride level is 98 mmol/L, which falls within the normal range of 96 to 106 mmol/L. Chloride is an important electrolyte that helps maintain acid-base balance, fluid balance, and is a component of gastric juice as hydrochloric acid.

There’s no immediate concern regarding the client’s chloride level.

Choice C rationale: The client’s phosphate level is 2.5 mg/dL, which is below the normal range of 2.8 to 4.5 mg/dL. Hypophosphatemia can lead to muscle weakness, bone pain, mental changes, and potentially life-threatening complications such as respiratory failure and heart failure.

In the context of anorexia nervosa, hypophosphatemia is a common complication during refeeding due to shifts in electrolytes.

Choice D rationale: The client’s potassium level is 3.5 mmol/L, which is at the lower end of the normal range of 3.5 to

5.0 mmol/L. Hypokalemia can cause muscle weakness, cramps, arrhythmias, and in severe cases, it can be life- threatening.

In the context of anorexia nervosa, this could be due to inadequate dietary intake, excessive losses due to vomiting or laxative abuse, or shifts in electrolytes during refeeding.

In conclusion, the nurse should follow up on the client’s magnesium, phosphate, and potassium levels due to their potential implications on the client’s health, especially considering the client’s current health status and the process of refeeding.

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Correct Answer is A

Explanation

A. A client who has depression - Correct.

Explanation:

Depression is a significant risk factor for suicide. Individuals with depression may experience feelings of hopelessness, helplessness, and despair, which can contribute to suicidal ideation. It is crucial for the mental health nurse to carefully assess and monitor individuals with depression for any signs of suicidal thoughts or behaviors. Prompt intervention and support are essential to address the underlying issues and mitigate the risk of suicide.

Explanation for other choices:

B. A client whose family visits him every week from out of town.

Family support is generally considered a protective factor against suicide. Regular family visits can provide emotional support and a sense of connection, reducing the risk.

C. A pregnant female client who is at 8 months gestation.

Pregnancy alone is not a direct risk factor for suicide. However, mental health issues during pregnancy, such as depression, should be assessed and addressed appropriately.

D. A client who has a lot of friends.

This scenario does not provide enough information for a clear assessment of suicide risk. Social interactions can be both protective and risk factors, depending on the individual's overall situation and support network. Further assessment would be needed to determine the significance of this factor.

A. "You may experience a decreased sex drive while taking this medication." B. "You will notice an improvement in your depressive symptoms in 2 to 3 days." C. "You may experience drooling while taking this medication." D. "You may notice that you have less appetite while taking this medication.".

Correct Answer is ["A","D"]

Explanation

Choice A rationale: Fluoxetine, also known as Prozac, is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. One of the common side effects of fluoxetine is a decreased interest in sexual intercourse. This can manifest as a decreased sex drive, difficulty in achieving an orgasm, or inability to have or keep an erection. It’s important for patients to be aware of this potential side effect so they can discuss it with their healthcare provider if it becomes a concern.

Choice B rationale: While fluoxetine is an effective treatment for depressive disorders, it does not typically cause an improvement in depressive symptoms in 2 to 3 days. In fact, it may take several weeks before patients begin to feel the full benefits of fluoxetine. Some people may even feel worse before they start to feel better. This is because it takes some time for fluoxetine to adjust the chemical balance in the brain.

Choice C rationale: Drooling is not typically associated with the use of fluoxetine. While fluoxetine can have many side effects, drooling is not commonly reported. If a patient experiences this side effect, it may be due to another medication or a different medical condition. It’s always important to discuss any new or unusual symptoms with a healthcare provider.

Choice D rationale: Loss of appetite is another potential side effect of fluoxetine. This can lead to weight loss in some patients. While this may be desirable for some, it can also lead to malnutrition and other health problems if not properly managed. Patients should be advised to monitor their weight and dietary intake while taking fluoxetine, and to discuss any concerns with their healthcare provider.

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Naxlex Comprehensive Predictor Exams

A mental health nurse is assessing the suicide risk of a group of clients on a mental health unit. Which of the following clients should the nurse identify as having a risk factor for a suicide attempt?

Correct Answer is A

Explanation

A nurse is teaching a client who has a depressive disorder about fluoxetine. Which of the following information should the nurse include in the teaching?

Correct Answer is ["A","D"]

Explanation

A nurse is teaching a group of clients about St. John's wort. Which of the following pieces of information should the nurse include in the teaching?

The registered nurse in the mental health unit recognizes which as being good therapeutic communication techniques? Select all that apply.

A nurse is assessing a client who has posttraumatic stress disorder (PTSD) following a sexual assault. Which of the following is an expected finding?

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

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.)

A nurse is making a home visit for a 16-year-old adolescent who attempted suicide. Which of the following behaviors should alert the nurse that the adolescent still has suicidal intent?

A mental health nurse on a mental health unit is caring for a client who has generalized anxiety disorder (GAD). The client received a telephone call that was upsetting, and now the client is pacing up and down the corridors of the unit.Which of the following actions should the nurse take?