A nurse is caring for a client who has bulimia nervosa. Which of the following actions should the nurse take first?

Observe the client during and after meals.

Suggest that the client assist with meal planning.

Instruct the client about effective coping strategies.

Refer the client to a support group for clients who have eating disorders.

Answer and Explanation

The Correct Answer is A

A.   Correct. Observing the client during and after meals is a priority because clients with bulimia nervosa often engage in episodes of binge eating followed by purging behaviors. Monitoring the client's behavior during meals and immediately after can help assess for potential purging behaviors.
B.   Incorrect. While involving the client in meal planning might be helpful, it is not the first action to address potential purging behaviors.
C.   Incorrect. Instructing the client about effective coping strategies is important, but observing for potential purging behaviors is the initial action to address the client's immediate safety.
D.   Incorrect. Referring the client to a support group is beneficial, but it is not the first action to address the client's immediate risk of purging behaviors.

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Correct Answer is C

Explanation

A. A nutritionist might provide information about feeding options, but a case manager can assist with financial concerns.
B. While a pediatric nurse practitioner can provide health guidance, a case manager is better suited for addressing financial matters.
C. Correct. A case manager can help the client access resources and assistance programs to afford necessary items like baby formula.
D. The primary care provider's role is more focused on medical care, not financial assistance.

A. Believes that his brother's death will be reversible B. Regresses to an earlier developmental level C. Alienates himself from his peers D. Believes his bad behavior is causing his brother's death

Correct Answer is D

Explanation

A.This belief is more common in preschool-age children who may not fully understand the permanence of death. School-age children generally have a better grasp of the concept of death being final.

B.Regression can occur in children of any age dealing with significant stress or trauma, but it is more typically seen in younger children. Older children might exhibit other forms of stress responses.

C.While alienation can happen, it is not the most typical response for a school-age child. They are more likely to seek support from peers or blame themselves through magical thinking, as they are still developing their understanding of complex emotional and social dynamics.

D.This choice reflects the magical thinking common in school-age children, where they might believe that their actions or thoughts can influence events. This can lead to feelings of guilt and responsibility for their sibling's illness or death.

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A nurse is caring for a client who has bulimia nervosa. Which of the following actions should the nurse take first?

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