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

Choice A rationale:

The nurse's first action when caring for a client with bulimia nervosa should be to observe the client during and after meals. This is essential to monitor for signs of binge-eating followed by compensatory behaviors such as vomiting or the misuse of laxatives. Timely observation can help ensure the client's safety and provide an opportunity for immediate intervention if necessary.

Choice B rationale:

Suggesting that the client assist with meal planning can be a beneficial intervention, but it should not be the first action. Clients with bulimia nervosa often have complex emotional and psychological issues related to their eating habits, so it's crucial to address the immediate risks of binge-purge episodes before moving on to meal planning.

Choice C rationale:

Instructing the client about effective coping strategies is important for long-term recovery, but it should not be the first action. Immediate safety concerns, such as monitoring for binge-purge behaviors, take precedence in the initial care of a client with bulimia nervosa.

Choice D rationale:

Referring the client to a support group is a valuable intervention in the long-term management of bulimia nervosa, but it should not be the first action. The immediate priority is to assess and address any acute risks associated with the disorder, such as binge-purge episodes.

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Correct Answer is B

Explanation

Correct answer is: B. 16 lb.

Choice A rationale: 32 lb. is too much weight gain for a client whose prepregnancy BMI was 30.5. According to the Institute of Medicine (IOM) guidelines, obese women (BMI greater than or equal to 30) should only gain 11 to 20 lb.during pregnancy 1 2.Excessive weight gain can increase the risk of gestational diabetes, hypertension, cesarean delivery, and postpartum weight retention 1.

Choice B rationale: 16 lb. is an acceptable weight gain for a client whose prepregnancy BMI was 30.5. This is within the recommended range of 11 to 20 lb.for obese women (BMI greater than or equal to 30) by the IOM guidelines 1 2.Adequate weight gain can help ensure optimal fetal growth and development, as well as maternal health 1.

Choice C rationale: 24 lb. is too much weight gain for a client whose prepregnancy BMI was 30.5. This exceeds the recommended range of 11 to 20 lb.for obese women (BMI greater than or equal to 30) by the IOM guidelines 1 2.Excessive weight gain can increase the risk of gestational diabetes, hypertension, cesarean delivery, and postpartum weight retention 1.

A. Use written signs to assist the client with locating the bathroom. B. Provide a stimulating environment for the client. C. Use confrontation to manage the client's behavior. D. Limit the number of choices for the client.

Correct Answer is D

Explanation

The correct answer is choiced. “Limit the number of choices for the client.”

Choice A rationale:

Using written signs to assist the client with locating the bathroom can be helpful, but it is not the most critical strategy for managing Alzheimer’s disease.

Choice B rationale:

Providing a stimulating environment for the client can sometimes lead to overstimulation, which may increase confusion and agitation in clients with Alzheimer’s disease.

Choice C rationale:

Using confrontation to manage the client’s behavior is not recommended as it can lead to increased agitation and aggression.

Choice D rationale:

Limiting the number of choices for the client helps reduce confusion and anxiety, making it easier for them to make decisions and feel more in control.

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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?

Nursing Test Bank

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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?