A nurse is caring for a client who has major depressive disorder and states that he has given away his personal belongings. Which of the following responses should the nurse make?

"Why did you feel like giving away your belongings?"

"You should find a support group to attend."

"Everyone feels a little down sometimes."

"Can you tell me how you have been feeling lately?"

Answer and Explanation

The Correct Answer is D

A. "Why did you feel like giving away your belongings?"
This response is empathetic and invites the client to explore their feelings and motivations. It shows understanding and can help the nurse comprehend the client's emotional state better.

B. "You should find a support group to attend."
This response suggests a proactive step to seek support, which can be helpful. However, it might be premature in this context as the nurse hasn't fully assessed the client's situation yet. It's important to understand the client's feelings and circumstances before recommending specific interventions.

C. "Everyone feels a little down sometimes."
This response minimizes the client's feelings and can be invalidating. It doesn't acknowledge the seriousness of the client's statement, which might discourage them from opening up further.

D. "Can you tell me how you have been feeling lately?"
As previously explained, this response is empathetic and open-ended, encouraging the client to share their emotions and thoughts. It's a good starting point for a therapeutic conversation, allowing the nurse to assess the client's current mental state.

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Correct Answer is C

Explanation

A. Prepare the client for electroconvulsive therapy:
Electroconvulsive therapy (ECT) is not a standard or appropriate treatment for anorexia nervosa. ECT is primarily used for severe depression, bipolar disorder, and certain other mental health conditions. Anorexia nervosa is typically managed through psychotherapy, nutritional counseling, and medical monitoring, often in an outpatient or inpatient setting, depending on the severity of the disorder.

B. Weigh the client twice per day:
Frequent weighing is generally discouraged in the treatment of anorexia nervosa. Individuals with this disorder often have an unhealthy fixation on their weight. Frequent weigh-ins can exacerbate anxiety, foster an unhealthy relationship with food and body image, and reinforce obsessive thoughts about weight and appearance. Healthcare providers should monitor weight and nutritional status regularly, but the frequency should be determined based on the individual's specific needs and in a manner that does not worsen their anxiety.

C. Encourage the client to participate in family therapy:
This is the appropriate choice. Family therapy is often a crucial component of the treatment plan for anorexia nervosa. It helps address family dynamics, communication patterns, and any dysfunctional relationships that might contribute to the eating disorder. Family therapy provides a supportive environment for both the individual with anorexia and their family members, aiding in understanding, coping, and healing.

D. Set a weight gain goal of 2.2 kg (4.9 lb) per week:
Setting specific weight gain goals can be counterproductive and potentially harmful for individuals with anorexia nervosa. Rapid or arbitrary weight gain goals may lead to unhealthy eating behaviors, excessive exercise, or other dangerous practices in an attempt to meet the goal quickly. Instead, healthcare providers focus on a more individualized and gradual approach to weight restoration, ensuring that it is safe, sustainable, and in line with the client's overall health and well-being.

A. Hgb 10 g/dL B. Blood glucose 100 mg/dL C. TIBC 11 mcg/dL D. Potassium 3.7 mEq/L

Correct Answer is A

Explanation

A. Hgb 10 g/dL
Anemia (low hemoglobin levels) is a common finding in individuals with anorexia nervosa due to inadequate nutrition, leading to a decreased production of red blood cells. Hemoglobin levels below the normal range are often seen in people with severe malnutrition, such as those with anorexia nervosa.

B. Blood glucose 100 mg/dL:
A blood glucose level of 100 mg/dL is within the normal range. Anorexia nervosa typically does not cause specific changes in blood glucose levels.

C. TIBC 11 mcg/dL:
Total Iron-Binding Capacity (TIBC) is a test that measures the blood's capacity to bind to iron. The given value of 11 mcg/dL is unusually low and might not be within the typical reference range. However, the significance of this value is not clear without the specific reference range for the laboratory performing the test.

D. Potassium 3.7 mEq/L:
A potassium level of 3.7 mEq/L is within the normal range. Electrolyte imbalances, including low potassium levels (hypokalemia), can occur in individuals with anorexia nervosa due to inadequate intake and purging behaviors. While this level is within the normal range, individuals with anorexia nervosa may still exhibit electrolyte imbalances that require monitoring and management.

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A nurse is caring for a client who has major depressive disorder and states that he has given away his personal belongings. Which of the following responses should the nurse make?

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