A nurse is caring for a client with a history of left-sided heart failure who begins to experience dyspnea and reports that “it feels hard to catch my breath.” The nurse notes increased respiratory effort and auscultates crackles in the bilateral lung bases. Which initial nursing intervention is most appropriate?

Choice A reason: Resting after meals may suggest the client is avoiding purging, a positive step in bulimia recovery. However, it does not address the underlying emotional triggers driving binge-purge cycles. Without developing healthier coping mechanisms, resting alone is insufficient to indicate significant progress in managing the disorder.

Choice B reason: Verbalizing knowledge of past eating patterns shows insight into bulimia nervosa but does not necessarily indicate behavioral change. Understanding patterns is a preliminary step, but without implementing healthier coping strategies, it does not demonstrate active progress in altering the binge-purge cycle or emotional regulation.

Choice C reason: Identifying calorie content reflects awareness of food intake, which may be part of nutritional education in bulimia treatment. However, this knowledge alone does not address the emotional or behavioral components of the disorder, such as binge-purge triggers, making it less indicative of positive progress.

Choice D reason: Bulimia nervosa is often driven by emotional distress, with binge-purge behaviors as maladaptive coping mechanisms. Exhibiting healthy ways to cope with emotions, such as through therapy or stress management techniques, directly addresses the root cause, reducing reliance on disordered eating and indicating significant progress in recovery.

Choice A reason: An untidy house and yard may indicate poor organization or neglect but is not specific to hoarding. It could result from various factors, such as depression or physical limitations, and does not inherently pose a dangerous safety risk associated with hoarding behaviors.

Choice B reason: A single path through the yard and house indicates severe accumulation of items, characteristic of hoarding disorder. This creates significant safety hazards, such as fire risks, tripping hazards, or blocked exits, which can impede emergency access and pose immediate dangers to the client’s well-being.

Choice C reason: Neighbor complaints about cats may suggest pet hoarding, a subtype of hoarding disorder. However, without evidence of excessive clutter or unsafe living conditions, this alone is less indicative of dangerous hoarding compared to physical obstructions like a single path through the home.

Choice D reason: A collection of scattered magazines may suggest early hoarding tendencies but does not necessarily indicate a dangerous level of hoarding. It lacks the severity of safety risks, such as blocked pathways or fire hazards, associated with a single path through the home.