A nurse is planning care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?
Offer the client a selection of beverages at each meal.
Inform the client that a weight gain of 2.3 kg (5 lb) per week is expected.
Arrange for someone to remain with the client for 30 min after meals.
Encourage the client to participate in developing dietary goals.
The Correct Answer is D
A. Offer the client a selection of beverages at each meal: Providing a variety of beverages may offer hydration and a sense of control, but clients with anorexia nervosa often use fluids to avoid calorie-dense solid foods. This approach can reinforce avoidance behaviors and does not contribute meaningfully to nutritional rehabilitation or psychological recovery.
B. Inform the client that a weight gain of 2.3 kg (5 lb) per week is expected: A weight gain goal of 2.3 kg per week is too aggressive and may provoke anxiety or resistance from the client. A slower, more gradual goal of 0.5 to 1 kg (1 to 2 lb) per week is considered safer and more psychologically tolerable. Unrealistic expectations can harm rapport and may lead to nonadherence or relapse.
C. Arrange for someone to remain with the client for 30 min after meals: Monitoring after meals is essential to prevent purging or other compensatory behaviors. The standard is 60 to 90 minutes post-meal observation to address delayed attempts at purging or exercising. Thus, while well-intentioned, this time frame is insufficient.
D. Encourage the client to participate in developing dietary goals: Involving the client in setting dietary goals promotes a sense of autonomy, collaboration, and ownership in the recovery process. This approach is therapeutic, reduces power struggles, and helps build trust between the nurse and the client.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Whole-wheat pasta, green salad, and diet cola: While this meal is low in fat and suitable for hypertension, it lacks a clear protein source. Additionally, diet cola contains caffeine and artificial sweeteners, which some clients may choose to avoid due to personal or health preferences.
B. Broiled chicken, grilled potatoes, and lemonade: This option is appropriate for a client with hypertension and complies with Islamic dietary laws. Chicken is a halal protein, and the meal is low in sodium and saturated fat. Lemonade is a non-caffeinated beverage that aligns with religious and health considerations.
C. Roast beef, brown rice, and coffee: Roast beef is permissible if it is halal, but this cannot be assumed unless specified. Coffee contains caffeine, which some individuals with hypertension may need to limit. The meal also lacks details on fat and sodium content.
D. Grilled pork loin, steamed vegetables, and water: Pork is strictly prohibited (haram) in Islamic dietary laws. Although the vegetables and water are appropriate, the inclusion of pork makes this meal unacceptable for a practicing Muslim.
Correct Answer is D
Explanation
A. Limits red meat intake to two servings a month: Limiting red meat intake is a protective dietary behavior when it comes to cancer prevention. High consumption of red and processed meats has been linked to colorectal and other cancers. Two servings a month is relatively low and does not place the client at increased risk, but rather may help reduce cancer risk.
B. Eats six servings of whole grains daily: Whole grains contain dietary fiber, antioxidants, and phytochemicals that support digestive health and reduce inflammation, which may protect against certain cancers, particularly colorectal cancer. Eating six servings of whole grains daily is consistent with cancer-preventive nutritional guidelines.
C. Eats at least five servings of fruits and vegetables daily: Fruits and vegetables provide essential vitamins, minerals, fiber, and phytonutrients that have cancer-fighting properties. A daily intake of at least five servings supports immune function, cellular repair, and may reduce the risk of various types of cancer, including stomach and lung cancers.
D. Limits alcohol consumption to two drinks per day: Consuming up to two alcoholic drinks daily may still increase cancer risk, especially for breast, liver, esophageal, and colorectal cancers. The safest approach in cancer prevention is to avoid alcohol or limit it to no more than one drink per day for women.
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