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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. Elevated vitamin K levels: While excessive levels of Vitamin K can sometimes increase the risk of bleeding, it does not directly hinder the body’s ability to heal pressure injuries. Healing of wounds is more dependent on factors like protein and collagen synthesis, which are affected by zinc levels rather than vitamin K.
B. Zinc deficiency: Zinc plays a crucial role in wound healing by supporting cell growth, collagen formation, and immune function. A deficiency in zinc impairs the synthesis of collagen, which is necessary for the healing of pressure injuries. It also weakens the immune system, increasing the risk of infection and delaying the healing process.
C. Constipation: While constipation can cause discomfort and lead to additional complications, such as straining or increased intra-abdominal pressure, it does not directly affect the healing process of the skin or tissue at the site of a pressure injury.
D. Acid reflux: Acid reflux, or gastroesophageal reflux disease (GERD), primarily affects the digestive system and is not directly related to wound healing. While chronic acid reflux can cause discomfort and complications like esophageal damage, it does not impact the body’s ability to heal a pressure injury.

A. Grapefruit B. Coffee C. Milk D. Oatmeal

Correct Answer is A

Explanation

A. Grapefruit: Grapefruit inhibits the cytochrome P450 3A4 enzyme in the liver, which is responsible for metabolizing atorvastatin. When this enzyme is blocked, the levels of atorvastatin in the blood can rise increasing the risk of serious side effects such as muscle toxicity and liver damage. Clients taking statins should completely avoid grapefruit to ensure the medication is processed safely and effectively.
B. Coffee: Coffee does not interact with atorvastatin in a clinically significant way. While excessive caffeine intake can have other health implications, it does not affect the metabolism or effectiveness of atorvastatin. Clients with hyperlipidemia may still consume coffee in moderation unless otherwise advised based on other health conditions.
C. Milk: Milk does not interfere with atorvastatin's absorption or metabolism. It is safe to consume while on the medication. In fact, low-fat dairy products can be part of a heart-healthy diet aimed at lowering cholesterol, making milk an acceptable food choice for clients with hyperlipidemia.
D. Oatmeal: Oatmeal is beneficial for clients with hyperlipidemia because it contains soluble fiber, which helps to lower LDL (bad) cholesterol levels. There are no known interactions between oatmeal and atorvastatin. Including oatmeal in the diet supports the therapeutic goals of atorvastatin by promoting heart health.

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A nurse is planning care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?

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