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
Choice A reason: Offering the client a selection of beverages at each meal is not a good action to include in the plan, as it may reduce the client's appetite and intake of solid foods. The nurse should limit the client's fluid intake before and during meals, and encourage the client to consume high-calorie and high-protein drinks, such as milkshakes or smoothies, after meals.
Choice B reason: Informing the client that a weight gain of 2.3 kg (5 lb) per week is expected is not a good action to include in the plan, as it may cause anxiety and resistance in the client. The nurse should set realistic and individualized weight goals for the client, and monitor the client's weight and vital signs regularly. The nurse should also avoid focusing on the client's weight, and instead emphasize the client's health and well-being.
Choice C reason: Arranging for someone to remain with the client for 30 min after meals is a good action to include in the plan, as it can prevent the client from purging or exercising excessively. The nurse should provide a supportive and nonjudgmental environment for the client, and supervise the client's eating and toileting behaviors. The nurse should also educate the client and the family about the complications and treatment of anorexia nervosa.
Choice D reason: Encouraging the client to participate in developing dietary goals is a good action to include in the plan, as it can increase the client's sense of control and motivation. The nurse should collaborate with the client, the dietitian, and the mental health team to create a personalized and flexible meal plan that meets the client's nutritional and psychological needs. The nurse should also praise the client for any progress or achievement, and reinforce the client's positive coping skills.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: "Limit the number of fast-food meals to five each week." is not a good information to include, as it implies that fast-food meals are acceptable as long as they are not too frequent. The nurse should discourage the students from consuming fast-food meals, as they are high in fat, salt, sugar, and calories, and low in nutrients, fiber, and antioxidants. The nurse should advise the students to choose healthier options, such as fruits, vegetables, whole grains, lean proteins, and low-fat dairy products.
Choice B reason: "You should drink a glass of milk with breakfast." is a good information to include, as it promotes the intake of calcium, which is essential for bone health and growth. Adolescents need about 1,300 mg of calcium per day, which can be obtained from milk and other dairy products, such as cheese and yogurt. The nurse should encourage the students to drink milk with breakfast, as it can also provide protein, vitamin D, and other nutrients.
Choice C reason: "Most of your dietary intake should come from protein." is not a good information to include, as it suggests that protein is more important than other macronutrients, such as carbohydrates and fats. The nurse should explain to the students that protein is necessary for tissue repair, muscle development, and immune function, but it should not exceed 10 to 30 percent of the total caloric intake. The nurse should recommend the students to consume a balanced diet that includes carbohydrates, fats, and protein, as well as vitamins, minerals, and water.
Choice D reason: "Your total intake for the day should not exceed 1,000 calories." is not a good information to include, as it indicates that calorie restriction is the key to a healthy diet. The nurse should inform the students that calorie needs vary depending on age, gender, activity level, and growth rate, and that 1,000 calories is too low for most adolescents. The nurse should advise the students to eat enough calories to meet their energy and nutritional needs, and to avoid skipping meals or starving themselves.
Correct Answer is A
Explanation
Choice A reason: Vitamin D is a fat-soluble vitamin that is essential for bone health, immune function, and calcium absorption. It is mainly obtained from exposure to sunlight and animal sources, such as dairy products, eggs, and fish. Vegans are at risk for vitamin D deficiency, especially if they live in areas with limited sunlight or do not take supplements.
Choice B reason: Vitamin C is a water-soluble vitamin that is important for collagen synthesis, wound healing, and antioxidant activity. It is abundant in plant sources, such as fruits and vegetables. Vegans are not likely to be deficient in vitamin C, unless they have a very restricted diet or a malabsorption disorder.
Choice C reason: Magnesium is a mineral that is involved in many enzymatic reactions, muscle contraction, nerve transmission, and bone formation. It is widely distributed in plant and animal foods, such as nuts, seeds, legumes, grains, and green leafy vegetables. Vegans are not prone to magnesium deficiency, unless they have a chronic condition that affects magnesium absorption or excretion.
Choice D reason: Folic acid is a water-soluble vitamin that is essential for DNA synthesis, cell division, and red blood cell production. It is found in fortified grains, cereals, breads, and pasta, as well as in dark green leafy vegetables, beans, and lentils. Vegans are not at risk for folic acid deficiency, as long as they consume enough of these foods or take supplements.
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