A nurse is reviewing the medical record of a client.
The client is an 18-year-old admitted to an inpatient psychiatric unit after passing out at home. The client reports using laxatives and "making myself throw up after eating" for about 6 months.
After reviewing the client's medical record and new diagnostic results, the nurse determines the client is at risk for further health issues.
The client is at risk for developing which of the following?

Hypomagnesemia

Renal failure

Heart failure

Hyperthyroidism.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

The client’s reported behavior of using laxatives and inducing vomiting after eating can lead to a condition known as hypomagnesemia. Hypomagnesemia is a condition characterized by low levels of magnesium in the blood. This condition can be caused by poor intake, excessive loss, or movement of magnesium from the blood into less accessible locations. The use of laxatives can lead to excessive loss of magnesium through increased bowel movements. Similarly, self-induced vomiting can also result in a loss of magnesium. Therefore, the client’s behavior puts them at risk for developing hypomagnesemia.

Choice B rationale:

Renal failure, also known as kidney failure, occurs when the kidneys lose their ability to filter waste products from the blood. While the use of laxatives and self-induced vomiting can lead to dehydration, which can strain the kidneys, these behaviors are not directly associated with renal failure. Therefore, while it’s possible for the client to develop kidney problems, it’s less likely compared to hypomagnesemia.

Choice C rationale:

Heart failure occurs when the heart muscle doesn’t pump blood as well as it should. This condition can cause symptoms like shortness of breath, swelling, fatigue, and other symptoms. While severe electrolyte imbalances, such as those that might result from the use of laxatives and self-induced vomiting, can affect heart function, they would typically result in arrhythmias (irregular heartbeats) rather than heart failure. Therefore, it’s less likely for the client to develop heart failure based on the behaviors described.

Choice D rationale:

Hyperthyroidism is a condition where the thyroid gland produces and releases too much thyroid hormone. This condition can cause symptoms like rapid heartbeat, weight loss, and anxiety. The client’s behaviors of using laxatives and inducing vomiting after eating do not directly influence the production of thyroid hormones. Therefore, it’s less likely for the client to develop hyperthyroidism based on the behaviors described.

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Correct Answer is ["A","C","E"]

Explanation

Choice A rationale: Potassium level A therapeutic response to the treatment plan for anorexia nervosa would be indicated by a normal potassium level. Anorexia nervosa often leads to electrolyte imbalances, including low potassium levels, due to inadequate food intake and, in some cases, purging behaviors. Therefore, a normal potassium level can indicate that the client is responding well to the treatment plan, as it suggests they are maintaining a more balanced diet and managing their symptoms effectively.

Choice B rationale: Temperature While body temperature can be affected by severe malnutrition, it is not a specific indicator of a therapeutic response to the treatment plan for anorexia nervosa. Therefore, while it’s important to monitor, it is not a definitive sign of improvement or recovery.

Choice C rationale: ECG report An ECG report can indicate a therapeutic response to the treatment plan for anorexia nervosa. This is because anorexia nervosa can lead to heart problems such as abnormal heart rhythms. Therefore, a normal ECG report can suggest that the client’s heart health is improving, which can be a sign that they are responding well to the treatment plan.

Choice D rationale: BUN level While the BUN (Blood Urea Nitrogen) level can provide information about hydration status and kidney function, it is not a specific indicator of a therapeutic response to the treatment plan for anorexia nervosa. Therefore, while it’s important to monitor, it is not a definitive sign of improvement or recovery.

Choice E rationale: BMI BMI (Body Mass Index) is a key indicator of a therapeutic response to the treatment plan for anorexia nervosa. Anorexia nervosa is characterized by a significantly low body weight, and one of the main goals of treatment is weight restoration. Therefore, an increase in BMI can indicate that the client is gaining weight and responding well to the treatment plan.

A. Giving opinion. B. Asking why. C. Silence. D. Change the subject. E. Reflecting. F. Clarification.

Correct Answer is ["C","E","F"]

Explanation

Choice A: Giving opinion: While sharing your opinions might seem helpful, it can actually shut down communication and make the patient feel judged or invalidated. Therapeutic communication focuses on understanding the patient's perspective, not imposing your own views.

Choice B: Asking why: Asking "why" can often come across as accusatory or judgmental, putting the patient on the defensive and hindering open communication. Instead, use open-ended s or clarifying statements to encourage the patient to elaborate on their feelings and experiences.

Choice C: Silence: In some situations, silence can be a powerful tool. It can provide a safe space for the patient to process their emotions, gather their thoughts, or initiate conversation themselves. However, be sure to use silence actively, paying close attention to nonverbal cues and ensuring the patient feels comfortable with the pause.

Choice D: Change the subject: While there may be times when it's appropriate to redirect the conversation, abruptly changing the subject can leave the patient feeling unheard and dismissed. It's important to acknowledge the patient's concerns and validate their feelings before moving on to another topic.

Choice E: Reflecting: Reflecting involves rephrasing the patient's words or statements in a way that acknowledges and emphasizes their emotions and experiences. This helps the patient feel heard and understood, promoting trust and openness in the communication. For example, if a patient says "I feel so alone," you could reflect by saying "It sounds like you're feeling isolated and disconnected."

Choice F: Clarification: Clarifying statements are a helpful way to ensure you understand the patient correctly. This can involve repeating parts of what they said, summarizing their message, or asking for specific details. For example, if a patient says "I just can't take it anymore," you could clarify by saying "You mentioned you're feeling overwhelmed. Can you tell me more about what's been difficult for you?"

By utilizing techniques like silence, reflecting, and clarification, nurses can create a safe and supportive environment for their patients in the mental health unit, fostering therapeutic communication that promotes healing and recovery.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an outpatient mental health clinic is caring for a client who has anorexia nervosa. The nurse is assessing the client during a follow-up visit.Which of the following findings indicate a therapeutic response to the treatment plan? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

The registered nurse in the mental health unit recognizes which as being good therapeutic communication techniques? Select all that apply.

Correct Answer is ["C","E","F"]

Explanation

A mental health nurse is reviewing the medical record of a client who self-harms. Which of the following pieces of information should the nurse identify as placing the client at risk for self-harm behaviors?

A mental health nurse is providing teaching for a client who has major depressive disorder (MDD) and is seeking voluntary admission to an acute mental health facility.Which of the following statements should the nurse include?

A mental health nurse is caring for a newly admitted client with obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first?

A nurse in a mental health clinic is assessing a client who was brought in by her adult daughter stating that her mother has not been able to leave her home for weeks because she is afraid to be outdoors alone.The nurse should anticipate planning care for managing which of the following phobias?

A nurse is assessing a client who has posttraumatic stress disorder (PTSD) following a sexual assault. Which of the following is an expected finding?

A nurse is caring for a client who requires a crisis intervention for acute anxiety. Which of the following actions should be the nurse's highest priority?

A nurse in an acute care mental health facility is preparing to administer morning medication to a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?

A nurse on an acute mental health unit is caring for a group of clients. For which of the following clients is seclusion contraindicated?