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 ["B","D","F"]

Explanation

Choice A rationale:

Personality disorders are not typically considered to be comorbidities of eating disorders. While some personality traits, such as perfectionism and obsessiveness, may be more common in individuals with eating disorders, these traits do not necessarily

constitute a personality disorder. Additionally, the presence of a personality disorder does not typically increase the risk of developing an eating disorder.

Choice B rationale:

Depression is one of the most common comorbidities associated with eating disorders. Studies have shown that up to 50% of individuals with eating disorders also experience depression. The relationship between eating disorders and depression is complex and bidirectional. Depression can contribute to the development of an eating disorder, and the behaviors associated with eating disorders can also worsen depression.

Choice C rationale:

Breathing-related sleep disorders, such as obstructive sleep apnea, are not typically associated with eating disorders. While some individuals with eating disorders may experience sleep disturbances, these disturbances are more likely to be related to other factors, such as anxiety or depression.

Choice D rationale:

Obsessive-compulsive disorder (OCD) is another common comorbidity of eating disorders. Studies have shown that up to 30% of individuals with eating disorders also have OCD. The symptoms of OCD, such as obsessive thoughts and compulsive behaviors, can overlap with the symptoms of eating disorders. For example, an individual with OCD may have obsessive thoughts about food and weight, and they may engage in compulsive behaviors related to eating, such as calorie counting or food restriction.

Choice E rationale:

Schizophrenia is not typically associated with eating disorders. While some individuals with schizophrenia may experience disturbances in eating behavior, these disturbances are more likely to be related to other symptoms of the disorder, such as delusions or hallucinations.

Choice F rationale:

Anxiety is another common comorbidity of eating disorders. Studies have shown that up to 60% of individuals with eating disorders also experience anxiety disorders. Anxiety can contribute to the development of an eating disorder, and the behaviors associated with eating disorders can also worsen anxiety.

A. Walk with the client at a gradually slower pace. B. Have a staff member escort the client to her room. C. Allow the client to pace alone until physically tired. D. Instruct the client to sit down and stop pacing.

Correct Answer is A

Explanation

Rationale for Choice A:

Pacing can be a physical manifestation of anxiety. It allows individuals to release some of the nervous energy that builds up during anxious moments. Restricting this behavior can potentially escalate anxiety.

Walking with the client can provide a sense of safety and support. It demonstrates to the client that they are not alone in their anxiety and that the nurse is there to help them.

Gradually slowing the pace of the walk can help to regulate the client's breathing and heart rate. This can have a calming effect on both the body and mind.

Walking can also be a form of distraction. It can help to take the client's mind off of their worries and focus on the present moment.

Walking can help to release endorphins, which have mood-boosting effects. This can help to counteract some of the negative emotions associated with anxiety.

Rationale for Choice B:

Escorting the client to their room may be perceived as restrictive and controlling. This could potentially increase the client's anxiety.

Removing the client from the public area of the unit may isolate them from other people and activities. This could make them feel more alone and anxious.

Rationale for Choice C:

Allowing the client to pace alone may not be safe. The client could potentially become agitated or injure themselves.

Pacing alone does not provide the client with any support or guidance. This could make it more difficult for them to manage their anxiety.

Rationale for Choice D:

Instructing the client to sit down and stop pacing may be perceived as dismissive and unhelpful. It does not address the underlying causes of the client's anxiety.

Forcing the client to stop pacing could potentially escalate their anxiety. This could lead to agitation, aggression, or other negative behaviors.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is discussing comorbidities associated with eating disorders with a newly admitted client. Which of the following conditions should the nurse include in the discussion? (Select all that apply.)

Correct Answer is ["B","D","F"]

Explanation

A mental health nurse on a mental health unit is caring for a client who has generalized anxiety disorder (GAD). The client received a telephone call that was upsetting, and now the client is pacing up and down the corridors of the unit.Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is caring for a client who has generalized anxiety disorder and is taking buspirone. Which of the following adverse effects should the nurse report to the provider?

A nurse is assessing an adolescent female client who has anorexia nervosa. Which of the following findings should the nurse expect?

A client with paranoid schizophrenia believes evil spirits are being summoned by a local minister and verbally threatens to bomb a local church.The psychiatric nurse notifies the local minister.The psychiatric nurse has:

A nurse is preparing to administer diphenhydramine 50 mg PO every 6 hr to a client who has acute dystonia. The available medication is diphenhydramine 25 mg tablets. How many tablets should the nurse administer per dose?

A mental health nurse is preparing a client who has chronic anxiety for discharge from the psychiatric unit. Which of the following instructions should the nurse include in the client's discharge plan?

A mental health nurse on an inpatient eating disorders unit is caring for a client who has anorexia nervosa and has a body mass index of 16.7. Which of the following actions should the nurse take? (Select all that apply.)