According to the ANA Systematic Practices, nurses’ contributions to quality health care and their professional roles are scaled in:

Choice A Reason

Feeling in control of her behavior is an important goal for clients with anorexia nervosa, as it addresses the psychological aspect of the disorder. Anorexia nervosa often involves a significant loss of control over eating behaviors and body image. However, while regaining a sense of control is crucial, it is not the immediate priority when the client is severely underweight and at risk for serious health complications. The primary focus should be on stabilizing the client’s physical health.

Choice B Reason

Making positive statements about improvements in body image is also an important goal, as it can help improve the client’s self-esteem and body perception. However, this goal is more long-term and secondary to addressing the immediate physical health risks associated with severe weight loss. Positive body image can be worked on concurrently with nutritional rehabilitation but should not overshadow the urgent need for weight gain.

Choice C Reason

Identifying changes within the family unit that promote the client’s autonomy is beneficial for long-term recovery. Family dynamics often play a significant role in the development and maintenance of eating disorders. Promoting autonomy and healthy family interactions can support the client’s recovery process. However, similar to the previous goals, this is a secondary priority compared to the immediate need to address the client’s critical nutritional status.

Choice D Reason

Gaining 2 pounds of weight per week is the most immediate and critical goal for a client with anorexia nervosa who is severely underweight. This goal directly addresses the life-threatening physical health risks associated with the disorder, such as malnutrition, electrolyte imbalances, and organ failure. Achieving a safe and steady weight gain is essential for stabilizing the client’s health and providing a foundation for addressing the psychological aspects of the disorder.

Choice A Reason:

Providing the LPN with reassurance that they may be overly self-critical and motivating them to independently carry out the task is supportive but not sufficient. While encouragement is important, it does not address the need for supervision and guidance in performing the task correctly. The LPN needs practical feedback to improve their skills and ensure patient safety.

Choice B Reason:

Ensuring patient safety by refraining from allowing the LPN to perform colostomy care until they feel confident might seem like a safe approach, but it can hinder the LPN’s learning and development. It is important to provide opportunities for practice under supervision to build their confidence and competence. Completely refraining from allowing them to perform the task does not facilitate learning.

Choice C Reason:

Taking on the task personally while having the LPN observe can be helpful initially, but it should not be the primary approach. Observation alone does not provide the hands-on experience necessary for skill development. The LPN needs to practice the task under supervision to gain confidence and proficiency.

Choice D Reason:

Watching the LPN and after they finish the task, offering constructive feedback is the most appropriate action. This approach ensures patient safety while providing the LPN with the opportunity to practice and improve their skills. Constructive feedback helps the LPN understand what they did well and what areas need improvement, fostering their professional growth and competence.