The nurse is caring for a young woman who is struggling with weight loss issues without apparent physical cause. Which is the most likely nursing assessment for this nutritional disorder in which normal body weight is not maintained?

Kwashiorkor.

Anorexia nervosa.

Crohn's disease.

Bulimia nervosa.

Answer and Explanation

The Correct Answer is B

Anorexia nervosa is a nutritional disorder characterized by a distorted body image and fear of weight gain, leading to an abnormally low body weight. Clients with anorexia nervosa may also engage in binge eating and purging behaviors.

Choice A is incorrect because Kwashiorkor is a type of protein-energy malnutrition caused by a severe protein deficiency.

Choice C is incorrect because Crohn's disease is a chronic inflammatory bowel disease.

Choice D is incorrect because Bulimia nervosa is a nutritional disorder characterized by binge eating and purging behaviors.

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Correct Answer is B

Explanation

Provide the client with warm fluids. Shivering is the body's natural response to try to warm itself up. Providing warm fluids to the client can help to increase the client's core temperature and decrease shivering.

Choice A is incorrect because a hypothermia blanket is used to reduce the client's core temperature, which is not appropriate for a client who is shivering.

Choice C is incorrect because a light blanket may not provide enough warmth for the client who is shivering.

Choice D is incorrect because the room temperature should be kept warm to prevent the client from getting colder and shivering more.

A. Report the condition to the physician immediately. B. Provide the client with nonprescription laxatives. C. Measure abdominal girth according to a set routine. D. Ask the client about food intake.

Correct Answer is C

Explanation

Measure abdominal girth according to a set routine. Abdominal enlargement is a common finding in clients with cirrhosis, which is a condition characterized by liver scarring and impaired liver function. Measuring abdominal girth regularly is an important nursing intervention to monitor the progression of abdominal distention and to identify potential complications such as ascites, which is an accumulation of fluid in the abdomen.

Choice A, reporting the condition to the physician immediately, may be necessary if the abdominal enlargement is sudden or accompanied by other symptoms such as severe pain or shortness of breath.

Choice B, providing the client with nonprescription laxatives, is not indicated for abdominal enlargement in clients with cirrhosis.

Choice D, asking the client about food intake, is not relevant to the assessment of abdominal enlargement in clients with cirrhosis.

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The nurse is caring for a young woman who is struggling with weight loss issues without apparent physical cause. Which is the most likely nursing assessment for this nutritional disorder in which normal body weight is not maintained?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following interventions would be appropriate for a client who has undergone surgery for a disorder and has started shivering?

Correct Answer is B

Explanation

When performing a physical examination on a client with cirrhosis, a nurse notices that the abdomen is enlarged. Which of the following interventions should the nurse consider?

Correct Answer is C

Explanation

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