The nurse is developing a plan of care for a 16-year-old client with bulimia nervosa. Which interventions would be included in the plan of care? (Select all that apply.)
Observe the client for 1–2 hours after each meal in a central area.
Assess the client for electrolyte imbalances.
Allow the client to remain on current laxatives.
Do not allow the client to keep a food diary during hospitalization.
Be alert to hidden or discarded wrappers.
Correct Answer : A,B,E
Choice A reason: Monitoring after meals reduces opportunities for purging behaviors such as vomiting or excessive exercise, which are common in bulimia nervosa.
Choice B reason: Electrolyte disturbances, particularly hypokalemia, are common due to vomiting and laxative abuse. Ongoing assessment is critical for patient safety.
Choice C reason: Continuing laxative use perpetuates the disorder and poses health risks such as dehydration and bowel damage. This is contraindicated.
Choice D reason: Food diaries are sometimes used in therapy to help patients increase awareness of eating patterns. Outright prohibition may remove a useful therapeutic tool unless misused.
Choice E reason: Patients with bulimia may attempt to conceal evidence of binge eating. Being attentive to hidden or discarded wrappers is an important part of monitoring.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Telling the patient to stop thinking a certain way invalidates their feelings and is not therapeutic.
Choice B reason: Offering presence and calm support provides safety and helps reduce anxiety. It is the most therapeutic intervention for severe anxiety.
Choice C reason: Telling the patient not to worry may feel dismissive, and in severe anxiety the patient may not be able to process reassurance.
Choice D reason: Asking "why" is not effective when the patient is overwhelmed by severe anxiety, as they cannot engage in rational discussion at that moment.
Correct Answer is C
Explanation
Choice A reason: These traits are characteristic of dependent personality disorder, where clients fear separation and rely heavily on others for decision-making and support.
Choice B reason: This describes schizoid personality disorder, in which individuals show detachment from relationships and emotional indifference.
Choice C reason: Histrionic personality disorder is marked by attention-seeking, dramatic and exaggerated emotions, and difficulty coping with delayed gratification, making this the correct description.
Choice D reason: These are traits of antisocial personality disorder, which involves manipulation, intimidation, and lack of empathy.
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