The PMHNP on an inpatient substance disorder unit is reviewing the labs for a 17-year-old patient diagnosed with anorexia nervosa who was recently introduced to a caloric intake program. She has pain on eating, and her labs are as follows: phosphorus 0.7 mg/dL, potassium 1.4 mEq/L, and magnesium 1.8 mg/dL. Which of the following is this patient most at risk for?
Refeeding syndrome
Metabolic alkalosis
Hypoglycemia
Purging behaviors
The Correct Answer is A
Choice A reason: Refeeding syndrome occurs when malnourished patients are introduced to nutritional support, leading to rapid shifts in electrolytes, particularly phosphorus, potassium, and magnesium. The patient’s severe hypophosphatemia, hypokalemia, and low magnesium indicate a high risk for life-threatening complications, including cardiac arrhythmias, respiratory failure, and neurologic dysfunction.
Choice B reason: Metabolic alkalosis is characterized by elevated bicarbonate and pH, often caused by vomiting or diuretic use, not the electrolyte shifts seen here.
Choice C reason: Hypoglycemia can occur in malnourished patients but is not directly linked to the severe electrolyte disturbances seen with refeeding syndrome.
Choice D reason: Purging behaviors refer to self-induced vomiting or laxative abuse, which are behavioral issues, not immediate physiologic risks from nutritional repletion.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Questioning the validity of the client’s gender identity is disrespectful and harmful, violating ethical and professional standards.
Choice B reason: Using the client’s chosen name in clinical documentation, while ensuring legal requirements are met separately, demonstrates respect for gender identity, supports mental health, and aligns with best practice guidelines for transgender care.
Choice C reason: While verbal recognition is important, clinical documentation should reflect the client’s preferred name to maintain consistency, trust, and respect, beyond just verbal acknowledgment.
Choice D reason: Concerns about insurance should not override the ethical imperative to respect the client’s gender identity. Legal requirements can be navigated separately without invalidating chosen names in clinical documentation.
Correct Answer is B
Explanation
Choice A reason: A living will is a legal document that specifies a person's wishes regarding medical treatment in situations where they are unable to communicate their decisions. However, it is not uniformly recognized or enforceable in all 50 states, as the exact requirements and legal weight of a living will can vary by state.
Choice B reason: A durable power of attorney (DPOA) for healthcare is recognized in all 50 states. It allows a designated agent to make healthcare decisions on behalf of the individual if they are incapacitated, providing a consistent and legally enforceable method of decision-making across the country.
Choice C reason: A living will does not typically address financial matters. It is specifically focused on healthcare decisions, such as the use of life-sustaining treatment, resuscitation, and palliative care preferences. Financial matters are addressed separately, often through a general durable power of attorney or estate planning documents.
Choice D reason: A living will is distinct from a healthcare proxy. While both relate to healthcare decisions, a healthcare proxy (or medical power of attorney) designates an agent to make decisions on the individual's behalf, whereas a living will documents specific treatment preferences directly.
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