When the nurse admits a client with anorexia nervosa for treatment, the therapeutic milieu should provide: (SELECT ALL THAT APPLY)
observation during and after meals.
adherence to scheduled meal times.
trips to the local fast food restaurant for foods.
monitoring during bathroom trips.
weekly weight checks.
Correct Answer : A,B,D
a. Observation during and after meals: To prevent the client from engaging in purging behaviors, such as vomiting or hiding food.
b. Adherence to scheduled meal times: To establish a regular eating pattern and help normalize the client’s relationship with food.
c. Trips to the local fast food restaurant for foods are not appropriate as they can promote unhealthy eating behaviors and do not align with the structured, therapeutic environment necessary for recovery.
d. Monitoring during bathroom trips: To prevent purging behaviors, especially right after meals when the temptation to vomit might be higher.
e. Weekly weight checks are important for monitoring progress, but daily or more frequent weight checks are often necessary to ensure safety and appropriate weight gain or stabilization.
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Related Questions
Correct Answer is C
Explanation
a. Encourage alone time for the client in seclusion: Encouraging alone time in seclusion may exacerbate feelings of isolation and is not typically recommended for clients with conversion disorder, who may benefit more from social support and therapeutic interventions.
b. Assess one time for self-harm during treatment: While assessing for self-harm is important, it is not specific to conversion disorder and should be part of routine nursing care for all clients, regardless of diagnosis.
c. Discuss alternative coping strategies with the client: This is correct because exploring alternative coping strategies can help the client manage stressors and symptoms associated with conversion disorder in healthier ways.
d. Allow for unlimited discussion of physical symptoms: Allowing unlimited discussion of physical symptoms may reinforce symptom focus and is not typically recommended in the treatment of conversion disorder, where the focus is on addressing underlying psychological distress.
Correct Answer is A
Explanation
a. experience no loss of contact with reality. The key difference is reality testing. Clients with neurosis (anxiety disorders, OCD) generally maintain contact with reality, even though their thoughts or behaviours might be distressing. Clients with psychosis (schizophrenia) experience a break with reality, such as hallucinations or delusions.
b. Never have mood or personality changes. Not true. Mood and personality changes can occur in both neurosis and psychosis.
c. Have conflict but only use adaptive defence mechanisms to cope. Défense mechanisms are used by everyone to cope with anxiety, but in neurosis, they might be less healthy or maladaptive.
d. Are always aware that their behaviours are maladaptive. Not necessarily. Clients with neurosis might have limited insight into how their behaviours affect themselves or others.
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