6. Outpatient treatment is planned for a patient diagnosed with anorexia nervosa. Select the most
important desired outcome related to the nursing diagnosis Imbalanced nutrition: less than body requirements. Within 1 week, the patient will a. weigh self accurately using balanced scales. b. limit exercise to less than 2 hours daily. c. select clothing that fits properly. d. gain 1 to 2 pounds. ANS: D
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Only the outcome of a gain of 1 to 2 pounds can be accomplished within 1 week when the patient is an outpatient. The focus of an outcome would not be on the patient weighing self. Limiting exercise and selecting proper clothing are important, but weight gain takes priority.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 18-13, 19 (Case Study and Nursing Care Plan), 58 (Table 18-3) TOP: Nursing Process: Outcomes Identification MSC: Client Needs: Physiological Integrity
7. Which nursing intervention has the highest priority as a patient diagnosed with anorexia
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nervosa begins to gain weight? a. Assess for depression and anxiety. b. Observe for adverse effects of refeeding. c. Communicate empathy for the patient’s feelings. d. Help the patient balance energy expenditures with caloric intake. ANS: B
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The nursing intervention of observing for adverse effects of refeeding most directly relates to weight gain and is a priority. Assessing for depression and anxiety, as well as communicating empathy, relates to coping. Helping the patient achieve balance between energy expenditure and caloric intake is an inappropriate intervention.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 18-14, 54 (Table 18-1) TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity 8. A patient diagnosed with anorexia nervosa is resistant to weight gain. What is the rationale for
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establishing a contract with the patient to participate in measures designed to produce a specified weekly weight gain? a. Because severe anxiety concerning eating is expected, objective and subjective data may be unreliable. b. Patient involvement in decision making increases sense of control and promotes adherence to the plan of care. c. Because of increased risk of physical problems with refeeding, the patient’s permission is needed. d. A team approach to planning the diet ensures that physical and emotional needs will be met. ANS: B
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