The nurse is preparing to administer orlistat to a client wi...

The nurse is preparing to administer orlistat to a client with obesity. Which safety warning(s) should the nurse consider when administering this medication to the client? Select all that apply.

A. Administer with meals, stagger administration with other drugs.
B. Provide a vitamin supplement with the medication.
C. Monitor liver function.
D. Avoid caffeine.
E. Avoid use among clients with heart disease, hypertension, and hyperthyroidism.

Correct Answer: A,B,C

Rationale: The safety warnings that the nurse should consider include administering orlistat with meals and staggering administration with other drugs, the requirement of vitamin supplementation due to nonabsorption of nutrients, and monitoring liver function. Avoiding caffeine and avoiding the use of the medication among clients with heart disease, hypertension, and hyperthyroidism are applicable to appetite suppressants such as benzphetamine, diethylpropion, phendimetrazine, and phentermine, not orlistat.

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A client has been diagnosed with bulimia nervosa. Which assessment finding(s) contribute to this diagnosis? Select all that apply.

A. Electrolyte imbalance
B. Dehydration
C. Chronic sore throat
D. Pulmonary embolism
E. Constipation

Correct Answer: A,B,C,E

Rationale: Self-induced vomiting and use of emetics such as ipecac damage teeth, cause chronic sore throat and risk of esophageal erosion and abuse of laxatives and enemas contributes to constipation. The non-prescribed use of diuretics and diet pills predisposes to liquid, electrolyte, and cardiac problems. Pulmonary embolism is not usually assessed for with bulimia nervosa.

A teenager who is attending a clinic for eating disorders has shown improvement in weight, but the laboratory values remain poor. Which behavior would the nurse identify as the likely cause of this finding?

A. Pushing food around the plate
B. Inducing vomiting after meals
C. Drinking water before weighing
D. Disposing of food

Correct Answer: C

Rationale: Drinking large volumes of water prior to being weighed is manipulative behavior that is likely the cause of improved weight without improved laboratory values. Pushing food around the plate to distort amount of food eaten, inducing vomiting, and disposing of food are all forms of manipulation but would not account for improvement of weight.

Clients with anorexia nervosa frequently use methods to avoid eating or to prevent weight gain. Which documentation most accurately describes the behavior of a client with anorexia?

A. Client observed to move food around the plate arranged in various patterns.
B. Client stares frequently into space and has to be prompted to participate in the mealtime conversation.
C. Client talks about food likes and dislikes and reminisces about holiday foods.
D. Client states feeling depressed and does not feel like eating right now.

Correct Answer: A

Rationale: Clients with anorexia practice various rituals such as cutting food into small pieces and rearranging food on the plate without actually eating.

The nurse is caring for a client with anorexia nervosa. What is the most important goal when planning care for this client?

A. Regain lost weight.
B. Restore fluid and electrolyte imbalances.
C. Improve self-esteem and body image.
D. Support healthy coping mechanisms.

Correct Answer: B

Rationale: In anorexia, electrolyte levels, especially potassium and sodium, are often dangerously low. Cardiac irregularities can be identified on electrocardiogram and are often directly linked to fluid and electrolyte imbalances that can lead to cardiac failure and death. Therefore, it is paramount to correct fluid and electrolyte imbalances. Regaining lost weight, supporting healthy coping mechanisms, and improving self-esteem are all goals that are significant in the management of anorexia.

A client who is diagnosed with anorexia nervosa agrees to participate in a recovery program. Which comment by the client indicates the best understanding of the recovery process?

A. Once I gain a few pounds, I will be fine.
B. If I take antidepressants, my compulsive symptoms will resolve.
C. Pulsive therapy could help me lose weight.
D. I may need to work on this for the remainder of my life.

Correct Answer: D

Rationale: Multiple biologic, psychological, and social factors influence the development of eating disorders. Recovery is considered a long and costly process, with fewer than 50% of clients achieving recovery over 5 years. Counseling and involvement in self-help groups for several years are often indicated. Because there is a link between eating disorders and obsessive-compulsive disorder, this may be a lifelong recovery plan. Gaining a few pounds is an appropriate first step to recovery. Antidepressants are often used to control the serotonin levels associated with anorexia.