The client has been diagnosed with anorexia nervosa and is currently receiving treatment. During a physical assessment, which of the following findings indicates the client may be noncompliant with therapeutic interventions?
1. Weight gain of 1 pound since the previous week
2. Urine specific gravity of 1.002
3. The client opts to wear only a gown when weighed
4. The client verbalizes that treatment is making the client feel better
2
Rationale: A weight gain of 1 pound over the course of a week for the client indicates treatment may be effective. The client who decides to only wear a gown while being weighed indicates treatment may be effective. Clients with eating disorders who wear heavy clothes or weights in their pockets and underwear exhibit noncompliant behaviors. The client who verbalizes that they feel treatment is making them feel better is possibly receiving effective treatment. However, the client with a low urine-specific gravity is most likely drinking large quantities of water prior to being weighed. This client is displaying noncompliant behavior.
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The nurse is performing the Romberg test and asks the client to stand with the feet together and eyes closed. The nurse notes the findings are normal. Which finding is expected during this assessment?
1. Swaying from side to side. 2. Exhibiting minimal swaying. 3. Feeling moderately dizzy. 4. Having complete loss of balance.
During the teaching session for a patient who has a new diagnosis of acute leukemia the patient is restless and is looking away, never making eye contact
After teaching about the complications associated with chemotherapy, the patient asks the nurse to repeat all of the information. Based on this assessment, which nursing diagnosis is most appropriate for the patient? a. Risk for ineffective adherence to treatment related to denial of need for chemotherapy b. Acute confusion related to infiltration of leukemia cells into the central nervous system c. Risk for ineffective health maintenance related to anxiety about new leukemia diagnosis d. Deficient knowledge: chemotherapy related to a lack of interest in learning about treatment
After interviewing S.R., you note the following: S.R. is under considerable stress. He owns his own business. The stress of overseeing his employees, meeting deadlines, and carrying out negotiations has led to poor sleep habits
He sleeps 3 to 4 hours per night. He keeps himself going by drinking 2 quarts of coffee and smoking three to four packs of cigarettes per day. He has gained 50 pounds over the 2 years, leading to a current weight of 250 pounds. He complains of difficulty staying awake, wakes up with headaches on most mornings, and has midmorning somnolence. He states that he is depressed and irritable most of the time and reports difficulty concentrating and learning new things. He has been involved in three auto accidents in the past year. S.R.'s vital signs are 164/90, 92, 18, and Spo2 90% on room air. His examination findings are normal, except for a few bruises over the right side of the rib cage. You inquire about the bruises, and S.R. reports that his wife jabs him with her elbow several times every night. In her own defense, the wife states, "Well, he stops breathing and I get worried, so I jab him to make him start breathing again. If I don't jab him, I find myself listening for his next breath and I can't go to sleep." You suspect sleep apnea. Identify two of the main types of apnea, and explain the pathology of each. Based on your findings, which type of sleep apnea do you believe S.R. has? Identify at least five signs or symptoms of this type of sleep apnea, and put a star next to those symptoms that S.R. is experiencing. How does the provider use diagnostic testing to diagnose sleep apnea?
The nurse reviews data collected during the assessment of a patient with a mental illness. For which reason should a nursing diagnosis instead of a DSM diagnosis be used as a guide to plan this patient's care?
1. The nursing diagnosis is more general. 2. The nursing diagnosis is more effective. 3. The nursing diagnosis is more accurate. 4. The nursing diagnosis is more specific.