A client with anorexia nervosa has refused meal trays and supplemental feedings for 3 days following admission to the general hospital. The nurse can anticipate that intervention will include:

Correct Answer: B

Rationale: The correct answer is B. Tube feedings until the client eats 90% of all meals for 1 day. This intervention is appropriate for a client with anorexia nervosa who is refusing to eat. Tube feedings ensure adequate nutrition while also encouraging the client to resume eating orally. It is a gradual approach that aims to transition the client back to regular eating habits. Explanation for why other choices are incorrect: A: IV infusions are not the first-line intervention for a client with anorexia nervosa refusing to eat. This choice does not address the underlying issue of the client's refusal to eat. C: Placing the client on suicide precautions and one-to-one observation is not indicated solely based on refusal to eat. This choice does not address the nutritional needs of the client. D: Limiting peer group visitors for 2 weeks does not address the client's refusal to eat and is not a relevant intervention in this situation.

Correct Answer: C

Rationale: Step 1: Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image. Step 2: Patients often use strict control over food intake as a way to cope with underlying emotional issues. Step 3: Maintaining a sense of control is crucial in managing anorexia nervosa as it addresses the core psychological aspects driving the disorder. Step 4: Managing weight gain (A) is not the primary focus as patients may resist gaining weight due to their fear. Step 5: Controlling personal stressors (B) may be important but does not address the underlying issue of control related to food and body. Step 6: Avoiding social interactions (D) does not address the core psychological need for control and can further isolate the patient.

Correct Answer: C

Rationale: In this question focusing on red flags for a communication disorder, option C is the correct choice. The red flags listed in option C - lack of pointing to show interests or needs, poor eye contact, and reduced joint attention - are commonly associated with communication disorders in children. Lack of pointing to show interests or needs can indicate a difficulty in expressing oneself, poor eye contact might suggest challenges in social communication, and reduced joint attention can impact the ability to engage and interact with others effectively. These signs are crucial for early identification and intervention in children with communication disorders. Analyzing the incorrect options: - Option A includes speech onset at 24 months, lack of pointing, and poor eye contact. While these can be potential concerns, they are not comprehensive enough to cover a range of communication issues. - Option B mentions short attention, odd intonation of speech, and poor pretend play. These are more related to cognitive or behavioral aspects rather than communication specifically. - Option D lists weak vocabulary, reduced joint attention, and poor interaction with peers. While these are relevant factors, they do not directly address the core communication indicators highlighted in option C. Educational Context: Understanding red flags for communication disorders is vital for educators, caregivers, and healthcare professionals to identify potential issues early and provide appropriate support. By recognizing these signs, interventions can be implemented to enhance communication skills, social interactions, and overall development in children. This knowledge equips professionals to collaborate effectively with families and specialists to create tailored interventions for children with communication challenges.

Correct Answer: B

Rationale: Refeeding syndrome is a potentially life-threatening condition that can occur when severely malnourished individuals, such as those with eating disorders, are aggressively fed after a period of starvation. In this context, the most important biochemical change to monitor is hypophosphatemia (Option B). Phosphate is essential for energy metabolism, cell signaling, and the formation of nucleic acids. During refeeding, insulin release is stimulated, which leads to increased cellular uptake of phosphate and other electrolytes. If phosphate replacement is inadequate, it can result in a sudden drop in serum phosphate levels, leading to cardiac and respiratory failure. Hypomagnesemia (Option A) is also common in refeeding syndrome due to increased renal magnesium excretion, but it is not the most critical change. Hypokalemia (Option C) and hypoglycemia (Option D) can also occur but are secondary to the risk posed by hypophosphatemia. Educationally, understanding the biochemical changes in refeeding syndrome is crucial for healthcare providers involved in the care of patients with eating disorders. Prompt recognition and appropriate management of these electrolyte imbalances are essential to prevent serious complications and improve patient outcomes. By prioritizing the correction of hypophosphatemia, healthcare providers can mitigate the risks associated with refeeding syndrome and ensure safe nutritional rehabilitation for these vulnerable patients.

Correct Answer: A

Rationale: In Singapore, MSF-funded disability services for preschool children serve those with congenital, physical, sensory, developmental, and behavioral disorders. This is the correct answer because MSF-funded services aim to support a wide range of disabilities to ensure inclusivity and comprehensive care for all children in need. By offering services for various types of disorders, the program can cater to the diverse needs of preschoolers with disabilities, promoting their holistic development and well-being. Option B is incorrect because MSF-funded disability services in Singapore are not exclusively center-based. These services are provided through a variety of settings, including home-based interventions, community programs, and collaborations with early childhood education centers to reach children where they are most comfortable and can benefit the most. Option C is incorrect because MSF-funded disability services are not limited to charity and public hospitals only. These services are often delivered through a network of community-based organizations, early intervention centers, and specialized service providers to ensure accessibility and availability across different regions in Singapore. Option D is incorrect because the oversight of MSF-funded disability services for preschool children in Singapore falls under the Ministry of Social and Family Development (MSF) and not the Early Childhood Development Agency (ECDA). MSF plays a key role in coordinating and funding disability services to support the development and well-being of children with disabilities in Singapore. In an educational context, understanding the scope and nature of MSF-funded disability services is crucial for educators, caregivers, and professionals working with preschool children with disabilities. It helps them make informed decisions about accessing appropriate support services and advocating for inclusive practices to promote the overall development and learning outcomes of children with diverse needs.