A nurse is developing a plan of care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?

Correct Answer: A

Rationale: The correct answer is option A: Encourage the client to participate in developing a system of rewards. This is the most appropriate action to include in the plan of care for a client with anorexia nervosa because it focuses on positive reinforcement for desired behaviors, which can help motivate the client to engage in the treatment process and work towards recovery. By involving the client in developing a system of rewards, the nurse empowers the client to take ownership of their progress and promotes a sense of control over their condition. Option B, arranging for someone to remain with the client for 30 minutes after meals, may not be as effective because it can foster dependence rather than autonomy in the client. Anorexia nervosa is often characterized by control issues, so promoting independence and self-regulation is crucial in the treatment plan. Option C, offering the client a selection of beverages at each meal, may not directly address the underlying psychological and behavioral aspects of anorexia nervosa. While proper nutrition is important, focusing solely on food choices may overlook the deeper emotional and mental health components of the disorder. Option D, informing the client that a weight gain of 2.3 kg per week is expected, could be counterproductive as it may increase anxiety and resistance in a client with anorexia nervosa. Setting rigid weight gain expectations can be overwhelming and may not align with the individualized nature of treatment for eating disorders. In an educational context, it is important for nurses to understand the complexities of eating disorders like anorexia nervosa and to approach care with empathy, sensitivity, and a focus on holistic well-being. Incorporating strategies that empower the client, such as involving them in goal-setting and positive reinforcement, can contribute to a more collaborative and effective treatment approach.

Correct Answer: D

Rationale: In this scenario, the correct action for the home health nurse to take first is option D: Perform a nutrition screening. This is the most appropriate initial step because it allows the nurse to assess the client's current nutritional status and identify any specific dietary needs or concerns. By conducting a nutrition screening, the nurse can gather essential information to develop a personalized care plan for the client. Option A, discussing nutritional requirements with the client, is not the most immediate action to take as it assumes the client's baseline knowledge and does not provide a comprehensive assessment of the client's current nutritional status. Option B, referring the client to a senior citizen center, may be a helpful resource in the long term but does not address the client's immediate need for assistance with meal preparation. Option C, arranging for a home-delivered meal program, could be a beneficial intervention after the nutrition screening has been completed and specific dietary requirements have been identified. However, without knowing the client's nutritional needs, this option may not address the underlying issues effectively. Educationally, it is essential for nurses to prioritize assessments and screenings to gather data before implementing interventions. Understanding the client's individual needs and challenges is crucial in providing holistic care and promoting optimal health outcomes. By starting with a nutrition screening, the nurse can lay the foundation for a client-centered care plan that addresses the older adult's unique nutritional requirements and promotes overall well-being.

Correct Answer: D

Rationale: In the context of formula feeding education, selecting option D, "If the infant turns away after taking most of the feeding, stop the feeding," is crucial for promoting healthy feeding practices. This instruction aligns with responsive feeding, where infants self-regulate their intake. Stopping the feeding when the infant signals fullness helps prevent overfeeding, which can lead to issues like obesity. Option A is incorrect because leftover formula shouldn't be reused due to contamination risks. Option B is inaccurate as whole milk is not recommended before the age of 1 due to inadequate iron and nutrients. Option C is unsafe advice as diluting formula can lead to inadequate nutrition and dehydration. Educationally, teaching parents about infant feeding requires knowledge of responsive feeding cues and the importance of proper nutrition for growth and development. By emphasizing the importance of recognizing infant cues and promoting a healthy feeding environment, nurses can support parents in providing optimal nutrition to their infants.

Correct Answer: C

Rationale: In teaching a client with coronary artery disease about implementing a heart-healthy diet, recommending broiled salmon (Option C) is crucial for several reasons. Salmon is a rich source of omega-3 fatty acids, which have been shown to have cardiovascular benefits, such as reducing inflammation and lowering the risk of heart disease. The American Heart Association recommends consuming fatty fish like salmon at least twice a week for heart health. On the other hand, the other options are not ideal for a heart-healthy diet. Baked ham (Option A) and processed cheese (Option B) are high in saturated fats and sodium, which can contribute to elevated cholesterol levels and hypertension, both of which are risk factors for coronary artery disease. Canned potato soup (Option D) may contain high levels of sodium and preservatives, which are not beneficial for heart health. Educationally, it is essential for nurses to provide evidence-based dietary recommendations to clients with coronary artery disease to help them manage their condition effectively. Teaching about specific foods that promote heart health, like salmon in this case, empowers clients to make informed choices that support their cardiovascular well-being. By explaining the rationale behind each food recommendation, nurses can enhance their clients' understanding and motivation to adhere to a heart-healthy diet.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) 1 oz cashews. Cashews have a high fiber content per serving compared to the other options. Cashews provide around 1 gram of fiber per ounce, making them a good source of dietary fiber. Option A) 1 cup cooked sweet potato contains fiber but not as high as cashews per serving. Option B) 1 slice rye toast may have some fiber, but typically not as much as cashews. Option C) 1 cup raw watermelon is low in fiber compared to cashews. In an educational context, it is important for the nurse to teach the client about high-fiber foods to improve digestive health, prevent constipation, and maintain overall wellness. By understanding which foods are rich in fiber, the client can make informed choices to meet their dietary needs. It is crucial for clients to have a balanced diet that includes an adequate amount of fiber for optimal health outcomes.