A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:

Correct Answer: D

Rationale: The correct answer is D: Identify two alternative methods of coping with loneliness and isolation. Rationale: 1. The nursing diagnosis is Ineffective coping related to feelings of loneliness and isolation, indicating the patient struggles with coping mechanisms. 2. The desired outcome is for the patient to identify alternative coping methods, which directly addresses the ineffective coping issue. 3. By identifying two alternative methods, the patient demonstrates an understanding of healthier coping strategies. 4. This outcome focuses on addressing the root cause of the behavior (loneliness and isolation) rather than just surface-level expressions or behaviors. Summary: A: Appropriately expressing angry feelings does not directly address coping mechanisms related to loneliness and isolation. B: Verbalizing positive things about oneself is beneficial but does not address the core issue of ineffective coping. C: Verbalizing the importance of a balanced diet is important but does not directly address coping with loneliness and isolation.

Correct Answer: D

Rationale: The correct answer is D: Assessing the level of consciousness and normal body functions. After electroconvulsive therapy (ECT), it is crucial to monitor the patient's level of consciousness and ensure all body functions are normal to detect any potential complications immediately. This includes assessing vital signs, neurological status, respiratory function, and cardiovascular stability. Monitoring for the return of full range of motion (A) is not a priority immediately post-ECT. Assessing memory impairment (B) may be important but is not the immediate priority. Making positive comments (C) is helpful for emotional support but does not address the critical need to assess physical status.

Correct Answer: B

Rationale: The correct answer is B: Lamotrigine (Lamictal). All the drugs listed are commonly used in the treatment of epilepsy and mood disorders. Lamotrigine is often prescribed alongside divalproex, carbamazepine, and gabapentin as a mood stabilizer and antiepileptic medication. It works by stabilizing electrical activity in the brain and preventing seizures. Clonazepam (A) is a benzodiazepine used for anxiety and seizures, not in the same class as the other drugs. Risperidone (C) and Aripiprazole (D) are antipsychotics used for schizophrenia and bipolar disorder, not primarily for epilepsy.

Correct Answer: A

Rationale: The correct answer is A because the behaviors described indicate that the patient is able to converse without interrupting, their clothing matches, and they participate in activities. These behaviors suggest improved impulse control, stable mood, and engagement in daily activities, indicating effectiveness of the treatment plan. Choice B describes symptoms of mania such as irritability and distractibility, which would indicate ongoing symptoms rather than improvement. Choice C indicates a short attention span and excessive journaling, which are not indicative of effective treatment. Choice D describes behaviors suggestive of hypersexuality and pressured speech, which are not signs of improvement in acute mania.

Correct Answer: C

Rationale: The correct answer is C: Engaging client in activities designed to permit success. This intervention is appropriate for addressing situational low self-esteem as it focuses on building the client's self-confidence through successful experiences. Engaging in activities that the client can excel at helps boost self-esteem and self-worth. By providing opportunities for success, the client can gain a sense of accomplishment, leading to improved self-esteem. A: Encouraging verbalization of feelings in a safe environment may be beneficial for emotional expression, but it does not directly address building self-esteem through success. B: Attempting to determine triggers to hallucinations is unrelated to addressing situational low self-esteem. D: Providing large muscle activities to relieve stress may be helpful for stress management but does not directly target improving self-esteem through success.