A patient with anorexia nervosa in outpatient treatment has begun refeeding. Between the first and second appointment, the patient gained 8 pounds. The nurse should:

Correct Answer: B

Rationale: The correct answer is B because assessing lung sounds and extremities is crucial after significant weight gain in a patient with anorexia nervosa to monitor for potential complications like refeeding syndrome. Praise in choice A may reinforce unhealthy behaviors. Choice C suggesting an exercise program may be harmful. Choice D could lead to excessive weight gain.

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.

Correct Answer: C

Rationale: The correct answer is C: Improvement in tardive dyskinesia. Tardive dyskinesia is a side effect of long-term antipsychotic use, like chlorpromazine. Quetiapine (Seroquel) is an atypical antipsychotic with a lower risk of causing tardive dyskinesia. By discontinuing chlorpromazine and switching to quetiapine, there is a higher likelihood of improvement or resolution of tardive dyskinesia symptoms. Options A and B are incorrect as they are related to other movement disorders caused by antipsychotics. Option D is incorrect as anticholinergic symptoms are not directly related to tardive dyskinesia improvement with the medication switch.