Correct Answer: C

Rationale: Anorexia nervosa can lead to electrolyte imbalances, including hyponatremia (low serum sodium level), due to inadequate intake of sodium and fluid restriction. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can also contribute to hyponatremia by causing the syndrome of inappropriate antidiuretic hormone secretion (SIADH), which leads to water retention and dilutional hyponatremia. However, it is not as life-threatening as hypokalemia. This is a common and potentially life-threatening complication in individuals with anorexia nervosa who are undergoing treatment. It can lead to cardiac arrhythmias. Anorexia nervosa typically does not lead to hyperkalemia (high serum potassium level), as potassium is usually lost through purging behaviors or inadequate intake. Antidepressants also do not commonly cause hyperkalemia as a side effect.

Correct Answer: C,D

Rationale: C. Hypochondriasis can strain interpersonal relationships due to excessive preoccupation with health concerns, frequent doctor visits, and seeking reassurance from others. D. Hypochondriasis often follows a chronic course with periods of intense anxiety about health alternating with periods of relative calm. Despite reassurances and negative medical tests, individuals with hypochondriasis may continue to worry about their health. A. Hypochondriasis typically develops in adulthood rather than childhood. It involves persistent anxiety about health and the interpretation of normal bodily sensations as signs of serious illness. Childhood is less commonly associated with the onset of hypochondriasis. B. While stress can exacerbate symptoms of hypochondriasis, it is not typically diagnosed immediately following a specific stressor. The disorder often develops gradually over time due to a combination of factors, including anxiety, personality traits, and past experiences with illness. E. There is no consistent evidence suggesting that exposure to serious illness in childhood predisposes individuals to hypochondriasis. The disorder is more associated with individual psychological factors, cognitive biases, and anxiety sensitivity rather than childhood illness exposure.

Correct Answer: D

Rationale: Major depressive disorder is characterized by persistent feelings of sadness and loss of interest or pleasure in activities. It does not involve manic or hypomanic episodes, which are essential for diagnosing bipolar disorder. Dysthymic disorder involves chronic, low-grade depression that lasts for at least two years. It does not typically present with episodes of mania or hypomania. Personality disorders involve enduring patterns of behavior, cognition, and inner experience that deviate markedly from the expectations of the individual's culture. While some personality disorders can present with mood instability, the description of severe and sudden mood swings from mania to depression is not characteristic of personality disorders in general. Bipolar disorder is characterized by episodes of mania or hypomania (elevated, expansive, or irritable mood, increased energy, racing thoughts) alternating with episodes of depression (sadness, loss of interest, low energy). The mood swings can be severe, and the transition between mood states can occur suddenly.

Correct Answer: A

Rationale: Lithium is excreted primarily by the kidneys, and its clearance can be affected by changes in fluid balance. It's important for clients taking lithium to maintain a stable and adequate fluid intake to help regulate lithium levels in the body. Stable fluid intake helps maintain electrolyte balance, which is crucial for the proper function of lithium and prevention of adverse effects. Lithium can affect sodium reabsorption in the kidneys. High levels of sodium intake can alter lithium levels in the body, potentially leading to toxicity.
Therefore, clients on lithium therapy are often advised to maintain a consistent and moderate level of sodium intake. Excessive dietary salt can interfere with lithium's therapeutic effects. Restricting fluid intake is not recommended unless there are specific medical reasons to do so. Lithium therapy generally requires adequate hydration to maintain kidney function and prevent dehydration, which can affect lithium levels. Exercising in hot weather can lead to increased sweating and fluid loss, which can potentially affect lithium levels by altering hydration status. However, the primary concern during exercise in hot weather is maintaining adequate hydration rather than restricting it.

Correct Answer: A

Rationale: This response acknowledges the client's feelings of helplessness, which can validate her experience and promote further discussion about her emotions and challenges related to her eating disorder. It shows empathy and encourages the client to explore her feelings. While this question is open-ended and invites the client to explore the underlying reasons for her behavior, it might inadvertently suggest that the client should have insights or control over her behavior that she may not currently possess. It could potentially make the client feel blamed or misunderstood if she cannot provide a clear answer. This response is directive and judgmental, which can lead to the client feeling criticized or defensive. It does not acknowledge the complexity of the client's experience and may not be effective in building rapport or promoting trust between the nurse and client. This response acknowledges the client's self-awareness and validates her recognition of the problem, which can be empowering and supportive. However, it does not directly address her expressed feelings of helplessness, making it less therapeutic in this context.