HESI Case Studies–Psychiatric/Mental Health-Feeding and Eating Disorders (Susan George)

1. Which short-term goal promote safety measures when refeeding the client?
The client will gain no more than 1-2 pounds during the initial week of refeeding
2. In developing the plan of care for initiation of nasogastric feeding, the RN recognizes which nursing intervention as having the highest priority?
Slow enteral feedings at the start of therapy
3. Which clinical manifestations should the RN observe for as indicators of hypophosphatemia? (Select all)
-Shallow respirations
-Weak cardiac contractions
-Seizure activity
-Altered mental status
4. Which laboratory finding result reveals the finding of protein malnutrition?
Prealbumin level 5.0mg/dL
5. Which member of the interprofessional team plays a major role in formulating the nasogastric feeding protocol?
Clinical Nutritionist
6. Which is the best rationale for this RN’s decision?
Night feedings can prevent reinforcing attention and sympathy from others
7. What action(s) should the RN take to implement the client’s plan of care? (Select all)
-Monitor fluid and electrolytes
-Supervise the client during and after feedings
-Perform skin assessments each shift
-Measure and document intake and output
8. Which nursing problem(s) have the highest priority during the acute phase of treatment? (Select all)
-Malnourishment
-Deficiency in fluid volume
9. What is the RN’s best response to Susan’s concerns?
“I understand your concern; however, let’s talk about how you are feeling.”
10. What action(s) should the RN take during this transitional phase? (Select all)
-Provide a supportive approach regarding the client’s expressed anxiety
-Continue to provide supervision during and after mealtimes
-Actively listen to the client’s concerns
11. What action should the RN take that has the highest priority?
Report this data to the primary HCP and the interprofessional team.
12. Which nursing diagnosis takes the highest priority according to Maslow’s Hierarchy of Needs?
Risk for self-directed violence
13. What is the RN’s primary purpose for establishing a treatment contract with the client?
To provide the client with greater control over the expression of feelings
14. Which nursing action is of the highest priority during one-on-one staffing?
Closely monitor the client and document the potential for self-harm
15. Which nursing diagnosis describes the client’s current problem?
Impaired social interaction
16. Which evaluative measure demonstrates improvement in the client’s ability to socially interact with peers?
The client eats breakfast and lunch with select peers
17. Which nursing diagnosis is a priority at this time?
Dysfunctional family processes
18. Which client outcome demonstrates progress towards positive change?
The client identifies two healthy coping behaviors that the family can use to improve the relationship
19. Which features are prominent in bulimia nervosa? (Select all)
-Erosion of tooth enamel
-Excessive intake of food
-Swollen salivary glands
20. Which features are prominent in anorexia nervosa? (Select all)
-Amenorrhea for three cycles
-Perfectionism
-Powerlessness
-Rigid food rituals
21. Which outcomes demonstrate the benefit of a cognitive-behavioral approach to treating eating disorders? (Select all)
-Clients identify and modify distorted perceptions of eating
-Clients reinterpret body image perceptions
-Clients utilize coping techniques to reduce anxiety
-Clients learn to predict recurrence of symptoms
22. Which outcome criteria demonstrate the client’s readiness to be discharged from the inpatient unit and continue treatment as an outpatient? (Select all)
-Client demonstrates three learned skills for managing triggers for relapse
-Client has reached and maintained 80-85% of weight restoration
-Client has remained free from self-directed harm
-Client commits to continuing individual and group therapies after discharge