The home health nurse is visiting an 86-year-old Israeli client ...

[ENagel]

The home health nurse is visiting an 86-year-old Israeli client for a routine medication check and vital signs. The client has declined since the last home visit, and the nurse suggests that the client should be transported to the hospital.
 
  The family states that the client will stay in the home. Which of the following is the best action by the nurse? 1. Call for an ambulance to transport the client to a hospital
   2. Encourage the family to take the client to the hospital
   3. Ask the client to state his or her preference
   4. Follow the decision of the family

Question 2

A college student tells the nurse that she often is out of control with eating, and to keep her weight down so her mother does not call her fat, she makes herself throw up. The nurse realizes the client is experiencing:
 
  1. Anorexia nervosa.
   2. Bulimia.
   3. Binge-eating.
   4. Purging disorder.

[smrerig]

Answer to Question 1

3. Ask the client to state his or her preference

Rationale:
Many cultures see death as inevitable, and in such cases the clients often prefer to die in their homes with their families. The nurse should ascertain that this is what the client wishes and respect that. Calling for an ambulance is inappropriate as is encouraging the family to take the client to a hospital against their wishes. The nurse would not follow the family's wishes without finding out what the client wants.

Answer to Question 2

2. Bulimia.

Rationale:
In bulimia, binge eating is followed by purging. Anorexia nervosa is characterized by extreme perfectionism; weight fear; significant weight loss; body image disturbances; strenuous exercising; peculiar food-handling patterns; reductions in heart rate, blood pressure, metabolic rate; and the production of estrogen or testosterone. Binge-eating is often associated with obesity and is characterized by binging twice a week for at least 6 months. Purging is not associated with the binge-eating disorder. In the purging disorder, purging is done without the ingestion of food beforehand.