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A nurse in an outpatient clinic is reviewing the medical record of a client who has anorexia nervosa.

**Exhibit 1: Vital Signs**

| Date | Blood Pressure (mm Hg) | Heart Rate (beats/min) | Respiratory Rate (breaths/min) | Temperature (°C/°F) | Oxygen Saturation (%) |
|------|-------------------------|------------------------|-------------------------------|---------------------|-----------------------|
| 6/4 | 100/64 | 62 | 16 | 36.3 / 97.3 | 98 |
| 6/4 | 102/66 | 56 | 18 | 36.4 / 97.5 | 99 |

**Exhibit 2: Diagnostic Results**

| Visit | ECG | Cholesterol (mg/dL) | Platelet Count (mm³) |
|-------|--------------------|---------------------|--------------------------------|
| 1 | Normal Sinus Rhythm| 196 | 155,000 (150,000 to 400,000) |
| 2 | QT Prolongation | 238 | 140,000 (150,000 to 400,000) |

**Exhibit 3: Nurse's Notes**

| Visit | Notes | BMI |
|-------|----------------------------------------------------------------------------------------------------------------------------------------------------------|------|
| 1 | Client reports taking laxatives daily and inducing vomiting 3-4 days per week.
Client states, "I have always been a nervous person, even as a kid. I feel like I need to be perfect, or everyone will think I am a complete failure. I can't believe I let myself gain this much weight. I look awful." | 16.8 |
| 2 | Client reports no longer taking laxatives.
Client also reports inducing vomiting most days and new onset of hematemesis.
Petechiae noted on face and sclera.
Client states, "I started therapy and have had two sessions." | |

**Question:**

Based on the information provided, what is the nurse's priority action?

A. Assess the client's respiratory status
B. Encourage the client to continue therapy sessions
C. Monitor the client's blood pressure
D. Evaluate the client's nutritional status

Answer :

Final answer:

The nurse's priority action is to evaluate the client's nutritional status due to the presence of hematemesis and petechiae, which are urgent health concerns related to the client's anorexia nervosa.

Explanation:

Based on the information provided, the nurse's priority action should be to evaluate the client's nutritional status. The client with anorexia nervosa has reported new onset of hematemesis, which is vomiting blood, a sign of potential gastrointestinal bleeding or injury likely due to induced vomiting. Additionally, the presence of petechiae on the face and sclera can be indicative of trauma from forceful vomiting. Assessments of the client's blood pressure and respiratory status, while pertinent, are less urgent in the context of the client's reported symptoms. Encouraging the client to continue therapy is important for long-term treatment but is not the immediate clinical priority given the acute physical findings.

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