Care Manager Certification Practice Exam

For a client who has lost significant weight and believes she is fat, what should be the nurse's first priority?

1. Identify the client's nutritional status.

2. Request a mental health consult.

3. Plan a therapeutic diet for the client.

4. Provide a structured environment for the client.

The correct answer is: Identify the client's nutritional status.

Identifying the client's nutritional status should be the nurse's first priority because it establishes a baseline understanding of the client's health. In the context of someone who has lost significant weight but still perceives themselves as overweight, evaluating nutritional status is critical to determine any underlying medical issues or health risks associated with malnutrition or an eating disorder. This assessment can involve examining factors such as body mass index (BMI), dietary intake, and physical examination to ascertain whether the weight loss has led to or is accompanied by negative health consequences. The other options, while important in their own right, are secondary to understanding the client's current nutritional situation. For instance, while a mental health consult could be beneficial if there are indications of an eating disorder or body image issues, it's essential first to know how the client’s dietary practices and physical health status may be impacting their mental health. Planning a therapeutic diet could be premature without first engaging with the nutritional assessment. Lastly, providing a structured environment may also be helpful, but it should be based on the findings from assessing nutritional needs and overall health. Thus, understanding the client's nutritional status lays the groundwork for all further interventions.