Eating Disorders

Which symptom is associated with anorexia nervosa? 1. Fever 2. Binging 3. Self-satisfaction 4. Excessive weight loss

4: Excessive weight loss is a symptom associated with anorexia nervosa because the client with anorexia eats little food.

Which finding in a client would lead the nurse to suspect anorexia nervosa? 1. The client's weight is 85% less than the expected weight. 2. The client eats very rapidly until feeling uncomfortably full. 3. The client eats huge amounts of food and exercises extensively. 4. The client eats huge amounts of food without purging behaviors.

1: A client with anorexia will be underweight and weigh 85% less than the expected weight.

Which behavior does the nurse suspect in clients with anorexia nervosa? 1. Starving themselves due to a fear of obesity 2. Consuming huge amounts of food in secret 3. Consuming huge amounts of food due to lack of control 4. Purging themselves of the excessive intake of food with self-induced vomiting

1: Anorexia nervosa is characterized by a morbid fear of obesity. Thus, these clients become excessively thin by starving themselves.

The clinic nurse is conducting eating disorder screenings at the local university. The nurse understands which body mass index (BMI) can characterize anorexia nervosa? 1. 17 2. 26 3. 38 4. 47

1: BMI for normal weight is 20 to 24.9. A BMI of 17 or lower may indicate anorexia nervosa.

Which adverse effect is associated with the use of sympathomimetics in the treatment of obesity? 1. Tolerance 2. Depression 3. Bradycardia 4. Amenorrhea

1: Certain sympathomimetics are useful as appetite suppressants. Due to these anorectic effects, tolerance is developed.

Which outcome does the nurse expect in a client with eating disorder who is on cognitive-behavioral therapy (CBT)? 1. Decrease in binging episodes 2. Decrease in purging episodes 3. Recognizing maladaptive behaviors 4. Gaining control over eating and exercise performed

1: Cognitive behavioral therapy is useful in the treatment of binge-eating disorder. It helps to normalize the client's behavior by reducing the number of binging episodes.

The nurse is developing a plan of care for a client with an eating disorder. Which nursing diagnosis would the nurse choose for a client who does not perceive personal relevance of symptoms or relevance of danger? 1. Denial 2. Obesity 3. Anxiety 4. Low self-esteem

1: Denial occurs when clients minimize symptoms and are unable to admit the impact of disease on their lives or see relevance of danger.

What should the nurse suspect in a client with anorexia nervosa as a symptom of imbalanced nutrition? 1. Amenorrhea 2. Poor eye contact 3. Increased tension 4. Dissatisfaction with appearance

1: Due to severe weight loss, absence of menstruation (amenorrhea) is noticed in A client with anorexia nervosa.

A patient who has sustained severe burns in a motor vehicle accident is starting parenteral nutrition (PN). Which principle should guide the nurse's administration of PN? Administration of PN requires clean technique. Central PN requires rapid dilution in a large volume of blood. Peripheral PN delivery is preferred over the use of a central line. Only water-soluble medications may be added to the PN by the nurse

Central PN requires rapid dilution in a large volume of blood.

The nurse instructs an obese 22-yr-old man with a sedentary job about the health benefits of an exercise program. The nurse evaluates that teaching is effective when the patient makes which statement? "The goal is to walk at least 10,000 steps every day of the week." "Weekend aerobics for 2 hours is better than exercising every day." "Aerobic exercise will increase my appetite and result in weight gain." "Exercise causes weight loss by decreasing my resting metabolic rate."

"The goal is to walk at least 10,000 steps every day of the week."

What are the symptoms associated with excessive weight loss due to anorexia nervosa? Select all that apply. 1. Edema 2. Lanugo 3. Tachycardia 4. Hypotension 5. Hyperthermia

1,2,4 1: Low consumption of food causes retention of fluids in the body tissues. Therefore, the nurse finds edema in a client with excessive weight loss due to anorexia. 2: The client with anorexia has significant weight loss and the body no longer has enough body fat to promote heat regulation. As a result, fine white hairs known as lanugo grow all over the body to trap heat. 4: Lack of nutrients in the diet and dehydration caused due to excess physical activity cause a decrease in the blood pressure, or hypotension. Excess fluid shifts from the vascular compartment to the tissues, also causing hypotension.

While assessing a client with an eating disorder, the nurse finds that the client has compulsive eating behaviors and a body mass index (BMI) of 30 kg/ m2. Which actions should the nurse take while caring for this client? Select all that apply. 1. Encourage the client to keep a diary of food intake. 2. Discuss with the client the feelings and emotions associated with eating. 3. Include only fruit juices in the client's diet plan. 4. Provide information about support groups to the client. 5. Plan a progressive exercise program for the client.

1,2,5 1: Compulsive eating behaviors and a body mass index (BMI) of 30 kg/ m2 indicate imbalanced nutrition: more than body requirements, defined as intake of nutrients that exceeds metabolic needs. The nurse should encourage the client to keep a diary of food intake to gain a realistic picture of amount of food ingested. 2: The nurse should discuss with the client the feelings and emotions associated with eating because it helps the nurse to identify whether the client is eating to satisfy an emotional need rather than a physiological one. 5: The nurse should plan a progressive exercise program for the client because exercise promotes weight loss by burning calories and reducing appetite.

Which medication would be beneficial to the client with anorexia nervosa whose body mass index (BMI) is 16 kg/m2? 1. Codeine 2. Naloxone 3. Morphine 4. Meperidine

2: A body mass index of 16 kg/m2 indicates that the client has moderate anorexia. Naloxone is an opioid antagonist that increases endogenous opioids levels and results in weight gain.

The nurse recognizes that a client who eats an amount of food that is larger than what most individuals would eat in similar periods of time would be consistent with which disorder? 1. Anorexia 2. Bulimia 3. Cachexia 4. Crohn's disease

2: Bulimia is a disorder in which the individual has a distortion of body image and an obsessive desire to lose weight followed by bouts of extreme overeating, depression, and self-induced vomiting, purging, or fasting.

While caring for a client with anorexia nervosa who is diagnosed with ineffective denial, the nurse shows a matter-of-fact approach during therapy. Which outcome should the nurse expect from this intervention? 1. The client develops a positive impression of the nurse. 2. The client reduces the use of manipulative behaviors. 3. The client expresses anger in an appropriate manner. 4. The client diminishes the need to gain control over maladaptive eating behaviors.

2: The nurse should not argue with the client who is resistant to treatment. Instead, the nurse should follow a matter-of-fact approach for unacceptable behaviors. This nursing intervention causes the client reduce the use of manipulative behaviors.

Which statements made by A client's mother supports the nurse's assumption that the client is suffering from anorexia nervosa? Select all that apply. 1. "My child prefers sedentary activities." 2. "My child enjoys having junk food twice a week." 3. "My child washes herhands20 times a day." 4. "My child talks about foods and recipes at great length." 5. "My child prepares elaborate meals for other family members."

3,4,5 3: A client with anorexia nervosa has obsessive-compulsive symptoms, such as repeated hand washing. 4: A client with anorexia nervosa has a prolonged loss of appetite. He or she may talk about foods and recipes at great length to satiate hunger. 5: A client with anorexia nervosa is obsessed with food. Therefore, he or she may prepare elaborate meals for others.

Which behaviors can be observed in a client with bulimia nervosa? Select all that apply 1. Determined 2. Self-willed 3. Dissatisfied 4. Stubbornness 5. Perfectionism

3,5 3: The client with bulimia is dissatisfied with himself or herself because of the inability to be perfect. 5: The client with bulimia tends to be a perfectionist.

Which finding indicates that a client with bulimia nervosa is showing extreme symptoms of binge-eating disorder? 1. Three binge-eating episodes per week 2. 10 binge-eating episodes per week 3. 16 binge-eating episodes per week 4. Six binge-eating episodes per week

3: Bulimia nervosa is at an extreme stage when the client shows 14 or more episodes of inappropriate compensatory behaviors per week.

Which medication suppresses the appetite by selectively acting on serotonin receptors? 1. Phentermine 2. Fluoxetine 3. Lorcaserin 4. Sibutramine

3: Lorcaserin is a weight-loss medication that suppresses appetite by selectively altering serotonin receptors.

While caring for a client with an eating disorder, the nurse discusses the possibility of reaching plateaus. Which client requires this nursing intervention? 1. A client with ineffective denial 2. A client with disturbed body image 3. A client whose imbalanced nutrition is not meeting the body's requirements 4. A client whose imbalanced nutrition intake is exceeding the body's requirements

4: If the weight remains stable for extended periods, there is probability of reaching plateaus due to metabolism changes. Therefore, a client whose nutrition intake is more than body requirements requires this intervention.

What is the rationale for including a behavior modification program when training clients diagnosed with anorexia nervosa and bulimia nervosa? 1. To help the clients correct the feelings of distorted body image 2. To address the client's underlying anger associated with the disorder 3. To allow the client to recognize the maladaptive eating behaviors 4. To allow the client to maintain control overeating behaviors

4: Lack of control over the maladaptive eating behaviors is common in a client with anorexia nervosa or bulimia nervosa. Behavior modification therapy allows the client to maintain control over eating and exercising.

Which area of the brain contains the appetite regulation center? 1. Thalamus 2. Parietal lobes 3. Hippocampus 4. Hypothalamus

4: The hypothalamus contains the appetite regulation center within the brain.

The stable patient has a gastrostomy tube for enteral feeding. Which care could the RN delegate to the LPN (select all that apply.)? Administer bolus or continuous feedings. Evaluate the nutritional status of the patient. Administer medications through the gastrostomy tube. Monitor for complications related to the tube and enteral feeding. Teach the caregiver about feeding via the gastrostomy tube at home.

Administer bolus or continuous feedings. Administer medications through the gastrostomy tube.

The nurse teaches a 50-yr-old woman who has a body mass index (BMI) of 39 kg/m2 about weight loss. Which dietary change would be most appropriate to recommend? Decrease fat intake and control portion size. Increase vegetables and decrease fluid intake. Increase protein intake and avoid carbohydrates. Decrease complex carbohydrates and limit fiber.

Decrease fat intake and control portion size.

The patient has parenteral nutrition (PN) infusing with amino acids and dextrose. During shift change, the nurse reports the tubing, bag, and dressing were changed 20 hours ago. What care should the incoming nurse plan to deliver (select all that apply.)? Giving the patient insulin if needed Ensuring that the next bag has been ordered Checking amount of solution left in the bag Assessing the insertion site and change the tubing Verifying the accuracy of the new solution and ingredients

Giving the patient insulin if needed Ensuring that the next bag has been ordered Checking amount of solution left in the bag Verifying the accuracy of the new solution and ingredients

A patient is admitted with anorexia nervosa and a serum potassium level of 2.4 mEq/L. What complication is most important for the nurse to observe for in this patient? Muscle weakness Cardiac dysrhythmias Correct Increased urine output Anemia and leukopenia

Cardiac dysrhythmias

After identifying that a patient has possible nutritional deficits, which action will the nurse perform next? Provide supplements between meals. Encourage eating meals with others. Have family bring in food from home. Complete a full nutritional assessment.

Complete a full nutritional assessment.

A malnourished patient has been diagnosed with protein deficiency. Which complications should the nurse anticipate (select all that apply.)? Edema Asthma Anemia Malabsorption syndrome Impaired wound healing Gastrointestinal bleeding

Edema Anemia Impaired wound healing

Which focused assessments would have priority in the care of a patient recently started on parenteral nutrition (PN)? Skin integrity and skin turgor Electrolyte levels and daily weights Auscultation of lung and bowel sounds Peripheral edema and level of consciousness

Electrolyte levels and daily weights

A patient who has dysphagia after a stroke is receiving enteral feedings through a percutaneous endoscopic gastrostomy (PEG). What intervention should the nurse integrate into the plan of care? Use 30 mL of normal saline to flush the tube every 4 hours. Avoid flushing the tube any time the patient is receiving continuous feedings. Flush the tube before and after feedings if the patient's feedings are intermittent. Flush the PEG with 100 mL of sterile water before and after medication administration.

Flush the tube before and after feedings if the patient's feedings are intermittent.

A patient is being admitted with anorexia nervosa. Which clinical manifestations should the nurse anticipate? Sensitivity to heat, fatigue, and polycythemia Hair loss; dry, yellowish skin; and constipation Tented skin turgor, hyperactive reflexes, and diarrhea Dysmenorrhea, hypoactive bowel sounds, and hunger

Hair loss; dry, yellowish skin; and constipation

A frail older adult with recent severe weight loss is instructed to eat a high-protein, high-calorie diet at home. Which foods would the nurse suggest for breakfast? Orange juice and dry toast Oatmeal with butter and cream Correct Waffles with fresh strawberries Banana and unsweetened yogurt

Oatmeal with butter and cream

The nurse recognizes that the majority of patients' caloric needs should come from which source? Fats Proteins Polysaccharides Monosaccharides

Polysaccharides

A patient who is unable to swallow because of progressive amyotrophic lateral sclerosis is prescribed enteral nutrition through a newly placed gastrostomy tube. Which task is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)? Irrigate the tube between feedings. Provide wound care at the gastrostomy site. Administer prescribed liquid medications through the tube. Position the patient with a 45-degree head of bed elevation. Correct

Position the patient with a 45-degree head of bed elevation.

Which symptom associated with an eating disorder is treated with topiramate? 1. Binge eating with obesity 2. Emaciation with bulimia 3. Weight loss with anorexia nervosa 4. Amenorrhea with anorexia nervosa

Rationales Option 1: Topiramate is an anticonvulsant medication used in the long-term treatment of binge-eating disorders for clients with obesity. It reduces the number of binge-eating episodes and causes weight loss by altering the brain chemistry.

A patient was admitted with a fractured hip after being found on the floor of her home. She was extremely malnourished and started on parenteral nutrition (PN) 3 days ago. Which assessment finding would be of most concern to the nurse? Blood glucose level of 125 mg/dL Serum phosphate level of 1.9 mg/dL Correct White blood cell count of 10,500/µL Serum potassium level of 4.6 mEq/L

Serum phosphate level of 1.9 mg/dL

The nurse is evaluating the nutritional status of a patient undergoing radiation treatment for oropharyngeal cancer. Which laboratory test would best indicate the patient has protein-calorie malnutrition (PCM)? Serum transferrin Serum prealbumin Correct C-reactive protein (CRP) Alanine transaminase (ALT)

Serum prealbumin

The nurse is providing care for a patient who is a strict vegetarian. Which dietary choices would the nurse recommend to prevent iron deficiency? Brown rice and kidney beans Cauliflower and egg substitutes Soybeans and hot breakfast cereal Correct Whole-grain bread and citrus fruits

Soybeans and hot breakfast cereal

A patient received a small-bore nasogastric (NG) tube after a laryngectomy. Which action has the highest priority before initiating enteral feedings? Testing aspirated fluid pH Auscultating while instilling air Elevating head of bed to 40 degrees Verifying NG tube placement on x-ray

Verifying NG tube placement on x-ray

A patient who cannot afford enough food for her family states she only eats after her children have eaten. At a clinic visit, she reports bleeding gums; loose teeth; and dry, itchy skin. Which vitamin deficiency would the nurse suspect? Folic acid Vitamin C Vitamin D Vitamin K

Vitamin C

Which findings enable the nurse to reach the conclusion that a client with an eating disorder has feelings of disturbed body image? Select all that apply. 1. The client refuses to eat. 2. The client views himself or herself as fat. 3. The client has poor eye contact. 4. The client has pale conjunctiva. 5. The client has poor muscle tone.

1,2 1: A client with an eating disorder, who also has a disturbed body image or low self-esteem, performs self-destructive behaviors such as refusing to eat. 2: A client with an eating disorder, who also has a disturbed body image or low self-esteem, believes he or she is fat even when emaciated.

Which statements made by the student nurses about binge-eating disorders require correction? Select all that apply. 1. "A client with an eating disorder stops binge-eating episodes by fasting frequently." 2. "A client with an eating disorder stops binge-eating episodes by exercising regularly." 3. "A client with an eating disorder stops binge-eating episodes during social interruption." 4. "A client with an eating disorder stops binge-eating episodes only during periods of sleep." 5. "A client with an eating disorder stops binge-eating episodes when having abdominal discomfort."

1,2 1: A client with bulimia nervosa will not engage in inappropriate compensatory behaviors such as fasting to stop binge-eating episodes. 2: Inappropriate compensatory behaviors such as exercising regularly are not done by a client with bulimia nervosa to stop binge-eating episodes.

The nurse finds the diagnosis of imbalanced nutrition: more than body requirements in the history of a client who has an eating disorder. Which behaviors are signs of this condition? Select all that apply. 1. Compulsive eating 2. Sedentary lifestyle 3. Decreased fluid intake 4. Occasional use of diuretics 5. Omitting intake of healthy foods

1,2 1: Compulsive eating is a symptom associated with bulimia. It results in imbalanced nutrition: more than body requirements. 2: Sedentary lifestyle is one of the symptoms associated with bulimia. It results in imbalanced nutrition: more than body requirements.

While caring for a client with bulimia nervosa, the nurse helps the client identify the fears that contribute to maladaptive eating behaviors. Which outcome should the nurse expect out of this intervention? 1. The client is free from life-threatening conditions. 2. The client develops compliance with the treatment. 3. The client is able to find a solution to unresolved issues. 4. The client is unable to perform inappropriate compensatory behaviors.

3: If the client identifies the reasons behind the maladaptive eating behavior, then the client may resolve the emotional issues.

Which actions should the nurse implement for a client with anorexia nervosa who has maladaptive eating behaviors and ineffective denial? Select all that apply. 1. Acknowledge the client's underlying anger. 2. Establish a trusting relationship with the client. 3. Administer appetite suppressant drugs to the client. 4. Use closed-ended questions while interacting with the client. 5. Develop an exercise program that the client can do twice a week.

1,2 1: The nurse should acknowledge the client's anger over loss of control brought about by the behavior modification program. 2: The nurse should establish a trusting relationship with the client by being honest, accepting, and available, and by trying to keep all promises.

Which interventions are beneficial for a client with anorexia nervosa who is having complications associated with imbalanced nutrition? Select all that apply. 1. Keeping a strict record of intake and output 2. Enforcing restrictions if weight loss is noticed 3. Monitoring weight gain by using different scales 4. Discussing the diet plan with the client after establishing protocol 5. Asking about the types of foods consumed to know the cause of the disorder

1,2 1: The nurse should keep a strict record of intake and output while caring for a client with anorexia nervosa. It provides information about the nutritional status of the client to plan effective treatment. 2: The nurse should enforce restrictions if weight loss is noticed to ensure the client's safety and compliance with the therapy.

The nurse is caring for a client with bulimia nervosa. The nurse stays with the client for 1 hour following meals. What could be the reason for such nursing intervention? Select all that apply. 1. To prevent the client from engaging in self-induced vomiting 2. To prevent the client from discarding food from the tray 3. To prevent power struggles 4. To prevent the client from eating unhealthy foods 5. To prevent the client from exploiting others

1,2 1: The nurse stays with the client for 1 hour following meals to prevent the client from engaging in self-induced vomiting. Option 2: The nurse stays with the client for 1 hour following meals being served to prevent the client from hiding or discarding food from the tray.

Which laboratory report values for a client with an eating disorder should the nurse report to the primary health-care provider? Select all that apply. 1. Hematocrit of 48% 2. Urine output of 600 mL/day 3. Urine concentration of 1.045 4. Blood pressure of120/80 mmHg 5. Pulse rate of100 beats/minute

1,2,3 1: Normal hematocrit value ranges between 42 to 46%. A client with an eating disorder has elevated hematocrit levels. Therefore, the nurse reports the hematocrit finding of 48% to the primary health-care provider. 2: The normal urinary output is 800 to 2000 mL/day. A client with an eating disorder has decreased urinary output. Therefore, the nurse reports the urine output finding of 600 mL/day to the primary health-care provider. 3: The normal concentration of urine ranges from 1.000 to 1.030. A client with an eating disorder has increased urine concentration. Therefore, the nurse reports the urine concentration finding of 1.045 to the primary health-care provider.

The nurse is teaching the signs of anorexia nervosa during an education session. What should the nurse include in the teaching plan? Select all that apply. 1. Clients in the adolescence age group are susceptible to this disorder. 2. The client with this disorder has delayed psychosexual development. 3. The client with this disorder expresses feelings of helplessness. 4. The client with this disorder self-induces vomiting. 5. The client with this disorder has weight within a normal range.

1,2,3 1: The age of onset of anorexia nervosa is early to late adolescence, which is an indicative sign of anorexia nervosa. Option 2: The client with anorexia nervosa often has delayed psychosexual development. Option 3: The feelings of helplessness and hopelessness are the clinical manifestations of depression, which is an indicative sign of anorexia nervosa.

After assessing a client with anorexia nervosa, the nurse finds that the client has lost 2 pounds. The nurse plans to enforce restrictions on the client. What could be the reason for this intervention? Select all that apply. 1. To avoid power struggles 2. To ensure safety of the client 3. To prevent self-induced vomiting 4. To encourage compliance with therapy 5. To eliminate discarding food from the tray

1,2,4 1: If weight loss is noticed, the nurse should enforce restrictions. This avoids power struggles. 2: Restrictions are enforced if further weight loss is noticed to ensure the safety of the client. 4: To encourage compliance with the therapy, restrictions are enforced when weight loss is observed.

Which behaviors are associated with a binge-eating disorder? Select all that apply. 1. Feeling guilty after overeating 2. Eating until the feeling of hunger goes away 3. Feeling disgusted with oneself 4. Eating much more slowly than normal 5. Eating large amounts of food when feeling physically hungry

1,3, 1: A client with a binge-eating disorder feels guilty after overeating because he or she is afraid of gaining excessive weight. 3: A client with a binge-eating disorder feels disgusted with oneself after overeating because he or she is afraid of gaining excessive weight.

Which complications should the nurse expect in the client with bulimia nervosa who has a history of laxative or diuretic abuse? Select all that apply. 1. Dehydration 2. Osteoarthritis 3. Electrolyte imbalance 4. Respiratory insufficiency 5. Erosion of the tooth enamel

1,3,5 1: A client with bulimia nervosa induces vomiting and has excessive laxative or diuretics use. These behaviors cause dehydration. 3: Purging and laxative and diuretics abuse in a client with bulimia nervosa cause depletion of electrolytes, resulting in an electrolyte imbalance. 5: Gastric acid produced during purging or vomiting can cause erosion of the tooth enamel.

Which statement made by the student nurse indicates effective learning about various medications used to treat symptoms associated with eating disorders? 1. "Fluoxetine acts by decreasing the craving for carbohydrates." 2. "Sibutramine suppresses the appetite by triggering the release of serotonin." 3. "Lorcaserin suppresses the appetite by inhibiting the release of norepinephrine." 4. "Topiramate reduces obsessive-compulsive symptoms by stimulating the central nervous system (CNS)."

1: Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor agent. It decreases cravings for carbohydrates. It is indicated for the treatment of binge eating associated with bulimia nervosa. This statement indicates effective learning.

Which client behavior led the nurse to suspect the client has the purging type of anorexia nervosa? 1. Using laxatives to get rid of excessive ingested food 2. Fasting for 5 days a week to lose weight 3. Losing 10 kg of weight due to a strict diet 4. Engaging in physical exercise for 10 hours a day to lose weight

1: Purging behavior refers to the self-induced vomiting or misuse of laxatives, diuretics, or enemas to get rid of excessive ingested food. Therefore, this client displays the purging type of anorexia nervosa.

Which client with anorexia nervosa needs additional attention and treatment to lead a healthy lifestyle? 1. The client who consumes 200 calories per day 2. The client who loses weight at a desirable rate 3. The client who gains 2 to 3 pounds of weight per week 4. The client who drinks 125 ml of fluid each hour during waking hours

1: The average individual consumes 2,000 calories per day. Therefore, the client who consumes only 200 calories may have anorexia nervosa and, therefore, this client requires additional attention.

Which symptoms occur upon withdrawal of anorexiants in clients with an eating disorder? 1. Depression 2. Weight loss 3. Amenorrhea 4. Tachycardia

1: The client shows depression and extreme lethargy upon withdrawal of anorexiant medication.

The nurse is calculating the body mass index of a client weighing 172 lbs who is 58 inches tall. What does the nurse infer about the condition of the client? 1. The client is obese. 2. The client is overweight. 3. The client is of normal weight. 4. The client has anorexia nervosa.

1: The formula for body mass index is weight (kg)/height (m2). The findings indicate that the client has a body mass index of 35.9. The client is said to be obese when the body mass index range is 30 kg/m2or higher.

While caring for a client with anorexia nervosa, the nurse suspects self-induced vomiting and purging behaviors in the client. What is the priority nursing intervention in this situation? 1. Accompany the client to the bathroom. 2. Administer intravenous fluids to the client. 3. Assist the client to assume supine position. 4. Administer antiemetic medications to the client.

1: The nurse should accompany the client to the bathroom if self-induced vomiting is suspected.

Which action should the nurse undertake to collect data regarding the client's hydration status? 1. Monitor skin integrity. 2. Monitor blood pressure. 3. Monitor respiratory rate. 4. Monitor body temperature.

1: The nurse should monitor skin integrity and the condition of mucous membranes to collect data regarding the client's hydration status.

The nurse is caring for a client diagnosed with a binge-eating disorder and obesity. The medical history of the client reveals the presence of migraine attacks. Which treatment strategy would be beneficial to the client in this situation? 1. Topiramate 2. Fenfluramine 3. Diethylpropion 4. Benzphetamine

1: Topiramate causes weight loss and reduces the number of binge-eating episodes. So it is used in the long-term treatment of binge-eating disorder with obesity. It is also known to prevent migraine attacks. Therefore, this medication is beneficial to the client.

Which complications should the nurse expect due to decreased blood pressure and electrolyte imbalances in a client with anorexia nervosa? Select all that apply. 1. Fever 2. Poor skin turgor 3. Elevated hematocrit 4. Increased urine output 5. Decreased urine concentration

2,3 2: Electrolyte imbalances may lead to poor skin turgor. Due to a deficiency in electrolytes, the skin may become dry. 3: A client with anorexia shows deficiency in fluid volume. Therefore, the percentage of red blood cells (hematocrit) in the blood becomes increased or elevated.

What are the signs of bulimia nervosa? Select all that apply. 1. Extremely thin 2. Dental problems 3. Slightly overweight 4. Electrolyte problems 5. Starving for weight loss

2,3,4 2: Dental problems are seen in the client with bulimia because one of the inappropriate methods for preventing weight gain is self-induced vomiting, which can damage teeth. 3: A client who has bulimia nervosa may be slightly overweight due to overeating. 4: Electrolyte problems are seen in the client with bulimia because he or she uses inappropriate methods for preventing weight gain, such as purging or using laxatives.

Which complications associated with eating disorders are life-threatening? Select all that apply. 1. Edema 2. Bradycardia 3. Amenorrhea 4. Dehydration 5. Electrolyte imbalance

2,4,5 2: Bradycardia is the decrease in the heart rate to less than 60 beats per minute. It is a life-threatening condition. 4: Dehydration is the excessive loss of body fluids followed by disturbances in metabolism. It is a life-threatening condition. 5: Loss of electrolytes such as potassium indicates electrolyte imbalance. It is a life-threatening condition caused by starvation.

The nurse explains to a client with anorexia nervosa that eating disorders may lead to cardiac irregularities. The client ignores the nurse's explanation and continues to exhibit the same eating behaviors. Which intervention is most beneficial for the client in this situation? 1. Engaging the client in physical activities 2. Encouraging the client to verbalize his or her feelings 3. Providing adequate nutritional supplements to the client 4. Enforcing restrictions on maladaptive eating behaviors

2: A client with anorexia does not understand the dangerous consequences of cardiac irregularities and always denies the explanation of others. Therefore, the nurse should encourage the client to verbalize his or her feelings, which may help resolve the issue.

The nurse is assessing a 16-year-old female in the primary care clinic. Upon assessment, the nurse notes erosion of tooth enamel and callouses on the dorsal surface of the hands. Upon review of the client's weight record, the nurse notes fluctuations in weight as well. To what will the nurse attribute these assessment findings? 1. Anorexia 2. Bulimia 3. Cachexia 4. Crohn's disease

2: Bulimia is a disorder in which the individual has a distortion of body image and an obsessive desire to lose weight, followed by bouts of extreme overeating, depression, and self-induced vomiting, purging, or fasting. The vomiting will cause the client's tooth erosion and callouses.

Which behavior should the nurse find in a client with anorexia nervosa? 1. Eating secretly 2. Washing hands frequently 3. Terminates eating by social interruption 4. Eating large amounts of food when not feeling physically hungry

2: Compulsive behaviors may also present in the client with anorexia nervosa. Therefore, frequent hand washing may be noticed in A client with anorexia nervosa.

What would the nurse expect to find in the medical history of a client with bulimia nervosa? 1. Schizophrenia 2. Depression 3. Xenophobia 4. Paranoid personality

2: Depression may contribute to binge eating when food provides comfort. Therefore, the nurse may find depression in the medical history of a client with bulimia nervosa.

Which abnormality is found in a client with anorexia nervosa? 1. Elevated levels of serotonin in the blood 2. Increased levels of endogenous opioids in the spinal fluid 3. Decreased levels of cortisol in the cerebrospinal fluid 4. Elevated levels of norepinephrine in the plasma

2: Due to high levels of endogenous opioids in the spinal fluid, the client may develop a denial for hunger. The client refuses to eat, which is a symptom of anorexia nervosa.

After reassessment of a client diagnosed with anorexia nervosa, the nurse finds that the client has lost 1.5 pounds in the past week in spite of eating all meals and snacks. What action should the nurse undertake in this situation? 1. Help the client identify the cause of maladaptive behaviors. 2. Observe the client for at least 1 hour after the client eats his or her meals. 3. Consult the dietician and increase the caloric intake of the client. 4. Refer the client to a support or therapy group.

2: Further weight loss in spite of eating all meals and snacks indicates that the client is still performing self-destructive behaviors. Therefore, the nurse should observe the client for at least 1 hour after meals.

While assessing a client with anorexia nervosa, the nurse finds that the client has developed white hair on most of the body. Which condition is responsible for this symptom? 1. Anemia 2. Dehydration 3. Osteoporosis 4. Electrolyte imbalance

2: Lanugo is the presence of small, white, fine hairs on the body. Lanugo indicates dehydration due to starvation. Therefore, the nurse should assess the client's skin integrity.

While caring for a client with anorexia nervosa, the nurse suspects the symptom of distorted body image in the client. Which statement of the client supports the nurse's suspicion? 1. "I am facing problems due to my low body weight." 2. "I have to reduce my weight from 100 lbs to 90 lbs by next week." 3. "I accept positive reinforcements from others because I am smart and fit." 4. "I can become a model because I am slim and beautiful."

2: Reducing by 10 lbs in a week is not a healthy goal. The client with anorexia always tries to lose weight even when he or she is excessively thin.

An emaciated client who is anemic and is unwilling to eat is admitted into the psychiatric unit. Which priority intervention should the nurse implement in this situation? 1. Convey the knowledge that perfection is unrealistic. 2. Provide a liquid diet to the client via nasogastric tube. 3. Institute a behavioral modification program immediately. 4. Offer support to the client's family members by educating them.

2: Since the client's physical condition is life-threatening, the priority nursing intervention is to stabilize the physical condition by providing a liquid diet to the client via a nasogastric tube.

The school nurse is educating children and adolescents about the importance of nutrition. Which statement of the school nurse needs correction? 1. "Healthy eating behaviors reduce the risk of cancer." 2. "Anorexia nervosa is a risk factor for the development of obesity." 3. "Obesity is the risk factor for the development of heart diseases." 4. "Conflict avoidance of parents is one of the predisposing factors for eating disorders."

2: The client with anorexia nervosa has very low weight and thus, this client is not at risk for the development of obesity.

The nurse is developing a plan of care for a client with an eating disorder who presents with decreased fluid intake, excessive use of laxatives, an increased hematocrit, and decreased urine output. Which nursing diagnosis would the nurse choose for this client? 1. Denial 2. Obesity 3. Deficient fluid volume 4. Imbalanced nutrition: Less than body requirements

3: Deficient fluid volume occurs when there is decrease in fluid intake, abnormal fluid loss caused by self-induced vomiting, use of laxatives, etc. Symptoms may include decreased urine output, elevated hematocrit, increased pulse rate, weakness, and dry skin.

Which medication suppresses the appetite by selectively acting on serotonin receptors? 1. Phentermine 2. Fluoxetine 3. Lorcaserin 4. Sibutramine Rationales Option 1: Phentermine is a central nervous system (CNS) stimulant that is thought to suppress the appetite by triggering release of the neurotransmitter norepinephrine. Option 2: Fluoxetine is prescribed for associated symptoms such as anxiety and depression. It is not an anorexiant. Option 3: Lorcaserin is a weight-loss medication that suppresses appetite by selectively altering serotonin receptors. Option 4: Sibutramine controls appetite by inhibiting the neurotransmitters serotonin and norepinephrine.

3: Lorcaserin is a weight-loss medication that suppresses appetite by selectively altering serotonin receptors.

The nurse is assessing a client with bulimia who is having eight to 13 episodes of inappropriate compensatory behaviors per week. How does the nurse classify the severity of this disorder? 1. Mild 2. Moderate 3. Severe 4. Extreme

3: Severe classification constitutes an average of eight to 13 episodes of inappropriate compensatory behaviors per week. Mild-> 1-3 Mod-> 4-7 Extreme- 14 or more

What is the body mass index (BMI) range of a normal weight client? 1. 30 to 35.0 kg/m2 2. 25 to 29.9 kg/m2 3. 20 to 24.9 kg/m2 4. 15 to 17.5 kg/m2

3: The BMI range of a normal weight client is 20 to 24.9 kg/m2.

The nurse is planning discharge for a client with anorexia nervosa who was diagnosed with imbalanced nutrition: less than body requirements 2 weeks ago. Which outcomes observed in the client enabled the nurse to plan discharge? 1. The client verbalizes positive aspects of self 2. The client establishes healthy eating patterns 3. The client shows no signs of malnutrition and dehydration 4. The client discontinues the use of maladaptive behaviors

3: The anorexia client diagnosed as imbalanced nutrition: less than body requirements shows realistic weight gain and no longer exhibits symptoms of malnutrition or dehydration. This outcome enabled the nurse to plan discharge for the client.

Which intervention made by the student nurse while providing care to A client with anorexia nervosa who presents with imbalanced nutrition requires correction? 1. Providing liquid diet through a nasogastric tube when client is unable to take in food orally 2. Providing adequate calories with a dietician's advice when the client is able to take in foods orally 3. Measuring the weight of the client at bedtime, following voiding 4. Discouraging the client from bathing everyday if his or her skin is dry

3: The nurse should weigh the client immediately on arising and following the first voiding. This intervention made by the student nurse requires correction.

Which predisposing factor is associated with obesity? 1. Parental criticism 2. Conflict avoidance 3. Unresolved dependency needs 4. Disturbance in mother-infant interaction

3: Unresolved dependency needs area predisposing factor for obesity. The client attempts to regain lost or frustrated nurturance and caring.

What are the behaviors associated with the restricting type of anorexia nervosa? Select all that apply. 1. Taking laxatives 2. Taking diuretics 3. Using enemas 4. Engaging in physical activities 5. Focusing on dieting and fasting

4,5 4: A client with anorexia nervosa will engage in inappropriate compensatory behaviors, such as engaging in prolonged and strenuous physical activities. 5: The client with anorexia nervosa will engage in inappropriate compensatory behaviors, such as focusing on dieting and fasting.

2. Which behaviors does the nurse expect to find in a client diagnosed with bulimia nervosa? Select all that apply. 1. Fasting 2. Refusal to eat 3. Excessive exercise 4. Preoccupation with food 5. Feelings of distorted body image

4,5 4: The client with bulimia nervosa displays frequent binge-eating episodes. Therefore, the client is preoccupied with food. 5: The client with bulimia nervosa induces self-vomiting because of the concern about body image. Therefore, the client has feelings of a distorted body image.

What should the nurse assess in a client with anorexia nervosa or bulimia nervosa who has low self-esteem? Select all that apply. 1. Skin integrity 2. Mucous membranes 3. Tears in the gastric mucosa 4. Source and level of motivation 5. Attitudes and feelings about weight

4,5 4: The nurse should assess the source and level of motivation in a client with anorexia nervosa or bulimia nervosa who has low self-esteem. 5: The nurse should assess attitudes and feelings about weight in a client with anorexia nervosa or bulimia nervosa who has low self-esteem.

The nurse is assessing a client with binge eating disorder who is having 14 or more binge eating episodes per week. How does the nurse classify the severity of this disorder? 1. Mild 2. Moderate 3. Severe 4. Extreme

4: Extreme classification constitutes an average of 14 or more episodes of binge eating per week.

Which statement made by the client supports the nurse's conclusion that the client has a binge-eating disorder? 1. "I eat low calorie foods because I am on diet." 2. "I exercise to burn fat." 3. "I vomit the ingested food when I eat in large amounts." 4. "I eat high-fat food, and I don't care about excess calories."

4: A client with a binge-eating disorder eats large amounts of food, and does not show any behavior to get rid of the excess calories.

What should the nurse infer about the condition of a client who has a body mass index of 17 kg/m2? 1. The client is obese. 2. The client is overweight. 3. The client is a normal weight. 4. The client has anorexia nervosa.

4: A client with anorexia nervosa has a body mass index of 17.5 kg/m2 or lower.

Which complication does the nurse expect in the client with bulimia nervosa who has a history of excessive vomiting and purging? 1. Seizures 2. Kidney stones 3. Muscle atrophy 4. Esophageal tears

4: A client with bulimia nervosa shows the symptoms of binging and purging. Purging causes abdominal distention, causing the formation of tears in the esophageal or gastric mucosa.

The nurse is planning care for a client with anorexia. What would be a realistic goal for this client? 1. Report only seven to nine episodes of inappropriate compensatory behavior per week 2. Report only four to six episodes of inappropriate compensatory behavior per week 3. Gain 1 pound per week 4. Gain 2 pounds per week

4: A realistic goal for this client with adequate calorie consumption would be to gain 2 to 3 pounds per week.

The nurse is developing a plan of care for a client with an eating disorder who refuses to eat, abuses laxatives, has pale conjunctiva and amenorrhea. Which nursing diagnosis would the nurse choose for this client? 1. Denial 2. Obesity 3. Anxiety 4. Imbalanced nutrition: Less than body requirements

4: A refusal to eat will result in imbalanced nutrition and the abnormal findings of pale conjunctiva and amenorrhea indicate the client's nutrition is less than body requirements.

The nurse is assessing a client with compulsive eating behavior and determines that the client experiences distress after overeating. Which symptom is likely to occur after binging? 1. Headache 2. Sore throat 3. Loss of taste 4. Abdominal pain

4: Binging is the intake of an excessive amount of food. The symptom that occurs following binging is abdominal pain due to stomach fullness.

The nurse is developing a plan of care for a client with an eating disorder who verbalizes negative feelings about her personal appearance, avoids eye contact, and presents with a depressed mood. Which nursing diagnosis would the nurse choose for this client? 1. Denial 2. Obesity 3. Anxiety 4. Low self-esteem

4: Low self-esteem occurs when a person has a distorted body image and views him or herself as fat even at a normal body weight. The client may exhibit self-destructive behavior and be preoccupied with the way he or she looks, often verbalizing negative feelings about it.

Which medication may the primary health-care provider prescribe for a client with anorexia nervosa? 1. Fluoxetine 2. Lorcaserin 3. Topiramate 4. Olanzapine (Zyprexa)

4: Olanzapine (Zyprexa) has had reported success in a clinical trial for the treatment of anorexia nervosa.

On reviewing the laboratory results fora client with anorexia nervosa, the nurse determines the client has hypovolemia. Which client behaviors support the nurse's findings? 1. Increased tension 2. Compulsive eating 3. Increased fluid intake 4. Excessive use of laxatives

4: The client loses excessive fluids due to intake of laxatives. This indicates risk of hypovolemia.

Which medication does the primary health-care provider prescribe to a client who has a body mass index of 16 kg/m2? 1. Lorcaserin 2. Topiramate 3. Benzphetamine 4. Cyproheptadine

4: The client who has a body mass index of 16 kg/m2 may have anorexia nervosa. Therefore, the primary health-care provider may prescribe cyproheptadine as an appetite stimulant.

While caring for a client with an eating disorder who is admitted in the psychiatric unit, the nurse finds that the client's body temperature is 97.1F with a heart rate of 60 beats per minute. Which intervention should the nurse implement in this situation? 1. Refer the client to a support group 2. Plan a progressive exercise program 3. Administer appetite-suppressant drugs 4. Offer support and positive reinforcement

4: The decreased body temperature and heart rate of 60 beats per minute indicate hypothermia and bradycardia, respectively. The client with an eating disorder has hypothermia and bradycardia due to imbalanced nutrition. The nurse should offer support and positive reinforcement to the client for improvement in eating behaviors.

What is the severity of anorexia nervosa in a client weighing 36 kg who is 58 inches tall? 1. Mild 2. Severe 3. Extreme 4. Moderate

4: The formula for body mass index is weight (kg)/height (m2). The body mass index for A client weighing 36 kg who is 58 inches tall is 16.6 kg/m2. The severity of anorexia nervosa is said to be moderate when the body mass index range is 16 to 16.99 kg/m2.

The student nurse is caring for a client with bulimia who has disturbed body image. Which intervention of the student nurse does the registered nurse correct during evaluation? 1. Exploring past eating behaviors of the client 2. Referring the client to a support group or group therapy 3. Assessing client's attitudes and feelings about weight 4. Focusing on client's past accomplishments related to physical appearance

4: The nurse should focus on the client's past accomplishments unrelated to physical appearance. Therefore, the registered nurse corrects this intervention of the student nurse.

What dose of fluoxetine does the primary health-care provider (PHP) prescribe to a client with bulimia? 1. 10 mg/day 2. 20 mg/day 3. 50 mg/day 4. 60 mg/day

4: The primary health-care provider prescribes a 60mg/day dose of fluoxetine to a client with bulimia because it is the recommended dose that shows the desired efficacy.

The nurse is reviewing the laboratory test results for a patient with metastatic lung cancer who was admitted with a diagnosis of malnutrition. The serum albumin level is 4.0 g/dL, and prealbumin is 10 mg/dL. How will the nurse interpret these results? The albumin level is normal therefore the patient does not have protein malnutrition. The albumin level is increased, which is common in patients with cancer who have malnutrition. Both the serum albumin and prealbumin levels are reduced, consistent with the diagnosis of malnutrition. Although the serum albumin level is normal, the prealbumin level more accurately reflects the patient's nutritional status. Correct

Although the serum albumin level is normal, the prealbumin level more accurately reflects the patient's nutritional status.

The nurse is teaching a patient with type 1 diabetes mellitus who had surgery to revise a lower leg stump with a skin graft about nutrition. What food should the nurse teach the patient to eat to best facilitate healing? Nonfat milk Chicken breast Fortified oatmeal Olive oil and nuts

Chicken breast