Eating disorders Prep U

During postprandial monitoring, a client with bulimia nervosa tells the nurse, "You can sit with me, but you're just wasting your time. After you sat with me yesterday, I was still able to purge. Today, my goal is to do it twice." What is the nurse's best response? "I trust you not to purge." "I need to know how and when you purge." "Don't worry. I won't allow you to purge today." "I know it's important for you to feel in control, but I'll monitor you for 90 minutes after you eat."

"I know it's important for you to feel in control, but I'll monitor you for 90 minutes after you eat."

Which statement made by the nurse managing the care of an anorexic teenager demonstrates an understanding of the client's typical, initial reaction to the nurse? "I'm sorry that you are angry but you cannot throw food at me." "I realize this must be very difficult for you but try to remember I'm not your enemy." "I'm not the root of your problem." "I'm not going to take your insults personally but you need to be more respectful."

"I realize this must be very difficult for you but try to remember I'm not your enemy."

The nurse has been teaching a client about bulimia. Which statement by the client indicates that the education has been effective? "I know if I eat pasta, I'll binge." "I'll eat small meals and snacks regularly." "I'll take my medication when I feel the urge to binge." "How I feel about my body has little to do with my binging."

"I'll eat small meals and snacks regularly."

A female client with anorexia nervosa tells the nurse that she has been experiencing amenorrhea. The nurse is aware that this is a result of: Alteration of critical body fat-to-muscle ratio needed for menses to occur Increased gonadotropin-releasing hormone (GnRH) production Increased estrogen production that occurs in the body A secondary decrease in sexual activity

Alteration of critical body fat-to-muscle ratio needed for menses to occur

Which is the most common disorder found in clients diagnosed with bulimia nervosa? Depression Anxiety Psychosis Substance abuse

Depression

A nurse is assessing a client with anorexia nervosa. Which would the nurse be most likely to find? Hyperkalemia Dry skin Tachycardia Oversensitivity to heat

Dry skin

The school nurse is assessing a 12-year-old client suspected of having bulimia. Which assessment finding would the nurse expect to see? Eroded dental enamel Thinning scalp hair Sparse body hair Dry skin

Eroded dental enamel

A nurse is caring for a 17-year-old female client with bulimia. Which complication of this disease may the nurse see in this child? Partial paralysis Hernia Severe acne Menstrual problems

Menstrual problems

A nurse is caring for a client diagnosed with bulimia nervosa. The most appropriate initial goal for this client is to: avoid shopping for large amounts of food. control eating impulses. identify a connection between anxiety and eating behaviors. restrict eating to three meals per day.

identify a connection between anxiety and eating behaviors.

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L (2.9 mmol/L). Which statement made by the client indicates the need for further teaching? "I can use laxatives and enemas but only once a week." "A good breakfast for me will include milk and a couple of bananas." "I will be sure to buy frozen vegetables when I grocery shop." "I will take a potassium supplement daily as prescribed."

"I can use laxatives and enemas but only once a week."

An extremely thin preadolescent is being assessed by the nurse. Which client statement will cause the nurse to suspect the client is experiencing anorexia nervosa? "I would like to grow up to be a model." "My mom says I am obsessed with fashion." "I feel chubby no matter what I wear." "I am afraid that someone is poisoning my food."

"I feel chubby no matter what I wear."

A nurse who provides care at an inpatient eating disorder clinic is performing an admission assessment of a young client who has been diagnosed with anorexia nervosa. Which assessment question reflects therapeutic communication? "Why do you prefer not to eat food?" "What do you think about how much you weigh right now?" "What do you believe has caused your anorexia?" "Is there anything that I can get you to eat right now?"

"What do you think about how much you weigh right now?"

A nurse is working in an eating disorder inpatient clinic. What does the nurse recognize as one of the most challenging aspects of treatment of anorexia nervosa? Recognizing that there is a problem Overcoming depression Socializing with other clients Gaining weight

Recognizing that there is a problem

A nurse is developing a care plan for a client with anorexia nervosa. Which action should the nurse include in the plan? Restrict visits with family members until the client begins to eat. Provide privacy for the client during meals. Set up a strict eating plan with the client. Encourage the client to exercise, to reduce anxiety.

Set up a strict eating plan with the client.

A 17-year-old child has been admitted with complications of anorexia nervosa. What diagnostic tests can be anticipated in the plan of care/treatment? Select all that apply. complete blood cell count MRI CT scan metabolic panel chest X-ray

complete blood cell count metabolic panel

A 16-year-old girl is brought to the clinic by her mother because she has not had a menstrual period for the past 8 months. Which findings might alert the nurse to the possibility that anorexia nervosa may be contributing to the client's amenorrhea? Select all that apply. hyperthermia bradycardia hypotension reduced subcutaneous fat evidence of secondary sex characteristics

bradycardia hypotension reduced subcutaneous fat

The nurse is caring for a girl with anorexia who has been hospitalized with unstable vital signs and food refusal. The girl requires enteral nutrition. The nurse is alert for which complications that signal refeeding syndrome? cardiac arrhythmias, confusion, seizures orthostatic hypotension and hypothermia hypothermia and irregular pulse bradycardia with ectopy and seizures

cardiac arrhythmias, confusion, seizures

The nurse is assessing a client who has bulimia nervosa. The nurse would expect the assessment data to include that the client: engages in binge eating. weighs less than 85% of normal weight for height. reports constipation, cold intolerance, and bradycardia. engages in alcohol and substance abuse.

engages in binge eating.

An adolescent is admitted for treatment of bulimia nervosa. When developing the care plan, the nurse anticipates including interventions that address which metabolic disorder? hypoglycemia metabolic alkalosis metabolic acidosis hyperkalemia

metabolic alkalosis

The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply. hyperthermia orthostatic hypotension weak pulse hypertension hypothermia

orthostatic hypotension weak pulse hypothermia

Which is a cardiac complication of an eating disorder? \ Bradycardia Hypertension Enlarged heart Thrombocytopenia

Bradycardia

A 15-year-old client with anorexia nervosa has been admitted to a mental health unit. The client refuses to eat. Which statement is appropriate for the nurse to make? "You don't have to eat." "If you don't eat, it may be necessary to feed you by tube or I.V." "Why do you think you're fat? You're underweight. Here — look in the mirror." "You really look terrible at this weight. I hope you'll eat."

"If you don't eat, it may be necessary to feed you by tube or I.V."

A 17-year-old client with a long-standing diagnosis of bulimia nervosa has been admitted to the emergency department after collapsing in a mall. The care team that admits the client to the hospital should prioritize which assessment? Complete blood count and differential Evidence of injury to skin by cutting Cardiac assessment and measurement of electrolyte levels Psychosocial assessment and determination of coping skills

Cardiac assessment and measurement of electrolyte levels

The nurse has been working for several days with an adolescent who has anorexia nervosa. What is an indication that the adolescent is developing trust in the nurse? The adolescent stating "You're the best nurse on the unit." The adolescent telling the nurse purging occurs after each meal. The adolescent stating the desire to eat again. Saying which nurse's orders the adolescent will follow.

The adolescent telling the nurse purging occurs after each meal.

A client with anorexia experienced a severe reduction in body fat by extreme caloric restriction and exercise. Which female reproductive abnormalities could be acquired as a result of this reduction in body fat? Select all that apply. delay or cessation of menstruation impaired potential for the implantation of a fertilized ovum higher risk of fibrocystic breast disease polycystic ovarian syndrome

delay or cessation of menstruation impaired potential for the implantation of a fertilized ovum

Which intervention has been found to be most effective reducing the initial symptoms of bulimia? Cognitive behavior therapy and pharmacologic interventions Behavioral therapy and psychoeducation Daily monitoring of sound dietary principles and meditation sessions Clearly stated unit rules and a supportive milieu

Cognitive behavior therapy and pharmacologic interventions

A nurse is developing a plan of care for a client newly diagnosed with bulimia nervosa. Which would the nurse expect to implement in conjunction with pharmacologic therapy? Behavioral therapy Cognitive behavioral therapy Interpersonal therapy Family therapy

Cognitive behavioral therapy

A nurse is reviewing the plan of care for a client with anorexia nervosa and notes a behavioral plan for increasing weight. The nurse correlates this intervention with which nursing diagnosis? Disturbed body image Anxiety Imbalanced nutrition: less than body requirements Ineffective coping

Imbalanced nutrition: less than body requirements

A client is experiencing anorexia related to the adverse effects of cancer treatment. Using Maslow's hierarchy, the nurse identifies this as a reflection of which need? Esteem and self-respect Safety and security Physiologic needs Belongingness and affection

Physiologic needs

When providing information about anorexia to a client, the nurse can ensure that the client can accurately comprehend the information by doing what? Presenting the information using language and terms the client will understand Interacting with the client in a nonthreatening, respectful manner Being careful not to overload the client with too much information at one time Giving the client ample opportunity to ask questions

Presenting the information using language and terms the client will understand

A nurse taking a health history from an adolescent female would become concerned about anorexia if the adolescent made which statement? "I try to eat three meals each day but don't always have enough time to sit down for each meal." "My monthly cycle is not always regular. Sometimes, I may skip a month or two between my cycles." "I exercise every day by running one mile in the late afternoon — or mornings on days that are really hot." "I've been really tired lately, but I'm afraid that if I rest I will get fatter than I am already."

"I've been really tired lately, but I'm afraid that if I rest I will get fatter than I am already."

The nursing educator has completed an educational program for new nurses on eating disorders in teenagers. Which statement by a participant would indicate a need for further education? "We need to allow the client to participate in developing the treatment plan." "Meal time should be structured but pleasant and relaxed without distractions." "If they refuse to eat, we need to sit with them and not let them leave the table until they do eat something." "We need to stay with them for at least 30 minutes after they eat so they don't try to vomit or dispose of the food."

"If they refuse to eat, we need to sit with them and not let them leave the table until they do eat something."

A client is an overweight 32-year-old who regularly binges on large amounts of food. After the client binges, the client feels guilty and ashamed about eating the food. Despite the bad feelings, the client binges almost daily. Which would the nurse most likely suspect? Anorexia nervosa Bulimia nervosa Binge eating disorder Eating disorder not otherwise specified

Binge eating disorder

The nurse is collecting data on a 16-year-old girl with the diagnosis of bulimia. What would the nurse most likely note in this child? The child is of normal weight for her height according to the growth charts. The child socializes with friends and shares all her dreams and secrets with them. The child has a ritualistic program of exercise that she does every day after school. The child is a perfectionist and tries hard to please her parents and teachers.

The child is of normal weight for her height according to the growth charts.

For a client with anorexia nervosa, which goal takes the highest priority? The client will establish adequate daily nutritional intake. The client will make a contract with the nurse that sets a target weight. The client will identify self-perceptions about body size as unrealistic. The client will verbalize the possible physiological consequences of self-starvation.

The client will establish adequate daily nutritional intake.

A client is admitted to the psychiatric clinic for treatment of anorexia nervosa. At the beginning of the client's hospitalization, the most important nursing action is to: severely restrict the client's physical activities. weigh the client daily, after the evening meal. monitor the client's vital signs, serum electrolyte levels, and acid-base balance. instruct the client to keep an accurate record of food and fluid intake.

monitor the client's vital signs, serum electrolyte levels, and acid-base balance.

A nurse plans to include the parents of a client with anorexia nervosa in the client's therapy sessions. The nurse should anticipate that the parents will: tend to overprotect their child. have a history of substance abuse. maintain emotional distance from their child. alternate between expressing love for and rejection of their child.

tend to overprotect their child.

Individuals with anorexia nervosa concentrate on which body cue? Controlling food intake Hunger Weakness Anxiety

Controlling food intake

An adolescent has been diagnosed with bulimia, and the parents are asking how to best deal with this problem. What suggestion should the nurse make to the parents to help care for the adolescent? Monitor the adolescent constantly to ensure that she is not binge eating. Administer antiemetics on a regular basis to reduce the urge to vomit after eating. Develop a contract with the adolescent, setting goals of behavior and her diet, as well as privileges gained by meeting the contracted goals. Minimize or ignore any comments made by the adolescent about body image distortion or being overweight and dieting.

Develop a contract with the adolescent, setting goals of behavior and her diet, as well as privileges gained by meeting the contracted goals.

A psychiatric-mental health nurse working in the community is planning an educational program for fifth- and sixth-grade teachers. Which would the nurse include? Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders Emphasis on the need for teachers to focus their prevention efforts on female students Stressing the need to allow students to eat without undue attention or supervision in order to prevent inadvertently influencing eating patterns Clarification that peer pressure is not typically problematic in children who are in the fifth and sixth grades

Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders

Which medication has been found to be worthy of a trial in clients with bulimia nervosa who have obsessive-compulsive traits? Lithium Haloperidol Fluoxetine Bupropion

Fluoxetine (Prozac)

A client with bulimia nervosa is scheduled for a visit to the clinic. When assessing this client, which would a nurse expect to find? Impulsivity Panic Hyperactivity Delusions

Impulsivity

A client has been diagnosed with bulimia. Which cognitive behavioral technique would be useful for the client? Self-monitoring Guided imagery Distraction Music therapy

Self-monitoring

People diagnosed with bulimia nervosa have lower levels of which neurotransmitter? Serotonin Norepinephrine Dopamine Acetylcholine

Serotonin

An adolescent diagnosed with anorexia nervosa is insistent on being allowed to take a laxative. Which response by the nurse best demonstrates the management of this client request? "Using laxatives is bad for you because your electrolytes can become unbalanced." "Using a laxative to purge is not an acceptable way to manage your weight." "Why do you want to take a laxative?" "Laxatives are not a part of your treatment plan."

"Laxatives are not a part of your treatment plan."

The client is 16 years old and has an identical twin just diagnosed with anorexia nervosa. The client shares with the nurse a concern about also developing the disorder. Which response by the nurse is the most appropriate? "Eating disorders have not been found to be genetic, so you do not have a particular risk." "While eating disorders have been shown to have a genetic basis, other factors also play a role in its development." "For identical twins, there is about a 5% chance that both twins develop an eating disorder." "It is not genetics but the environment that increases your risk. Since you live together, you have the same risk as your twin."

"While eating disorders have been shown to have a genetic basis, other factors also play a role in its development."

A client is 5 feet 6 inches tall, weighs 105 pounds, exercises 4 hours per day, and does not engage in any binging or purging behaviors. The client believes that he or she is becoming obese and states, "I'm shocked that you think I'm underweight. You don't understand me." The most likely diagnosis for this client is what? Anorexia nervosa, binge eating, and purging type Anorexia nervosa, restricting type Bulimia nervosa, nonpurging type. Eating disorder not otherwise specified

Anorexia nervosa, restricting type

A client is suspected of having anorexia nervosa and meets the diagnostic criteria for the disorder. When conducting the physical examination, which would be a probable finding from the assessment? Heat intolerance Complaints of heartburn Hypertension Bradycardia

Bradycardia

While a nurse talks to the mother of a 15-year-old client, the mother expresses concern over the client's eating and exercise habits. The mother says that as soon as the client comes home from school, the client exercises for 2 to 3 hours every day. She says the client eats very little at dinner, but in the morning she notices that large amounts of food are missing from the kitchen. The client was complaining of tooth pain, and when the mother took the client to the dentist, the client had over 10 cavities. Which disorder is the client most likely suffering from? Anorexia nervosa Binge-eating disorder Bulimia nervosa Eating disorder not otherwise specified

Bulimia nervosa

Anorexia nervosa, bulimia nervosa, and binge-eating disorder are becoming more and more common, with assessments for these disorders being made as young as 9 years of age. In the adult population, what means of controlling binge eating is most prevalent in men? Self-induced vomiting Compulsive exercise Laxative use Compulsive working

Compulsive exercise

The nurse is performing the history and physical examination on a client who is being admitted for anorexia nervosa. The client, a 23-year-old, is 5 feet 2 inches, and weighs 88 pounds. The nurse assesses the client's history of weight gain and loss, typical daily food intake, electrolyte and other blood studies, and elimination patterns. The nurse observes typical physical findings such as dry skin, lanugo, and brittle hair and nails. Which factor is a priority for the nurse to assess next? Throat and esophagus Condition of mouth and gums Heart rate and rhythm Patterns of activity and rest

Heart rate and rhythm

When teaching a client with bulimia nervosa about possible complications, which condition should the nurse emphasize? allergies lung cancer diabetes mellitus hepatitis A

diabetes mellitus