prep u chapter 70

A parent whose daughter is diagnosed with bulimia nervosa asks a nurse, "How can my child have an eating disorder when she isn't underweight?" Which response is best?

"A person with bulimia nervosa can maintain a normal weight."

A nurse is collecting data about possible substance abuse in a client with bulimia nervosa. Which question is best for obtaining information about this possible problem?

"Have you ever used diet pills?"

The nurse is counseling a client who is overweight and would like to begin to lose weight. Which statement by the client requires further information from the nurse?

"I am planning on drinking a lot of water in the morning and the afternoon which will help me skip both breakfast and lunch. That will help me reduce my calorie count for the day."

Which statement indicates a client with bulimia nervosa is making progress in interrupting the binge-purge cycle?

"I called my friend the last two times I got upset."

One approach to establish adequate eating patterns for a client with anorexia is to assume a positive expectation of the client. Which is the best statement by the nurse?

"I will sit here quietly with you while you eat."

The parents of a client with anorexia nervosa ask the nurse about the predisposing risk factors for developing this disorder. After reinforcement of the teaching plan by the nurse, which statement by the parents best indicates that the teaching has been effective?

"Risk factors include low self-esteem and problems with family relationships."

A nurse who provides care at an inpatient eating disorder clinic is performing an admission assessment of a young woman who has been diagnosed with anorexia nervosa. Which of the following assessment questions is most therapeutic?

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

A client with bulimia nervosa is discussing her abnormal eating behaviors. Which statement by the client indicates she's beginning to understand this eating disorder?

"When my loneliness gets to me, I start to binge."

A nurse is providing a community seminar about eating disorders. Which age group would the nurse be most likely to target because of their increased risk?

12 to 25 years

A client with an eating disorder is 5 feet, 5 inches tall and weighs 87 lbs. The nurse calculates the client's BMI as what number? Fill in the blank with a number.

14.5

A client desires to lose 40 lb and is undergoing a physical before beginning a weight loss regimen. During the education session, the client asks how many calories an average adult should consume daily. What is the nurse's reply?

1500 to 2500 calories

A client comes to the health clinic for a physical exam. He is complaining that he is not happy with himself about being overweight. He has been depressed for several weeks. When discussing his weight goal, he asks the nurse, "What is a normal or healthy BMI?" The nurse's correct response would include which of the following?

18 to 24.9

A client is in treatment for anorexia nervosa and has a BMI of 16. What BMI would the nurse be likely to set as a goal for the client by the end of treatment? Fill in the blank with a number.

18.5

The BMI range deemed healthy is:

18.5 to 24.9

The nurse is assisting the client with anorexia nervosa who is on bathroom restrictions after meals. For how many hours after meals would the nurse typically restrict the client's use of the bathroom? Record your answer using a whole number.

2

A client has anorexia nervosa. The nurse is reviewing her food intake. Which of the following daily calorie counts would be most consistent with the client's diagnosis.

600 to 900 calories/day

The nurse is explaining the etiology of bulimia nervosa to the mother of a preteen newly diagnosed with the disorder. What would the nurse tell the mother the behaviors center on?

A dissatisfaction with body size and shape

A client with anorexia nervosa tells a nurse she always feels fat. Which intervention is best for this client?

Addressing the dynamics of the disorder

What are the primary components of medical management for anorexia nervosa? Select all that apply.

All answers are correct.

Which statements about eating disorders are true? Select all that apply.

All choices are true.

A teenage client is diagnosed with an eating disorder. What psychological characteristics would this client be likely to demonstrate?

All options are correct.

A 15-year-old adolescent female is brought to the clinic by her parents because of a significant amount of weight loss in the past 4 months. Which accompanying condition would indicate that the client is suffering from anorexia nervosa?

Amenorrhea

A 12-year-old girl is brought to the pediatrician for her annual physical examination. The nurse notes that the girl has lost 15 pounds over the past 6 months when she was last seen for bronchitis. The nurse asks the child if she has been dieting and the girl proudly responds "yes." What would the nurse suspect of this child?

Anorexia nervosa

A client is being seen in the health clinic. During the nursing assessment, the client states that she has amenorrhea for the last 6 months. She weighs 80 pounds and is 5'2" tall. She states that she usually eats salads so that she does not gain weight. The nurse suspects that the client most likely has:

Anorexia nervosa

A 14-year-old ballet dancer is underweight with recent hair loss, yellowish skin, facial lanugo, and peripheral edema. Her parents have brought the client to the community health center with concerns that their daughter may have a liver problem. The nurse can assess Brittany's symptoms as indicative of which disorder?

Anorexia nervosa.

The nurse is caring for an 18-year-old gymnast who has been admitted for investigation of seizures. She weighs 50 kg. For two meals, the nurse observes that she eats a very small amount of salad and skim milk. What approach would you take?

Ask her about her appetite, reasons for her low intake and her usual eating patterns.

The nurse in the pediatric clinic is beginning an assessment of a 7-year old child. The child is severely underweight and appears to have little to no energy. In looking at the child's past history, the child has not gained weight in 15 months. The nurse asks the mother of the child bout the child's eating habits. The mother states that the child will not eat or drink anything that is yellow, green or purple in color, won't chew meat and doesn't like any food that is soft when put in the mouth. The nurse is aware that this child may be dealing with what eating disorder?

Avoidant/restrictive food intake disorder

A 14-year-old girl is brought to the clinic by her mother. Her mother tells the nurse that on "several" occasions, she has found her daughter during the night eating things like a whole pizza or a carton of ice cream. The nurse asks the girl about this behavior and the girl begins to cry. The nurse knows that this behavior is a symptom of what?

Bulimia nervosa

An adolescent client is being admitted to the psychiatric unit for treatment of an eating disorder. Her admission interview reveals a history of recurrent episodes of binge eating and self-induced vomiting. The nurse recognizes these as symptoms of what disease?

Bulimia nervosa

The nurse is caring for several clients with various suspected eating disorders as follows:

Client B

The difference between clients with anorexia nervosa and bulimia nervosa is which of the following?

Clients who are anorexic are proud of their control over eating, whereas bulimic clients are ashamed of their behavior.

A nurse is assisting with a comprehensive history and physical examination of a client with a suspected eating disorder. Which of the following signs and symptoms would the nurse recognize as consistent with anorexia nervosa? Select all that apply.

Decrease of 25% in body weight since last measurement Weight is 75% or less of normal Amenorrhea

A client was admitted to the eating disorder unit with bulimia nervosa. When the nurse assesses for a history of complications of this disorder, which of the following are expected?

Dental erosion and swollen parotid glands.

The nurse in an adolescent clinic receives a phone call from a health care professional who believes a client being seen at this clinic has bulimia nervosa. The nurse is aware that which health care professional is often the first one to note characteristics of this disorder?

Dentist

The nurse is assessing an older adult client and notes that the client has lost 15 pounds in the last three months. Diagnostic tests do not reveal any physiologic problem. The nurse is aware that weight loss in an older adult is indicative of which psychosocial problem?

Depression

A client with bulimia and a history of purging by vomiting is hospitalized for further observation because she is at risk for which of the following?

Electrolyte imbalances and cardiac dysrhythmias

The grandparents of a client with anorexia nervosa want to support the client but aren't sure what they should do. Which intervention is best?

Encouraging positive expressions of affection

Binge eating in anorexia nervosa is usually followed by purging. A mental health nurse knows that purging is defined as what?

Evacuation of the digestive tract by self-induced vomiting or excessive use of laxatives and diuretics

A client with bulimia nervosa tells a nurse she was doing well until last week, when she had a fight with her father. Which nursing intervention would be most helpful?

Examining the relationship between feelings and eating

Clients with anorexia nervosa become totally absorbed in their quest for weight loss and thinness. This exacerbation of anorexia nervosa results from the client's effort to:

Gain control of one part of her life

Which of the following interventions would be appropriate for a client with anorexia nervosa?

Having the client in view of staff for 90 minutes after each meal

A client with anorexia nervosa tells a nurse, "I'll never have the slender body I want." Which intervention is best to handle this problem?

Helping the client work on developing a realistic body image

A client with binge-eating disorder is significantly overweight. What complications of the condition would the nurse address with the client as part of health education? Select all that apply.

Hyperlipidemia Hypertension Degenerative arthritis

A client admits to binging and purging for the past month. What step can family take to help this client?

Identify situations which trigger the behavior.

Implementation of the nursing treatment plan for the client with bulimia may include which of the following?

Increasing coping skills for anxiety

Clients with eating disorders are generally not aware of how much or how little they are eating because of their altered perception of their body's size and shape. What intervention by the nurse can assist these clients in recognizing what they are actually eating?

Maintain a strict intake and output log.

The nurse is caring for a client with bulimia nervosa and should know to recognize this disorder because of which characteristics? Select all that apply.

Near normal or overweight Engages in binging and purging Acknowledging the behavior is abnormal

The nurse is aware that approximately one-third of clients with anorexia nervosa have also been diagnosed with which anxiety disorder?

Obsessive-compulsive disorder

The nurse is talking to a client with an eating disorder who has received a prescription for naltrexone/bupropion. The nurse is aware that this medication will cause which type of medications to lose their effectiveness?

Opioids

A nurse is taking the health history of a client with anorexia nervosa. Which of the following traits would be most consistent with the client's eating disorder?

Perfectionism

A client with anorexia is hospitalized to manage her eating disorder. Which of the following interventions should the nurse include in the plan of care?

Provide highly structured mealtimes with regular meals of sufficient caloric intake to promote weight gain.

The immediate goal of nursing interventions in the care of a client with anorexia nervosa is which of the following?

Restoring nutritional status to normal

During an initial interview at a clinic, a young female client states that there is nothing wrong with her. Which of the following would indicate to the nurse that this client might have anorexia nervosa?

Severe weight loss due to self-imposed dieting

What would the nurse consider evaluation criteria for psychotherapeutic progress in the client with an eating disorder?

The client embraces a realistic self-image.

For a client with anorexia nervosa, which goal takes the highest priority?

The client will establish adequate daily nutritional intake.

Which behavior differentiates an individual with bulimia nervosa from a person who has anorexia nervosa?

The person engages in episodic binge eating.

Which statement about the binge-purge cycle that occurs with bulimia nervosa is correct?

There are emotional triggers connected to binging.

A client has gained 100 lb over the past 20 years, and wants to lose weight. What strategy will greatly contribute to this client's success?

a sensible weight loss regimen prescribed by a dietitian

A teenage client is receiving a complete physical examination. The client's weight is significantly below normal limits, yet the client participates in family meals, consuming a reasonable amount of food. Diagnostic tests for parasites, bowel abnormalities, and endocrine disorders are negative. What could be causing the client's weight loss?

bulimarexia

The nurse is caring for several clients with various eating disorders as follows: Client A = Male client, 45 years old, BMI of 32 Client B = Male client, 15 years old, BMI of 16 Client C = Female client, 25 years old, BMI of 26 Client D = Female client, 60 years old, BMI of 24 Based only on these findings, which of these clients is most at risk for binge-eating disorder?

client A

Eating in the absence of hunger or regardless of feeling full is:

compulsive overeating.

A client with a long-standing bulimia problem has developed complications from the eating disorder. Which is not a complication associated with bulimia?

eczema

A client desires to lose 40 lb and is undergoing a physical before beginning a weight loss regimen. During the education session, the client asks what determines the daily amount of caloric intake needed. What is the nurse's answer?

energy needs, cell repair and growth

During a binge, people with bulimia consume 3500 to 11,500 calories of food in 2 hours or less. Which does not end an episode of binging?

medication

Understanding the definition of eating disorders is important in communicating facts while managing these conditions. Which is not an eating disorder?

obesity

A teenage client is brought to the ED with a fractured left hip. The client is is 5'4" tall and weighs 82 lbs, and reports dieting to fit into a prom dress. What likely caused the fracture?

osteopenia

What methods do clients with bulimia use to compensate for binging? Select all that apply.

purging (elimination of nutrients using self-induced vomiting, laxatives, enemas, or diuretics) fasting, using diet pills, or engaging in excessive exercise

What is the cause of anorexia nervosa?

unknown

A 15-year-old client is brought to the clinic by her mother. Her mother expresses concern about her daughter's weight loss and constant dieting. The nurse conducts a health history interview. Which comment indicates that the client may be suffering from anorexia nervosa?

"I just can't seem to get down to the weight I want to be. I'm so fat compared to other girls."

Which assessment finding would most likely be seen in a client with anorexia?

BMI of 16 or less anemia low potassium and sodium

The nurse is caring for several clients with various suspected eating disorders as follows: Client A = Male client, 45 years old, BMI of 32 Client B = Male client, 15 years old, BMI of 16 Client C = Female client, 25 years old, BMI of 26 Client D = Female client, 60 years old, BMI of 24 Based only on these findings, which of these clients is most at risk for anorexia nervosa?

Client B

The nurse is caring for several clients with various eating disorders as follows: Client A = Male client, 50 years old, BMI of 30 Client B = Male client, 15 years old, BMI of 14 Client C = Female client, 28 years old, BMI of 27 Client D = Female client, 60 years old, BMI of 17 Based only on these findings, which of these clients is most at risk for bulimia nervosa?

Client C

Clients with overeating problems often experience psychological problems. These would include:A client has symptoms including an inability to accurately interpret hunger and fullness signals, swelling of parotid glands, frequent weight fluctuations, and irregular menses. This client's eating disorder is likely:

bulimia nervosa.