Chapter 20

What is the primary difference between anorexia nervosa and bulimia nervosa?

Clients who are anorexic are proud of their control over eating, and clients with bulimia are ashamed of their behavior.

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

The nurse is teaching a client with bulimia to use self-monitoring techniques. Which of the following statements by the client would let the nurse know that this has been effective?

"I am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging."

A client on an in-patient psychiatric unit has been diagnosed with bulimia nervosa. The client states, "I'm going to the bathroom and will be back in a few minutes." Which response by the nurse is most appropriate?

"I will accompany you to the bathroom."

Which nursing statement is most effective in communicating a positive expectation of the client?

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

The nurse has been teaching a client about bulimia. Which statement by the client indicates that the teaching has been effective?

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

The nurse is sitting with the client at mealtime. The nurse uses cognitive-behavioral approaches to assist the client with bulimia toward recovery. Which of the following statement by the nurse would be consistent with this approach?

"Is there any way you can look at that sandwich as fuel for your body?"

The nurse has been teaching the client's family about the client's eating disorder, anorexia nervosa. Which statement would indicate that teaching was effective?

"We will negotiate resolutions to family conflicts."

All of the following nursing diagnoses are appropriate for the care of a client with anorexia nervosa. Which nursing diagnosis has the highest priority?

Imbalanced nutrition: less than body requirements

Which factors may contribute to the frequency of eating disorders in adolescents? Select all that apply.

Media portrayal of slimness as an ideal Body dissatisfaction in adolescent females Body image disturbance Seeking autonomy Seeking to develop a unique identity

The nurse is assessing a client with bulimia nervosa. Which of the following symptoms would the nurse expect to find? Select all that apply.

Normal weight for height Dental erosion Metabolic alkalosis

A client diagnosed with anorexia nervosa is newly admitted to an in-patient psychiatric unit. Which nursing intervention takes priority?

assessment and monitoring of vital signs and lab values to recognize and anticipate medical problems

A client has an eating disorder characterized by consuming an amount of food much larger than a person would normally eat. Afterward, the client often purges the food or exercises excessively. Between binges, the client often eats low-calorie foods or fasts. What is the client's most likely diagnosis?

bulimia nervosa

When working with the family of a client with anorexia nervosa, which of the following issues must be addressed?

control issues

Which nursing diagnosis would be most difficult to successfully resolve in a client who had anorexia nervosa?

disturbed body image

The nurse is assessing a client with an eating disorder. Which of the following personality characteristic would the nurse expect to detect when interacting with the client?

eager to please

A 16-year-old female with anorexia nervosa is admitted to the unit. Which is the most appropriate short-term outcome?

The client will admit she has a fear of gaining weight.

A nurse is presenting information to a community group about health. Which information should the nurse provide regarding calorie restriction diets at an early age in children?

Dieting at an early age may lead to the development of eating disorders.

Which of the following would be most supportive for family and friends of a client with an eating disorder?

Emotional support, love, and attention

The nurse is teaching the family of a client who has bulimia about nutritional needs. Which dietary pattern would be most helpful to assist the client in recovering from bulimia?

Encourage the entire family to engage in a balanced and regular dietary pattern.

The nurse understands that which biologic factors may influence the development of an eating disorder? Select all that apply.

Family history of eating disorders Dysfunction of the hypothalamus Norepinephrine imbalances Decreased serotonin levels

When preparing a client with bulimia for the implementation of discharge, the nurse suggests that the client and family continue with family therapy on an outpatient basis. Which of the following is the rationale for this suggestion?

Family members often need to learn role independence and autonomy.

While assessing the family dynamics of a client with an eating disorder, which of the following does the nurse most likely discover?

Over controlling parents

A nurse, sitting with a client diagnosed with anorexia nervosa, notices that the client has eaten 80 percent of lunch. The client asks the nurse, "What do you like better, hamburgers or spaghetti?" Which is the best response by the nurse?

"Let's focus on your continued improvement. You ate 80 percent of your lunch."

The nurse has just completed her admission assessment of the client with anorexia. When documenting the mental status exam findings in the chart, the nurse notes poor judgment and insight. Which client statement would support this impression?

"Others are just trying to keep me from looking good."

The nurse is assisting the client with anorexia nervosa to express feelings more openly. Which response by the nurse would be most likely to encourage expression of feelings?

"Tell me what you are feeling right now."

A client is being admitted to the in-patient psychiatric unit with a diagnosis of bulimia nervosa. The nurse would expect this client to fall within which age range?

18 to 22 years old

A client who has an eating disorder is becoming dependent on the nurse for direction in food choices. Which approach by the nurse would demonstrate the nurse's self-awareness?

Approach the client with an adult-like objectivity.

The nurse is helping a client with an eating disorder to accept her body image, but she must first learn effective coping skills. Which of the following statement best describes the relationship between body image and coping skills?

Being able to cope in healthy ways improves the ability to accept a realistic body image.

Which may help a person to overcome an eating disorder that causes weight gain?

Believing that gaining weight is an effect of unhealthy lifestyle behaviors and losing weight is an effect of healthy lifestyle behaviors

A 15-year-old female is admitted for treatment of anorexia nervosa. Which is characteristic of anorexia nervosa?

Body weight less than normal for age, height, and overall physical health

Which is the primary objective of nursing interventions in the care of a client with anorexia nervosa?

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 would indicate to the nurse that this client might have anorexia nervosa?

Severe weight loss due to self-imposed dieting

A client with a long history of bulimia nervosa is seen in the emergency department. The client is seeing things that others do not, is restless, and has dry mucous membranes. Which is most likely the cause of this client's symptoms?

vomiting, which may lead to dehydration and electrolyte imbalance

Which nursing intervention would be most likely to help the client with anorexia to establish healthy eating patterns?

Offer liquid protein supplements if the client is unable to complete meal.

Several medications are prescribed for a client who has anorexia. Which medication may be prescribed to help treat the client's distorted body image?

Olanzapine