Chapter 20: Eating Disorders

20. Physical assessment of a patient diagnosed with bulimia nervosa often reveals:

a. prominent parotid glands.

15. One bed is available on the inpatient eating disorders unit. Which patient should be admitted? The patient whose weight dropped from:

a. 150 to 100 pounds over a 4-month period. Vital signs: temperature, 35.9 C; pulse, 38 beats/min; blood pressure, 60/40 mm Hg

14. Which nursing intervention has the highest priority for a patient diagnosed with bulimia nervosa?

a. Assist the patient to identify triggers to binge eating.

27. A patient diagnosed with anorexia nervosa has a body mass index (BMI) of 14.8 kg/m2. Which assessment finding is most likely to accompany this value?

a. Cachexia

4. A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and has lost 25% of body weight. A nurse asks, Describe what you think about your present weight and how you look. Which response by the patient is most consistent with the diagnosis?

a. I am fat and ugly.

23. Which statement is a nurse most likely to hear from a patient diagnosed with anorexia nervosa?

a. I would be happy if I could lose 20 more pounds.

1. A patient referred to the eating disorders clinic has lost 35 pounds in 3 months and has developed amenorrhea. For which physical manifestations of anorexia nervosa should a nurse assess? Select all that apply.

a. Peripheral edema c. Constipation d. Hypotension f. Lanugo

25. An outpatient diagnosed with anorexia nervosa has begun re-feeding. Between the first and second appointments, the patient gained 8 pounds. The nurse should:

a. assess lung sounds and extremities.

1. Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. She wears layered, loose clothing and now has amenorrhea. Her current weight is 95 pounds, a loss of 35 pounds. Which medical diagnosis is most likely?

b. Anorexia nervosa

7. Which nursing intervention has priority as a patient diagnosed with anorexia nervosa begins to gain weight?

b. Observe for adverse effects of re-feeding.

8. A patient diagnosed with anorexia nervosa is resistant to weight gain. What is the rationale for establishing a contract with the patient to participate in measures designed to produce a specified weekly weight gain?

b. Patient involvement in decision-making increases a sense of control and promotes compliance with the treatment.

21. Which personality characteristic is a nurse most likely to assess in a patient diagnosed with anorexia nervosa?

b. Rigidity, perfectionism

12. What behavior by a nurse caring for a patient diagnosed with an eating disorder indicates the nurse needs supervision?

b. The nurse uses an authoritarian manner when interacting with the patient.

11. An appropriate intervention for a patient diagnosed with bulimia nervosa who binges and purges is to teach the patient to:

b. avoid skipping meals or restricting food.

2. A patient diagnosed with anorexia nervosa is hospitalized for treatment. What features should the milieu provide? Select all that apply.

c. Adherence to a selected menu d. Observation during and after meals e. Monitoring during bathroom trips

17. As a patient admitted to the eating disorders unit undresses, a nurse observes that the patients body is covered by fine, downy hair. The patient weighs 70 pounds and is 5 feet, 4 inches tall. Which condition should be documented?

c. Lanugo

3. A patient who is referred to the eating disorders clinic has lost 35 pounds in the past 3 months. To assess the patients oral intake, the nurse should ask:

c. What do you eat in a typical day?

16. While providing health teaching for a patient diagnosed with bulimia nervosa, a nurse should emphasize information about:

c. recognizing symptoms of hypokalemia.

26. When a nurse finds a patient diagnosed with anorexia nervosa vigorously exercising before gaining the agreed-upon weekly weight, the nurse should state:

d. According to our agreement, no exercising is permitted until you have gained a specific amount of weight.

10. A psychiatric clinical nurse specialist uses cognitive therapy techniques with a patient diagnosed with anorexia nervosa. Which statement by the staff nurse supports this type of therapy?

d. Being thin does not seem to solve your problems. You are thin now but still unhappy.

9. The nursing care plan for a patient diagnosed with anorexia nervosa includes the intervention Monitor for complications of re-feeding. Which body system should a nurse closely monitor for dysfunction?

d. Cardiovascular

24. Which nursing diagnosis is more applicable for a patient diagnosed with anorexia nervosa who restricts intake and is 20% below normal weight than for a 130-pound patient diagnosed with bulimia nervosa who purges?

d. Imbalanced nutrition: less than body requirements

5. A patient was diagnosed with anorexia nervosa. The history shows the patient virtually stopped eating 5 months ago and has lost 25% of body weight. The patients current serum potassium is 2.7 mg/dl. Which nursing diagnosis applies?

d. Imbalanced nutrition: less than body requirements, related to malnutrition as evidenced by loss of 25% of body weight and hypokalemia

18. A patient being admitted to the eating disorders unit has a yellow cast to the skin and fine, downy hair covering the body. The patient weighs 70 pounds; height is 5 feet, 4 inches. The patient is quiet and says only, I wont eat until I look thin. What is the priority initial nursing diagnosis?

d. Imbalanced nutrition: less than body requirements, related to self-starvation

2. Disturbed body image is the nursing diagnosis for a patient diagnosed with an eating disorder. Which outcome indicator is most appropriate to monitor?

d. Patient expresses satisfaction with body appearance.

22. Which assessment finding for a patient diagnosed with an eating disorder meets a criterion for hospitalization?

d. Systolic blood pressure: 62 mm Hg

6. Outpatient treatment is planned for a patient diagnosed with anorexia nervosa. Select the most important outcome related to the nursing diagnosis: Imbalanced nutrition: less than body requirements. Within 1 week, the patient will:

d. gain 1 to 2 pounds.

13. A nursing diagnosis for a patient diagnosed with bulimia nervosa is: Ineffective coping, related to feelings of loneliness as evidenced by overeating to comfort self, followed by self-induced vomiting. The best outcome related to this diagnosis is, Within 2 weeks the patient will:

d. identify two alternative methods of coping with loneliness.

19. A nurse conducting group therapy on the eating disorders unit schedules the sessions immediately after meals for the primary purpose of:

d. processing the heightened anxiety associated with eating.