Ch. 26 PrepU
c
After complaining of weakness and confusion while at school, a 16-year-old client was admitted to the hospital where admission assessments revealed hypokalemia. The client has normal body weight. In planning the client's nursing care and treatment, which outcome should be prioritized? a. The client will verbalize fears relating to the client's health needs. b. The client will acknowledge self-harm thoughts. c. The client will be free of self-induced vomiting. d. The client will identify alternatives to current coping patterns.
c
The immediate goal of nursing interventions in the care of a client with anorexia nervosa is which of the following? a. Changing her irrational thinking about her body b. Establishing a target weight to be achieved by discharge c. Restoring nutritional status to normal d. Gaining insight into the effects of anorexia on her physical health
a
The nurse is caring for a client diagnosed with bulimia. Which would be important for the nurse to do first? a. Ask the client directly about thoughts of suicide or self-harm b. Identify the cues related to binging c. Control the eating responses d. Provide small regular meals and snacks
a
The nurse is caring for an adolescent female who reports amenorrhea, weight loss, and depression. Which additional assessment finding would suggest that the woman has an eating disorder? a. Excessive exercise b. Wearing tight-fitting clothing c. Tachycardia d. Moist skin
c
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? a. Throat and esophagus b. Condition of mouth and gums c. Heart rate and rhythm d. Patterns of activity and rest
a
The nurse is providing care to a client diagnosed with anorexia and notes that the client demonstrates behaviors that reflect an intense physical and emotional process that overrides all physiologic body cues. Which term would the nurse use to document this finding? a. Drive for thinness b. Body image distortion c. Interoceptive awareness d. Perfectionism
d
A client was admitted to the eating disorder unit with bulimia. When the nurse assesses for a history of complications of this disorder, which are expected? a. Respiratory distress and dyspnea b. Bacterial gastrointestinal infections and overhydration c. Metabolic acidosis and constricted colon d. Dental erosion and chronic edema
a
A client with an eating disorder states, "I've gained 2 pounds, so soon I'll be up by 100 pounds." The nurse interprets this as which of the following? a. Dichotomous thinking b. Magnification c. Selective abstraction d. Catastrophizing
a
At the prompting of friends, a 16-year-old client has agreed to meet with the school nurse who suspects that the client may have an eating disorder. During the nurse's assessment, the nurse has asked the client to describe the client's family. Which family process and characteristic is thought to contribute to eating disorders? a. Poor communication and enmeshed family dynamics b. The absence of a parent and/or the presence of a stepparent c. Passive parenting and lack of encouragement d. An overemphasis of peer relationships over family relationships
d
During a physical assessment, the nurse would recognize that there is the potential for medication-induced weight loss in a client who is being treated with which medication? a. Olanzapine b. Ziprasidone c. Risperidone d. Fluoxetine
b
During a therapy session, a client with anorexia tells the nurse, "I measured my thighs today. They are a quarter-inch larger than they were yesterday. I feel like a pig; I'm so fat." Which potential response by the nurse is most therapeutic? a. "I don't think you are fat." b. "Has something occurred that caused you to measure your thighs?" c. "You are exactly the right weight for your height." d. "You have always been very focused on your thighs. Is that the part of your body you like least?"
a
Exacerbation of anorexia nervosa results from the client's effort to do what? a. Gain control of one part of life b. Manipulate family members c. Diminish conflict d. Live up to family expectations
a
Historically, which of the following was the most widely accepted theory about anorexia nervosa? a. Conflicts of separation-individuation and autonomy b. Learned behavior from internalized peer pressure c. Changes in the structure of the brain d. Reduction in brain-derived neurotrophic factor (BDNF)
a
People diagnosed with bulimia nervosa have lower levels of which neurotransmitter? a. Serotonin b. Norepinephrine c. Dopamine d. Acetylcholine
d
The client with bulimia reports feeling helpless and says, "What's the use?" As the nurse plans the client's care, the priority diagnosis is which? a. Ineffective individual coping b. Anxiety c. Nutrition that is less than body requirements d. Risk for self-directed violence
a
The school nurse is evaluating a 16-year-old student who came to the office complaining of dizziness. The student is very thin and was pacing in the office while waiting to see the nurse. The nurse asks the student to step on the scale. The student asks if the student can go to the bathroom first to empty the student's bladder, stating, "That can make a big difference." The student's comment raises the nurse's suspicion that the student has ... a. anorexia nervosa. b. binge-eating disorder. c. bulimia nervosa. d. eating disorder not otherwise specified.
b
When working with the family of a client with anorexia nervosa, which issue must be addressed? a. Codependence b. Control c. Self-discipline d. Sexual identity
a
Which is a typical characteristic of parents of clients diagnosed with anorexia nervosa? a. Overprotective of their children b. A history of substance abuse c. Maintenance of emotional distance from their children d. Alternation between loving and rejecting their children
