Chapter 18: Eating and Feeding Disorders

A client on an inpatient 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 nursing response is most appropriate?

B. I will accompany you to the bathroom

4. A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and 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."

15. One bed is available on the inpatient eating-disorder unit. Which patient should be admitted to this bed? The patient whose weight decreased from

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

27. A 7-year-old child was diagnosed with pica. Which assessment finding would the nurse expect associated with this diagnosis?

a. The child frequently eats newspapers and magazines.

12. A nurse provides care for an adolescent patient diagnosed with an eating disorder. Which behavior by this nurse indicates that additional clinical supervision is needed?

a. The nurse interacts with the patient in a protective fashion.

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

b. Observe for adverse effects of refeeding.

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

b. Rigidity, perfectionism

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

23. A nurse finds a patient diagnosed with anorexia nervosa vigorously exercising before gaining the agreed-upon weekly weight. Which response by the nurse is appropriate?

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-behavioral therapy for a patient diagnosed with anorexia nervosa. Which statement by the staff nurse supports this type of therapy?

d. "Being thin doesn't 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 refeeding." Which system should a nurse closely monitor for dysfunction?

d. Cardiovascular

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

d. Patient expresses satisfaction with body appearance

A client diagnosed with an eating disorder has a nursing diagnosis of low self esteem. Which nursing intervention would address this client's problem?

A. Offer independent decision making opportunities

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.

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

a. prominent parotid glands.

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

d. Systolic blood pressure 62 mm Hg

Which outcome indicates that the client's problem of impaired body image has improved?

D. The client has acknowledged that perception of being fat is incorrect

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

C. Let's focus on your continued improvement. You ate 80% of your lunch

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?

C. Vomiting, which may lead to dehydration and electrolyte imbalance

Which anorexia nervosa symptom is physical in nature?

Dry yellow skin

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

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

26. The treatment team discusses adding a new prescription for lisdexamfetamine dimesylate to the plan of care for a patient diagnosed with binge eating disorder. Which finding from the nursing assessment is most important for the nurse to share with the team?

a. The patient's history of poly-substance abuse

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

a. assess lung sounds and extremities.

Three months ago a patient diagnosed with binge eating disorder weighed 198 pounds. Lorcaserin (Belviq) was prescribed. Which current assessment finding indicates the need for reevaluation of this treatment approach? The patient:

a. now weighs 196 pounds.

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 sense of control and promotes adherence to the plan of care.

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

b. not to skip meals or restrict food.

3. A patient referred to the eating disorders clinic has lost 35 pounds during the past 3 months. To assess eating patterns, the nurse should ask the patient:

c. "What do you eat in a typical day?"

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 that within 2 weeks the patient will

d. identify two alternative methods of coping with loneliness.

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

c. Anorexia nervosa

17. As a patient admitted to the eating-disorder unit undresses, a nurse observes that the patient's body is covered by fine, downy hair. The patient weighs 70 pounds and is 5'4" tall. Which term should be documented?

c. Lanugo

A 5-year-old child was diagnosed with encopresis. Which assessment finding would the nurse expect associated with this diagnosis? The child:

c. has accidents of defecation at kindergarten three times a week.

16. A nurse provides health teaching for a patient diagnosed with bulimia nervosa. Priority information the nurse should provide relates to

c. how to recognize hypokalemia.

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

c. promoting processing of anxiety associated with eating.

24. Which nursing diagnosis is more appropriate 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 lost 25% of body weight. The serum potassium is currently 2.7 mg/dL. Which nursing diagnosis applies?

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

18. A patient being admitted to the eating-disorder unit has a yellow cast to the skin and fine, downy hair over the trunk. The patient weighs 70 pounds; height is 5'4". The patient says, "I won't eat until I look thin." Select the priority initial nursing diagnosis.

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

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

d. gain 1 to 2 pounds.