Chapter 21 Davis Edge

Which statement made by the student nurse indicates effective learning about various medications used to treat symptoms associated with eating disorders? A. "fluoxetine acts by decreasing the craving for carbs" B. "sibutramine suppresses the appetite by triggering the release of serotonin" C. "Lorcaserin suppresses the appetite by inhibiting the release of norepinephrine" D. "Topiramate reduces obsessive-compulsive symptoms by stimulation the central nervous system"

A. "fluoxetine acts by decreasing the craving for carbs" Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor agent. It decreases cravings for carbohydrates. It is indicated for the treatment of binge eating associated with bulimia nervosa. This statement indicates effective learning.

What would the nurse suspect in a client with anorexia nervosa as a symptom of imbalanced nutrition? A. amenorrhea B. poor eye contact C . increases tension D. dissatisfaction with appearance

A. amenorrhea Due to severe weight loss, absence of menstruation (amenorrhea) is noticed in a client with anorexia nervosa.

Which are the symptoms associated with excessive weight loss due to anorexia nervosa? Select all that apply. A. edema B. lanugo C. tachycardia D. hypotension E. hyperthermia

A. edema B. lanugo C. tachycardia D. hypotension Low consumption of food causes retention of fluids in the body tissues. Therefore, the nurse finds edema in a client with excessive weight loss due to anorexia. The client with anorexia has significant weight loss, and the body no longer has enough body fat to promote heat regulation. As a result, fine white hairs known as lanugo grow all over the body to trap heat. Starvation and refusal to eat food causes decreased cardiac output, resulting in decreased heart rate, called bradycardia. Lack of nutrients in the diet and dehydration caused by excess physical activity cause a decrease in the blood pressure, or hypotension. Excess fluid shifts from the vascular compartment to the tissues, also causing hypotension.

Which behaviors are associated with a binge-eating disorder? Select all that apply. A. feeling guilty after overeating B. eating until the feeling of hunger goes away C. feeling disgusts with oneself D. eating much more slowly than normal E. eating large amounts of food when feeling physically hungry

A. feeling guilty after overeating C. feeling disgusts with oneself A client with a binge-eating disorder feels guilty after overeating because he or she is afraid of gaining excessive weight. A client with a binge-eating disorder feels disgusted with oneself after overeating because he or she is afraid of gaining excessive weight.

Which complications would the nurse expect due to decreased blood pressure and electrolyte imbalances in a client with anorexia nervosa? Select all that apply. A. fever B. poor skin tugor C. elevated hematocrit D. increased urine output E. increased urine concentration

A. fever B. poor skin tugor C. elevated hematocrit E. increased urine concentration Electrolyte imbalances are complications of imbalanced nutrition. A client with anorexia due to imbalanced nutrition shows hypothermia, not hyperthermia. Electrolyte imbalances may lead to poor skin turgor. Due to a deficiency in electrolytes, the skin may become dry. A client with anorexia shows deficiency in fluid volume. Therefore, the percentage of red blood cells (hematocrit) in the blood becomes increased or elevated. Due to decreased fluid volume, the urine of the client will be more concentrated.

After assessing a client with anorexia nervosa, the nurse finds that the client has lost 2 pounds. The nurse plans to enforce restrictions on the client. Which could be the reason for this intervention? Select all that apply. A. to avoid power struggles B. to ensure safety of the client C. to prevent self-induced vomiting D. To encourage compliance with therapy E. to eliminate discarding food from the tray

A. to avoid power struggles B. to ensure safety of the client D. To encourage compliance with therapy If weight loss is noticed, the nurse should enforce restrictions. This avoids power struggles. Restrictions are enforced if further weight loss is noticed to ensure the safety of the client. To encourage compliance with the therapy, restrictions are enforced when weight loss is observed.

The nurse is caring for a client diagnosed with a binge-eating disorder and obesity. The medical history of the client reveals the presence of migraine attacks. Which treatment strategy would be beneficial to the client in this situation? A. topiramate B. fenfluramine C. diethylproprion D. benzphetmaine

A. topiramate Topiramate causes weight loss and reduces the number of binge-eating episodes, so it is used in the long-term treatment of binge-eating disorder with obesity. It is also known to prevent migraine attacks. Therefore, this medication is beneficial to the client.

which client behavior led the nurse to suspect the client has the purging type of anorexia nervosa A. using laxatives to get rid of excessive ingested food B. fasting for 5 days a week to lose weight C. losing 10 kg of weight due to a strict diet D. engaging in physical exercises for 10 hours a day to lose weight

A. using laxatives to get rid of excessive ingested food Purging behavior refers to the self-induced vomiting or misuse of laxatives, diuretics, or enemas to get rid of excessive ingested food. Therefore, this client displays the purging type of anorexia nervosa.

which would the nurse expectant find in the medical history of a client with bulimia nervosa? A. schizophrenia B. depression C. xenophobia D. paranoid personality

B. depression Depression may contribute to binge eating when food provides comfort. Therefore, the nurse may find depression in the medical history of a client with bulimia nervosa.

After reassessment of a client diagnosed with anorexia nervosa, the nurse finds that the client has lost 1.5 pounds in the past week in spite of eating all meals and snacks. Which action would the nurse undertake in this situation A. help the client identify the cause of maladaptive behaviors B. observe the client for at least 1 hour after the client eats his or her meals C. consult the dietician and increase the caloric intake of the client D. refer the client to a support or therapy group

B. observe the client for at least 1 hour after the client eats his or her meals urther weight loss in spite of eating all meals and snacks indicates that the client is still performing self-destructive behaviors. Therefore, the nurse would observe the client for at least 1 hour after meals.

Which would the nurse infer from finding that a client has six binge-eating episodes every week? A. client has mild symptoms of binge eating B. the client has moderate symptoms if binge eating C. the client has severe symptoms of binge eating D. the client has extreme symptoms of binge eating

B. the client has moderate symptoms if binge eating A client having four to seven binge-eating episodes per week indicates moderate symptoms of binge eating. Because six binge-eating episodes falls within this range, the nurse infers moderate symptoms of binge eating in this client.

While caring for a client with anorexia nervosa who is diagnosed with ineffective denial, the nurse shows a matter-of-fact approach during therapy. Which outcome would the nurse expect from this intervention? A. the client develops a positive impression of the nurse B. the client reduces the use of manipulative behaviors C. the client expresses anger in an appropriate manner D. the client diminishes the need to gain control over maladaptive eating behaviors

B. the client reduces the use of manipulative behaviors The nurse would not argue with the client who is resistant to treatment. Instead, the nurse would follow a matter-of-fact approach for unacceptable behaviors. This nursing intervention causes the client to reduce the use of manipulative behaviors.

Which behavior would the nurse find in a client with anorexia nervosa? A. eating secretly B. washing hands frequently C. terminating eating by social interruption D. eating large amounts of food when not feeling physically hungry

B. washing hands frequently Compulsive behaviors may also present in the client with anorexia nervosa. Therefore, frequent hand washing may be noticed in a client with anorexia nervosa.

Which intervention by the student nurse providing care to a client with anorexia nervosa who presents with imbalanced nutrition requires correction? A. providing liquid diet through an NG tube when the client is unable to take in food orally B. providing adequate calories with a dietician's advice when the client is able to take in foods orally C. measuring the weight of the client at bedtime, following voiding D. discoursing the client from bathing every day if his or her skin is dry

C. measuring the weight of the client at bedtime, following voiding The nurse would weigh the client immediately on arising and following the first voiding. This intervention made by the student nurse requires correction.

Which statement made by the client supports the nurse's conclusion that the client has a binge-eating disorder? A. "I eat low-calorie foods because I am on a diet" B. "I exercise to burn fat" C. "I vomit the ingested food when I eat in large amounts" D. "I eat high fat food and I don't care about excess calories"

D. "I eat high fat food and I don't care about excess calories" A client with a binge-eating disorder eats large amounts of food and does not show any behavior to get rid of the excess calories.

Which complication does the nurse expect in the client with bulimia nervosa who has a history of excessive vomiting and purging? A. seizures B. kidney stones C. muscle atrophy D. esophageal tears

D. esophageal tears A client with bulimia nervosa shows the symptoms of binging and purging. Purging causes abdominal distention, causing the formation of tears in the esophageal or gastric mucosa.

On reviewing the laboratory results for a client with anorexia nervosa, the nurse determines the client has hypovolemia. Which client behaviors support the nurse's findings? A. increased tension B. compulsive eating C. increased fluid intake D. excessive use of laxatives

D. excessive use of laxatives The client loses excessive fluids due to intake of laxatives. This indicates risk of hypovolemia.

which area of the brain contains the appetite regulation center A. thalamus B. parietal lobes C. hippocampus D. hypothalamus

D. hypothalamus

which would the nurse infer about the condition of a client who has a body mass index (BMI) of 17 kg/m2? A. the client is obese B. the client is overweight C. the client is a normal weight D. the client has anorexia nervosa

D. the client has anorexia nervosa

Which is the rationale for including a behavior modification program when training clients diagnosed with anorexia nervosa and bulimia nervosa? A. to help the clients correct the feelings of of distorted body image B. to address the client's underlying anger associated with the disorder C. to allow the client to recognize the maladaptive eating behaviors D. to allow the client to maintain control over eating behaviors

D. to allow the client to maintain control over eating behaviors Lack of control over the maladaptive eating behaviors is common in a client with anorexia nervosa or bulimia nervosa. Behavior modification therapy allows the client to maintain control over eating and exercising.