Eating Disorders Worksheet

1. A female with bulimia nervosa tells a nurse she and her parents don't agree on anything. Which method is best to address this problem when the family comes for a family meeting? A. Focus on conflict resolution skills. B. Establish an internal locus of control. C. Construct a three-generation genogram. D. Discuss age-specific developmental problems.

A. Focus on conflict resolution skills.

1. A nurse is assessing a client with bulimia nervosa for possible substance abuse. Which question is best to obtain information about this possible problem? A. "Have you ever used diet pills?" B. "Where would you go to buy drugs?" C. "At what age did you start drinking?" D. "Do your peers ever offer you drugs?"

A. "Have you ever used diet pills?"

1. Which statement made by the client about the binge-purge cycle that occurs with bulimia nervosa indicates understanding of the disorder? A. "There are emotional triggers connected to bingeing." B. "Over time, people usually grow out of bingeing behaviors." C. "Bingeing isn't the problem, purging is the issue to address." D. "When a person gets too hungry, there's a tendency to binge."

A. "There are emotional triggers connected to bingeing."

1. A female client with bulimia nervosa is discussing her abnormal eating behaviors. Which statement by the client indicates she's beginning to understand this eating disorder? A. "When my loneliness gets to me, I start to binge." B. "I know that when my life gets better I'll eat right." C. "I know I waste food and waste my money on food." D. "After my parents' divorce, I'll talk about bingeing and purging."

A. "When my loneliness gets to me, I start to binge."

A parent with a daughter with bulimia nervosa asks a nurse, "How can my child have an eating disorder when she isn't underweight?" Which response is best?" A. A person with bulimia nervosa can maintain a normal weight." B. "It's hard to face this type of problem in a person you love." C. "At first there is no weight loss; it comes later in the disease." D. "This is a serious problem even though there is no weight loss."

A. A person with bulimia nervosa can maintain a normal weight."

1. A young female client with bulimia nervosa wants to lessen her feelings of powerlessness. Which short term goal is most important initially? A. Learn problem solving skills. B. Decrease symptoms of anxiety. C. Perform self-care activities daily. D. Verbalize how to set limits with others.

A. Learn problem solving skills.

1. A 15 year-old female is brought to the clinic by her parents because of a significant amount of weight loss in the past 4 months. Which accompanying conditions would indicate that the client is suffering from anorexia nervosa? A. Hypertension B. Amenorrhea C. Hyperthermia D. Diarrhea

B. Amenorrhea

1. A client with bulimia and a history of purging by vomiting is hospitalized for further observation because she's at risk for which following? A. Diabetes mellitus B. Electrolyte imbalance C. GI obstruction D. Septicemia

B. Electrolyte imbalance

1. A female client with bulimia nervosa tells a nurse her parents don't know about her eating disorder. Which goal is appropriate for this client and her family? A. Decrease the chaos in the family unit. B. Learn effective communication skills. C. Spend time together in social situations. D. Discuss the client's need to be responsible.

B. Learn effective communication skills.

1. A client with a diagnosis of bulimia nervosa is working on relationship issues. Which nursing intervention is most important? A. Have the client work on developing social skills. B. Focus on how relationships cause bulimic behavior. C. Help the client identify feelings about relationships. D. Discuss how to prevent getting overinvolved in relationships.

C. Help the client identify feelings about relationships.

1. When discussing self-esteem with a client with bulimia nervosa, which area is the most important? A. Personal fears B. Family strengths C. Negative thinking D. Environmental stimuli

C. Negative thinking

1. Which complication of bulimia nervosa is life-threatening? A. Serum calcium 10.1 mg/dl B. Heart rate 56 beats/minute C. Serum potassium 2.9 mEq/L D. Respiratory rate 16 breaths/minute

C. Serum potassium 2.9 mEq/L

1. A nurse is assessing a client with a history of recent binge eating. Which of the following symptoms would the nurse most likely observe in this client? A. Ageusia B. Headache C. Pain D. Sore throat

C. pain

1. A female client is talking to a nurse about her binge-purge cycle. Which question should the nurse ask about the cycle? A. "Do you know how to stop the binge purge cycle?" B. "Does the binge-purge cycle help you lose weight?" C. "Can the binge-purge cycle take away your anxiety?" D. "How often do you go through the binge-purge cycle?"

D. "How often do you go through the binge-purge cycle?"

1. A nurse is talking to a client with bulimia nervosa about the complication of laxative abuse. Which statement by the client indicates that she's beginning to understand the risks associated with laxative abuse? A. "I don't really have much taste for food, so there's no loss in getting it out my system more quickly." B. "Laxatives helps me get rid of extra calories before they're added to my body. I know I just shouldn't eat the extra calories to begin with." C. "Laxatives are over-the-counter medications that have no harmful effect." D. "Using laxatives prevents my body from absorbing essentials nutrients such as protein, fat, and calcium."

D. "Using laxatives prevents my body from absorbing essentials nutrients such as protein, fat, and calcium."

1. A client with anorexia nervosa is worried about rectal bleeding. Which question should be asked to obtain more information about this problem? a. "How often do you use laxatives?" b. "How many days ago did you stop vomiting?" c. "Are you eating anything that causes irritation?" d. "Do you have bleeding before or after exercise?"

a. "How often do you use laxatives?"

1. Which question is most useful in assessing the self-esteem of a client with anorexia nervosa? a. "How would you describe yourself to others?" b. "What activities do you enjoy doing with your friends?" c. "Do you play any sports at school or in your community?" d. "How do you decide how to spend your free time?"

a. "How would you describe yourself to others?"

1. Which statement indicates a female client with bulimia nervosa is making progress in interrupting the binge-purge cycle? a. "I called my friend the last two times I got upset." b. "I know I'll have this problem with eating forever." c. "I started asking my mother or sister to watch me eat each meal." d. "I can have my boyfriend bring me home from parties if I want to purge."

a. "I called my friend the last two times I got upset."

1. In making a care plan for a family with a member who has anorexia nervosa, which information should be included? a. Coping mechanisms used in the past. b. Concerns about changes in lifestyle and daily activities. c. Rejection of feedback from family and significant others. d. Appropriate eating habits and social behaviors centering on eating.

a. Coping mechanisms used in the past.

1. A female client with bulimia nervosa tells a nurse she was doing well until last week, when she had a fight with her father. Which nursing intervention should help most? a. Examine the relationship between feelings and eating. b. Discuss the importance of therapy for the entire family. c. Encourage the client to avoid certain family members. Identify daily stressors and learn stress management skills

a. Examine the relationship between feelings and eating.

1. Which goal is best to help a client with anorexia nervosa recognize self-distortions? a. Identify the client's misperceptions of self. b. Acknowledge immature and childlike behaviors. c. Determine the consequences of faulty support system. d. Recognize the age-appropriate tasks to be accomplished.

a. Identify the client's misperceptions of self.

1. The grandparents of a client with anorexia nervosa want to support the client, but aren't sure what they should do. Which intervention is best? a. Promote positive expressions of affection. b. Encourage behaviors that enhance socialization. c. Discuss how eating disorders create powerlessness. d. Discuss the meaning of hunger and body sensations.

a. Promote positive expressions of affection.

1. What initial action should a nurse take when a young female client with anorexia nervosa says, "I'll try to eat something"? a. Provide a small portion of a healthy food. b. Weigh the client before and after eating. c. Ask the client what she thinks she can eat. d. Suggest the client drink something before eating.

a. Provide a small portion of a healthy food.

1. A nurse is caring for an anorexic client with a nursing diagnosis of Imbalanced nutrition: Less than body requirements related to dysfunctional eating patterns. Which interventions would be supportive for this client? Select all that apply. a. Provide small, frequent meals. b. Monitor weight gain. c. Allow the client to skip meals until the anti-depressant levels are therapeutic. d. Encourage the client to keep a journal. e. Encourage the client to eat three substantial meals per day.

a. Provide small, frequent meals. b. Monitor weight gain. d. Encourage the client to keep a journal.

1. An adolescent female client with anorexia nervosa tells a nurse about her outstanding academic achievements and her thoughts about suicide. Which factor must the nurse consider when making a care plan for this client? a. Self-esteem b. Physical illnesses c. Paranoid delusions d. Relationship avoidance

a. Self-esteem

1. A nurse should be alert for which findings in a client with bulimia nervosa? Select all that apply: a. Severe electrolyte imbalances b. Damaged teeth due to the eroding effects of gastric acids on tooth enamel c. Pneumonia from aspirated stomach contents d. Cessation of menses e. Esophageal tears and gastric rupture f. Intestinal inflammation

a. Severe electrolyte imbalances b. Damaged teeth due to the eroding effects of gastric acids on tooth enamel d. Cessation of menses e. Esophageal tears and gastric rupture

1. A nurse plans to include the parents of a client with anorexia nervosa in therapy sessions along with the client. What fact should the nurse remember about parents of clients with anorexia? a. They tend to overprotect their children. b. They usually have a history of substance abuse. c. They maintain emotional distance from their children. d. They alternate between loving and rejecting their children.

a. They tend to overprotect their children.

1. A client with bulimia nervosa asks a nurse, "How can I ask for help from my family?" Which response is the most appropriate? a. "When you ask for help, make sure you really need it." b. "Have you ever asked for help before?" c. "Ask family members to spend time with you at mealtime." d. "Think about how you can handle this situation without help."

b. "Have you ever asked for help before?"

1. An adolescent female client with anorexia nervosa starts outpatient treatment. Which client statement indicates that she has a basic understanding of her eating disorder? a. "I'm not worried because no one ever dies from anorexia." b. "I still feel fat even though I'm told that I'm not." c. "My old school friends aren't important to me anymore." d. "I don't feel right unless I do an intense workout every day."

b. "I still feel fat even though I'm told that I'm not."

1. A nurse is talking to a family of a client with anorexia nervosa. Which family behavior is most likely to be seen during the family's interaction? a. Sibling rivalry b. Rage reactions c. Parental disagreement d. Excessive independence

c. Parental disagreement

1. A female client with bulimia nervosa tells a nurse that she doesn't eat during the day, but after 5:00 pm, she begins to binge and vomit. Which intervention should be the most useful to this client? a. Help the client stop eating the foods on which she binges. b. Discuss the effects of fasting on the client's pattern of eating. c. Encourage the client to become involved in food preparation. d. Teach the client to eat earlier in the day and decrease intake at night.

b. Discuss the effects of fasting on the client's pattern of eating.

1. A client with bulimia nervosa has a history of severe GI problems caused by excessive purging. Based on this finding, the nurse must stay alert for which physiologic problem? a. Renal calculi b. Esophageal tears c. Focal seizures d. Muscle atrophy

b. Esophageal tears

1. A client with anorexia nervosa tells a nurse, "I'll never have the slender body I want." Which intervention is bestto handle this problem? a. Call a family meeting to get help from the parents. b. Help the client work on developing a realistic body image. c. Make an appointment to see the dietitian on a weekly basis. d. Develop an exercise program the client can do twice a week.

b. Help the client work on developing a realistic body image.

17. Which nursing diagnosis should have the highest priority in the plan of care for a client with an eating disorder? a. Interrupted family processes b. Imbalanced nutrition: Less than body requirements c. Disturbed body image d. Ineffective coping

b. Imbalanced nutrition: Less than body requirements

1. A client with anorexia nervosa attended psychoeducational sessions on principles of adequate nutrition. Which statement by the client indicates the teaching was effective? a. "I eat while I'm doing things to distract myself." b. "I eat all my food at night right before I go to bed." c. "I eat small amounts of food slowly at every meal. d. "I eat only when I'm with my family and trying to be social."

c. "I eat small amounts of food slowly at every meal.

1. Parents of a client with anorexia nervosa ask about the risk factors for this disorder. After the parents receive reinforcement of the teaching plan from the nurse, which statement by the parents best indicates that the teaching has been effective? a. "Risk factors include the inability to be still and emotional liability." b. "Risk factors include a high level of anxiety and disorganized behavior." c. "Risk factors include low self-esteem and problems with family relationships." d. "Risk factors include a lack of life experience and no opportunities to learn skills."

c. "Risk factors include low self-esteem and problems with family relationships."

1. A client with anorexia nervosa tells a nurse, "I feel so awful and inadequate." Which response is best? a. "You're being too hard on yourself." b. "Someday you'll feel better about things." c. "Tell me something you like about yourself." d. "Maybe relaxing by yourself will help you feel better."

c. "Tell me something you like about yourself."

1. A nurse is analyzing the need for health teaching in a female client with anorexia nervosa who lives in a chaotic family situation. Which question is most important for the nurse to ask the client? a. "How many months have your periods been irregular?" b. "How often do you think about food in a 24-hour period?" c. "What were the circumstances before your eating disorder?" d. "How much and what kinds of exercise do you engage in every day?"

c. "What were the circumstances before your eating disorder?"

1. A female client with anorexia nervosa tells a nurse she always feels fat. Which intervention is the best for this client? a. Talk about how important the client is. b. Encourage her to look at herself in a mirror. c. Address the dynamics of the disorder. d. Talk about how she's different from her peers.

c. Address the dynamics of the disorder.

1. A female client with anorexia nervosa tells as nurse that she has developed hair on most of her body. Which of the following disorders would the nurse most likely expect to be associated with anorexia nervosa? a. Anemia b. Osteoporosis c. Dehydration d. Electrolyte imbalance

c. Dehydration

1. A female client with bulimia nervosa tells a nurse her major problem is eating too much food in a short period of time and then vomiting. Which short-term goal is the most important? a. Help the client to understand every person has a satiety level. b. Encourage the client to verbalize fears and concerns about food. c. Determine the amount of food the client will eat without purging. d. Obtain a therapy appointment to look at the emotional causes of bulimia nervosa.

c. Determine the amount of food the client will eat without purging.

1. Which psychosocial finding should a nurse expect when assessing a client with anorexia nervosa? a. Avoidant behavior b. Antisocial behavior c. Introverted behavior d. Hypervigilant behavior

c. Introverted behavior

1. What's the treatment's team priority in planning the care of a client with an eating disorder? a. Preventing the client from performing any muscle-building exercises b. Keeping the client on bedrest until she attains a specified weight c. Meeting daily to discuss manipulation and countertransference d. Monitoring the client's weight and vital signs daily

c. Meeting daily to discuss manipulation and countertransference

1. Which communication strategy is best to use with a client with anorexia nervosa who is having problems with peer relationships? a. Use concrete language and maintain a focus on reality. b. Direct the client to talk about what is causing the anxiety. c. Teach the client to communicate feelings and express self appropriately. d. Confront the client about being depressed and self-absorbed.

c. Teach the client to communicate feelings and express self appropriately.

1. A female client with anorexia nervosa is talking to a nurse about her group therapy. Which statement shows the group experience has helped the client? a. "I feel I'm different and I don't need a lot of friends." b. "I'll tell my parents it's not just me who has problems." c. "I can see how to do things better and become the best." d. "I think I have some unrealistic expectations of myself."

d. "I think I have some unrealistic expectations of myself."

1. A female client with anorexia nervosa is discharged from the hospital after gaining 12lb. Which statement by the client best indicates that the nurse's reinforcement of discharge teachings has been effective? a. "I plan to eat two small meals a day." b. "I feel that this is scary, but I'm not going to write about it in my journal." c. "I have to diet because I've gained 12 pounds." d. "I'll need to attend therapy for support to stay healthy."

d. "I'll need to attend therapy for support to stay healthy."

1. Which statement from a bulimic client shows that she understands the concept of relapse? a. "If I can't maintain control over things, I'll have problems." b. "If I have problems, then that says I haven't learned much." c. "If this illness becomes chronic, I won't be able to handle it." d. "If I have problems, I can start over again and not feel hopeless."

d. "If I have problems, I can start over again and not feel hopeless."

16. A mother of a female client with bulimia nervosa asks a nurse if bulimia nervosa will stop her daughter from menstruating. Which response is best? a. "All women with anorexia nervosa or bulimia nervosa will have amenorrhea." b. "When your daughter is bingeing and purging, she won't have normal periods." c. "The eating disorder must be ongoing for your daughter's menstrual cycle to change." d. "Women with bulimia nervosa may have a normal or abnormal menstrual cycle, depending on the severity of the problem."

d. "Women with bulimia nervosa may have a normal or abnormal menstrual cycle, depending on the severity of the problem."

1. A female client with anorexia nervosa is receiving care from her family after successfully completing the refeeding stage of treatment. Which nursing intervention takes priority at this time? a. Providing a strong support system and opportunities to do reality testing b. Teaching the family stress-reduction skills to help promote family harmony c. Promoting anticipatory grieving over the loss each family member is experiencing d. Assisting the family to work on the issues of autonomy and separation

d. Assisting the family to work on the issues of autonomy and separation

1. A client with anorexia nervosa tells a nurse, "My parents never hug me or say I've done anything right." Which intervention is the best to use with this family? a. Teach the family principles of assertive behavior. b. Discuss the difficulties the family has in social situations. c. Help the family convey a positive attitude toward the client. d. Explore the family's ability to express affection appropriately.

d. Explore the family's ability to express affection appropriately.

1. Which of the following is the priority during assessment of a client with an eating disorder? a. Cultural and gender needs b. Substance abuse history c. Academic achievement and performance d. Level of danger to self or others

d. Level of danger to self or others

1. A client with anorexia nervosa has started taking fluoxetine hydrochloride (Prozac). The nurse should closely monitor the client for which adverse reaction? a. Drowsiness b. Dry mouth c. Light-headedness d. Nausea

d. Nausea

1. A nurse is working with a female client with anorexia nervosa who has acrocyanosis in her extremities. Which short-term goal is the most important for the client? a. Do daily range-of-motion exercises. b. Eat some fatty foods daily. c. Check neurologic reflexes. d. Promote adequate circulation.

d. Promote adequate circulation.

1. A nurse notes severe hypocalcemia in a client with anorexia nervosa. Which history finding supports a diagnosis of osteoporosis? a. Eating a vegetarian diet b. Drinking well water c. Going scuba diving d. Smoking cigarettes

d. Smoking cigarettes

1. A nurse and her female client who has anorexia nervosa are working on the goal of developing social relationships. Which action by the client is an indication the client is meeting her goal? a. The client talks about the value of peer relationships. b. The client decides to talk to her parents about her friends. c. The client expresses the need to establish trust relationships. d. The client attends an activity without prompting from others.

d. The client attends an activity without prompting from others.