Mental Health Ch. 21

The diagnosis of ____________________ nervosa includes the symptoms of gross distortion of body image, preoccupation with food, and refusal to eat.

ANS: anorexia

The episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over a short period of time is termed ____________________.

ANS: binging

To rid the body of excessive calories, a client diagnosed with bulimia nervosa may engage in ____________________ behaviors, which include self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

ANS: purging

The nurse is caring for a client diagnosed with binge eating disorder (BED). Which medication should the nurse administer to the client to decrease binging? 1. Lisdexamfetamine (Vyvanse) 2. Chlorpromazine (Thorazine) 3. Haloperidol (Haldol) 4. Diazepam (Valium)

ANS: 1

The nurse is teaching a client diagnosed with bulimia nervosa about the symptom of tooth enamel deterioration. Which explanation for this complication of bulimia nervosa should the nurse provide? 1. The emesis is acidic and corrodes the tooth enamel. 2. Purging causes the depletion of dietary calcium. 3. Food is rapidly ingested without proper mastication. 4. Poor dental and oral hygiene leads to dental caries.

ANS: 1

The nurse is teaching about the differences between the symptoms of anorexia nervosa and the symptoms of bulimia. Which information should the nurse include? 1. Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not. 2. Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not. 3. Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not. 4. Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not.

ANS: 1 The nurse would include that clients diagnosed with anorexia nervosa experience nutritional deficits, whereas clients diagnosed with bulimia usually do not

The nurse is caring for a client with anorexia nervosa. Which nursing interventions would the nurse add to the plan of care? (Select all that apply.) 1.Minimize the focus on food and eating 2.Limit mealtime to 30 minutes 3.Monitor for 30 minutes after eating 4.Weigh client weekly 5.If weight loss occurs, bargain for restrictions

ANS: 1, 2

The family of a teenager diagnosed with anorexia nervosa becomes defensive when the treatment team calls for a family meeting to implement the Maudsley approach. Which is the appropriate nursing response? 1. "Tell me why this family meeting is causing you to be defensive. All clients are required to participate in two family sessions." 2. "For the plan to be successful, we need your involvement. The parents establish the rules and guidelines around eating." 3. "While the client is the primary focus, this meeting will provide your child with family support." 4. "Clients diagnosed with anorexia nervosa are part of the family system, and any alteration in family processes needs to be addressed."

ANS: 2

The nurse is teaching about the DSM-5 criteria for the diagnosis of binge eating disorder. Which statements by the staff indicate successful teaching? (Select all that apply.) 1. "Binge eating occurs exclusively during the course of bulimia nervosa." 2. "Binge eating occurs, on average, at least once a week for three months." 3. "Binge eating occurs because of an intense fear of becoming fat." 4. "Marked distress regarding binge eating is present." 5. "Marked distress regarding purging is present."

ANS: 2, 4

The client diagnosed with bulimia nervosa has been attending an outpatient mental health clinic for several months. Which factor should a nurse identify as an appropriate indicator of a positive client behavioral change? 1. Gained two pounds in one week 2. Focused conversations on nutritious food 3. Demonstrated healthy coping mechanisms that decreased anxiety 4. Verbalized an understanding of the etiology of the disorder

ANS: 3

The client's altered body image is evidenced by claims of "being obese," even though the client is emaciated. Which outcome criterion is appropriate for this client's problem? 1. The client will consume adequate calories to sustain normal weight. 2. The client will cease strenuous exercise programs. 3. The client will verbally state a misperception of body image as "fat." 4. The client will not express a preoccupation with food.

ANS: 3 The nurse should identify that the appropriate outcome for this client is to verbally state a misperception of body image as "fat."

Which historical perspective would the nurse include when teaching about the home environment and the development of anorexia nervosa? 1. Maintains loose personal boundaries 2. Places an overemphasis on food 3. Is overprotective with emphasis on perfection 4. Condones corporal punishment

ANS: 3 The nurse would include that a home environment that is overprotective and demands perfection is a historical perspective that has been shown to negatively influence care. The American Academy for Eating Disorders (AED) stands firmly against any model of eating disorders in which blame is assigned to the family. The AED recommends that family be included in the recovery process

An adolescent is diagnosed with anorexia nervosa and is hospitalized for severe malnutrition. Which body mass index (BMI) measurement would the nurse observe upon assessment of this client? 1.30 2.24 3.20 4.16

ANS: 4

The nurse is teaching a client diagnosed with an eating disorder about behavior-modification programs. What is the priority rationale for this treatment? 1. It helps the client correct a distorted body image. 2. It addresses the underlying client anger. 3. It manages the client's psychotic behaviors. 4. It allows clients to maintain control.

ANS: 4

The adolescent diagnosed with a history of anorexia nervosa comes to an outpatient clinic after being medically cleared. The client states, "Since going back to school, I am nervous, get apprehensive, and have a hard time eating food." Which nursing diagnosis would take priority at this time? 1. Imbalanced nutrition: less than body requirements 2. Disturbed body image/Low self-esteem 3. Impaired verbal communication 4. Anxiety

ANS: 4 The priority diagnosis is anxiety. The client is exhibiting evidence of anxiety, such as nervousness, apprehension, and increased difficulty taking oral nourishment.