Mental Health Chapter 18 Practice Questions

Which statement is true of the eating disorder referred to as bulimia? a. Patients with bulimia often appear at a normal weight. b. Patients with bulimia binge eat but do not engage in compensatory measures. c. Patients with bulimia severely restrict their food intake. d. One sign of bulimia is lanugo.

a. Patients with bulimia often appear at a normal weight.

A client reveals that she induces vomiting as often as a dozen times a day. The nurse would expect assessment findings to support which electrolyte imbalance? a. Hypernatremia b. Hypokalemia c. Hypercalcemia d. Hypolipidemia

b. Hypokalemia

Assessment of a client suspected of experiencing bulimia nervosa calls for the nurse to perform a. a range of motion assessment. b. inspection of body cavities. c. inspection of the oral cavity. d. body fat analysis.

c. inspection of the oral cavity.

Safety measures are of concern in eating-disorder treatments. Patients with anorexia nervosa are supervised closely to monitor: Select all that apply. a. Foods that are eaten b. Attempts at self-induced vomiting c. Relationships with other patients d. Weight

a. Foods that are eaten b. Attempts at self-induced vomiting d. Weight

A client hospitalized with anorexia nervosa has a weight that is 65% of normal. For this client, what is a realistic short-term goal for the first week of hospitalization regarding the physical impact of his/her weight? a. Gain a maximum of 3 lb. b. Develop a pattern of normal eating behavior. c. Discuss fears and feelings about gaining weight. d. Verbalize awareness of the sensation of hunger.

a. Gain a maximum of 3 lb

When considering the need for monitoring, which intervention should the nurse implement for a patient with anorexia nervosa? Select all that apply. a. Provide scheduled portion-controlled meals and snacks. b. Congratulate patients for weight gain and behaviors that promote weight gain. c. Limit time spent in bathroom during periods when not under direct supervision. d. Promote exercise as a method to increase appetite. e. Observe patient during and after meals/snacks to ensure that adequate intake is achieved and maintained.

a. Provide scheduled portion-controlled meals and snacks. c. Limit time spent in bathroom during periods when not under direct supervision e. Observe patient during and after meals/snacks to ensure that adequate intake is achieved and maintained.

The nurse working with clients diagnosed with eating disorders can help families develop effective coping mechanisms by implementing which intervention? a. Teaching the family about the disorder and the client's behaviors b. Stressing the need to suppress overt conflict within the family c. Urging the family to demonstrate greater caring for the client d. Encouraging the family to use their usual social behaviors at meals

a. Teaching the family about the disorder and the client's behaviors

Obesity can be the end result of a binge-eating disorder. The nurse understands that the best treatment option in persons with a binge-eating disorder promotes: a. Bariatric surgery b. Coping strategies c. Avoidance of public eating d. Appetite suppression medications

b. Coping strategies

A client diagnosed with bulimia nervosa uses enemas and laxatives to purge to maintain weight. What is the likely physiological outcome of this practice? a. Increase in the red blood cell count b. Disruption of the fluid and electrolyte balance c. Elevated serum potassium level d. Elevated serum sodium level

b. Disruption of the fluid and electrolyte balance

When educating a client diagnosed with bulimia nervosa about the medication fluoxetine, the nurse should include what information about this medication? a. It will reduce the need for cognitive therapy. b. It will be prescribed at a higher than typical dose. c. There are a variety of medications to prescribe if fluoxetine proves to be ineffective. d. Long-term management of symptoms is best achieved with tricyclic antidepressants.

b. It will be prescribed at a higher than typical dose.

Malika agrees to try losing weight according to the nurse practitioner's outlined plan. Additional teaching is warranted when Malika states: a. "I am willing to admit I am depressed." b. "Psychotherapy will be a part of my treatment." c. "I prefer to have a gastric bypass rather than use this plan." d. "My comorbid conditions may improve with weight loss."

c. "I prefer to have a gastric bypass rather than use this plan.

Which patient statement acknowledges the characteristic behavior associated with a diagnosis of pica? a. "Nothing could make me drink milk." b. "I'm ashamed of it, but I eat my hair." c. "I haven't eaten a green vegetable since I was 3 years old." d. "I regurgitate and re-chew my food after almost every meal."

b. "I'm ashamed of it, but I eat my hair."

A 16-year-old patient being treated for anorexia, has been prescribed medication to reduce compulsive behaviors regarding food now that ideal weight has been reached. Which class of medication is prescribed for this specific issue associated with eating disorders? a. Mood stabilizers b. Antidepressants c. Anxiolytics d. Atypical antipsychotics

b. Antidepressants

Which coping mechanism is used excessively by clients diagnosed with bulimia nervosa to cope with their obsession with their body image? a. Denial b. Humor c. Altruism d. Projection

a. Denial

Taylor, a psychiatric registered nurse, orients Regina, a patient with anorexia nervosa, to the room where she will be assigned during her stay. After getting Regina settled, the nurse informs Regina: a. "I need to go through the belongings you have brought with you." b. "You can use the scale in the back room when you need to." c. "You will be eating five times a day here." d. "The daily structure is based around your desire to eat."

a. "I need to go through the belongings you have brought with you."

Which patient statement supports the diagnosis of anorexia nervosa? a. "I'm terrified of gaining weight." b. "I wish I had a good friend to talk to." c. "I've been told I drink way too much alcohol." d. "I don't get much pleasure out of life anymore."

a. "I'm terrified of gaining weight."

When considering an eating disorder, what is a physical criterion for hospital admission? a. A daytime heart rate of less than 50 beats per minute b. An oral temperature of 100°F or more c. 90% of ideal body weight d. Systolic blood pressure greater than 130 mm Hg

a. A daytime heart rate of less than 50 beats per minute

The client experiencing bulimia differs from the client diagnosed with anorexia nervosa by exhibiting which characteristic? a. Maintaining a normal weight b. Holding a distorted body image c. Doing more rigorous exercising d.Purging to keep weight down

a. Maintaining a normal weight

After stabilization of symptoms, what is the primary focus of treatment for a client diagnosed with anorexia nervosa? a. Weight restoration b. Improving interpersonal skills c. Learning effective coping methods d. Changing family interaction patterns

a. Weight restoration

Which intervention would be least useful for accurate assessment of the weight of a client diagnosed with anorexia nervosa? a. Weigh 2 times daily first week, then three times weekly. b. Weigh fully clothed before breakfast. c. Do not reweigh client when client requests. d. Permit no oral intake before weighing.

b. Weigh fully clothed before breakfast.

Ali is a 17-year-old patient with bulimia coming to the outpatient mental health clinic for counseling. Which of the following statements by Ali indicates that an appropriate outcome for treatment has been met? a. "I purge only once a day now instead of twice." b. "I feel a lot calmer lately, just like when I used to eat four or five cheeseburgers." c. "I am a hard worker and I am very compassionate toward others." d. I always purge when I'm alone so that I'm not a bad role model for my younger sister."

c. "I am a hard worker and I am very compassionate toward others."

According to current theory, which statement regarding eating disorders is accurate? a. Eating disorders are psychotic disorders in which patients experience body dysmorphic disorder. b. Eating disorders are frequently misdiagnosed. c. Eating disorders are possibly influenced by sociocultural factors. d. Eating disorders are rarely comorbid with other mental health disorders.

c. Eating disorders are possibly influenced by sociocultural factors.

Which diagnosis from the list below would be given priority for a client diagnosed with bulimia nervosa? a. Disturbed body image b. Chronic low self-esteem c. Risk for injury: electrolyte imbalance d. Ineffective coping: impulsive responses to problems

c. Risk for injury: electrolyte imbalance

Biological theorists suggest that the cause of eating disorders may be related to which factor? a. Normal weight phobia b. Body image disturbance c. Serotonin imbalance d. Dopamine excess

c. Serotonin imbalance

Which intervention will promote independence in a patient being treated for bulimia nervosa? a. Have the patient monitor daily caloric intake and intake and output of fluids. b. Encourage the patient to use behavior modification techniques to promote weight gain behaviors. c. Ask the patient to use a daily log to record feelings and circumstances related to urges to purge. d. Allow the patient to make limited choices about eating and exercise as weight gain progresses.

d. Allow the patient to make limited choices about eating and exercise as weight gain progresses.

Which subjective symptom should the nurse would expect to note during assessment of a client diagnosed with anorexia nervosa? a. Lanugo b. Hypotension c. 25-lb weight loss d. Fear of gaining weight

d. Fear of gaining weight

The nurse can determine that inpatient treatment for a client diagnosed with an eating disorder would be warranted when which assessment data is observed? a. Weighs 10% below ideal body weight. b. Has serum potassium level of 3 mEq/L or greater. c. Has a heart rate less than 60 beats/min. d. Has systolic blood pressure less than 70 mm Hg.

d. Has systolic blood pressure less than 70 mm Hg

A client who is 16 years old, 5 foot, 3 inches tall, and weighs 80 pounds eats one tiny meal daily and engages in a rigorous exercise program. Which nursing diagnosis addresses this assessment data? a. Death anxiety b. Ineffective denial c. Disturbed sensory perception d. Imbalanced nutrition: less than body requirements

d. Imbalanced nutrition: less than body requirements

Malika has been overweight all of her life. Now an adult, she has health problems related to her excessive weight. Seeking weight loss assistance at a primary care facility Malika is surprised when the nurse practitioner suggests: a. A trial of SSRI antidepressant therapy b. Mild exercise to start, increasing in intensity over time c. Removing snack foods from the home d. Medication treatment for hypertension

d. Medication treatment for hypertension