Mental Health- PrepU Chapter 32

Family-based theories of causality propose that eating disorders develop how?

As a way for the child to feel a sense of control in response to controlling parents

The client with bulimia reports feeling helpless and says, "What's the use?" As the nurse plans the client's care, the priority diagnosis is which?

Risk for self-directed violence

A client has been diagnosed with bulimia. Which cognitive behavioral technique would be useful for the client?

Self-monitoring

A hospitalized client weighs 72% of their ideal body weight. What is the priority consideration for the nurse in the planning process?

Slowly introduce calories.

A client with a history of anorexia nervosa comes to the clinic for evaluation. During the visit, the client's body mass index (BMI) is obtained. The nurse determines that treatment has been effective based on which BMI measurement?

19.2 kg/m2

A nurse is assessing a client for an eating disorder. Which screening question made by the nurse would assess for a possible eating disorder in the client?

"Do thoughts about food, weight, dieting, or eating dominate your life?"

During a therapy session, a client with anorexia tells the nurse, "I measured my thighs today. They are a quarter-inch larger than they were yesterday. I feel like a pig; I'm so fat." Which potential response by the nurse is most therapeutic?

"Has something occurred that caused you to measure your thighs?"

A client on an in-patient psychiatric 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 response by the nurse is most appropriate?

"I will accompany you to the bathroom."

One approach to establish adequate eating patterns for a client with anorexia is to assume a positive expectation of the client. Which is the best statement by the nurse?

"I will sit here quietly with you while you eat."

A nurse is providing care to a client with an eating disorder. Which client statement best demonstrates an understanding of the etiology of the disorder?

"There are many factors involved with how I developed anorexia ."

While caring for a client with anorexia nervosa, a nurse anticipates that the client would have difficulty making which comment(s)? Select all that apply.

- "I'm mad at you because you won't let me go on a pass unless I gain weight." - "I saw that client looking at me; they need to mind their own business."

The client has an eating disorder and is brought to the emergency department after a failed attempt at suicide. Which element(s) could relate to the cause of this attempt? Select all that apply.

- online bullying of "body shaming" - ineffective coping mechanisms - impulsive behaviors

A nurse is providing care to a client with anorexia who is beginning a refeeding protocol. Based on the nurse's understanding of these protocols, the nurse would expect the client to start with how many calories per day?

1500

A client is diagnosed with mild anorexia nervosa based on body mass index (BMI). Which BMI would the nurse identify as reflecting mild anorexia nervosa?

17.3 kg/m2

The parents of a teenage girl who has just been diagnosed with anorexia nervosa are distraught at this development, stating, "We have no idea where this all came from." The anorexia nervosa client is typically what?

A high achiever

A client is 5 feet 6 inches tall, weighs 105 pounds, exercises 4 hours per day, and does not engage in any binging or purging behaviors. The client believes that he or she is becoming obese and states, "I'm shocked that you think I'm underweight. You don't understand me." The most likely diagnosis for this client is what?

Anorexia nervosa, restricting type

Treatment of eating disorders often combines psychotherapy and psychopharmacology. Which classes of medications can be used to treat eating disorders?

Antidepressants

The nurse is assisting a client with an eating disorder to accept their body image and use effective coping skills. Which will the nurse discuss with the client in relation to body acceptance and coping skills?

Being able to cope in healthy ways improves the ability to accept a realistic body image.

A client with anorexia nervosa self-describes as "a whale." However, the nurse's assessment reveals that the client is 5 feet 8 inches tall and weighs only 90 pounds. The nurse identifies this as reflecting what?

Body image disturbance

While a nurse talks to the mother of a 15-year-old client, the mother expresses concern over the client's eating and exercise habits. The mother says that as soon as the client comes home from school, the client exercises for 2 to 3 hours every day. She says the client eats very little at dinner, but in the morning she notices that large amounts of food are missing from the kitchen. The client was complaining of tooth pain, and when the mother took the client to the dentist, the client had over 10 cavities. Which disorder is the client most likely suffering from?

Bulimia nervosa

The dentist of a client noticed that the client's teeth were losing enamel. The client is of average weight. The dentist refers the client for follow up based on the understanding that eating disorder is most often associated with enamel loss?

Bulimia nervosa, purging type

The difference between clients with anorexia nervosa and bulimia nervosa is which of the following?

Clients who are anorexic are proud of their control over eating, whereas bulimic clients are ashamed of their behavior.

When working with the client with bulimia, the nurse should be aware that the nurse's own feelings and needs may affect care. Feelings that may be aroused in the nurse may include what?

Control

When working with the family of a client with anorexia nervosa, which of the following issues must be addressed?

Control issues

Which is the most common disorder found in clients diagnosed with bulimia nervosa?

Depression

The nurse is assessing a client with an eating disorder. Which personality characteristic would the nurse identify when interacting with the client?

Eager to please

A client meets some (but not all) of the diagnostic criteria for anorexia nervosa. Despite having lost considerable weight, the client's weight is within the normal range. The nurse understands that based on DSM-5 criteria, this client would most likely be diagnosed with which of following?

Eating disorder not otherwise specified

Which would be most supportive for family and friends of a client with an eating disorder?

Emotional support, love, and attention

The nurse is teaching the family of a client who has bulimia about nutritional needs. Which dietary pattern would be most helpful to assist the client in recovering from bulimia?

Encourage the entire family to engage in a balanced and regular dietary pattern.

Which of the following terms describes a lack of clear role boundaries?

Enmeshment

During a physical assessment, the nurse would recognize that there is the potential for medication-induced weight loss in a client who is being treated with which medication?

Fluoxetine

Which medication has been found to be worthy of a trial in clients with bulimia nervosa who have obsessive-compulsive traits?

Fluoxetine

The nurse is planning the care of a client admitted with anorexia nervosa. Which intervention will the nurse develop that is appropriate for this client?

Having the client in view of staff for 90 minutes after each meal

The nurse is performing the history and physical examination on a client who is being admitted for anorexia nervosa. The client, a 23-year-old, is 5 feet 2 inches, and weighs 88 pounds. The nurse assesses the client's history of weight gain and loss, typical daily food intake, electrolyte and other blood studies, and elimination patterns. The nurse observes typical physical findings such as dry skin, lanugo, and brittle hair and nails. Which factor is a priority for the nurse to assess next?

Heart rate and rhythm

The nurse is caring for a client admitted with anorexia nervosa. When creating the nursing interventions for the plan of care, which is the primary objective?

Restoring nutritional status to normal

A mental health nurse is completing an initial assessment on a client diagnosed with anorexia nervosa. Which of the following is a typical characteristic of parents of clients diagnosed with anorexia nervosa?

Overprotect their children

Which is a typical characteristic of parents of clients diagnosed with anorexia nervosa?

Overprotective of their children

The immediate goal of nursing interventions in the care of a client with anorexia nervosa is which of the following?

Restoring nutritional status to normal

A client diagnosed with anorexia nervosa is brought to the emergency room after a friend states, "They just passed out." The client is assessed and discovered to have severe dehydration and malnutrition. Which is the priority action by the nurse?

Start IV fluids as prescribed and obtain consultation for total parenteral nutrition.

A client diagnosed with anorexia nervosa is being prescribed a medication. Which medication would the nurse prepare for the client?

fluoxetine

A client diagnosed with anorexia nervosa weighs 78% of their ideal body weight and continues to state that they are "fat." Which symptom does the nurse identify?

body image distortion

What behavior is likely a result of an adolescent's attempt to manage the effects of over-productive parenting?

engaging in severe dieting

An adolescent client is diagnosed with an eating disorder. The client has been restricting intake for 4 months, and the client does not binge and purge. The parents are agreeable to family therapy. Which type of treatment setting is most appropriate for the client?

outpatient therapy

When working with a client with bulimia, the nurse should encourage the client to keep a diary or journal for what reason?

to improve coping through behavioral changes