MH- Eating Disorders
A nurse is caring for an adolescent client who has anorexia nervosa with recent rapid weight loss and a current weight of 90lbs. Which of the following statements indicates that client is experiencing the cognitive distortion of catastrophizing? A. "Life isn't worth living if I gain weight." B. "Don't pretend like you don't know how fat I am." C. "If I could be skinny, I know I'd be popular." D. "When I look in the mirror, I see myself as obese."
A
What are predisposing factors to eating disorders? SATA A. genetics B. physiological C. family dynamics D. environment E. lifestyle
A, B, C, D, E
The nurse is preparing to perform an admission assessment on a client with a diagnosis of bulimia nervosa. Which assessment findings should the nurse expect to note? SATA A. Dental decay B. Moist, oily skin C. Loss of tooth enamel D. Electrolyte imbalances E. body weight well below ideal range
A, C, D
Clients with a morbid fear of obesity and distorted body image are diagnosed with ______________?
Anorexia Nervosa
The onset of this eating disorder is often associated with a stressful life event.
Anorexia nervosa
A client with a diagnosis of anorexia nervosa, who is in a state of starvation, is in a 2-bed room. A newly admitted client will be assigned to this client's room. Which client would be the best choice as a roommate for the client with anorexia nervosa? A. A client with pneumonia B. A client undergoing diagnostic tests C. A client who thrives on managing others D. A client who could benefit from the client's assistance at mealtime.
B
The nurse is caring for a female client who has admitted to the mental health until recently for anorexia nervosa. The nurse enters the client's room and notes that the client is engaged in rigorous push-ups. Which nursing action is most appropriate? A. Interrupt the client and weigh her immediately B. Interrupt the client and offer to take her for a walk. C. Allow the client to complete her exercise program. D. Tell the client that she is not allowed to exercise rigorously.
B
A nurse if performing an admission assessment of a client who has bulimia nervosa with purging behavior. Which of the following is an expected finding? SATA A. Amenorrhea B. Hypokalemia C. Yellowing of the skin D. Slightly elevated body weight E. Presence of lanugo on the face
B, D
How does the National Institute of Health classify obesity?
BMI of 30 or more
__________ can lead to obesity.
Binge eating
Huge amounts of food consumed in a short period of time is often a characteristic of clients diagnosed with ____________________?
Bulimia Nervosa
A nurse is caring for a client who has bulimia nervosa and has stopped purging behavior. The client tells the nurse about fears of gaining weight. Which of the following responses should the nurse make? A. "Many clients are concerned about their weight. However, the dietitian will ensure that you don't get to many calories in your diet." B. "Instead of worrying about your weight, try to focus on other problems at this time." C. " I understand you have concerns about your weight, but first, let's talk about your recent accomplishments." D. "You are not overweight, and the staff will ensure that you do not gain weight while you are in the hospital. We know that is important to you."
C
Why is BED different from bulimia nervosa?
Client does not RID their bodies of excess calories
These are characterized by unsure self-identification and grossly disturbed eating habits.
Eating Disorders
Excessive vomiting and laxative or diuretic abuse may lead to problems with ______________.
Electrolyte and Fluid Imbalance
What do clients with anorexia nervosa experience that clients with bulimia nervosa do not experience?
Extreme nutritional deficiencies ***Clients will bulimia do not experience this***
TRUE OR FALSE Eating disorders have continued to decrease since the middle of the 20th century.
FALSE **Eating disorders have increased!**
__________ in the vomitus also contributes to the erosion of tooth enamel in client's with bulimia nervosa.
Gastric acid
TRUE OR FALSE A client with bulimia nervosa often has tension relieved and pleasure felt when binging.
True ** but feelings of depression and guilt follow soon after.**
What treatment modalities are used to treat eating disorders?
behavior modification individual psychotherapy cognitive behavioral therapy family treatment psychopharmacology
Russell's sign
calluses on the knuckles or back of the hand due to repeated self-induced vomiting over long periods of time
Emesis
gastric acid in the vomitus
These are characteristics of a client with binge eating disorder (BED). SATA A. feel depressed after over-eating B. consume food more rapidly C. repeated self-induced vomiting D. have calluses on their hands E. often eat alone
A, B, E
What are physical alterations that might be seen in a client with anorexia nervosa? SATA A. decrease temperature B. decreased blood sugar C. constipation D. decrease pulse E. increased sleep
A, C, D **decrease in BP, weight loss, tooth decay, vomiting, dry, scaly skin, sleep disturbances, cyanosis and numbness in extremities, and bone degeneration may also be present.**
A nurse is obtaining a nursing hx from a client who has a new diagnosis of anorexia nervosa. Which of the following questions should the nurse include in the assessment? SATA A. "What is your relationship like with your family?" B. "Why do you want to lose weight?" C. "Would you describe your current eating habits?" D. "At what weight do you believe you will look better?" E. "Can you discuss your feelings about your appearance?"
A, C, E
Anorexia is commonly accompanied by what? SATA A. depression B. tachycardia C. restlessness D. anxiety
A, D
What do clients with bulimia nervosa often misuse? SATA A. laxatives B. food C. supplements D. diuretics E. enemas
A, D, E
A nurse is planning care for a client who has anorexia nervosa with binge-eating and purging behavior. Which of the following actions should the nurse include in the client's plan of care? A. Allow the client to select preferred meal times. B. Establish consequences for purging behavior C. Provide the client with a high-fat diet at the start of treatment. D. Implement one-to-one observation during meal times
D
_________________ are central in eating disorders.
Issues of control
What is the priority nursing intervention for hospitalized client with bulimia nervosa?
Sit with the client for 1 hour after eating. *** this is to ensure that the client does not purge after eating***
TRUE or FLASE In rare instances of clients with bulimia nervosa, the client may experience ruptures of tears in the gastric or esophageal mucosa.
TRUE
For the program to treat an eating disorder to be successful, the client must perceive that he or she is _________________ of the treatment.
in control of behavioral choices
A client with anorexia nervosa is a member of a pre-discharge support group. The client verbalizes that she would like to buy some new clothes, but her finances are limited. Group members have brought some used clothes to the client to replace the client's old clothing. The client believes that the new clothes are much too tight and has reduced her calorie intake to 800 calories daily. How should the nurse evaluate this behavior? A. Normal behavior B. Evidence of the client's disturbed body image C. Regression as the client is moving toward the community D. Indicative of the client's ambivalence about hospital discharge
B
