Behavioral PrepU Chapter 26: Eating Disorders

The nurse is talking with family members of a client with an eating disorder that state, "What is the best way for us to show support during this time?" Which will the nurse inform the family as the most supportive action they can take?

Give the client emotional support

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

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

An individual with which body mass index (BMI) would be classified as having mild anorexia nervosa?

17.4 kg/m2

The nurse provides care for a client who is diagnosed with anorexia nervosa. Which question should the nurse ask to assess the client for neuropsychiatric complications associated with the diagnosed eating disorder?

"Do you experience constipation or diarrhea?"

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."

A client diagnosed with anorexia nervosa has regained weight and is being discharged to an outpatient program. Which statement made by the client would indicate the need for further teaching?

"I will go to all my support groups so that I don't need to go to therapy."

A psychiatric-mental health nurse is presenting to community members about eating disorders, including cultural considerations. Which statement made by a community member would indicate a need for further education?

"Immigrants from cultures in which eating disorders are rare will not develop an eating disorder as they assimilate into other cultures."

The nurse is sitting with the client at mealtime. The nurse uses cognitive-behavioral approaches to assist the client with bulimia toward recovery. Which statement by the nurse would be consistent with this approach?

"Is there any way you can look at that sandwich as fuel for your body?"

The nurse has conducted a community health fair about eating disorders. After the teaching, a community resident approaches the nurse and states that they are concerned about a family member having a possible eating disorder. Which advisement made by the nurse to the resident would be appropriate?

"Tell your family member that you are concerned and would like help."

An adult client is diagnosed with bulimia nervosa. Which outcome would be appropriate for the client in the immediate phase of care?

"The client will be free from self-inflicted harm throughout hospitalization."

An outpatient client diagnosed with anxiety, depression, and anorexia nervosa is receiving treatment to develop healthy coping skills. The client has recently lost more weight. Which statement made by the nurse would be appropriate?

"What stressors are you currently experiencing?"

The client is 16 years old and has an identical twin just diagnosed with anorexia nervosa. The client shares with the nurse a concern about also developing the disorder. Which response by the nurse is the most appropriate?

"While eating disorders have been shown to have a genetic basis, other factors play a role in its development."

A nurse is interviewing a client and suspects an eating disorder. Which client statement would the nurse interpret as demonstrating a risk for the development of an eating disorder? Select all that apply. -"I consider myself a really laid-back individual." -"I'll stand up for what I want, regardless of what you say." -"Everything about my school work needs to be perfect." -"I want things to be the way I want them to be." -"Things being out of order really bothers me."

-"Everything about my school work needs to be perfect." -"I want things to be the way I want them to be." -"Things being out of order really bothers me."

A client is diagnosed with anorexia nervosa, restricting type. The nurse interprets this as indicating the use of which of the following? Select all that apply. -Diuretics -Dieting -Laxatives -Exrcising -Enemas

-Dieting -Exercise

Individuals with anorexia nervosa often experience comorbid conditions. Which of the following would be most common? Select all that apply. -Factitious disorder -Somatic symptoms disorder -Obsessive compulsive disorder -Panic disorder -Depression

-Obsessive compulsive disorder -Panic disorder -Depression

The nurse is creating a plan of care for a client diagnosed with bulimia nervosa that has just been admitted. Which immediate outcome(s) will the nurse assign for evaluation of effective care? Select all that apply. -The client will begin keeping a journal to deal with stress -The client will be free from self-induced harm to self -The client will verbalize feelings of guilt, anxiety, or anger within 4 days -The client will express feelings in a non-food related way -The client will verbalize a realistic body image

-The client will begin keeping a journal to deal with stress -The client will be free from self-inflicted harm to self -The client will verbalize feelings of guild, anxiety, or anger within 4 days

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. -impulsive behaviors -breach of contract -online bullying of "body shaming" -cognitive behavioral therapy -ineffective coping mechanisms

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

A nurse is assessing a client diagnosed with anorexia nervosa. Which symptom(s) would require an inpatient admission to the hospital for the client? Select all that apply. -less than 85% ideal body weight -anxiety -suicidal ideations -hypotension -bradycardia -depression

-suicidal ideations -hypotension -bradycardia -depression

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

Which of the following clients being treated for anorexia displays assessment values that warrant hospitalization?

A 25-year-old whose weight is 70% of ideal and who has a serum magnesium level of 1.2 mg/dl

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 is an overweight 32-year-old who regularly binges on large amounts of food. After the client binges, the client feels guilty and ashamed about eating the food. Despite the bad feelings, the client binges almost daily. Which would the nurse most likely suspect?

Binge eating disorder

A client is suspected of having anorexia nervosa and meets the diagnostic criteria for the disorder. When conducting the physical examination, which would be a probable finding from the assessment?

Bradycardia

Which is a cardiac complication of an eating disorder?

Bradycardia

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

Individuals with anorexia nervosa concentrate on which body cue?

Controlling food intake

A client was admitted to the eating disorder unit with bulimia. When the nurse assesses for a history of complications of this disorder, which are expected?

Dental erosion and chronic edema

A nurse is assessing a client with anorexia nervosa. Which would the nurse be most likely to find?

Dry skin

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 statement best describes the theories of the etiology of eating disorders?

Eating disorders involve dysregulation of multiple neurotransmitter systems, whether as a cause or an effect of the eating disorder, and my be influenced by behavioral, cultural, and familial factors

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

Enmeshment

A client has been diagnosed with anorexia nervosa. Which of the following is a dental complication associated with purging?

Erosion of dental enamel

Which is a dental complication associated with purging?

Erosion of ental enamel

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

A nurse is developing the plan of care for a client with bulimia. Which intervention would the nurse most likely include?

Increasing client's coping skills for anxiety

The nurse provides care to a client who is diagnosed with an eating disorder. Which strategy should the nurse include in the client's plan of care to increase the client's self-concept?

Keep a list of accomplishments

A psychiatric-mental health nurse is self-reflecting on their own feelings while caring for clients diagnosed with an eating disorder. Which point is important to consider when self-reflecting as a health care professional?

Keep in mind the client's perspective and fears while gaining weight

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

A 21-year-old client admits to recently using diuretics and laxatives to lose weight quickly. The client doesn't want to feel fat in a bathing suit on vacation. The client's sodium level is 150 mEq/L; potassium level is 3.2 mEq/L. The client is 5 feet tall, weighs 100 pounds, and has lost 15 pounds in 3 weeks. Which goal is a priority at this time?

Stabilize electrolyte levels

Fluoxetine includes a black box warning concerning which of the following?

Suicidality in children and adolescents

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

fluoxetine

A client with anorexia nervosa describes herself as "a whale." However, the nurse's assessment reveals that the client is 5' 8" tall and weighs only 90 lb. When considering the client's unrealistic body image, which intervention should be included in the care plan?

Telling the client of the nurse's concern for her health and desire to help her make decisions to keep her healthy

After complaining of weakness and confusion while at school, a 16-year-old client was admitted to the hospital where admission assessments revealed hypokalemia. The client has normal body weight. In planning the client's nursing care and treatment, which outcome should be prioritized?

The client will be free of self-induced vomiting

Which is most often the criterion for determining the effectiveness of treatment in the client diagnosed with anorexia nervosa?

Weight gain

The school nurse is evaluating a 16-year-old student who came to the office complaining of dizziness. The student is very thin and was pacing in the office while waiting to see the nurse. The nurse asks the student to step on the scale. The student asks if the student can go to the bathroom first to empty the student's bladder, stating, "That can make a big difference." The student's comment raises the nurse's suspicion that the student has ...

anorexia nervosa

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

engaging in severe dieting

A client diagnosed with anorexia nervosa is experiencing bradycardia, cold intolerance, and fatigue. Which complication of anorexia nervosa does the nurse identify?

hypothyroidism

A nurse has conducted an education session for parents with children at risk for eating disorders. Which topic would be included in the education session for the parents?

identifying signs and symptoms of eating disorders

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

A psychiatric-mental health nurse has learned about how eating disorders develop in clients. Which theories emphasize the importance of the media, fashion industry, and peer pressure causing eating disorders?`

social theories

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