PNU 128 Videbeck PrepU Chapter 20: Eating Disorders

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

Which technique is a type of cognitive behavioral therapy implemented for bulimic clients?

Self-monitoring

An adolescent client has been diagnosed with anorexia nervosa. Which intervention should be included in the client's plan of care?

Set up a strict eating plan for the client

Which statement made by the nurse managing the care of an anorexic teenager demonstrates an understanding of the client's typical, initial reaction to the nurse?

"I realize this must be very difficult for you but try to remember I'm not your enemy."

What percentage of clients who have fully recovered from bulimia nervosa later experience a relapse?

30%

The nurse has been teaching a client about bulimia. Which statement by the client indicates that the education has been effective?

"I'll eat small meals and snacks regularly."

The client is 16 years old with an identical twin just diagnosed with anorexia nervosa. The client tells the nurse the client is concerned that the client may also develop the disorder. Which response by the nurse is the most appropriate?

"While eating disorders have shown a genetic link, other factors also play a role in its development."

Which client 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 glucose of 58mg/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

Fluoxetine has been approved for the treatment of anorexia nervosa. Fluoxetine is from which drug classification?

Antidepressant

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

Which is a cardiac complication of an eating disorder?

Bradycardia

A 17-year-old client with a long-standing diagnosis of bulimia nervosa has been admitted to the emergency department after collapsing in a mall. The care team that admits the client to the hospital should prioritize which assessment?

Cardiac assessment and measurement of electrolyte levels

A nurse is developing a plan of care for a client newly diagnosed with bulimia nervosa. Which would the nurse expect to implement in conjunction with pharmacologic therapy?

Cognitive behavioral therapy

A client's diagnosis of anorexia nervosa is supported when the psychiatric nurse documents assessment data that includes which finding? Select all that apply.

Client reports "being depressed." Client claims that she "hasn't had a menstrual period in over 2 years." Client is overheard telling other clients "I weigh myself three times a day when I'm home." Client consistently denies that she "has a problem with the way she looks."

For clients with bulimia, nursing interventions are often directed toward improving self-concept and regaining control. Which would be included in the primary interventions?

Cognitive-behavioral therapy (CBT) including self-monitoring

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

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 caring for several hospitalized clients with anorexia nervosa. The nurse would be especially alert for which if noted in the clients' histories?

Depression

A psychiatric-mental health nurse working in the community is planning an educational program for fifth- and sixth-grade teachers. Which would the nurse include?

Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders

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

Fluoxetine

Exacerbation of anorexia nervosa results from the client's effort to do what?

Gain control of one part of life

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

Which area of the brain has been associated with the symptoms of eating disorders?

Hypothalamus

A nurse is reviewing the plan of care for a client with anorexia nervosa and notes a behavioral plan for increasing weight. The nurse correlates this intervention with which nursing diagnosis?

Imbalanced nutrition: less than body requirements

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

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

Overprotective of their children

The nurse on an inpatient psychiatric unit is developing the plan of care for a 17-year-old client admitted with anorexia nervosa. The client's weight is 20% below normal. The client engages in many rituals related to eating, asks to be weighed several times per day, and complains that access to the bathroom is limited. The nurse develops a contract with the client. The purpose of the contract is to do what?

Provide the client with a feeling of responsibility and control over the client's behavior

For clients who purge, what is the most important goal?

Stop the behavior

A nurse is reviewing the medical records of several clients at the community mental health center being treated for eating disorders. Which behavior would the nurse identify as differentiating a client who is believed to have bulimia nervosa from one who has anorexia nervosa?

The person engages in episodic binge eating.

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