PrepU Videbeck Ch 20 Eating Disorders

A nurse is discussing the plan of care with a client who has anorexia nervosa. The client's weight is 15% below ideal. The nurse and client are now discussing the client's activity level. The client would like to run 5 miles per day as the client normally does. Which response by the nurse is best? "Aerobic exercise is not the best choice now. Anaerobic exercise will help you increase lean body mass." "Five miles per day is too much. How about 3 miles per day?" "That's fine as long as you adhere to your eating program and do not use laxatives or purging." "No, exercise is not allowed until your weight is closer to normal."

"Aerobic exercise is not the best choice now. Anaerobic exercise will help you increase lean body mass."

A nurse is assessing a client with anorexia nervosa. Which would the nurse be most likely to find? Dry skin Tachycardia Oversensitivity to heat Hyperkalemia

Dry skin

Which is a metabolic complication related to weight loss? Amenorrhea Hypothyroidism Bradycardia Leukopenia

Hypothyroidism

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 Anxiety Nutrition that is less than body requirements Ineffective individual coping

Risk for self-directed violence

A nurse is preparing to discharge a client who has been hospitalized with anorexia nervosa. Which would the nurse include in the education plan? Knowing the calorie content of numerous foods Setting realistic goals Learning strategies to control impulses Describing physiologic consequences of anorexia nervosa

Setting realistic goals

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. "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." "I'll stand up for what I want, regardless of what you say." "I consider myself a really laid-back individual."

"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."

The nurse is performing an assessment on a 16-year-old female client who has been diagnosed with anorexia nervosa. Which statement, made by the client, would the nurse identify as necessitating further assessment on a priority basis? "I check my weight every day without fail." "I've been told that I am 10% below ideal body weight." "I exercise 3 to 4 hours every day to keep my slim figure." "My best friend was in the hospital with this disease a year ago."

"I exercise 3 to 4 hours every day to keep my slim figure."

The nurse is interviewing an 18-year-old client about eating behaviors. The client's parents have brought the client to treatment because the client's mother suspects that the client has been binge eating and vomiting. The nurse asks the client if the client ever feels that the client cannot control the client's eating. The client's mother states, "I know the client can't control it; the client ate an entire cake last night!" Which comment by the nurse is best? "Do you often have to answer for your child?" "I see. What are your thoughts on what your mother has said?" "I see. Do you ever feel as though you cannot control your eating?" " Is what your mother said true?"

"I see. Do you ever feel as though you cannot control your eating?"

A client with anorexia weighs less than 85% of the client's normal body weight. The client says, "I'm so fat, I can't even get through this doorway, much less fit into any of my clothes." Which is the nurse's most therapeutic response? "Let's talk about your ideas about your body and why you perceive yourself to be fat." "You only weigh 100 pounds. It is just not true that you are fat." "You must try and stop thinking that way. Let's think of some alternative ideas for describing your body." "I understand what you are saying. However, you are under your ideal body weight, and it is causing you to have the medical problems that we have talked about."

"I understand what you are saying. However, you are under your ideal body weight, and it is causing you to have the medical problems that we have talked about."

A clinic nurse is monitoring a client with anorexia nervosa. Which client statement should indicate to the nurse that treatment has been effective? "I'll eat until I don't feel hungry." "I no longer have a weight problem." "I don't want to starve myself anymore." "My friends and I went out to lunch today."

"My friends and I went out to lunch today."

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 client with pneumonia A client undergoing diagnostic tests A client who thrives on managing others A client who could benefit from the client's assistance at mealtime

A client undergoing diagnostic tests

The nurse is caring for a client diagnosed with bulimia. Which would be important for the nurse to do first? Identify the cues related to binging Ask the client directly about thoughts of suicide or self-harm Provide small regular meals and snacks Control the eating responses

Ask the client directly about thoughts of suicide or self-harm

A college student has been referred to the clinic for evaluation for anorexia nervosa. The nursing assessment to substantiate this disorder should include what? Oily skin and acne Temper tantrums and sleep disturbance Body weight significantly below ideal for height and age Onset of symptoms in early adolescence

Body weight significantly below ideal for height and age

A 30-year-old client is in therapy for bulimia, depression, and anxiety. The client relates that the client feels unable to cope with the demands of the client's job and that the client's partner recently ended their long-term relationship. The client states that the client frequently binges when stress levels are high. The client denies feeling suicidal but states, "I'm a mess. I'm just not smart enough to figure out how to run my life!" Which nursing diagnosis would best identify the client's problems? Chronic low self-esteem related to unrealistic self-expectations Risk for impulse control related to unidentified triggers Anxiety related to job stressors Social isolation related to recent loss of significant relationship

Chronic low self-esteem related to unrealistic self-expectations

A client's diagnosis of bulimia nervosa is supported when the psychiatric nurse documents assessment data that includes (Select all that apply.) Client reports of "being depressed" History of purging "3 times a week for 2 years." Often heard discussing "how hard it is to stay thin" with other clients Lanugo observed on forearms and face Serum potassium of 3.8 mEq/L

Client reports of "being depressed" History of purging "3 times a week for 2 years." Often heard discussing "how hard it is to stay thin" with other clients

Despite being admitted to the hospital yesterday for the treatment of complications of anorexia nervosa, a 19-year-old client continues to have only bites of food and small sips of fluids. Which of the following nursing diagnoses is paramount in this client's care? Deficient fluid volume related to inability to meet bodily fluid requirements Imbalanced nutrition less than body requirements related to refusal to eat Impaired social interaction related to aggressive behavior Anxiety related to inadequate coping mechanisms

Deficient fluid volume related to inability to meet bodily fluid requirements

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? Select all that apply. Dental decay Moist, oily skin Loss of tooth enamel Electrolyte imbalances Body weight well below ideal range

Dental decay Loss of tooth enamel Electrolyte imbalances

During a home visit, the nurse suspects that a young daughter of the client is bulimic. The nurse bases this suspicion on which primary characteristics of bulimia? Refusing to eat and excessive exercising Eating only vegetables and fruits and fasting Hoarding of food and difficulty controlling food intake Eating a lot of food in a short period of time and misuse of laxatives

Eating a lot of food in a short period of time and misuse of laxatives

Which assessments should the nurse closely monitor when caring for a hospitalized client diagnosed with bulimia nervosa? Select all that apply. Electrolyte levels Exercise patterns Intake and output Pupillary response Elimination patterns Deep tendon reflexes

Electrolyte levels Intake and output Elimination patterns

A nurse is planning to explain the purpose of the behavioral therapy technique of self-monitoring to a client diagnosed with bulimia nervosa. The nurse would emphasize keeping a diary to record what? Feelings of hunger Efforts at distraction Rigid rules about eating Environmental cues

Environmental cues

A client with anorexia nervosa is a member of a predischarge 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 clothes. 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? Normal behavior Evidence of the client's disturbed body image Regression as the client is moving toward the community Indicative of the client's ambivalence about hospital discharge

Evidence of the client's disturbed body image

When a client is admitted to an inpatient mental health unit with the diagnosis of anorexia nervosa, a cognitive behavioral approach is used as part of the treatment plan. The nurse plans care based on which purpose of this approach? Providing a supportive environment xamining intrapsychic conflicts and past issues Emphasizing social interaction with clients who withdraw Helping the client to examine dysfunctional thoughts and beliefs

Helping the client to examine dysfunctional thoughts and beliefs

A nurse is reviewing the plan of care for a client diagnosed with anorexia nervosa and notes a behavioral plan for increasing weight. The nurse correlates this intervention with which nursing diagnosis? Anxiety Ineffective coping Disturbed body image Imbalanced nutrition: less than body requirements

Imbalanced nutrition: less than body requirements

The nurse is caring for a female client who was admitted to the mental health unit 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? Interrupt the client and weigh her immediately. Interrupt the client and offer to take her for a walk. Allow the client to complete her exercise program. Tell the client that she is not allowed to exercise rigorously.

Interrupt the client and offer to take her for a walk

The nurse has developed a plan of care for a client diagnosed with anorexia nervosa. Which client problem would the nurse select as the priority in the plan of care? Disrupted appearance because of weight Inability to feed self because of weakness Pain because of an inflamed gastric mucosa Nutritional imbalance because of lack of intake

Nutritional imbalance because of lack of intake

The nurse is caring for a client with anorexia nervosa. Which behavior is characteristic of this disorder and reflects anxiety management? Engaging in immoral acts Always reinforcing self-approval Observing rigid rules and regulations Having the need always to make the right decision

Observing rigid rules and regulations

A nurse is reviewing the medical records of several clients being treated for eating disorders at the community mental health center. Which behavior would the nurse identify as differentiating a client who is believed to have bulimia nervosa from one who has anorexia nervosa? The client is preoccupied with body image. The client has feelings of powerlessness. The client is of normal body weight. The client is preoccupied with food consumption.

The client is of normal body weight.

When reviewing the documented history of an adult client with anorexia nervosa, what is the nurse most likely to find? (Select all that apply.) reports strong relationship with parents had successful outpatient treatment one year after onset of disorder food restriction began at age 15 reported believing that friends were "jealous" of her body depression at age 16 lasting one month

food restriction began at age 15 depression at age 16 lasting one month reported believing that friends were "jealous" of her body