Chapter 18 - Eating and Feeding Disorders

Ali is a 17-year-old patient with bulimia coming to the outpatient mental health clinic for counseling. Which of the following statements by Ali indicates that an appropriate outcome for treatment has been met? "I purge only once a day now instead of twice." "I feel a lot calmer lately, just like when I used to eat four or five cheeseburgers." "I am a hard worker and I am very compassionate toward others." "I always purge when I'm alone so that I'm not a bad role model for my younger sister."

"I am a hard worker and I am very compassionate toward others."

A 16-year-old patient being treated for anorexia, has been prescribed medication to reduce compulsive behaviors regarding food now that ideal weight has been reached. Which class of medication is prescribed for this specific issue associated with eating disorders? Mood stabilizers Antidepressants Anxiolytics Atypical antipsychotics

Antidepressants

The nurse can determine that inpatient treatment for a client diagnosed with an eating disorder would be warranted when which assessment data is observed? Weighs 10% below ideal body weight. Has serum potassium level of 3 mEq/L or greater. Has a heart rate less than 60 beats/min. Has systolic blood pressure less than 70 mm Hg.

Has systolic blood pressure less than 70 mm Hg.

Which coping mechanism is used excessively by clients diagnosed with bulimia nervosa to cope with their obsession with their body image? Denial Humor Altruism Projection

Denial

A client diagnosed with bulimia nervosa uses enemas and laxatives to purge to maintain weight. What is the likely physiological outcome of this practice? Increase in the red blood cell count Disruption of the fluid and electrolyte balance Elevated serum potassium level Elevated serum sodium level

Disruption of the fluid and electrolyte balance

According to current theory, which statement regarding eating disorders is accurate? Eating disorders are psychotic disorders in which patients experience body dysmorphic disorder. Eating disorders are frequently misdiagnosed. Eating disorders are possibly influenced by sociocultural factors. Eating disorders are rarely comorbid with other mental health disorders.

Eating disorders are possibly influenced by sociocultural factors.

Which subjective symptom should the nurse would expect to note during assessment of a client diagnosed with anorexia nervosa? Lanugo Hypotension 25-lb weight loss Fear of gaining weight

Fear of gaining weight

A client hospitalized with anorexia nervosa has a weight that is 65% of normal. For this client, what is a realistic short-term goal for the first week of hospitalization regarding the physical impact of his/her weight? Gain a maximum of 3 lb. Develop a pattern of normal eating behavior. Discuss fears and feelings about gaining weight. Verbalize awareness of the sensation of hunger.

Gain a maximum of 3 lb.

A client reveals that she induces vomiting as often as a dozen times a day. The nurse would expect assessment findings to support which electrolyte imbalance? Hypernatremia Hypokalemia Hypercalcemia Hypolipidemia

Hypokalemia

A client who is 16 years old, 5 foot, 3 inches tall, and weighs 80 pounds eats one tiny meal daily and engages in a rigorous exercise program. Which nursing diagnosis addresses this assessment data? Death anxiety Ineffective denial Disturbed sensory perception Imbalanced nutrition: less than body requirements

Imbalanced nutrition: less than body requirements

When educating a client diagnosed with bulimia nervosa about the medication fluoxetine, the nurse should include what information about this medication? It will reduce the need for cognitive therapy. It will be prescribed at a higher than typical dose. There are a variety of medications to prescribe if fluoxetine proves to be ineffective. Long-term management of symptoms is best achieved with tricyclic antidepressants.

It will be prescribed at a higher than typical dose.

The client experiencing bulimia differs from the client diagnosed with anorexia nervosa by exhibiting which characteristic? Maintaining a normal weight Holding a distorted body image Doing more rigorous exercising Purging to keep weight down

Maintaining a normal weight

Which diagnosis from the list below would be given priority for a client diagnosed with bulimia nervosa? Disturbed body image Chronic low self-esteem Risk for injury: electrolyte imbalance Ineffective coping: impulsive responses to problems

Risk for injury: electrolyte imbalance

Which statement is true of the eating disorder referred to as bulimia? Patients with bulimia often appear at a normal weight. Patients with bulimia binge eat but do not engage in compensatory measures. Patients with bulimia severely restrict their food intake. One sign of bulimia is lanugo.

Patients with bulimia often appear at a normal weight.

Biological theorists suggest that the cause of eating disorders may be related to which factor? Normal weight phobia Body image disturbance Serotonin imbalance Dopamine excess

Serotonin imbalance

The nurse working with clients diagnosed with eating disorders can help families develop effective coping mechanisms by implementing which intervention? Teaching the family about the disorder and the client's behaviors Stressing the need to suppress overt conflict within the family Urging the family to demonstrate greater caring for the client Encouraging the family to use their usual social behaviors at meals

Teaching the family about the disorder and the client's behaviors

Which intervention would be least useful for accurate assessment of the weight of a client diagnosed with anorexia nervosa? Weigh 2 times daily first week, then three times weekly. Weigh fully clothed before breakfast. Do not reweigh client when client requests. Permit no oral intake before weighing.

Weigh fully clothed before breakfast.

After stabilization of symptoms, what is the primary focus of treatment for a client diagnosed with anorexia nervosa? Weight restoration Improving interpersonal skills Learning effective coping methods Changing family interaction patterns

Weight restoration

Assessment of a client suspected of experiencing bulimia nervosa calls for the nurse to perform a range of motion assessment. inspection of body cavities. inspection of the oral cavity. body fat analysis.

inspection of the oral cavity.