Chapter 18: Eating Disorders

12. The nurse is assessing a patient with bulimia nervosa. Which of the following symptoms would the nurse expect to find? (Select all that apply) A) Cold intolerance B) Normal weight for height C) Dental erosion D) Hypotension E) Metabolic alkalosis

B) Normal weight for height C) Dental erosion

9. One approach to establish adequate eating patterns for a client with anorexia is to assume a positive expectation of the client. Which is the best statement by the nurse? A) "I'll give you 90 minutes to eat." B) "I will allow you space to eat in peace." C) "I will sit here quietly with you while you eat." D) "There are people who would truly appreciate this food."

C) "I will sit here quietly with you while you eat."

21. The nurse is assisting the patient with anorexia express feelings more openly. Which of the following is the most helpful response by the nurse to encourage expression of feelings? A) "Are you sad?" B) "You look anxious." C) "Tell me what you are feeling right now." D) "Tell me when you feel bad."

C) "Tell me what you are feeling right now.

20. The nurse performs with of the following interventions to establish healthy eating patterns for a patient with anorexia? A) Leave the patient alone to relax during meals B) Offer liquid protein supplements if client is unable to complete meal. C) Observe the patient for 30 minutes after all meals. D) Weigh the patient weekly in the same clothing at the same time of day.

B) Offer liquid protein supplements if client is unable to complete meal.

28. A client has been purging to maintain weight loss. Which of the following would be an important goal for this client? A) Understanding that purging is an ineffective means of weight control B) Stopping the behavior C) Recognizing that purging promotes binge eating D) Developing the technique of distraction

B) Stopping the behavior

1. When working with a client with anorexia nervosa, which of the following nursing diagnoses is most difficult to resolve successfully? A) Imbalanced nutrition: less than body requirements B) Disturbed body image C) Deficient knowledge (nutritious eating patterns) D) Social isolation

B) Disturbed body image

22. The nurse is teaching a patient with bulimia to using self-monitoring techniques. The nurse would evaluate successful use of this technique in which of the following patient statements? A) "I am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging." B) "I am beginning to understand how my lack of self-control is hurting me." C) "I am keeping a record of everything I eat and how I am feeling every day." D) "I am getting more comfortable confronting people when I have conflict with them."

A) "I am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging."

18. When documenting the mental status exam findings in the chart of a patient with anorexia, the nurse notes poor judgment and insight. A patient statement that would support this impression might include: A) "I know I have a problem. I need help." B) "Others are just trying to keep me from looking good." C) C"I know my weight is a little below normal." D) "Those weight charts are for normal people. I am not normal."

A) "I know I have a problem. I need help."

16. The nurse uses cognitive-behavioral approaches to assist the patient with bulimia toward recovery. Which of the following responses would the nurse say when using this approach? A) "Is there any way you can look at that sandwich as fuel for your body?" B) "You have to eat in moderation for good nutrition." C) "You seem to have a really hard time controlling your eating patterns." D) "Is this your way of showing your family that you can make decisions?"

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

19. All of the following nursing diagnoses are appropriate for the care of a patient with anorexia. List the diagnoses in order of priority. A) Activity Intolerance B) Ineffective Coping C) Chronic Low Self-esteem D) Imbalanced Nutrition: Less than Body Requirements

A) Activity Intolerance B) Ineffective Coping C) Chronic Low Self-esteem D) Imbalanced Nutrition: Less than Body Requirements

27. A patient with an eating disorder seems dependent on the nurse for direction in food choices. A self-aware nurse that understands the patient's dependency will take which approach in caring for this patient? A) Approach the patient with an adult-like objectivity B) Give the support and direction that the patient is seeking C) Give approval for positive changes seen in the patient D) Take care of the needs that the patient is neglecting

A) Approach the patient with an adult-like objectivity

11. A 15 year old female is admitted for treatment of anorexia nervosa. Which of the following is diagnostic of anorexia nervosa? A) Body weight less than 85% of normal for age and height B) Amenorrhea for at least 2 cycles C) Absence of hunger feelings D) Erosion of dental enamel

A) Body weight less than 85% of normal for age and height

14. The nurse understands that which of the following biologic factors may influence the development of an eating disorder? (Select all that apply) A) Family history of eating disorders B) Dysfunction of the hypothalamus C) Norepinephrine imbalances D) First degree relatives with psychotic disorder E) Decreased serotonin levels

A) Family history of eating disorders B) Dysfunction of the hypothalamus C) Norepinephrine E) Decreased serotonin levels

24. When preparing a bulimic patient for discharge, the nurse suggests the patient and family continue with family therapy on an outpatient basis. Then nurse explains the main reason this is suggested is which of the following? A) Family members often need to learn role independence and autonomy B) Family members needs to learn to monitor for signs of patient relapse C) Family relationships need strengthened due to a lifetime of disengagement D) Family members often feel jealous of the attention the patient has been receiving in treatment

A) Family members often need to learn role independence and autonomy

26. The nurse is teaching nutritional needs to the family of a patient with bulimia. The nurse should encourage the family to develop which of the following dietary patterns to assist the patient in recovering from bulimia? A) Provide the patient a diet of mainly vegetables and salads B) Encourage the entire family to engage in a balanced and regular dietary pattern C) Encourage autonomy by allowing the patient total control over food choices D) Insist that the patient complete all meals provided

B) Encourage the entire family to engage in a balanced and regular dietary pattern

3. The nurse has been teaching a client about bulimia. Which of the following statements by the client indicates that the teaching has been effective? A) "I know if I eat pasta, I'll binge." B) "I'll eat small meals and snacks regularly." C) "I'll take my medication when I feel the urge to binge." D) "I'll limit my intake of carbohydrates and fats."

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

2. The nurse has been teaching the client's family about the client's eating disorder, anorexia nervosa. Which of the following statements would indicate that teaching was effective? A) "We will eat our evening meals together with no exceptions." B) "We will negotiate resolutions to family conflicts." C) "We will spend less time discussing troublesome family members." D) "We will give her frequent encouragement for eating well and maintaining her weight."

B) "We will negotiate resolutions to family conflicts."

10. A 16-year-old female with anorexia nervosa is admitted to the unit. The most appropriate short-term outcome is that the client will A) Accept herself as having value and worth B) Admit she has a fear of gaining weight C) Follow a nutritionally balanced diet for her age D) Identify her problems and potential alternative coping strategies

B) Admit she has a fear of gaining weight

4. The difference between clients with anorexia nervosa and bulimia nervosa is which of the following? A) Anorexia has a psychological basis, whereas the cause of bulimia is biologic. B) Clients who are anorexic are proud of their control over eating, whereas bulimic clients are ashamed of their behavior. C) Bulimia can be life threatening, whereas anorexia is seldom so. D) There is no real difference between these two types of clients.

B) Clients who are anorexic are proud of their control over eating, whereas bulimic clients are ashamed of their behavior.

7. When working with the family of a client with anorexia nervosa, which of the following issues must be addressed? A) Codependence B) Control issues C) Self-discipline D) Sexual identity

B) Control issues

23. The nurse understands that before a patient with an eating disorder can accept their body image, they must first learn effective coping skills. The relationship between body image and coping skills is best described in which of the following statements? A) Coping skills are dependent on a supportive upbringing. B) When body image is positive the patient will develop better coping skills C) Being able to cope in healthy ways improves the ability to accept a realistic body image D) Neurotransmitters that are deficient in patients with eating disorders prohibit the development of effective coping skills

C) Being able to cope in healthy ways improves the ability to accept a realistic body image

5. Which of the following interventions would be appropriate for a client with anorexia nervosa? A) Allowing the client to eat whenever she feels hungry B) Insisting that the client sit in the dining room until all food is eaten C) Having the client in view of staff for 90 minutes after each meal D) Permitting the client to eat any food she chooses, as long as she is eating

C) Having the client in view of staff for 90 minutes after each meal

15. A patient with anorexia is prescribed several medications. Which of the following medications may be prescribed to help treat the patient's distorted body image? A) Amitriptyline (Elavil) B) Cyproheptadine (Periactin) C) Olanzapine (Zyprexa) D) Fluoxetine (Prozac)

C) Olanzapine (Zyprexa)

6. The immediate goal of nursing interventions in the care of a client with anorexia nervosa is which of the following? A) Changing her irrational thinking about her body B) Establishing a target weight to be achieved by discharge C) Restoring nutritional status to normal D) Gaining insight into the effects of anorexia on her physical health

C) Restoring nutritional status to normal

25. A nurse is conducting an education class open to community members on various topics of health promotion. The nurse should include which of the following regarding calorie-restriction diets at an early age in children? A) Dieting helps build a positive self-image in children B) Dieting during childhood restricts essential nutrients needed for normal growth C) Dieting at an early age teaches healthy eating habits D) Dieting at an early age may lead to the development of eating disorders

D) Dieting at an early age may lead to the development of eating disorders

17. The nurse is assessing a patient with an eating disorder. Which of the following personality characteristics is the nurse likely to detect through interacting with the patient? A) Careless B) Outspoken C) Defiance D) Eager to please

D) Eager to please

13. While assessing the family dynamics a of a patient with an eating disorder, which of the following would the nurse most likely discover? A) Multiple siblings B) Lack of interest in the patient by other family members C) Supportive and encouraging relationships D) Over controlling parents

D) Over controlling parents

8. During an initial interview at a clinic, a young female client states that there is nothing wrong with her. Which of the following would indicate to the nurse that this client might have anorexia nervosa? A) Episodes of overeating and excessive weight gain B) Expressions of a positive self-concept C) Flexible thought patterns and spontaneity D) Severe weight loss due to self-imposed dieting

D) Severe weight loss due to self-imposed dieting