Eating & Feeding Disorders - CC
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 Denial of incongruence between body reality, body ideal, and body presentation is the mainstay of the client diagnosed with bulimia nervosa. None of the other mechanisms are as vital to their coping technique.REF: 344
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 Vomiting causes loss of potassium, leading to hypokalemia. Vomiting is not the trigger for any of the other options presented.REF: 344
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. Repeated vomiting often causes dental erosions and caries. None of the other options represent frequently engaged dysfunctional behaviors.REF: 343
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 Fear of weight gain is the only subjective data listed, and it is universally true of clients diagnosed with anorexia nervosa.REF: 334
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 The client who engages in purging and excessive use of laxatives and enemas is at risk for metabolic acidosis from bicarbonate loss. This electrolyte imbalance is potentially life threatening. While appropriate none of the other options are as likely to risk the client's life.REF: 343
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 selective serotonin reuptake inhibitors have been shown to improve the rate of weight gain and reduce the occurrence of relapse. None of the remaining options are currently supported by any biological theories.REF: 335
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 Families need information about specific eating disorders and the behaviors often seen in clients with these disorders. This information can serve as a basis for additional learning about how to support the family member. While the other options may be appropriate for specific client families, they are not as fundamental as the correct option.REF: 337
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 Weight restoration is the priority goal of treatment for the client with anorexia nervosa because health is seriously threatened by the underweight status. The other options are addressed are secondary to the physiological goal of weight restoration.REF: 338
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 Disruption of the fluid and electrolyte balance is usually the result of excessive use of enemas and laxatives. There would be a decrease in potassium and sodium levels while the concentration of but not actual red cell count would be affected.REF: 344
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. The critical outcome during hospitalization for anorexia nervosa is weight gain. A maximum of 3 pounds weekly is considered sufficient initially. Too-rapid weight gain can cause pulmonary edema. While all the remaining goals are appropriate, none have the physical focus that is the initial priority.REF: 340-341
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. Systolic blood pressure of less than 70 mm Hg is one of the established criteria signaling the need for hospitalization of a client with anorexia nervosa. It suggests severe cardiovascular compromise. None of the remaining options represent data aligned with the criteria for hospitalization.REF: 346-347
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 A body weight of 80 pounds for a 16-year-old who is 5 foot, 3 inches tall is ample evidence of this diagnosis. There is no support in the data as presented to justify any of the other nursing diagnoses.REF: 337
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 Many bulimics are at or near normal weight, whereas clients with anorexia nervosa are underweight. The other characteristics are commonly shared among persons with either disorder.REF: 352
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. Clients should be weighed daily first week, then three times weekly wearing only bra and panties or underwear before ingesting any food or fluids in the morning. Reweighing is not a request that should be afforded to the client.REF: 340-341
