Eating Disorders

A nurse assesses an adolescent female diagnosed with anorexia nervosa. Which physical findings support the diagnosis? Select all that apply. 1. Lanugo 2. Oily skin 3. Irregular heart rate 4. Extremities hot to touch 5. Pulse rate 48 beats per minute

1, 3, 5 - lanugo and cold extremities occur w. starvation - skin often yellow due to hypercarotenemia - cardio changes include bradycardia, irregular HR

A patient presents with decreased cardiac output. The nurse notes that the patient experiences binging and then exercises excessively to make up for the calories gained. What should the nurse suspect? 1. Binge eating 2. Bulimia nervosa 3. Anorexia nervosa 4. Weight management

2

According to current theory, which statement is true regarding eating disorders? 1. They are psychotic disorders in which patients experience body dysmorphic disorder. 2. They are frequently misdiagnosed. 3. They are possibly influenced by sociocultural factors. 4. They are rarely comorbid with other mental health disorders.

3

Biological theorists suggest that the cause of eating disorders may be 1. Normal weight phobia 2. Body image disturbance 3. Serotonin imbalance 4. Dopamine excess

3

Which statement made by a patient diagnosed with bulimia indicates that an appropriate outcome for treatment has been met? 1. "I purge only once a day now instead of twice." 2. "I feel a lot calmer lately, just like when I used to eat four or five cheeseburgers." 3. "I'm both a hard worker and a compassionate person." 4. "I always purge when I'm alone so that I'm not a bad role model for my younger sister."

3

the patient with bulimia differs from the patient with anorexia nervosa by 1. Maintaining a normal weight 2. Holding a distorted body image 3. Doing more rigorous exercising 4. Purging to keep weight down

1

A nurse is assessing an 8-year-old boy with autism. The family complains that the boy often eats paper and pencils. What condition does the nurse suspect? 1. Pica 2. Enuresis 3. Rumination 4. Binge eating

1 - enuresis is an elimination problem where pt. voids in bed/clothing - rumination is a feeding problem where regurgitation w. chewing again and then swallowing or spitting

The nurse is caring for a patient with bulimia nervosa who overuses laxatives but does not purge. Which drug is known to be effective to treat the patient? 1. Bupropion (Wellbutrin) 2. Olanzapine (Zyprexa) 3. Lorcaserin (Belviq) 4. Qsymia

1 Bupropion is known to be effective in patients with bulimia nervosa who do not purge. It is contraindicated in patients who purge as it increases the risk of seizures. Antipsychotic agents such as olanzapine are effective to treat anorexia nervosa. Olanzapine improves the mood, decreases obsessive behaviors, and reduces resistance to weight gain. Belviq and Qsymia are known to be effective to treat patients with binge eating. They block appetite signals and produce feelings of fullness.

The nurse working with patients diagnosed with eating disorders can help families develop effective coping mechanisms by 1. Teaching the family about the disorder and the patient's behaviors 2. Stressing the need to suppress overt conflict within the family 3. Urging the family to demonstrate greater caring for the patient 4. Encouraging the family to use their usual social behaviors at meals

1 Families need information about specific eating disorders and the behaviors often seen in patients with these disorders. This information can serve as a basis for additional learning about how to support the family member.

patient has been hospitalized with anorexia nervosa. The patient's weight is 65% of normal. For this patient, a realistic short-term goal for the first week of hospitalization would be: by the end of week 1, the patient will 1. Gain a maximum of 3 lb 2. Develop a pattern of normal eating behavior 3. Discuss fears and feelings about gaining weight 4. Verbalize awareness of the sensation of hunger

1 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.

A nurse is caring for a patient with bulimia nervosa. Which factors should the nurse discuss when educating the patient about the eating disorder? Select all that apply. 1. Meal planning 2. Effects of purging 3. Effects of starvation 4. Relaxation techniques 5. Eating forbidden foods

1, 2, 4

A nurse is assessing a patient with anorexia nervosa. Which clinical findings does the nurse expect? Select all that apply. 1. Dry skin 2. Emaciation 3. High blood pressure 4. Decreased urinary concentration 5. Decreased urine output

1, 2, 5

A patient is suspected of having anorexia nervosa. What clinical manifestations does the nurse identify as symptoms of anorexia nervosa? Select all that apply. 1. Emaciation 2. Russell's sign 3. Dehydration 4. Yellow skin 5. Hyperkalemia

1, 3, 4

Which medical complication is associated with the diagnosis of bulimia nervosa? Select all that apply. 1. Russell's sign 2. Positive Babinski sign 3. Parotid gland enlargement 4. Hypochloremia 5. Hyperkalemia

1, 3, 4

The nurse suspects bulimia nervosa in a patient. Based on the presence of which symptoms does the nurse identify the condition as bulimia nervosa? Select all that apply. 1. Scars on hand 2. Amenorrhea 3. Dental erosion 4. Parotid swelling 5. Constipation

1, 3, 4 Bulimia nervosa is an eating disorder where the patient has recurrent episodes of uncontrollable binging that is followed by inappropriate compensatory behaviors, such as excessive exercise and induced vomiting. Due to self-induced vomiting, the patient presents with scars on hands and dental erosion. The reflux of hydrochloric acid over the tooth enamel causes dental cavities. The parotid glands swell due to an increase in serum amylase levels. Patients are usually normal in weight due to excessive caloric intake with purging. They do not have amenorrhea. Amenorrhea is seen more often in patients with anorexia nervosa. Such patients also have constipation due to starvation.

A nurse is assessing a patient suffering from bulimia nervosa. For what reason would the nurse assess the patient for the presence of dental cavities? 1. Vomiting 2. Binge eating 3. Ipecac intoxication 4. Excessive caloric intake

1.

adolescent patient diagnosed with anorexia nervosa currently weighs 97 lbs. The patient's ideal body weight is 127 pounds. Identify the highest priority goal for this patient. The patient will: 1. Attain a weight of 114.3 pounds 2. Verbalize a realistic body image 3. Demonstrate elevated self-concept 4. Seek input from others when making decisions

1. After intervention for any acute symptoms, the patient with anorexia begins a weight restoration program that allows for incremental weight gain. A treatment goal is set at 90% of ideal body weight, the weight at which most women are able to menstruate. Verbalizing a realistic body image and improved self-concept are important goals, but nutritional integrity is a higher priority. The goal of treatment is to achieve independence with decision-making processes.

A nurse is attending to a patient with bulimia nervosa. What reason does the nurse suspect for the presence of gastric dilation in the patient? 1. Induced vomiting 2. Binge eating 3. Ipecac intoxication 4. Use of laxatives

2

Which intervention would be least useful for accurate assessment of the weight of a patient diagnosed with anorexia nervosa? 1. Weigh two times daily, then three times weekly. 2. Weigh fully clothed before breakfast. 3. Do not reweigh patient when patient requests. 4. Permit no oral intake before weighing.

2

Therapeutic nutrition is initiated for a patient hospitalized with anorexia nervosa. Two days later, the nurse notes that the patient has developed peripheral edema. What is the nurse's correct analysis of this situation? 1. The patient's electrolyte balance has improved. 2. The patient may be experiencing refeeding syndrome. 3. Peripheral edema is the consequence of preexisting low bone density. 4. The therapeutic nutrition program has improved the patient's hydration.

2 - this is a potential complication of initiation of therapeutic nutrition for pt. diagnosed w. anorexia nervosa, causing peripheral edema

A nurse is assessing a patient experiencing anorexia nervosa. What diagnosis should the nurse consider when the patient exhibits destructive behavior towards self? 1. Powerlessness 2. Ineffective coping 3. Imbalanced nutrition 4. Disturbed body image

2 Ineffective coping is presented as destructive behavior towards oneself or inability to meet expectations. Powerlessness is presented by indecisive behavior or a feeling of shame. Imbalanced nutrition is diagnosed when there are signs of emaciation or decreased urine output. Disturbed body image is noted when there is excessive self-monitoring regarding body image.

A nurse is teaching a patient with bulimia nervosa about scheduling healthy, balanced meals. Why does a nurse consider providing this patient education important? 1. To identify trigger foods 2. To avoid binge-purge cycles 3. To include forbidden foods 4. To realize health effects

2 Learning about scheduled balanced meals can help the patient to maintain a steady dietary regimen and avoid binge-purge cycles. Identifying trigger foods can be done by encouraging the patient to explore ideas about trigger foods. Including forbidden foods can be achieved by discussing the patient's irrational thoughts regarding those foods. Health effects of purging can be taught by educating the patient about the ill effects of induced vomiting.

A patient with bulimia nervosa wants to reduce the feeling of powerlessness. What outcome is most important for the patient to reduce the feeling of powerlessness? 1. Being satisfied with body appearance 2. Making informed life decisions 3. Willingness to call others for help 4. Using a personal support system

2 When the patient makes informed life decisions, there is a sense of control and power over his or her own life. Development of this skill reduces the feeling of powerlessness associated with bulimia nervosa. When the patient is satisfied with body appearance, there is a reduction of disturbed body image and obsession with the body. When the patient is willing to call others for help, it decreases social isolation. By using a personal support system, the patient can develop effective coping mechanisms.

A patient reveals that he or she induces vomiting as often as a dozen times a day. The nurse would expect assessment findings to reveal 1. Tachycardia 2. Hypokalemia 3. Hypercalcemia 4. Hypolipidemia

2. hypokalemia causes loss of K, leading to hypokalemia

During assessment of a patient with anorexia nervosa, it is not likely that the nurse would note indications of 1. Introversion 2. Social isolation 3. High self-esteem 4. Obsessive-compulsive tendencies

3

Which intervention would be removed from the plan of care for a patient diagnosed with bulimia nervosa? 1. Teach that fasting sets one up to binge eat. 2. Assist patient to identify trigger foods. 3. Support importance of avoiding forbidden foods. 4. Teach patient to plan and eat regularly scheduled meals.

3

A patient diagnosed with anorexia nervosa and which assessment finding meets criteria for hospitalization? 1. Oral temperature 98.1° F 2. Heart rate 56 beats per minute 3. Serum potassium level 2.6 mEq/L 4. Systolic blood pressure 88 mm Hg

3 electrolyte imbalances, hypothermia (T <36), HR < 40, and systolic bp > 70 require hospitalization

Assessment of a patient suspected of experiencing bulimia nervosa calls for the nurse to perform 1. A range of motion assessment 2. Inspection of body cavities 3. Inspection of the oral cavity 4. Body fat analysis

3 repeated vomiting causes dental erosions and caries

As the nurse prepares to administer lorcaserin (Belviq) to a patient diagnosed with binge eating disorder, the tablet accidentally falls on the floor. What are the nurse's best actions? Select all that apply. 1. Omit the dose. 2. Reschedule the dose for a later time. 3. Obtain a replacement dose for administration. 4. Complete a controlled substance discrepancy form. 5. Ask the patient, "Are you willing to take this pill after it fell on the floor?"

3, 4 - makes pt. feel full after eating smaller meals - controlled substance IV

Which diagnosis would be given priority for a patient diagnosed with bulimia nervosa? 1. Disturbed body image 2. Chronic low self-esteem 3. Risk for injury: electrolyte imbalance 4. Ineffective coping: impulsive responses to problems

3.

the nurse recognizes bariatric surgery as a treatment for which disorder? 1. Anorexia nervosa 2. Bulimia nervosa 3. Binge eating 4. Rumination

3.

A patient tells the nurse, "I eat whenever I'm stressed." What would be the nurse's best response to confirm if the patient has developed ineffective coping when stressed? 1. "Have you gained any weight recently?" 2. "How do you feel about your body image?" 3. "Can I check you for increased blood pressure?" 4. "Do you continue to eat even after you feel full?"

4

what term is used to document the symptom where pt. is underweight but monitors the weight excessively to prevent weight gain 1. powerlessness 2. ineffective coping 3. imbalanced nutrition 4. disturbed body image

4

A nurse is assessing a child who does not like certain foods in daily diet. On examination, the nurse notes that the body mass index (BMI) of the child is very low. What should the nurse anticipate the diagnosis to be? 1. Encopresis 2. Rumination 3. Elimination disorder 4. Avoidant/restrictive food intake disorder

4 - this is a feeding disorder where pt. avoids or restrits certain foods from childhood - encopresis elimination disorder where child involuntary or intentionally passes feces

Which of the following would be assessed as a negative symptom of schizophrenia? 1. Anhedonia 2. Hostility 3. Agitation 4. Hallucinations

Negative symptoms refer to deficits that characterize schizophrenia. They include the crippling symptoms of affective blunting (lack of facial expression), anergia (lack of energy), anhedonia (inability to experience happiness), avolition (lack of motivation), poverty of content of speech, poverty of speech, and thought blocking.