mental health exam 2

A patient was diagnosed with anorexia nervosa. The history shows the patient virtually stopped eating 5 months ago and lost 25% of body weight. The serum potassium is currently 2.7 mg/dL. Which nursing diagnosis applies

Imbalanced nutrition: less than body requirements related to reduced oral intake as evidenced by loss of 25% of body weigt and hypokalemia

A patient referred to the eating disorders clinic has lost 35 pounds during the past 3 months. To assess eating patterns, the nurse should ask the patient:

a. "Do you often feel fat?" b. "Who plans the family meals?" c. "What do you eat in a typical day?" d. "What do you think about your present weight?"

A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and lost 25% of body weight. A nurse asks, "Describe what you think about your present weight and how you look." Which response by the patient is most consistent with the diagnosis?

a. "I am fat and ugly." b. "What I think about myself is my business." c. "I'm grossly underweight, but that's what I want." d. "I'm a few pounds overweight, but I can live with it."

A psychiatric clinical nurse specialist uses cognitive-behavioral therapy for a patient diagnosed with anorexia nervosa. Which statement by the staff nurse supports this type of therapy?

a. "What are your feelings about not eating foods that you prepare?" b. "You seem to feel much better about yourself when you eat something." c. "It must be difficult to talk about private matters to someone you just met. d. Being thin doesn't seem to solve your problems. You are thin now but still unhappy "

A nurse finds a patient diagnosed with anorexia nervosa vigorously exercising before gaining the agreed-upon weekly weight. Which response by the nurse is appropriate?

a. "You and I will have to sit down and discuss this problem." b. "It bothers me to see you exercising. I am afraid you will lose more weight." c. "Let's discuss the relationship between exercise, weight loss, and the effects on your body." d. "According to our agreement, no exercising is permitted until you have gained a specific amount of weight."

Which nursing intervention has the highest priority as a patient diagnosed with anorexia nervosa begins to gain weight?

a. Assess for depression and anxiety. b. Observe for adverse effects of refeeding. c. Communicate empathy for the patient's feelings. d. Help the patient balance energy expenditures with caloric intake. The nursing intervention of observing for adverse effects of refeeding most directly relates to weight gain and is a priority. Assessing for depression and anxiety, as well as communicating empathy, relate to coping. Helping the patient achieve balance between energy expenditure and caloric intake is an inappropriate intervention.

Which nursing intervention has the highest priority for a patient diagnosed with bulimia nervosa?

a. Assist the patient to identify triggers to binge eating b. Provide corrective consequences for weight loss. c. Assess for signs of impulsive eating. d. Explore needs for health teaching.

Which personality characteristic is a nurse most likely to assess in a patient diagnosed with anorexia nervosa?

a. Carefree flexibility b. Rigidity, perfectionism c. Open displays of emotion d. High spirits and optimism

The school nurse is conducting an assessment to determine if a client has anorexia nervosa. Which of the following statements by the client will most suggest that the client may indeed have anorexia nervosa? select all that apply

a. I know I have a problem with eating b. People say I'm skinny, but I'm fat and repulsive c. The idea of eating makes me nauseated d. I dont have periods anymore. I'm glad e. i want to be a chef and cook for other people B,C,D,E

Which nursing diagnosis is more appropriate for a patient diagnosed with anorexia nervosa who restricts intake and is 20% below normal weight than for a 130-pound patient diagnosed with bulimia nervosa who purges?

a. Powerlessness b. Ineffective coping c. Disturbed body image d. Imbalanced nutrition: less than body requirements

A nurse provides care for an adolescent patient diagnosed with an eating disorder. Which behavior by this nurse indicates that additional clinical supervision is needed?

a. The nurse interacts with the patient in a protective fashion. b. The nurse's comments to the patient are compassionate and nonjudgmental. d. The nurse refers the patient to a self-help group for individuals with eating disorders.

Disturbed body image is a nursing diagnosis established for a patient diagnosed with an eating disorder. Which outcome indicator is most appropriate to monitor?*

a. Weight, muscle, and fat congruence with height, frame, age, and sex b. Calorie intake is within required parameters of treatment plan c. Weight reaches established normal range for the patient d. Patient expresses satisfaction with body appearance

A nursing diagnosis for a patient diagnosed with bulimia nervosa is Ineffective coping related to feelings of loneliness as evidenced by overeating to comfort self, followed by self-induced vomiting. The best outcome related to this diagnosis is that within 2 weeks the patient will:

a. appropriately express angry feelings. b. verbalize two positive things about self. c. verbalize the importance of eating a balanced diet. d. identify two alternative methods of coping with loneliness.

An outpatient diagnosed with anorexia nervosa has begun refeeding. Between the first and second appointments, the patient gained 8 pounds. The nurse should:

a. assess lung sounds and extremities. b. suggest use of an aerobic exercise program. c. positively reinforce the patient for the weight gain. d. establish a higher goal for weight gain the next week. Weight gain of more than 2 to 5 pounds weekly may overwhelm the heart's capacity to pump, leading to cardiac failure. The nurse must assess for signs of pulmonary edema and congestive heart failure. The incorrect options are undesirable because they increase the risk for cardiac complications.

Which patient statement acknowledges the characteristic behavior associated with the diagnosis of pica

a. nothing could make me drink milk b. I haven't eaten a green vegetable since I was three years old c. I regurgitate and rechew my food after almost every meal d. I'm ashamed of it, but I eat my hair

Physical assessment of a patient diagnosed with bulimia often reveals

a. prominent parotid glands. b. peripheral edema c. thin, brittle hair. d. 25% underweight.

An appropriate intervention for a patient diagnosed with bulimia nervosa who binges and purges is to teach the patient:

a. to eat a small meal after purging. b. Not to skip meals or restrict food c. to increase oral intake after 4 PM daily. d. the value of reading journal entries aloud to others.

which assessment finding for a patient diagnosed with an eating disorder meets criteria for hospitalization?

pulse rate 58 beats/min Serum potassium 3.4 mEq/L Urine output 40 mL/hour Systolic blood pressure 62 mm Hg

A nurse provides health teaching for a patient diagnosed with bulimia nervosa. Priority information the nurse should provide relates to

self- monitoring of daily food and fluid intake how to recognize hypokalemia establishing the desired daily weight gain Self-esteem Maintenance

Outpatient treatment is planned for a patient diagnosed with anorexia nervosa. Select the most important desired outcome related to the nursing diagnosis Imbalanced nutrition: less than body requirements. Within 1 week, the patient will

weigh self accurately using balanced scales Gain 1 to 2 pounds select clothing that fits properly limit exercise to less than 2 hours daily