Question 1

A group of nurses are discussing how food is used in their families and the effects this might have on their ability to work with clients diagnosed with eating disorders.Which of these nurses will probably be most effective with these clients?

Accepted Answer

The nurse who refuses to engage in power struggles related to food consumption will probably be most effective when dealing with clients diagnosed with eating disorders.Because of this attitude the nurse recognizes that the real issues have little to do with food or eating patterns.The nurse will be able to focus on the control issues that precipitated these behaviors.

Question 2

Family dynamics are thought to be a major influence in the development of anorexia nervosa.Which information related to a client's home environment should a nurse associate with the development of this disorder?

Accepted Answer

The nurse should assess that a home environment that is overprotective and demands perfection may be an influence in the development of anorexia nervosa.In adolescence,distorted eating patterns may represent a rebellion against controlling and demanding parents.

Question 3

Which nursing intervention is appropriate when caring for clients diagnosed with either anorexia nervosa or bulimia nervosa?

Accepted Answer

A nurse should remain with clients diagnosed with either anorexia nervosa or bulimia nervosa for at least 1 hour after meals.This allows the nurse to monitor for food discarding (anorexia nervosa)and/or self-induced vomiting (bulimia nervosa).

Question 4

A nursing instructor is teaching students about the differences between the symptoms of anorexia nervosa and the symptoms of bulimia nervosa.Which student statement indicates that learning has occurred?

Accepted Answer

The nursing student statement that clients diagnosed with anorexia nervosa experience nutritional deficits,whereas clients diagnosed with bulimia nervosa do not,indicates that learning has occurred.Anorexia is characterized by low caloric and nutritional intake.Bulimia is characterized by episodic,rapid indigestion of large quantities of food,followed by purging.

Question 5

A client who is 5 foot 6 inches tall and weighs 98 pounds is admitted with a medical diagnosis of anorexia nervosa.Which nursing diagnosis would take priority at this time?

Accepted Answer

Based on Maslow's hierarchy,the priority nursing diagnosis for this client must address physical needs prior to emotional considerations.This client must be immediately physically stabilized due to the life-threatening nature of his or her nutritional status.

Question 6

A nursing diagnosis of ineffective coping R/T feelings of loneliness AEB bingeing then purging when alone,is assigned to a client diagnosed with bulimia nervosa.Which is an appropriate outcome related to this nursing diagnosis?

Accepted Answer

The ability to identify alternative methods of dealing with isolation will provide the client with effective coping strategies to use instead of bingeing and purging.

Question 7

A client diagnosed with bulimia nervosa is to receive fluoxetine (Prozac)by oral solution.The medication is supplied in a 100-mL bottle.The label reads 20 mg/5 mL.The doctor orders 60 mg q day.Which dose of this medication should the nurse dispense?

Accepted Answer

Twenty mg of Prozac multiplied by three results in the calculated 60-mg daily dose ordered by the physician.Each 5 mL contains 20 mg.Five mL multiplied by three equals the liquid dosage of 15 mL.

Question 8

A nurse responsible for conducting group therapy on an eating disorder unit schedules the sessions immediately after meals.Which is the best rationale for scheduling group therapy at this time?

Accepted Answer

When the nurse schedules group therapy immediately after meals,the nurse is addressing the emotional issues related to eating disorders that must be resolved if these maladaptive responses are to be eliminated.

Question 9

A nurse is seeing a client in an outpatient clinic for treatment of anorexia nervosa.Which is the most appropriate,correctly written short-term outcome for this client?

Accepted Answer

The symptoms of anorexia nervosa do not include purging.Correctly written outcomes must be client centered,specific,realistic,and measurable and also include a time frame.

Question 10

A morbidly obese client is prescribed an anorexiant medication.The nurse should prepare to teach the client about which medication?

Accepted Answer

Lorcaserin was approved by the FDA in 2012.It suppresses the appetite by altering various 5-HT2C serotonin receptors.Withdrawal from anorexiants can result in rebound weight gain,lethargy,and depression.

Question 11

A client diagnosed with anorexia nervosa stopped eating 5 months ago and lost 25% of total body weight.Which subjective client response would the nurse assess to support this medical diagnosis?

Accepted Answer

When the client states,"I don't know why people are worried.I need to lose this weight," the client is exhibiting the subjective response of ineffective denial.This client is minimizing symptoms and is unable to admit impact of the disease on life patterns.The client does not perceive personal relevance of symptoms or danger.

Question 12

A nurse observes dental deterioration when assessing a client diagnosed with bulimia nervosa.What explains this assessment finding?

Accepted Answer

The nurse recognizes that dental deterioration has resulted from the acidic emesis produced during purging that corrodes the tooth enamel.Excessive vomiting may also lead to dehydration and electrolyte imbalance.

Question 13

The family of a client diagnosed with anorexia nervosa becomes defensive when the treatment team calls for a family meeting.Which is the appropriate nursing reply?

Accepted Answer

The nurse should educate the family on the importance of family dynamics,involvement,and support in the treatment of anorexia nervosa.Families engaging in conflict avoidance and struggling with issues of power and control may contribute to the development of this disorder or impede the progress of recovery.

Question 14

A potential Olympic figure skater collapses during practice and is hospitalized for severe malnutrition.Anorexia nervosa is diagnosed.Which client statement best reflects a theory about the underlying etiology of this disorder?

Accepted Answer

This client statement reflects a possible underlying etiology of anorexia nervosa.The client is expressing feelings about family dynamics that may have influenced the development of this disorder.Families who are overprotective and perfectionistic can contribute to a family member's development of anorexia nervosa.

Question 15

When a community health nurse arrives at the home of a client diagnosed with bulimia nervosa,the nurse finds the client on the floor unconscious.The client has a history of using laxatives for purging.To what would the nurse attribute this client's symptoms?

Accepted Answer

Excessive vomiting and laxative or diuretic abuse may lead to problems with dehydration and electrolyte imbalance.The nurse should attribute this client's fainting to the loss of alkaline stool due to laxative abuse,which would lead to a relative metabolic acidotic condition.

Question 16

A client diagnosed with bulimia nervosa has been attending a mental health clinic for several months.Which factor should a nurse identify as an appropriate indicator of a positive client behavioral change?

Accepted Answer

The nurse should identify that when a client uses healthy coping mechanisms that decrease anxiety,positive behavioral change is demonstrated.Stress and anxiety can increase bingeing,which is followed by inappropriate compensatory behaviors.

Question 17

A client's altered body image is evidenced by claims of "feeling fat," even though the client is emaciated.Which is the appropriate outcome criterion for this client's problem?

Accepted Answer

The nurse should identify that the appropriate outcome for this client is to perceive an ideal body weight and shape as normal.Additional goals include accepting self on the basis of self-attributes instead of appearance and to realize that perfection is unrealistic.

Question 18

A nurse working with a client diagnosed with bulimia nervosa asks the client to recall a time in life when food could be consumed without purging.Which is the purpose of this nursing intervention?

Accepted Answer

By asking the client to recall a time in life when food could be consumed without purging,the nurse is assessing previously successful coping strategies.This information can be used by the client to modify maladaptive behaviors in the present and future.

Question 19

Why are behavior modification programs the treatment of choice for clients diagnosed with eating disorders?

Accepted Answer

Behavior modification programs are the treatment of choice for clients diagnosed with eating disorders because the programs allow clients to maintain control.Issues of control are central to the etiology of these disorders.Behavior modification techniques aid in restoring healthy body weight.

Question 20

A high school senior is diagnosed with anorexia nervosa and is hospitalized for severe malnutrition.The treatment team is planning to use behavior modification.What rationale should a nurse identify as the reasoning behind this therapy choice?

Accepted Answer

The nurse should identify that behavior modification therapy will be used because it provides the client with control over behavioral choices.Clients diagnosed with anorexia nervosa are often allowed to contract privileges based on weight gain.The client maintains control over eating and exercise.

Quiz 31: Eating Disorders