Question 1

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

A) Gained two pounds in one week
B) Focused conversations on nutritious food
C) Demonstrated healthy coping mechanisms that decreased anxiety
D) Verbalized an understanding of the etiology of the disorder

Accepted Answer

The nurse should identify the demonstration of healthy coping mechanisms that decreased anxiety as an appropriate indicator of positive client behavioral change. This suggests that the client is learning effective ways to manage their symptoms and may be making progress towards recovery. Gaining two pounds in one week may not necessarily indicate positive change, as weight fluctuations are common in individuals with eating disorders. Focusing conversations on nutritious food and verbalizing an understanding of the disorder are important, but they alone do not necessarily indicate significant behavioral changes.

Question 2

The nurse is teaching about the differences between the symptoms of anorexia nervosa and the symptoms of bulimia. Which information should the nurse include?&#10;A) Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not.&#10;B) Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not.&#10;C) Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not.&#10;D) Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not.&#10;

Accepted Answer

Clients diagnosed with anorexia nervosa often experience extreme nutritional deficits due to severe restriction of food intake, leading to significant weight loss and malnutrition. In contrast, clients with bulimia nervosa may maintain a normal weight or be overweight due to binge eating followed by compensatory behaviors such as vomiting, which may not result in the same level of nutritional deficit.

Question 3

The nurse is teaching a client diagnosed with an eating disorder about behavior-modification programs. What is the priority rationale for this treatment?&#10;A) It helps the client correct a distorted body image.&#10;B) It addresses the underlying client anger.&#10;C) It manages the client's psychotic behaviors.&#10;D) It allows clients to maintain control.&#10;

Accepted Answer

Behavior-modification programs allow clients, especially those with eating disorders, to maintain a sense of control over their eating habits and treatment process, which is crucial since issues of control are often at the core of these disorders.

Question 4

The family of a teenager diagnosed with anorexia nervosa becomes defensive when the treatment team calls for a family meeting to implement the Maudsley approach. Which is the appropriate nursing response?

A) "Tell me why this family meeting is causing you to be defensive. All clients are required to participate in two family sessions."
B) "For the plan to be successful, we need your involvement. The parents establish the rules and guidelines around eating."
C) "While the client is the primary focus, this meeting will provide your child with family support."
D) "Clients diagnosed with anorexia nervosa are part of the family system, and any alteration in family processes needs to be addressed."

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Accepted Answer

The Maudsley approach involves the parents in establishing the rules and guidelines around eating, and the treatment is most successful when the family is involved. It is important for the nurse to explain this to the family members and emphasize their critical role in the treatment plan. Option A does not assertively explain the importance of family involvement in the treatment. Option C may not be the best choice because it solely focuses on providing family support, and option D is not directly related to the importance of involving family members in the Maudsley approach.

Question 5

To rid the body of excessive calories, a client diagnosed with bulimia nervosa may engage in ____________________ behaviors, which include self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

Accepted Answer

The answer of To rid the body of excessive calories,...

Question 6

The nurse is caring for a client with anorexia nervosa. Which nursing interventions would the nurse add to the plan of care? (Select all that apply.)&#10;A) Minimize the focus on food and eating&#10;B) Limit mealtime to 30 minutes&#10;C) Monitor for 30 minutes after eating&#10;D) Weigh client weekly&#10;E) If weight loss occurs, bargain for restrictions&#10;

Accepted Answer

The answer of The nurse is caring for a client...

Question 7

Which historical perspective would the nurse include when teaching about the home environment and the development of anorexia nervosa?&#10;A) Maintains loose personal boundaries&#10;B) Places an overemphasis on food&#10;C) Is overprotective with emphasis on perfection&#10;D) Condones corporal punishment&#10;

Accepted Answer

The historical perspective that links the home environment to the development of anorexia nervosa often points to families that are overprotective and emphasize perfection. This environment can contribute to the development of anorexia as individuals may strive for perfection in their appearance and control over their eating as a way to cope with or meet family expectations.

Question 8

An adolescent is diagnosed with anorexia nervosa and is hospitalized for severe malnutrition. Which body mass index (BMI) measurement would the nurse observe upon assessment of this client?&#10;A) 30&#10;B) 24&#10;C) 20&#10;D) 16&#10;

Accepted Answer

Anorexia nervosa is characterized by severe weight loss and malnutrition. A BMI of 16 or less is considered severely underweight and is common in individuals with anorexia nervosa. A BMI between 17-18.5 is considered underweight, 18.5-24.9 is considered normal, 25-29.9 is considered overweight, and 30 or higher is considered obese. Therefore, the client in this scenario would likely have a BMI of 16 or less.

Question 9

The nurse is teaching a client diagnosed with bulimia nervosa about the symptom of tooth enamel deterioration. Which explanation for this complication of bulimia nervosa should the nurse provide?&#10;A) The emesis is acidic and corrodes the tooth enamel.&#10;B) Purging causes the depletion of dietary calcium.&#10;C) Food is rapidly ingested without proper mastication.&#10;D) Poor dental and oral hygiene leads to dental caries.&#10;

Accepted Answer

The emesis (vomit) associated with bulimia nervosa is highly acidic and can erode tooth enamel over time, leading to tooth decay and deterioration.

Question 10

The episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over a short period of time is termed ____________________.

Accepted Answer

The answer of The episodic, uncontrolled, compulsive, rapid ingestion of...

Question 11

The diagnosis of ____________________ nervosa includes the symptoms of gross distortion of body image, preoccupation with food, and refusal to eat.

Accepted Answer

The answer of The diagnosis of ____________________ nervosa includes the...

Question 12

The nurse is teaching about the DSM-5 criteria for the diagnosis of binge eating disorder. Which statements by the staff indicate successful teaching? (Select all that apply.)&#10;A) &#34;Binge eating occurs exclusively during the course of bulimia nervosa.&#34;&#10;B) &#34;Binge eating occurs, on average, at least once a week for three months.&#34;&#10;C) &#34;Binge eating occurs because of an intense fear of becoming fat.&#34;&#10;D) &#34;Marked distress regarding binge eating is present.&#34;&#10;E) &#34;Marked distress regarding purging is present.&#34;&#10;

Accepted Answer

The answer of The nurse is teaching about the DSM-5...

Question 13

The nurse is caring for a client diagnosed with binge eating disorder (BED). Which medication should the nurse administer to the client to decrease binging?&#10;A) Lisdexamfetamine (Vyvanse)&#10;B) Chlorpromazine (Thorazine)&#10;C) Haloperidol (Haldol)&#10;D) Diazepam (Valium)&#10;

Accepted Answer

The answer of The nurse is caring for a client...

Question 14

The adolescent diagnosed with a history of anorexia nervosa comes to an outpatient clinic after being medically cleared. The client states, "Since going back to school, I am nervous, get apprehensive, and have a hard time eating food." Which nursing diagnosis would take priority at this time?

A) Imbalanced nutrition: less than body requirements
B) Disturbed body image/Low self-esteem
C) Impaired verbal communication
D) Anxiety

Accepted Answer

The answer of The adolescent diagnosed with a history of...

Question 15

The client's altered body image is evidenced by claims of &#34;being obese,&#34; even though the client is emaciated. Which outcome criterion is appropriate for this client's problem?&#10;A) The client will consume adequate calories to sustain normal weight.&#10;B) The client will cease strenuous exercise programs.&#10;C) The client will verbally state a misperception of body image as &#34;fat.&#34;&#10;D) The client will not express a preoccupation with food.&#10;

Accepted Answer

The answer of The client's altered body image is evidenced...

Deck 21: Eating Disorders