Deck 20: Eating Disorders

Question 1

A 15-year-old female is admitted for treatment of anorexia nervosa. Which is characteristic of anorexia nervosa?

A) Body weight less than normal for age, height, and overall physical health
B) Amenorrhea for at least two cycles
C) Absence of hunger feelings
D) Erosion of dental enamel

Answer 1

Body weight less than normal for age, height, and overall physical health

Question 2

The nurse is assessing a client with bulimia nervosa. Which of the following symptoms would the nurse expect to find? Select all that apply.

A) Cold intolerance
B) Normal weight for height
C) Dental erosion
D) Hypotension
E) Metabolic alkalosis

Answer 2

Normal weight for height
Dental erosion
Metabolic alkalosis

Question 3

Which eating disorder is characterized by consuming an amount of food much larger than a person would normally eat and of near-normal weight? Afterward, the client may purge the food or exercise excessively, and between binges, the client may eat low- calorie foods or fast.

A) Anorexia nervosa
B) Bulimia nervosa
C) Pica
D) Rumination

Answer 3

Bulimia nervosa

Question 4

When working with the family of a client with anorexia nervosa, which of the following issues must be addressed?

A) Codependence
B) Control issues
C) Self-discipline
D) Sexual identity

Question 5

During an initial interview at a clinic, a young female client states that there is nothing wrong with her. Which would indicate to the nurse that this client might have anorexia nervosa?

A) Episodes of overeating and excessive weight gain
B) Expressions of a positive self-concept
C) Flexible thought patterns and spontaneity
D) Severe weight loss due to self-imposed dieting

Question 6

What is the primary difference between anorexia nervosa and bulimia nervosa?

A) Anorexia has a psychological basis, whereas the cause of bulimia is biologic.
B) Clients who are anorexic are proud of their control over eating, and clients with bulimia are ashamed of their behavior.
C) Bulimia can be life threatening, whereas anorexia is seldom so.
D) There is no real difference between these two types of disorders.

Question 7

While assessing the family dynamics of a client with an eating disorder, which of the following does the nurse most likely discover?

A) Multiple siblings
B) Lack of interest in the client by other family members
C) Supportive and encouraging relationships
D) Over controlling parents

Question 8

The nurse understands that which biologic factors may influence the development of an eating disorder? Select all that apply.

A) Family history of eating disorders
B) Dysfunction of the hypothalamus
C) Norepinephrine imbalances
D) First-degree relatives with psychotic disorder
E) Decreased serotonin levels

Question 9

Which factors may contribute to the frequency of eating disorders in adolescents? Select all that apply.

A) Media portrayal of slimness as an ideal
B) Body dissatisfaction in adolescent females
C) Stress-free existence of adolescents
D) Body image disturbance
E) Seeking autonomy
F) Seeking to develop a unique identity

Question 10

Several medications are prescribed for a client who has anorexia. Which medication may be prescribed to help treat the client's distorted body image?

A) Amitriptyline (Elavil)
B) Cyproheptadine (Periactin)
C) Olanzapine (Zyprexa)
D) Fluoxetine (Prozac)

Question 11

The nurse uses cognitiveñbehavioral approaches to assist the client with bulimia toward recovery. Which statement by the nurse would be consistent with this approach?

A) Is there any way you can look at that sandwich as fuel for your body?
B) You have to eat in moderation for good nutrition.
C) You seem to have a really hard time controlling your eating patterns.
D) Is this your way of showing your family that you can make decisions?

Question 12

Which may help a person to overcome an eating disorder that causes weight gain?

A) Being ashamed of his or her body image
B) Believing that gaining weight is a side effect of unhealthy lifestyle behaviors and losing weight is a side effect of healthy lifestyle behaviors
C) Being reminded that every morsel of food he or she consumes will make him or her fat
D) Knowing that his or her current weight is abnormal

Question 13

The nurse is assessing a client with an eating disorder. Which personality characteristic would the nurse expect to detect when interacting with the client?

A) Careless
B) Outspoken
C) Defiance
D) Eager to please

Question 14

When documenting the mental status exam findings in the chart of a client with anorexia, the nurse notes poor judgment and insight. Which client statement would support this impression?

A) I know I have a problem. I need help.
B) Others are just trying to keep me from looking good.
C) I know my weight is a little below normal.
D) Those weight charts are for normal people. I am not normal.

Question 15

All of the following nursing diagnoses are appropriate for the care of a client with anorexia. Which nursing diagnosis has the highest priority?

A) Activity intolerance
B) Ineffective coping
C) Chronic low self-esteem
D) Imbalanced nutrition: less than body requirements

Question 16

Which nursing intervention would be most likely to help the client with anorexia to establish healthy eating patterns?

A) Leave the client alone to relax during meals.
B) Offer liquid protein supplements if the client is unable to complete meal.
C) Observe the client for 30 minutes after all meals.
D) Weigh the client weekly in the same clothing at the same time of day.

Question 17

The nurse is assisting the client with anorexia to express feelings more openly. Which response by the nurse would be most likely to encourage expression of feelings?

A) Are you sad?
B) You look anxious.
C) Tell me what you are feeling right now.
D) Tell me when you feel bad.

Question 18

The nurse is teaching a client with bulimia to use self-monitoring techniques. Which client statement would let the nurse know that this has been effective?

A) I am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging.
B) I am beginning to understand how my lack of self-control is hurting me.
C) I am keeping a record of everything I eat and how I am feeling every day.
D) I am getting more comfortable confronting people when I have conflict with them.

Question 19

The nurse understands that before a client with an eating disorder can accept their body image, he or she must first learn effective coping skills. Which statement best describes the relationship between body image and coping skills?

A) Coping skills are dependent on a supportive upbringing.
B) When body image is positive, the client will develop better coping skills.
C) Being able to cope in healthy ways improves the ability to accept a realistic body image.
D) Neurotransmitters that are deficient in clients with eating disorders prohibit the development of effective coping skills.

Question 20

When preparing a client with bulimia for discharge, the nurse suggests that the client and family continue with family therapy on an outpatient basis. Which of the following is the rationale for this suggestion?

A) Family members often need to learn role independence and autonomy.
B) Family members need to learn to monitor for signs of client relapse.
C) Family relationships need to be strengthened due to a lifetime of disengagement.
D) Family members often feel jealous of the attention the client has been receiving in treatment.

Question 21

Which nursing diagnosis would be most difficult to successfully resolve in a client who had anorexia nervosa?

A) Imbalanced nutritionóless than body requirements
B) Disturbed body image
C) Deficient knowledge (nutritious eating patterns)
D) Social isolation

Question 22

Which of the following interventions would be appropriate for a client with anorexia nervosa?

A) Allowing the client to eat whenever she feels hungry
B) Insisting that the client sit in the dining room until all food is eaten
C) Having the client in view of staff for 90 minutes after each meal
D) Permitting the client to eat any food she chooses, as long as she is eating

Question 23

Which is the primary objective of nursing interventions in the care of a client with anorexia nervosa?

A) Changing her irrational thinking about her body
B) Establishing a target weight to be achieved by discharge
C) Restoring nutritional status to normal
D) Gaining insight into the effects of anorexia on her physical health

Question 24

Which nursing statement is most effective in communicating a positive expectation of the client?

A) I'll give you 90 minutes to eat.
B) I will allow you space to eat in peace.
C) I will sit here quietly with you while you eat.
D) There are people who would truly appreciate this food.

Question 25

A 16-year-old female with anorexia nervosa is admitted to the unit. Which is the most appropriate short-term outcome?

A) The client will accept herself as having value and worth.
B) The client will admit she has a fear of gaining weight.
C) The client will follow a nutritionally balanced diet for her age.
D) The client will identify her problems and potential alternative coping strategies.

Question 26

A nurse is presenting information to a community group about health. Which information should the nurse provide regarding calorie restriction diets at an early age in children?

A) Dieting helps build a positive self-image in children.
B) Dieting during childhood restricts essential nutrients needed for normal growth.
C) Dieting at an early age teaches healthy eating habits.
D) Dieting at an early age may lead to the development of eating disorders.

Question 27

The nurse is teaching the family of a client who has bulimia about nutritional needs. Which dietary pattern would be most helpful to assist the client in recovering from bulimia?

A) Provide the client a diet of mainly vegetables and salads.
B) Encourage the entire family to engage in a balanced and regular dietary pattern.
C) Encourage autonomy by allowing the client to have total control over food choices.
D) Insist that the client complete all meals provided.

Question 28

Which of the following would be most supportive for family and friends of a client with an eating disorder?

A) Emotional support, love, and attention
B) Focus on food intake, calories, and weight
C) Unlimited access to unhealthy foods that the client enjoys
D) Positive reinforcement for weight gain

Question 29

The nurse has been teaching the client's family about the client's eating disorder, anorexia nervosa. Which statement would indicate that teaching was effective?

A) We will eat our evening meals together with no exceptions.
B) We will negotiate resolutions to family conflicts.
C) We will spend less time discussing troublesome family members.
D) We will give her frequent encouragement for eating well and maintaining her weight.

Question 30

The nurse has been teaching a client about bulimia. Which statement by the client indicates that the teaching has been effective?

A) I know if I eat pasta, I'll binge.
B) I'll eat small meals and snacks regularly.
C) I'll take my medication when I feel the urge to binge.
D) I'll limit my intake of carbohydrates and fats.

Question 31

A client who has an eating disorder is becoming dependent on the nurse for direction in food choices. Which approach by the nurse would demonstrate the nurse's self- awareness?

A) Approach the client with an adult-like objectivity.
B) Give the support and direction that the client is seeking.
C) Give approval for positive changes seen in the client.
D) Take care of the needs that the client is neglecting.