Deck 14: Eating Disorders

Question 1

The nurse is reviewing the plan of care for a 15-year-old client diagnosed with anorexia nervosa. The treatment team plans to implement cognitive behavior therapy (CBT). Which is the best rationale for the use of CBT for clients diagnosed with anorexia nervosa?

A) Recognize maladaptive eating patterns as defense mechanisms.
B) Promote autonomy and control over eating behaviors.
C) Eliminate emotional components of maladaptive eating patterns.
D) Allow client to establish goals of the treatment plan.

Answer 1

Eliminate emotional components of maladaptive eating patterns.

Question 2

The nurse is preparing an education program regarding early identification of students at risk for developing anorexia nervosa. Which client does the nurse recognize as having the highest risk of developing an eating disorder?

A) Female ballet dancer
B) Female cheerleader
C) Male wrestler
D) Male swimmer

Answer 2

Female ballet dancer

Question 3

The nurse is developing a care plan for a client diagnosed with anorexia nervosa and determines "disturbed body image" is the priority nursing diagnosis. Which is the most appropriate outcome criterion?

A) Achieve and maintain expected body mass index (BMI).
B) Verbalize understanding of maladaptive eating behaviors.
C) Exhibit decreased preoccupation with own appearance.
D) Discuss feelings and emotions associated with eating.

Answer 3

Exhibit decreased preoccupation with own appearance.

Question 4

While assessing a client diagnosed with bulimia nervosa, the nurse observes multiple cavities, enamel erosion, and tooth sensitivity. Which best explains the nurse's findings?

A) Electrolyte imbalances
B) Self-induced vomiting
C) Nutritional deficits
D) Dehydration

Question 5

Which is used as first-line outpatient psychological treatment for adolescents diagnosed with anorexia nervosa?

A) Cognitive-based therapy
B) Family-based therapy
C) Dialectical behavior therapy
D) Individual psychotherapy

Question 6

The nurse is assessing an adolescent who was brought to the emergency department after collapsing during Olympic figure skating training. The adolescent is diagnosed with severe malnutrition due to anorexia nervosa. Which client statement supports the use of a family-based approach?

A) "I just didn't drink enough water during practice."
B) "I eat just as much as everyone else on the team."
C) "I have to practice until my skating routine is perfect."
D) "I'm tired of fighting with my parents about eating."

Question 7

The nurse tells the parents of an adolescent diagnosed with anorexia nervosa, "The social worker will be contacting you to schedule a family meeting." One of the client's parents states, "Why is that necessary? Our child is the one who needs treatment." Which response by the nurse is best?

A) "We expect every client and their family to attend two family sessions."
B) "Family intervention and support are important in managing eating disorders."
C) "The sessions are used to educate all family members about eating disorders.
D) "During the meeting you will be able to resolve conflicts with your child."

Question 8

A client diagnosed with bulimia nervosa has been receiving CBT at the eating disorders clinics. Which of the following client actions indicates to the nurse that the client is making progress toward using adaptive eating behaviors?

A) Gains 2 lb in 1 week
B) Verbalizes importance of adequate nutrition
C) Identifies feelings associated with desire to binge
D) Takes antidepressant medications as prescribed

Question 9

The nurse is teaching parents of a 14-year-old client diagnosed with anorexia nervosa about prescribed medications. Which carries a black-box warning?

A) Fluoxetine
B) Phenelzine
C) Topiramate
D) Amitriptyline

Question 10

A nursing instructor is teaching students about eating disorders. Which statement indicates that a student understands the differences between anorexia nervosa and bulimia nervosa?

A) "Clients diagnosed with anorexia nervosa exhibit malnutrition and dehydration."
B) "Hyperkalemia and hyponatremia are associated with anorexia nervosa."
C) "Signs of bulimia nervosa include hypotension, edema, and erosion of tooth enamel."
D) "Amenorrhea and parotid gland enlargement are symptoms of bulimia nervosa."

Question 11

The clinic nurse is reviewing assessment findings of a client diagnosed with anorexia nervosa. Which of the following indicate that the client requires immediate hospitalization?

A) Body temperature of 98.6ºF
B) Potassium level above 3.5 mmol/L
C) BMI less than 75% of expected
D) Weight less than 90% of expected

Question 12

The nurse is developing nursing diagnoses for a newly admitted client diagnosed with anorexia nervosa. The client has a BMI of 15.8 kg/m². Which is the priority nursing diagnosis?

A) Ineffective coping
B) Imbalanced nutrition
C) Obesity
D) Disturbed body image

Question 13

The nurse in the outpatient clinic determines the priority nursing diagnosis for a client diagnosed with anorexia nervosa is "imbalanced nutrition: less than body requirements." Which is the most appropriate short-term goal for the client?

A) Demonstrate adaptive eating behaviors.
B) Discuss fears and anxieties.
C) Gain 2 lb per week.
D) Exhibit no signs of malnutrition and dehydration.

Question 14

A 20-year-old client tells the nurse in the outpatient clinic, "I am so disgusted with myself. For the past month, there are times when I eat everything I can find. I want to vomit it all back up, but I have never been able to." Which is the nurse's best reply?

A) "It's normal to feel depressed after eating so much."
B) "Tell me about relationships with the people in your life."
C) "I am not surprised to hear you feel so disgusted with yourself."
D) "Have you ever been diagnosed with clinical depression?"

Question 15

An experienced nurse on the eating disorders unit is explaining to a newly hired nurse the rationale for setting limits with clients. Which is the nurse's most appropriate explanation?

A) It encourages awareness of emotional issues.
B) It encourages understanding of behavior modification plan.
C) It promotes sense of control unhealthy eating behaviors.
D) It prevents power struggles with staff.

Question 16

The nurse in the eating disorders clinic asks a client diagnosed with bulimia nervosa, "Can you recall a time when you were able to eat without purging?" Which is the most appropriate rationale for the nurse's question?

A) Determine the severity of symptoms.
B) Identify previous coping strategies.
C) Determine triggers for purging episodes.
D) Establish realistic treatment goals.

Question 17

The nurse is reviewing assessment data of a client diagnosed with anorexia nervosa. The client's BMI dropped from 17 to 15.5 kg/m² over the past 3 months. Which client statement best supports the assessment data?

A) "I'm glad I don't make myself throw up."
B) "My hair started falling out last week."
C) "You don't know what it's like to be fat."
D) "At least I am not gaining any weight."

Question 18

The nurse assigns the nursing diagnosis "ineffective coping related to feelings of helplessness" to a client diagnosed with bulimia nervosa. Which is the most appropriate outcome related to this nursing diagnosis?

A) Exhibits ability to use adaptive strategies to cope with emotional issues
B) Achieves and maintains an expected BMI for weight and age
C) Demonstrates positive self-esteem by verbalizing positive aspects of self
D) Identifies consequences of fluid loss caused by self-induced vomiting

Question 19

The nurse is assessing a client newly admitted to the eating disorders unit. Which findings indicate the client may have a diagnosis of bulimia nervosa? Select all that apply.

A) BMI of 24 kg/m²
B) Amenorrhea
C) Erosion of tooth enamel
D) Lanugo
E) Russell's sign