Question 1

Which finding indicates that a patient diagnosed with anorexia nervosa has met a major objective of psychotherapeutic management?

Accepted Answer

D

Question 2

One bed is available on the inpatient eating disorders unit. Assessment findings for four patients are listed as follows. Which patient has priority for admission?

Accepted Answer

Patient A has the most significant weight loss and the lowest vital signs, indicating severe malnutrition and potentially life-threatening complications. Amenorrhea for 8 months also suggests a severely low body weight. This patient requires urgent admission to the inpatient eating disorder unit.

Question 3

Which assessment finding would the nurse document as subjective evidence of anorexia nervosa?

Accepted Answer

Subjective evidence refers to symptoms or findings that the patient reports or experiences, and fear of gaining weight is a subjective symptom frequently noted in patients with anorexia nervosa. The other options are objective findings (presence of lanugo, bradycardia) or quantifiable measures (weight loss).

Question 4

A patient diagnosed with an eating disorder refuses to be weighed and says, "I just drank a big glass of water." What is the nurse's best response to the patient's comment?

Accepted Answer

Being weighed is an important part of monitoring and treating an eating disorder, and the patient should not be allowed to negotiate or avoid this necessary measure. The nurse should be firm but compassionate in explaining the importance of the weigh-in and encourage the patient to cooperate.

Question 5

A patient diagnosed with anorexia nervosa has the nursing diagnosis imbalanced nutrition, less than body requirements, related to inadequate food intake. What is an appropriate long-term goal of the treatment plan for this patient?

Accepted Answer

The ultimate goal of treatment for anorexia nervosa is to restore healthy eating patterns and normalize weight. A gain of 1 to 3 lb weekly (Choice A) may be an early short-term goal, but the ultimate goal is to achieve a healthy weight. Exhibiting fewer signs of malnutrition (Choice B) is also a short-term goal, but the ultimate goal is to achieve a state of balanced nutrition. Identifying cognitive distortions about weight and shape (Choice D) is an important component of treatment, but it is not the ultimate goal of treatment.

Question 6

A nurse planning care for a patient diagnosed with bulimia nervosa should recommend the use of what for therapy?

Accepted Answer

Cognitive-behavioral therapy has been shown to be an effective treatment for bulimia nervosa. It focuses on identifying and changing negative thought patterns and behaviors associated with the disorder. It also helps the patient develop and practice healthier coping skills and stress management techniques. Psychodynamic group therapy and psychodrama are not as commonly used for treating bulimia nervosa. While pharmacotherapy may be used in some cases, it is typically not recommended as the primary form of treatment for this disorder.

Question 7

Which assessment findings related to the same patient help confirm a diagnosis of anorexia nervosa? (Select all that apply.)

Accepted Answer

- Amenorrhea is common in anorexia nervosa due to hormonal changes from malnutrition.- A weight of 85 lb at a height of 5 feet 4 inches indicates a significantly low body weight, a hallmark of anorexia nervosa.- Low blood pressure is often seen in anorexia nervosa due to decreased cardiac output and dehydration.- Poor skin turgor is indicative of dehydration, which can occur with anorexia nervosa due to inadequate fluid and food intake.

Question 8

What assessment finding supports a diagnosis of anorexia rather than bulimia?

Accepted Answer

The answer of What assessment finding supports a diagnosis of...

Question 9

The nurse interviews a patient who restricts food and is 25% underweight. When the patient says, "I still need to lose weight. I'm not thin enough" which defense mechanism is being implemented?

Accepted Answer

Denial is when a person refuses to acknowledge or address a specific problem or reality, instead insisting that it does not exist. In this scenario, the patient is in denial about the seriousness of their restricted eating and significant underweight status, believing that they still need to lose weight despite the potential negative consequences to their health.

Question 10

What should the nurse consider as the initial step in the nurse-patient relationship for a patient diagnosed with anorexia nervosa?

Accepted Answer

Formulating the nurse-patient contract is important for establishing clear boundaries, expectations, and a mutual understanding of the goals and objectives for treatment. This can help build trust and rapport in the nurse-patient relationship. Placing limits on family involvement and using confrontation may not be the best initial steps, as these actions could potentially harm the trust building process. Identifying a therapeutic group may be helpful later in treatment, but it is not necessarily the initial step.

Question 11

School nurses should be particularly vigilant for signs of eating disorders related to what timeline?

Accepted Answer

The answer of School nurses should be particularly vigilant for...

Question 12

A patient diagnosed with an eating disorder asks to be excused from a meal to use the restroom. What is the nurse's best response to the patient's request?

Accepted Answer

The nurse should offer to accompany the patient to the restroom to monitor for any signs of purging. This is an important measure to ensure the patient's safety and well-being. Option A and D are insensitive and dismissive, while option B may not address the issue at hand.

Question 13

A patient diagnosed with anorexia nervosa spills milk over a plate of partially eaten food. What is the nurse's best response to facilitate effective patient care?

Accepted Answer

The nurse's best response is to offer a fresh plate of food to allow the patient to finish their meal. This approach is non-judgmental and helps the patient continue their progress towards recovery. The other options are confrontational and can undermine the therapeutic relationship between the patient and the nurse, making it more difficult to provide effective care.

Question 14

Which personality characteristic would the nurse expect in a patient diagnosed with an eating disorder?

Accepted Answer

Perfectionism is a common personality characteristic found in people with eating disorders, particularly those with anorexia nervosa. These individuals often have a desire for control and orderliness, and they may set unrealistic goals and have an intense fear of failure. Grandiosity, impulsivity, and suspiciousness are not typically associated with eating disorders.

Question 15

A nurse teaches a class about bulimia nervosa to high school biology students. The nurse should provide what neurotransmitter process as a possible cause of this eating disorder?

Accepted Answer

Bulimia nervosa has been associated with serotonin deficits. Serotonin is a neurotransmitter that plays a role in appetite regulation, mood, and impulse control, which are all affected in this eating disorder.

Question 16

Which information about a patient diagnosed with bulimia nervosa should the nurse document as subjective data?

Accepted Answer

Feeling out of control is a subjective experience that the patient reports and cannot be observed by the nurse. The other options (scarred fingers, sores around mouth, loss of tooth enamel) are objective data that can be observed by the nurse.

Question 17

A patient diagnosed with bulimia nervosa has not responded to psychotherapeutic management. The health care provider is likely to prescribe a drug from which classification?

Accepted Answer

Bulimia nervosa is commonly treated with psychotherapy, but if the patient is not responding, an antidepressant medication from the selective serotonin reuptake inhibitor (SSRI) class may be prescribed. SSRIs, such as fluoxetine, have been shown to reduce binge eating and purging behaviors in patients with bulimia nervosa. Mood stabilizers or monoamine oxidase inhibitors would not typically be used to treat bulimia nervosa, and typical antipsychotics are not considered a first-line treatment for this disorder.

Question 18

A nurse assesses a 25-year-old man with a suspected eating disorder. Which comment is most likely from this patient when the nurse asks about the patient's sexuality?

Accepted Answer

The answer of A nurse assesses a 25-year-old man with...

Question 19

To meet DSM-V criteria for bulimia nervosa, the patient's history must reveal episodes of binge eating and compensatory behaviors occurring at least how often?

Accepted Answer

The answer of To meet DSM-V criteria for bulimia nervosa,...

Question 20

A nurse is engaged in psychoeducational activities with a hospitalized teenage patient diagnosed with bulimia nervosa. What response should the nurse provide when a patient asks, "What should I do when I feel the need to vomit?"

Accepted Answer

Seeking out a staff member to talk about feelings is the best choice. This allows the patient to verbalize their feelings and seek support instead of engaging in harmful behaviors such as self-induced vomiting. Encouraging exercise, calling parents, or allowing vomiting without purging are not effective ways to address the urge to vomit in someone with bulimia nervosa.

Quiz 32: Eating Disorders