Question 1

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

The defense mechanism being implemented is denial, as the patient is denying the reality of their underweight state and continuing to believe they need to lose more weight.

Question 2

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

Allowing the patient to use the restroom with the nurse present ensures that the patient is not engaging in harmful behaviors related to their eating disorder, while also respecting their need to use the restroom. Option A is not appropriate as it does not take into consideration the patient's individual needs and could potentially be harmful. Option B may cause distress to the patient and trigger disordered behaviors. Option D is accusatory and may cause the patient to become defensive, hindering the therapeutic relationship.

Question 3

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

Accepted Answer

Perfectionism is a common personality characteristic seen in patients with eating disorders. These individuals may have an intense fear of gaining weight and strive for an unrealistic ideal of thinness, often accompanied by a desire for control and order. Grandiosity, impulsivity, and suspiciousness are not necessarily characteristic of eating disorders.

Question 4

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 long-term goal for a patient with anorexia nervosa is to restore healthy eating patterns and normalize weight. Gaining 1 to 3 lb weekly (choice A) may be part of the short-term goal, but not the long-term goal. Exhibiting fewer signs of malnutrition (choice B) may be a short-term goal, but the ultimate goal is to restore overall health. Identifying cognitive distortions about weight and shape (choice D) may be part of the treatment plan, but it is not the long-term goal.

Question 5

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

Selective serotonin reuptake inhibitors (SSRIs) have shown effectiveness in treating bulimia nervosa by regulating mood, decreasing binge and purge behavior, and reducing preoccupation with body shape and weight. Other classifications of drugs listed (mood stabilizers, typical antipsychotics, and monoamine oxidase inhibitor antidepressants) are not typically used for the treatment of bulimia nervosa.

Question 6

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 the initial step in the nurse-patient relationship for a patient diagnosed with anorexia nervosa. This contract sets the boundaries, expectations, and goals of the therapeutic relationship, which is crucial in the treatment of this disorder. It helps establish trust between the nurse and patient, clarify the roles of each, and provide a basis for accountability. It is important for the patient to be in agreement with the contract and to have a clear understanding of what is expected of them in the treatment process. Placing limits on family involvement, identifying a therapeutic group of similar aged patients, or using confrontation should only come after the nurse-patient contract has been formulated.

Question 7

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

According to the DSM-V, the criteria for bulimia nervosa include episodes of binge eating and compensatory behaviors occurring at least once a week for three months.

Question 8

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 9

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

Patients with eating disorders often experience a decrease in sex drive due to malnutrition and psychological factors.

Question 10

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 11

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 provide the patient with a fresh plate of food so they can continue with their meal. This response is supportive and encourages the patient to continue working towards their goal of completing their meal. Option A and B are confrontational and can cause the patient to feel defensive, which can be counterproductive in building a therapeutic relationship. Option D is not helpful as it places pressure on the patient to eat and may cause them to feel overwhelmed.

Question 12

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

Accepted Answer

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

Question 13

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

Accepted Answer

Cognitive-behavioral therapy (CBT) is the most evidence-based therapy for treating bulimia nervosa. It focuses on changing negative thought patterns and behaviors related to food and body image. CBT should be combined with nutritional counseling and close monitoring of weight and vital signs. Psychodynamic group therapy, psychodrama or pharmacotherapy may have some benefits but are not the first-line treatment of choice for bulimia nervosa.

Question 14

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

Accepted Answer

Subjective data refers to a patient's feelings and perceptions, which are personal and cannot be measured. Feeling out of control is an example of subjective data. Scarred fingers, sores around the mouth, and loss of tooth enamel are objective data, which can be observed or measured.

Question 15

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

Accepted Answer

Achieving 90% of average body weight is a measurable and objective indicator of progress in the treatment of anorexia nervosa, reflecting improvement in physical health and nutritional status.

Question 16

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 17

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

Accepted Answer

The patient stating fear of gaining weight is subjective evidence as it is a symptom that the patient expresses and cannot be observed by the nurse. The presence of lanugo, bradycardia, and weight loss are all objective evidence that can be observed and measured by the nurse.

Question 18

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

Serotonin deficits have been implicated in the development of bulimia nervosa. Serotonin is involved in regulating mood, appetite, and impulse control, and low levels of serotonin have been linked to binge eating behavior.

Question 19

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, lowest blood pressure, and longest duration of amenorrhea, indicating severe malnutrition and potential cardiovascular compromise. This patient requires urgent medical attention and should be prioritized for admission to the inpatient eating disorders unit.

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 your feelings is a healthier and more productive way to cope with the urge to vomit than engaging in excessive exercise, calling parents, or allowing oneself to vomit without purging. Talking about one's feelings can help the patient learn to manage the underlying emotions that often trigger the urge to binge and purge in individuals with bulimia nervosa.

Quiz 32: Eating Disorders