During a well-child physical, a 16-year-old girl has a normal history and physical except for an excessive amount of tooth enamel erosion, a greater-than-normal number of filled cavities, and calluses on the back of her hand. Her body mass index is in the 25th to 50th percentile for her age. Based on these findings, which disorder would the nurse suspect?

Question

Quizplus · Accepted Answer

The excessive tooth enamel erosion and filled cavities suggest frequent vomiting, which is a common symptom of bulimia nervosa. The calluses on the back of her hand can be from inducing vomiting using her fingers. The normal BMI indicates that she is likely purging after consuming normal or large amounts of food, rather than restricting her intake as in anorexia nervosa. Marasmus and kwashiorkor are severe protein-energy malnutrition disorders that typically present with symptoms such as severe weight loss, muscle wasting, and edema, which are not present in this case.

During a Well-Child Physical, a 16-Year-Old Girl Has a Normal