Deck 32: Eating Disorders

Question 1

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

A) The patient's residual volume is less than 30 mL before tube feedings.
B) The patient says, "I am no longer fearful of gaining weight."
C) The patient reads cookbooks and plans nutritious meals.
D) The patient weighs 90% of average body weight.

Answer 1

The patient weighs 90% of average body weight.

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?

A) Weight decreased from 150 to 102 lb in 4 months. Vital signs are T 96.9°F; P 46 beats/min; BP 68/48 mm Hg. Amenorrhea for 8 months.
B) Weight decreased from 110 to 86 lb in 4 months. Vital signs are T 97.5°F; P 60 beats/min; BP 80/66 mm Hg. Amenorrhea for 2 months.
C) Weight decreased from 120 to 90 lb in 3 months. Vital signs are T 98°F; P 50 beats/min; BP 70/50 mm Hg. Menstruation scant for 3 months.
D) Weight decreased from 90 to 78 lb in 5 months. Vital signs are T 97.7°F; P 62 beats/min; BP 74/52 mm Hg. Menstruation irregular for 6 months.

Answer 2

Weight decreased from 150 to 102 lb in 4 months. Vital signs are T 96.9°F; P 46 beats/min; BP 68/48 mm Hg. Amenorrhea for 8 months.

Question 3

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

A) Presence of lanugo on body
B) Bradycardia notes upon regular assessment
C) 25-lb weight loss over 3-month period
D) Patient states fear of gaining weight

Answer 3

Patient states fear of gaining weight

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?

A) "Call me after you have emptied your bladder."
B) "Being weighed today is not negotiable."
C) "I will weigh you tomorrow."
D) "You know the rules."

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?

A) Gain 1 to 3 lb weekly.
B) Exhibit fewer signs of malnutrition.
C) Restore healthy eating patterns and normalize weight.
D) Identify cognitive distortions about weight and shape.

Question 6

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

A) Psychodynamic group therapy.
B) Cognitive-behavioral therapy.
C) Pharmacotherapy.
D) Psychodrama.

Question 7

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

A) Patient reports amenorrhea for 9 months
B) Patient is 5 feet 4 inches tall and weighs 85 lb
C) Blood pressure (BP) 70/42 mm Hg
D) Skin turgor is poor
E) Pulse 68 beats/min

Question 8

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

A) Body weight near normal for height
B) Fluid and electrolyte imbalances are present
C) Engages in strenuous exercise daily
D) Eating disorder begin at age 14

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?

A) Rationalization
B) Projection
C) Splitting
D) Denial

Question 10

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

A) Formulate the nurse-patient contract.
B) Place limits on the family involvement in treatment.
C) Identify a therapeutic group of similar aged patients.
D) Use confrontation to establish boundaries and limits.

Question 11

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

A) Fourth-graders who have never attended another school.
B) Rebellious, aggressive girls at any age.
C) Pre and post holidays and prior to summer break.
D) At transitions between elementary, middle, and high school.

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?

A) "No one is permitted to leave the table during meals."
B) "You may go after you've finished your meal."
C) "I will go with you to the restroom."
D) "No. I know you want to vomit."

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?

A) "That won't work. You are manipulating."
B) "You are deliberately making mealtime difficult."
C) "I will get you a fresh plate of food so you can finish."
D) "You must eat your meal. I'll wait until you finish."

Question 14

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

A) Grandiosity
B) Impulsivity
C) Perfectionism
D) Suspiciousness

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?

A) Hypersensitivity of norepinephrine
B) Excessive dopamine activity
C) Overproduction of GABA
D) Serotonin deficits

Question 16

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

A) Scarred fingers
B) Sores around mouth
C) Loss of tooth enamel
D) Feeling out of control

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?

A) Mood stabilizer
B) Selective serotonin reuptake inhibitor (SSRI) antidepressant
C) Typical antipsychotic
D) Monoamine oxidase inhibitor antidepressant

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?

A) "I just don't have much of a sex drive anymore."
B) "I'm here because my girlfriend is worried about how much I exercise."
C) "I am sexually active, but I sometimes have trouble maintaining an erection."
D) "I've been involved in a satisfying relationship with my girlfriend for 3 years."

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?

A) Once a week for 6 months
B) Once weekly for 3 months
C) Three times weekly for a year
D) Four times weekly for 6 months

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?"

A) "Do vigorous aerobic exercise until the urge goes away."
B) "Seek out a staff member to talk about your feelings."
C) "Call your parents on the phone to show you care."
D) "Allow yourself to vomit, but avoid purging."

Question 21

What priority nursing assessments should be made early in the refeeding process for a patient with anorexia nervosa? (Select all that apply.)

A) Vital signs
B) Skin integrity
C) Peripheral edema
D) Lung and heart sounds
E) Level of consciousness