Question 1

A psychiatric clinical nurse specialist uses cognitive-behavioral therapy for a patient diagnosed with anorexia nervosa.Which statement by the staff nurse supports this type of therapy?

Accepted Answer

A)   "What are your feelings about not eating foods that you prepare?"
B)   "You seem to feel much better about yourself when you eat something."
C)   "It must be difficult to talk about private matters to someone you just met."
D)   "Being thin doesn't seem to solve your problems. You are thin now but still unhappy." D

Question 2

Which assessment finding for a patient diagnosed with an eating disorder meets criteria for hospitalization?

Accepted Answer

A)   Urine output 40 mL/hr
B)   Pulse rate 58 beats/min
C)   Serum potassium 3.4 mEq/L
D)   Systolic blood pressure 62 mm Hg D

Question 3

Which nursing intervention has the highest priority for a patient diagnosed with bulimia nervosa?

Accepted Answer

A)   Assist the patient to identify triggers to binge eating.
B)   Provide corrective consequences for weight loss.
C)   Assess for signs of impulsive eating.
D)   Explore needs for health teaching. A

Question 4

Which personality characteristic is a nurse most likely to assess in a patient diagnosed with anorexia nervosa?

Accepted Answer

A)   Carefree flexibility
B)   Rigidity, perfectionism
C)   Open displays of emotion
D)   High spirits and optimism

Question 5

An outpatient diagnosed with anorexia nervosa has begun refeeding.Between the first and second appointments,the patient gained 8 pounds.The nurse should:

Accepted Answer

A)   assess lung sounds and extremities.
B)   suggest use of an aerobic exercise program.
C)   positively reinforce the patient for the weight gain.
D)   establish a higher goal for weight gain the next week.

Question 6

Disturbed body image is a nursing diagnosis established for a patient diagnosed with an eating disorder.Which outcome indicator is most appropriate to monitor?

Accepted Answer

A)   Weight, muscle, and fat congruence with height, frame, age, and sex
B)   Calorie intake is within required parameters of treatment plan
C)   Weight reaches established normal range for the patient
D)   Patient expresses satisfaction with body appearance

Question 7

One bed is available on the inpatient eating disorders unit.Which patient should be admitted to this bed? The patient whose weight decreased from:

Accepted Answer

A)   150 to 100 pounds over a 4-month period. Vital signs are temperature, 35.9° C; pulse, 38 beats/min; blood pressure 60/40 mm Hg
B)   120 to 90 pounds over a 3-month period. Vital signs are temperature, 36° C; pulse, 50 beats/min; blood pressure 70/50 mm Hg
C)   110 to 70 pounds over a 4-month period. Vital signs are temperature 36.5° C; pulse, 60 beats/min; blood pressure 80/66 mm Hg
D)   90 to 78 pounds over a 5-month period. Vital signs are temperature, 36.7° C; pulse, 62 beats/min; blood pressure 74/48 mm Hg

Question 8

A patient being admitted to the eating disorders unit has a yellow cast to the skin and fine,downy hair over the trunk.The patient weighs 70 pounds; height is 5 feet 4 inches.The patient says,"I won't eat until I look thin." Select the priority initial nursing diagnosis.

Accepted Answer

A)   Anxiety related to fear of weight gain
B)   Disturbed body image related to weight loss
C)   Ineffective coping related to lack of conflict resolution skills
D)   Imbalanced nutrition: less than body requirements related to self-starvation

Question 9

As a patient admitted to the eating disorders unit undresses,a nurse observes that the patient's body is covered by fine,downy hair.The patient weighs 70 pounds and is 5 feet 4 inches tall.Which term should be documented?

Accepted Answer

A)   Amenorrhea
B)   Alopecia
C)   Lanugo
D)   Stupor

Question 10

Physical assessment of a patient diagnosed with bulimia often reveals:

Accepted Answer

A)   prominent parotid glands.
B)   peripheral edema.
C)   thin, brittle hair.
D)   25% underweight.

Question 11

The nursing care plan for a patient diagnosed with anorexia nervosa includes the intervention "monitor for complications of refeeding." Which system should a nurse closely monitor for dysfunction?

Accepted Answer

A)   Renal
B)   Endocrine
C)   Integumentary
D)   Cardiovascular

Question 12

A nurse conducting group therapy on the eating disorders unit schedules the sessions immediately after meals for the primary purpose of:

Accepted Answer

A)   maintaining patients' concentration and attention.
B)   shifting the patients' focus from food to psychotherapy.
C)   promoting processing of anxiety associated with eating.
D)   focusing on weight control mechanisms and food preparation.

Question 13

A patient diagnosed with anorexia nervosa is hospitalized for treatment.What features should the milieu provide? Select all that apply.

Accepted Answer

A)   Flexible mealtimes
B)   Unscheduled weight checks
C)   Adherence to a selected menu
D)   Observation during and after meals
E)   Monitoring during bathroom trips F)  Privileges correlated with emotional expression

Question 14

A 5-year-old child was diagnosed with encopresis.Which assessment finding would the nurse expect associated with this diagnosis? The child:

Accepted Answer

A)   frequently smears feces on clothing and toys.
B)   experiences frequent nocturnal episodes of bedwetting.
C)   has accidents of defecation at kindergarten three times a week.
D)   has occasional episodes of voiding accidents at the day care center.

Question 15

A patient diagnosed with anorexia nervosa is resistant to weight gain.What is the rationale for establishing a contract with the patient to participate in measures designed to produce a specified weekly weight gain?

Accepted Answer

A)   Because severe anxiety concerning eating is expected, objective and subjective data may be unreliable.
B)   Patient involvement in decision making increases sense of control and promotes compliance with treatment.
C)   Because of increased risk of physical problems with refeeding, the patient's permission is needed.
D)   A team approach to planning the diet ensures that physical and emotional needs will be met.

Question 16

Which nursing diagnosis is more appropriate for a patient diagnosed with anorexia nervosa who restricts intake and is 20% below normal weight than for a 130-pound patient diagnosed with bulimia nervosa who purges?

Accepted Answer

A)   Powerlessness
B)   Ineffective coping
C)   Disturbed body image
D)   Imbalanced nutrition: less than body requirements

Question 17

Outpatient treatment is planned for a patient diagnosed with anorexia nervosa.Select the most important desired outcome related to the nursing diagnosis Imbalanced nutrition: less than body requirements.Within 1 week,the patient will:

Accepted Answer

A)   weigh self accurately using balanced scales.
B)   limit exercise to less than 2 hours daily.
C)   select clothing that fits properly.
D)   gain 1 to 2 pounds.

Question 18

A nurse provides care for an adolescent patient diagnosed with an eating disorder.Which behavior by this nurse indicates that additional clinical supervision is needed?

Accepted Answer

A)   The nurse interacts with the patient in a protective fashion.
B)   The nurse's comments to the patient are compassionate and nonjudgmental.
C)   The nurse teaches the patient to recognize signs of increasing anxiety and ways to intervene.
D)   The nurse refers the patient to a self-help group for individuals with eating disorders.

Question 19

A nursing diagnosis for a patient diagnosed with bulimia nervosa is Ineffective coping related to feelings of loneliness as evidenced by overeating to comfort self,followed by self-induced vomiting.The best outcome related to this diagnosis is that within 2 weeks the patient will:

Accepted Answer

A)   appropriately express angry feelings.
B)   verbalize two positive things about self.
C)   verbalize the importance of eating a balanced diet.
D)   identify two alternative methods of coping with loneliness.

Question 20

A patient referred to the eating disorders clinic has lost 35 pounds in 3 months.For which physical manifestations of anorexia nervosa should a nurse assess? Select all that apply.

Accepted Answer

A)   Peripheral edema
B)   Parotid swelling
C)   Constipation
D)   Hypotension
E)   Dental caries F)  Lanugo

Exam 18: Feeding, Eating, and Elimination Disorders