Question 1

Which nursing intervention is appropriate when caring for clients diagnosed with either Anorexia Nervosa or Bulimia Nervosa?

Accepted Answer

Remaining with the client for at least 1 hour after meals is a common intervention for both Anorexia Nervosa and Bulimia Nervosa to prevent purging behaviors.

Question 2

A client diagnosed with Anorexia Nervosa stopped eating 5 months ago and lost 25 percent of total body weight.Which subjective client response should the nurse assess to support this medical diagnosis?

Accepted Answer

The statement "I don't know why people are worried. I need to lose this weight." reflects a distorted body image and denial of the seriousness of low body weight, which are characteristic of Anorexia Nervosa.

Question 3

The nurse observes dental deterioration when assessing a client diagnosed with Bulimia Nervosa.Which best explains this assessment finding?

Accepted Answer

Bulimia Nervosa often involves recurrent episodes of binge eating followed by purging behaviors, such as induced vomiting. The frequent exposure of the teeth to stomach acid during vomiting can lead to erosion of tooth enamel, which can result in dental deterioration.

Question 4

A morbidly obese client is prescribed an anorexiant medication.The nurse should prepare to teach the client about which medication?

Accepted Answer

Loracaserin is an FDA-approved medication for weight loss and is classified as an anorexiant medication. Diazepam is a benzodiazepine used for anxiety and muscle relaxation, dexfenfluramine was taken off the market due to cardiovascular complications, and pemoline was withdrawn due to liver toxicity.

Question 5

The family of a client diagnosed with anorexia nervosa becomes defensive when the treatment team calls for a family meeting.Which is the most appropriate nursing reply?

Accepted Answer

This response acknowledges the family's defensive reaction, while also reaffirming the importance of family involvement in the client's recovery. It is essential for families to be supportive during the treatment process, and this response emphasizes that fact.

Question 6

A client diagnosed with Bulimia Nervosa is to receive fluoxetine (Prozac)by oral solution.The medication is supplied in a 100-mL bottle.The label reads 20 mg/5 mL.The doctor orders 60 mg q day.How much should the nurse dispense?

Accepted Answer

The correct dosage is calculated by setting up a proportion based on the concentration of the medication: $ \frac{20 \, \text{mg}}{5 \, \text{mL}} = \frac{60 \, \text{mg}}{x \, \text{mL}} $. Solving for $x$ gives $x = 15 \, \text{mL}$.

Question 7

A potential Olympic figure skater collapses during practice and is hospitalized for severe malnutrition.Anorexia Nervosa is diagnosed.Which client statement best reflects a theory about the underlying etiology of this disorder?

Accepted Answer

This statement suggests that the client may be using the eating disorder as a way to cope with unresolved psychological issues, such as a need for parental approval or anger towards a parent. This is consistent with the theory that anorexia nervosa is often linked to underlying emotional and psychological factors. The other statements do not provide as clear a connection to underlying psychological issues.

Question 8

A high-school senior is diagnosed with Anorexia Nervosa and is hospitalized for severe malnutrition.The treatment team is planning to use behavior modification.Which should the nurse identify as the reasoning behind this therapy choice?

Accepted Answer

Behavior modification therapy focuses on changing maladaptive behaviors through reinforcing positive behaviors. This therapy will provide the client with control over behavioral choices, which is important for individuals with anorexia nervosa who often feel a loss of control in their life. Rewarding the client for weight gain or punishing them for not gaining weight may reinforce the negative thoughts associated with the disorder. While perfectionism is a common trait in individuals with anorexia nervosa, it is not a reason to use behavior modification therapy. Additionally, there is no evidence that behavior modification therapy protects the client from parental overindulgence.

Question 9

Family dynamics are thought to be a major influence in the development of anorexia nervosa.Which information related to a client's home environment should the nurse associate with the development of this disorder?

Accepted Answer

An overprotective and perfectionistic home environment is commonly associated with the development of anorexia nervosa. The individual may feel pressure to meet unrealistic standards and feel as though their worth is based on their ability to achieve perfection, which can manifest in controlling their food intake and weight. Loose personal boundaries or corporal punishment are not typically associated with the development of anorexia nervosa. Overemphasis on food may contribute to disordered eating patterns but does not necessarily lead to anorexia nervosa specifically.

Question 10

Which indicates the reason behavior modification programs are the treatment of choice for clients diagnosed with eating disorders?

Accepted Answer

The answer of Which indicates the reason behavior modification programs...

Question 11

The nurse working with a client diagnosed with Bulimia Nervosa asks the client to recall a time in life when food could be consumed without purging.Which best explains the purpose of the nurse's question?

Accepted Answer

The nurse's question aims to emphasize that the client is capable of consuming food without purging, which can help to promote positive thinking and reinforce the idea that recovery is possible. It also serves to build rapport and trust between the nurse and the client by encouraging the client to reflect on positive memories. While the other options may be relevant to the nurse's overall goals, they do not directly address the purpose of the specific question posed by the nurse.

Question 12

A nursing instructor is teaching students about the differences between the symptoms of anorexia nervosa and the symptoms of bulimia nervosa.Which student statement indicates that learning has occurred?

Accepted Answer

This student statement accurately differentiates between the symptoms of anorexia nervosa and bulimia nervosa. Clients with anorexia nervosa typically experience extreme nutritional deficits, while clients with bulimia nervosa tend to maintain a normal weight.

Question 13

A nursing diagnosis of ineffective coping R/T feelings of loneliness AEB binging then purging when alone is assigned to a client diagnosed with bulimia Nervosa.Which is the most appropriate outcome related to this nursing diagnosis?

Accepted Answer

The most appropriate outcome for a nursing diagnosis of ineffective coping related to feelings of loneliness is for the client to identify alternative methods of dealing with isolation. This outcome directly addresses the coping deficit identified in the nursing diagnosis and can be measured within a short timeframe (day 3). The other options are not as directly related to the nursing diagnosis or may not be as measurable.

Question 14

The nurse is seeing a client in an outpatient clinic for treatment of anorexia nervosa.Which is the most appropriate,correctly written,short-term outcome for this client?

Accepted Answer

Option C is the most appropriate short-term outcome for a client with anorexia nervosa because gaining weight is a primary focus of treatment. The other options may be appropriate long-term outcomes, but they do not address the immediate need for weight restoration. Option A focuses on avoiding purging, but does not address weight gain directly. Option B focuses on identifying triggers for purging, but does not address weight gain. Option D focuses on preventing signs and symptoms of malnutrition and dehydration, but does not address weight gain.

Question 15

The nurse responsible for conducting group therapy on an eating disorder unit schedules the sessions immediately after meals.Which is the best rationale for scheduling group therapy at this time?

Accepted Answer

Scheduling group therapy immediately after meals can help promote the processing of anxiety associated with eating. This timing allows clients to discuss their thoughts and feelings related to the meal while they are still experiencing them, which may make it easier for them to identify and work through any anxiety or discomfort. It also allows the nurse to provide immediate feedback and support, which can help clients feel more comfortable and supported in their recovery. Additionally, scheduling therapy after meals can help clients look beyond the physical act of eating and focus more on the underlying emotional issues that may be driving their disordered eating behaviors.

Question 16

A client's altered body image is evidenced by claims of "feeling fat," even though the client is emaciated.Which is the appropriate outcome criterion for this client's problem?

Accepted Answer

The appropriate outcome criterion for this client's problem is that the client will perceive an ideal body weight and shape as normal, as this indicates a shift in their altered body image perception. Consuming adequate calories or ceasing strenuous exercise programs may be necessary treatment goals, but they do not address the underlying issue of the client's altered body image perception. Additionally, not expressing a preoccupation with food may be a reasonable outcome criterion, but it does not address the specific issue of the client's altered body image perception.

Question 17

When a community health nurse arrives at the home of a client diagnosed with Bulimia Nervosa,the nurse finds the client on the floor unconscious.The client has a history of using laxatives.The nurse would attribute this client's symptoms to which of the following?

Accepted Answer

Given the client's history of using laxatives, it is possible that the client's metabolic balance was disrupted, leading to metabolic acidosis. The symptoms of unconsciousness could be attributed to this acidosis. Increased creatinine and BUN levels are associated with kidney dysfunction and not specifically related to Bulimia Nervosa. Abnormal EEG results could be a sign of neurological issues but may not necessarily be related to this specific client's symptoms. Metabolic alkalosis would not lead to unconsciousness.

Question 18

A group of nurses is discussing how food is used in their families and the effects this might have on their ability to work with clients diagnosed with eating disorders.Which nurse is most likely to be most effective with these clients?

Accepted Answer

The nurse who refuses to engage in power struggles related to food consumption is most likely to be effective with clients diagnosed with eating disorders. Eating disorders often involve the struggle for control over food, and a nurse who understands the importance of not engaging in power struggles related to food consumption can help clients feel more at ease and create a more positive therapeutic relationship. The other options may not be as relevant or helpful in working with clients diagnosed with eating disorders.

Question 19

A client diagnosed with bulimia nervosa has been attending a mental health clinic for several months.Which factor should the nurse identify as an appropriate indicator of a positive client behavioral change?

Accepted Answer

The correct indicator of positive behavioral change for a client diagnosed with bulimia nervosa is demonstrating healthy coping mechanisms that decrease anxiety. This indicates that the individual is employing new strategies that are aligned with recovery goals and will facilitate a long-term change in behavior. Gaining weight (A) is not necessarily a positive change; it may occur due to bingeing or compensatory behaviors. Focusing conversations on nutritious food (B) may indicate an increase in preoccupation with food and appearance, which is symptomatic of the disorder. An understanding of the etiology of the disorder (D) is valuable but does not necessarily indicate a change in behavior or a reduction in symptoms.

Question 20

A client who is 5 foot 6 inches tall and weighs 98 pounds is admitted with a medical diagnosis of Anorexia Nervosa.Which nursing diagnosis should take priority at this time?

Accepted Answer

Altered nutrition: less than body requirements is the priority nursing diagnosis in this case, as the client's weight is significantly below the expected range for their height. This diagnosis reflects the client's physical state and the immediate need for intervention to restore weight and nutrition status. While the other diagnoses may also be applicable, they are secondary concerns at this time.

Quiz 31: Eating Disorders