Question 1

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

A)  The client will identify two alternative methods of dealing with isolation by day 3.
B)  The client will appropriately express angry feelings about lack of control by week 2.
C)  The client will verbalize two positive self attributes by day 3.
D)  The client will list five ways that the body reacts to binging and purging. A

Question 2

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

A)  Ineffective coping R/T food obsession
B)  Altered nutrition: less than body requirements R/T inadequate food intake
C)  Risk for injury R/T suicidal tendencies
D)  Altered body image R/T perceived obesity B

Question 3

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

A)  To shift the clients' focus from food to psychotherapy
B)  To prevent the use of maladaptive defense mechanisms
C)  To promote the processing of anxiety associated with eating
D)  To focus on weight control mechanisms and food preparation C

Question 4

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

A)  This therapy will increase the client's motivation to gain weight.
B)  This therapy will reward the client for perfectionist achievements.
C)  This therapy will provide the client with control over behavioral choices.
D)  This therapy will protect the client from parental overindulgence.

Question 5

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

Accepted Answer

A)  Emesis from purging corrodes the tooth enamel.
B)  Purging causes the depletion of dietary calcium.
C)  Food is rapidly ingested without proper mastication.
D)  Poor dental and oral hygiene leads to dental caries.

Question 6

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

A)  The client gains 2 pounds in 1 week.
B)  The client focuses conversations on nutritious food.
C)  The client demonstrates healthy coping mechanisms that decrease anxiety.
D)  The client verbalizes an understanding of the etiology of the disorder.

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

A)  "I was just trying to be like everyone else."
B)  "All the skaters on the team are following an approved 1200-calorie diet."
C)  "When I lose skating competitions,I also lose my appetite."
D)  "I am angry at my mother.I can get her approval only when I win competitions."

Question 8

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

Accepted Answer

A)  They help clients correct distorted body image.
B)  They address underlying client anger.
C)  They help clients manage uncontrollable behaviors.
D)  They allow clients to maintain control.

Question 9

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

A)  "Clients diagnosed with Anorexia Nervosa experience extreme nutritional deficits,whereas clients diagnosed with Bulimia Nervosa do not."
B)  "Clients diagnosed with Bulimia Nervosa experience amenorrhea,whereas clients diagnosed with Anorexia Nervosa do not."
C)  "Clients diagnosed with Bulimia Nervosa experience hypotension,edema,and lanugo,whereas clients diagnosed with Anorexia nervosa do not."
D)  "Clients diagnosed with Anorexia Nervosa have eroded tooth enamel,whereas clients diagnosed with Bulimia Nervosa do not."

Question 10

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

A)  "I do not use any laxatives or diuretics to lose weight."
B)  "I am losing lots of hair.It's coming out in handfuls."
C)  "I know that I am thin,but I refuse to be fat!"
D)  "I don't know why people are worried.I need to lose this weight."

Question 11

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

A)  Increased creatinine and blood urea nitrogen (BUN) levels
B)  Abnormal electroencephalogram (EEG) 
C)  Metabolic acidosis
D)  Metabolic alkalosis

Question 12

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

A)  The client will consume adequate calories to sustain normal weight.
B)  The client will cease strenuous exercise programs.
C)  The client will perceive an ideal body weight and shape as normal.
D)  The client will not express a preoccupation with food.

Question 13

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

A)  "Tell me why this family meeting is causing you to be defensive.All clients are required to participate in two family sessions."
B)  "Family intervention and support are important in your child's recovery."
C)  "Family dynamics are not linked to eating disorders.The meeting is to provide your child with family support."
D)  "Clients diagnosed with anorexia nervosa are part of the family system,and any alteration in family processes needs to be addressed."

Question 14

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

Accepted Answer

A)  Diazepam (Valium) 
B)  Dexfenfluramine (Redux) 
C)  Lorcaserin (Belviq) 
D)  Pemoline (Cylert)

Question 15

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

A)  The home environment maintains loose personal boundaries.
B)  The home environment places an overemphasis on food.
C)  The home environment is overprotective and demands perfection.
D)  The home environment condones corporal punishment.

Question 16

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

A)  25 mL
B)  20 mL
C)  15 mL
D)  10 mL

Question 17

The nurse should identify topiramate (Topamax)as the drug of choice for which of the following conditions? Select all that apply.

Accepted Answer

A)  Binge eating with obesity
B)  Binging and purging with a diagnosis of bulimia nervosa
C)  Weight loss with a diagnosis of anorexia nervosa
D)  Amenorrhea with a diagnosis of anorexia nervosa
E)  Emaciation with a diagnosis of bulimia nervosa

Question 18

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

A)  To gain additional information about the progression of the disease process
B)  To emphasize that the client is capable of consuming food without purging
C)  To incorporate specific foods into the meal plan to reflect pleasant memories
D)  To assist the client to become more compliant with the treatment plan

Question 19

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

A)  The nurse who understands the importance of three balanced meals a day
B)  The nurse who permits children to have dessert only after finishing the food on their plate
C)  The nurse who refuses to engage in power struggles related to food consumption
D)  The nurse who grew up poor and frequently did not have enough food to eat

Question 20

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

A)  The client will use stress-reducing techniques to avoid purging.
B)  The client will discuss chaos in personal life and be able to verbalize a link to purging.
C)  The client will gain 2 pounds prior to the next weekly appointment.
D)  The client will remain free of signs and symptoms of malnutrition and dehydration.

Exam 31: Eating Disorders