Question 1

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

Accepted Answer

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. A

Question 2

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

Accepted Answer

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

Question 3

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?

Accepted Answer

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." A

Question 4

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

Accepted Answer

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 5

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?

Accepted Answer

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

Question 6

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?

Accepted Answer

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

Question 7

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?"

Accepted Answer

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 8

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?

Accepted Answer

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 9

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

Accepted Answer

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.

Question 10

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

Accepted Answer

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

Question 11

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?

Accepted Answer

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 12

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

Accepted Answer

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 13

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?

Accepted Answer

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.

Question 14

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

Accepted Answer

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

Question 15

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?

Accepted Answer

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 16

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?

Accepted Answer

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

Question 17

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?

Accepted Answer

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 18

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

Accepted Answer

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 19

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

Accepted Answer

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

Question 20

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

Accepted Answer

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

Exam 32: Eating Disorders