Question 1

The nurse is identifying outcomes for a teenager diagnosed with anorexia nervosa.Which outcome has the greatest impact on long-term prognosis?

Accepted Answer

A)   Verbalize underlying psychological issues.
B)   Demonstrate effective coping skills related to conflict management.
C)   Demonstrate improvement in body imagine reflecting a realistic viewpoint.
D)   Consume adequate calories appropriate for age, height, and metabolic needs. B

Question 2

A patient diagnosed with bulimia nervosa is hospitalized for treatment of electrolyte imbalance.Which response by the nurse to the patient's request to use the bathroom immediately after eating lunch is most therapeutic?

Accepted Answer

A)   "No one is allowed to leave the dining room during meals."
B)   "Okay, but as you know I will accompany you to the bathroom."
C)   "We've discussed that there are other options than to induce vomiting."
D)   "I think I understand your plan, and I cannot permit you to carry it out." B

Question 3

In an art therapy session,a patient with anorexia nervosa was asked to draw a picture of herself.Which drawing would likely depict the patient's view of herself?

Accepted Answer

A)   A tall, slim girl with obvious muscle definition
B)   A shapely figure of a model who she really admires
C)   A malnourished teenager with thin, lanky extremities
D)   A grossly obese figure lacking feminine characteristics D

Question 4

The nurse observes a distorted thinking pattern in a teenage patient diagnosed with an eating disorder.Which statement characterizes personalization by the patient?

Accepted Answer

A)   "I've got to be thin to get a good job."
B)   "There is no such thing as a healthy carbohydrate."
C)   "My mother and dad fight all the time because I'm fat."
D)   "My whole family will be disgraced if I don't get into a good college."

Question 5

Which reports describe behaviors that meets the criteria for a diagnosis of binge eating? Select all that apply.

Accepted Answer

A)   Sister reports, "She is so sad after she finishes."
B)   Claims, "I can't control myself when I get that way."
C)   The patient reports, "making myself vomit" at least twice a week.
D)   Mother reports seeing the patient, "eat entire loaf of bread for lunch."
E)   Maintains that, "I look okay now but I do this so I don't gain any weight."

Question 6

A parent of a teenager being treated for anorexia nervosa asks the nurse what,"Being an enmeshed family" means.Which question provides the best response to the question?

Accepted Answer

A)   "What do you think that statement means?"
B)   "Who told you your family was enmeshed?"
C)   "Are the members of your family expected to be independent and self-reliant?"
D)   "Does your family place importance on being successful and accepted by others?"

Question 7

The mother of a teenager is concerned that the child may be anorexic.Which report of the teenager's behavior is support of such a diagnosis?

Accepted Answer

A)   Insists she likes "really baggy clothes"
B)   Will eat only lean protein, fruits, and vegetables
C)   Has had one menstrual period in the last 2 years
D)   Although she has grown 3 inches, she has gained no weight
E)   Regularly claims that she will "eat later" but seldom does

Question 8

The interdisciplinary care team has suggested family-based therapy as a part of the care plan of a teenager diagnosed with an eating disorder.Which statement is the basis for this recommendation?

Accepted Answer

A)   This approach encourages family involvement in the patient's recovery.
B)   The family is often dysfunctional, enmeshed, and in need of counseling.
C)   This approach has shown a significant impact on successful long-term prognosis.
D)   The family implements the behavioral contract as established by the plan of care.

Question 9

Which patient statement demonstrates the expected emotional response to bingeing?

Accepted Answer

A)   "I know it's bad but I can't help bingeing."
B)   "Everyone indulges in bingeing some times."
C)   "After I binge I feel happy for a little while."
D)   "Bingeing isn't bad if I do it only when I'm stressed."

Question 10

A patient's plan of care is being managed by an interdisciplinary team familiar with the etiology of eating disorders.Which team principle is most important to the successful treatment of this patient population?

Accepted Answer

A)   The team must preserve the patient's sense of autonomy.
B)   The patient must be an active member of the care planning team.
C)   The patient's family must be included in the decision-making process.
D)   The plan of care must demonstrate collaboration and consistency by the team.

Question 11

Which statement is the basis for the cross-cultural assessment practices of eating disorders?

Accepted Answer

A)   Mediterranean cultures are more likely to exhibit symptoms.
B)   Male-dominated cultures are more likely to accept this disorder.
C)   Westernized cultures tend to have similar numbers of diagnosed cases.
D)   Access to food is the primary factor in determining incidence of the disorder.

Question 12

Long-term prognosis for eating disorders is improved dramatically when treatment includes long-term cognitive-behavioral therapy.What statement provides the best explanation to the patient for this component to the treatment plan?

Accepted Answer

A)   "This will help you identify a healthy, weight restoration diet."
B)   "Medication alone will not help you from relapsing back to your old habits."
C)   "In order to manage your disorder, you have to understand the root problems."
D)   "Prognosis has been proven to be much better with both medication and therapy."

Question 13

A patient who is hospitalized with anorexia nervosa states during a one-to-one session with the nurse,"I'm freaking out.I'm losing it." Which nurse response would be most therapeutic at this time?

Accepted Answer

A)   "Would you feel better if I called your parents?"
B)   "Just sit here and relax that will help you regain control."
C)   "May I sit with you while you think about what is happening?"
D)   "Please tell me what thoughts are going through your head right now."

Question 14

A patient is being assessed for possible anorexia nervosa.Which behaviors are supportive of such a diagnosis? Select all that apply.

Accepted Answer

A)   Eats only red apples and green grapes
B)   Exercises 3 times a day every day
C)   Has lost 25 pounds but wears only pre-loss clothing
D)   Becomes extremely agitated whenever expected to eat
E)   Reports fantasies about being able to eat without gaining weight

Question 15

Accomplishment of which expectation should be considered most critical prior to discharging a patient with anorexia nervosa?

Accepted Answer

A)   Attainment of minimum normal weight
B)   Resumption of normal menstrual cycle
C)   Reduction of periods of active exercise to three times daily
D)   Knowledge of nutritional value of foods required for a balanced diet

Question 16

After ignoring a unit rule regarding being weighed,a patient receiving treatment for an eating disorder tells the nurse,"I can't get weighed this morning,because I drank a glass of juice a few minutes before breakfast." Which statement by the nurse is consistent with treatment principles?

Accepted Answer

A)   "I'm pleased that you took in some calories."
B)   "This is weight day. Please step on the scale."
C)   "We need to discuss why you chose to ignore the rules about being weighed."
D)   "The rule is 'weigh before eating'; now we have to put it off until tomorrow."

Question 17

The nurse is caring for a patient who is being treated for comorbid eating and affective disorders.For which medication would the nurse expect to prepare a patient teaching plan?

Accepted Answer

A)   Fluoxetine (Prozac) 
B)   Diazepam (Valium) 
C)   Lorazepam (Ativan) 
D)   Lithium

Question 18

A 16-year-old patient has anorexia nervosa.Which term used to describe the menstrual history is characteristic of this disorder?

Accepted Answer

A)   Amenorrhea
B)   Dysmenorrhea
C)   Premenstrual syndrome
D)   Heavy menstrual flow

Question 19

A patient with severe weight loss as a result of anorexia nervosa has refused meal trays and supplemental feedings for 3 days since being admitted to the hospital and so refeeding has been ordered.Which intervention will initiate this treatment?

Accepted Answer

A)   Scheduling a nutrition consult with the hospital dietitian
B)   Tube feedings until the patient eats 90% of all meals for 1 day
C)   IV infusions beginning immediately and continuing for 48 hours
D)   Placing the patient on suicide precautions and one-to-one observation

Question 20

The mother of a teen with an eating disorder expresses a concern that the family is responsible for the problem.Which question will best help the nurse identify another influence that is likely to have played a role in the teenager's eating disorder?

Accepted Answer

A)   "Does she have an after-school job?"
B)   "Does she have access to nutritious foods?"
C)   "Is there a family history of underweight adults?"
D)   "Is your daughter interested in clothes and fashion?"

Exam 18: Eating Disorders: Anorexia Nervosa and Bulimia Nervosa