Question 1

Care planning requires that a nurse recognize that the dynamic focus directing care of a patient with anorexia nervosa is:

Accepted Answer

A)   managing weight gain.
B)   controlling personal stressors.
C)   minimizing dependency on food.
D)   expressing independence and autonomy. B

Question 2

A patient who has a maladaptive response to eating regulation says,"I know my parents are already upset about me losing so much weight,but I need to lose a lot more to be at a weight that doesn't make me feel fat." This statement suggests that the best treatment setting for this patient would be:

Accepted Answer

A)   the hospital.
B)   an outpatient program.
C)   a day treatment program.
D)   at home with weekly nursing visits. A

Question 3

After assessing a patient with anorexia nervosa,a nurse writes the following nursing diagnosis: imbalanced nutrition,less than body requirements related to refusal to eat as evidenced by being 25% below body weight for height.The expected outcome should be listed as "Patient will:

Accepted Answer

A)   identify cognitive distortions about food, weight, and body shape."
B)   exhibit fewer signs of malnutrition within 2 weeks of hospitalization."
C)   be able to describe both the physical and emotional complications of the eating disorder."
D)   restore healthy eating patterns and normalize physiological parameters related to ideal weight." D

Question 4

Which statement would help the nurse conclude that a patient with an eating disorder is exhibiting cognitive distortion?

Accepted Answer

A)   "I see now that I need to establish my own preferences and routines."
B)   "Bingeing makes my feelings of both isolation and loneliness go away."
C)   "Controlling what I eat has been a way for me to exert control over my life."
D)   "I need to watch for hunger and fatigue as triggers for my eating disorder."

Question 5

A patient has a maladaptive response to eating regulation.Findings include the following: T,96.6° F; BP,68/40; P,40; R,20; poor skin turgor; admits to restricting intake to 350 calories daily; and diagnostic testing reveals serum potassium of 2.9 mEq/L and urine specific gravity of 1.028.What is the highest priority nursing diagnosis for this patient?

Accepted Answer

A)   Imbalanced nutrition, less than body requirements
B)   Disturbed body image
C)   Deficient fluid volume
D)   Powerlessness

Question 6

What is the rationale for establishing a contract with a patient with an eating disorder at the beginning of treatment?

Accepted Answer

A)   The patient and nurse form a coalition that is difficult for the family to disrupt.
B)   A team approach to planning therapy ensures that physical and emotional needs will be met.
C)   Patient involvement in decision making increases the sense of control and promotes cooperation.
D)   Permission for refeeding is essential because this measure has the potential for negative effects.

Question 7

An individual is seeking treatment for bulimia nervosa.The therapist decides to use cognitive behavioral therapy and medication.For what medication can a nurse expect to develop a patient education program?

Accepted Answer

A)   A selective serotonin reuptake inhibitor (SSRI) , such as escitalopram (Lexapro) 
B)   A mood stabilizer, such as lithium
C)   A calcium channel blocker, such as nifedipine (Procardia) 
D)   An antianxiety medication, such as buspirone (Buspar)

Question 8

A patient with an eating disorder states,"Now that I've gained 4 pounds,I can't wear shorts until I lose it again." The patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?

Accepted Answer

A)   Magnification
B)   Personalization
C)   Superstitious thinking
D)   Dichotomous thinking

Question 9

A nurse has completed the assessment for a patient who has a maladaptive response to eating regulation.Findings include: height,5 feet 3 inches; current weight,80 pounds with weight loss of 30% of body weight; poor skin turgor; lanugo; amenorrhea of 6 months' duration; and admits to restricting intake to 350 calories daily.These assessment findings are most consistent with the medical diagnosis of:

Accepted Answer

A)   bulimia nervosa.
B)   anorexia nervosa.
C)   binge-eating disorder.
D)   disturbed body image.

Question 10

A nurse would assess for which behavior to substantiate a diagnosis of bulimia nervosa?

Accepted Answer

A)   Abuse of diuretics and laxatives
B)   Introverted personality traits
C)   Disinterest in sexual activity
D)   Denial of hunger at all times

Question 11

The first step in the creation of a therapeutic alliance between a nurse and a patient with a maladaptive response to eating regulation is:

Accepted Answer

A)   formulation of a nurse-patient contract.
B)   resolution of conflicts with family members.
C)   nurse and patient will agree on perception of patient's body.
D)   the means of stabilizing the patient's nutritional status will be specified.

Question 12

What is the central concept around which a family education plan for preventing childhood eating problems is constructed?

Accepted Answer

A)   Promoting self-demand feeding for the child
B)   Distinguishing between physical and psychological hunger
C)   Scheduling meals because children do not recognize physical hunger
D)   Parental expectations of ideal intake as determinants of healthy eating habits

Question 13

Which therapy is shown through evidence to be most effective for a patient with an eating disorder?

Accepted Answer

A)   Supportive therapy
B)   Behavioral therapy
C)   Cognitive behavioral therapy
D)   Psychoanalytical group therapy

Question 14

A patient is diagnosed with anorexia nervosa.A nurse who is assessing for co-morbid psychiatric disorders should begin by looking for signs of which common,concurrent diagnosis?

Accepted Answer

A)   Phobias
B)   Depression
C)   Schizophrenia
D)   Personality disorder

Question 15

A patient with an eating disorder states,"I heard people laughing behind me in the check-out line at the department store.I bet they thought it was funny that I gained a pound in the last few days." The patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?

Accepted Answer

A)   Magnification
B)   Personalization
C)   Overgeneralization
D)   Dichotomous thinking

Question 16

The coping mechanism patients with anorexia nervosa use maladaptively is:

Accepted Answer

A)   denial.
B)   projection.
C)   introjection.
D)   rationalization.

Question 17

Which information would be most important to a nurse assessing a patient's motivation to change behavior associated with maladaptive eating regulation responses?

Accepted Answer

A)   The number, on a scale of 1 to 10, that reflects the patient's desire for treatment
B)   The name of a support person the patient identifies for emotional support
C)   The disadvantages the patient identifies as resulting from the maladaptive behavior
D)   The reasons the patient identifies as the factors that originally caused the maladaptive behavior

Question 18

A short-term goal for a patient with anorexia nervosa is "Patient will select and eat a balanced diet." The nurse includes which nursing intervention in the care plan that will foster attainment of this goal?

Accepted Answer

A)   Allow patient to weigh self every time a meal is completely eaten.
B)   Assist the patient to fill out the dietary menus to ensure a balanced diet.
C)   Encourage the patient to engage in only appropriate compensatory exercise.
D)   Implement contracted consequences 50% of the time if a meal is not completed.

Question 19

A nurse assesses that which individual is most likely to engage in binge-eating behaviors characteristic of bulimia? A person who:

Accepted Answer

A)   weighs 225 pounds and is 5 feet 4 inches tall.
B)   is 5 pounds overweight and cannot stick to a diet.
C)   lost 40 pounds but gained it back within 1 year.
D)   monitors caloric intake in order to fit into a small suit.

Question 20

A nurse would evaluate that a family education plan for preventing childhood eating problems was effective if which outcome is evident?

Accepted Answer

A)   Parents serve three meals per day plus midmorning, midafternoon, and bedtime snacks.
B)   Parents indicate an interest in learning about healthier eating patterns for their children.
C)   Parents use food to reward their children for only especially good behavior or outstanding achievements.
D)   Parents keep a diary to record both physical and psychological signs of hunger for themselves and their children.

Exam 24: Eating Regulation Responses and Eating Disorders