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NURS 663 EXAM 2 (Langford) with complete verified solutions 2025.

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NURS 663 EXAM 2 (Langford) with complete verified solutions 2025.

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  • September 21, 2024
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NURS 663 EXAM 2 (Langford)
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Anorexia Nervosa
"RID" - answer R: Restriction of intake leading to significantly low
body weight
I: Intense fear of weight gain
D: Disturbance in perception of one's weight or body image


When Anorexia Nervosa is Diagnosed - answer When a person's
weighs at least 15% less than their normal/idea body weight


Anorexia Nervosa
Subtype Restricting Type - answer Extreme diet, fasting, excessive
exercise


Anorexia Nervosa
Subtype Binge/Purge Type - answer Self-induced vomiting, laxative
abuse, diuretic abuse, enemas


(Significantly low body weight/Low BMI)


Differentiating Anorexia Nervosa Binge/Purge Type from Bulimia
Nervosa - answer Anorexia nervosa has significantly low body
weight / low BMI


Anorexia Nervosa

,Severity Based on BMI - answer Mild: > 17
Moderate: 16-16.99
Severe: 15-15.99
Extreme: < 15


Anorexia Nervosa
Treatment - answer - Behavioral, interpersonal, cognitive, and
family therapies
- Assessments both psychological and physical
- Psychological and behavioral interventions are key
- Nutritional interventions are required
Pharmacological interventions have limited role with the exception
of treating co-morbidities (MDD, GAD)


Anorexia Nervosa
Conclusion - answer - Least prevalent, the most obvious due to
obvious low weight
- No FDA medication, treat co-occurring mood disorders (MDD, GAD
with SSRI)


Bulimia Nervosa
"Bulimics Over-Consume Pasteries" - answer B: recurrent Binge
episodes (1x/wk x 3 months)
O: Out of control overeating
C: excessive Concern with body shape/weight
P: Purging or other compensatory behaviors


Bulimia Nervosa
Severity Based on # of Episodes/week - answer Mild: 1-3/wk
Moderate: 4-7/wk

,Severe: 8-13/wk
Extreme: 14+/wk


Bulimia Nervosa
Pharmacological Interventions - answer fluoxetine (Prozac) only
FDA-approved, higher dose used than for MDD


Bulimia Nervosa
Conclusion - answer - Second most-prevalent, easier to hide
- fluoxetine (Prozac) FDA-approved, treat co-occurring disorders if
needed (mood stabilizer for MDD treatment-resistant)


Binge Eating Disorder
"Binge-Eaters Overeat" - answer B: recurrent Binge episodes
(1x/wk x 3 months)
O: Out of control overeating


Plus 3 or more of the following:
1. Eat fast past full
2. Feast when not famished
3. Flushed and flustered and feeling disgusted


Binge-Eating Disorder - answer - A sense of lack of control
overeating during the episode
- Occurring AT LEAST 1x per week for 3 MONTHS
- Associated with marked distress


Binge Episodes are Associated with ≥ 3 of the Following: - answer -
Eating more rapidly than usual
- Eating until feeling uncomfortably full

, - Eating large amounts of food when not feeling physically hungry
- Eating alone because of feeling embarrassed by how much one is
eating
- Feeling disgusted with oneself, depressed or guilty afterwards
(Common for all 5 to be present)


Binge-Eating Disorder
Severity Based on # of Episodes/week - answer Mild: 1-3/wk
Moderate: 4-7/wk
Severe: 8-13/wk
Extreme: 14+/wk


Binge Eating Disorder
Pharmacological Interventions - answer lisdexamfetamine
(Vyvanse): Currently the only FDA approved medication


Topiramate: Causes cognitive dysfunction when dosed for
effectiveness
Anti-obesity agents target appetite and weight, but no the behavior
Naltrexone: "Hit or miss," results
Baclofen: Some evidence it reduces automatic behaviors, it can take
high doses; do not abruptly disrupt due to possible psychosis
Dasotraline: In phase 3 for BED and dual-acting DA and NE reuptake
inhibitor, shows promise, not on the market yet


Binge-Eating Disorder
Conclusion - answer - Most prevalent, often not screened for
- Known as a "shameful secret"
- lisdexamefetamine (Vyvanse) only FDA-approved medication

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