Exam (elaborations)

Eating Disorders NURS133 MENTAL HEALTH

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Nurs133

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NURS133 MENTAL HEALTH 1. A nurse is performing an admission assessment of a client who has bulimia nervosa with purging behavior. Which of the following is an expected finding? (Select all that apply) A. Amenorrhea B. Hypokalemia C. Mottling of the skin D. Slightly elevated body weight E. ...

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NURS Eating Disorders

NURS133 MENTAL HEALTH
1. A nurse is performing an admission assessment of a client who has bulimia nervosa with
purging behavior. Which of the following is an expected finding? (Select all that apply)
A. Amenorrhea
B. Hypokalemia
C. Mottling of the skin
D. Slightly elevated body weight E. Presence of lanugo on the face Rationale:
A. Amenorrhea is an expected finding in anorexia nervosa rather than bulimia nervosa.
B. CORRECT: Hypokalemia is an expected finding of purging-type bulimia nervosa.
C. Mottling of the skin is an expected finding of anorexia nervosa rather than bulimia
nervosa.
D. CORRECT: Most clients who have bulimia nervosa maintain a weight within a
normal or slightly higher.
E. Lanugo is an expected finding of anorexia nervosa rather than bulimia nervosa.
2. A nurse on an acute care unit is planning care for a client who has anorexia nervosa with
binge-eating and purging behavior. Which of the following nursing actions should the nurse
include in the client’s plan of care?
A. Allow the client to select preferred meal times.
B. Establish consequences for purging behavior.
C. Provide the client with a high-fat diet at the start of treatment.
D. Implement one-to-one observation during meal times.
Rationale:
A. The nurse should provide a highly structured meliu, including meal times, for the
client requiring acute care for the treatment of anorexia nervosa.
B. The nurse should use a positive approach to client care that includes rewards rather
than consequences.
C. The nurse should limit high-fat and gas-producing foods at the start of treatment.
D. CORRECT: The nurse should closely monitor the client during and after meals to
prevent purging.
3. A client diagnosed with an eating disorder and admitted to an inpatient unit 4 days ago states
“I hate this place. I need to go home now”!’ Which is the most appropriate nursing response?

A. “Ask your social worker about discharge plans.”
B. ‘Why do you feel this way”?
C. “Tomorrow you will be better.”

,D. “ You seem upset.Let’s discuss how you
feel.” Rationale:
A. This response ignores the client’s statement by directing the client to social services
rather than addressing the client’s concern.
B. This statement is non therapeutic because it requests an explanation. This response
will put the client on the defensive and will not contribute to addressing the clients
concerns
C. This stereotypical statement gives false assurance and does not address the client’s
concerns
D. Correct: The nurse is making an observation, acknowledging the client’s feelings and
concerns, and offering self. This would be the most appropriate nursing response
4. Which individuals have the highest risk for obesity?
A. Caucasian women
B. Black men
C. Poor black women
D. Wealthy black men Rationales:
A. Obesity is more common in black women than it is in caucasian women
B. Obesity is more common in caucasian men that it is in black men
C. Correct: Obesity is more common in black women, and the prevalence of obesity
among lower socioeconomic classes is six times that in upper socioeconomic classes.
Compared to the others presented, a poor black woman would be at the highest risk for
obesity
D. The prevalence of obesity among lower socioeconomic classes is six times that in
upper socioeconomic classes. Obesity is less common in black men that it is in
caucasian men
5. Which structure of the brain contains the appetite regulation center?
A. Thalamus
B. Amygdala
C. Hypothalamus
D. Medulla
Rationale:
A. The thalamus integrated all sensory input (except smell) on its way to the cortex nd is
involved with emotions and mood. It does not regulate appetite.
B. The amygdala is located in the temporal lobe of the brain and may play a major role in
memory processing and “learned fear” It does not regulate appetite.
C. The hypothalamus exerts control over the actions of the autonomic nervous system and
regulates appetite and temperature.
D. The medulla of the brain contains vital centers that regulate heart rate, blood pressure,
respirations, and reflex centers for swallowing, sneezing, coughing and vomiting. It does
not regulate appetite.

,6. The nurse is assessing a client with a body mass index (BMI) of 35. The nurse would
suspect the client to be at risk for which of the following conditions? (select all that apply)
A. Hypoglycemia
B. Rheumatoid arthritis
C. Angina
D. Respiratory insufficiency
E. Hyperlipidemia
Rationale:
A. Obese clients commonly have hyperglycemia, not hypoglycemia, and are at risk for
developing DM.
B. Osteoarthritis, not rheumatoid arthritis, results from trauma to weight bearing joints
and is commonly seen in obese clients.
C. Workload on the heart is increased in obese clients often leading to symptoms of
angina.
D. Workload on the lungs in increased in obese clients often leading to respiratory
insufficiency.
E. Due to intake of increased amounts of fatty foods, obese patients often present with
hyperlipidemia, particularly elevated triglyceride and cholesterol levels.
7. A client is 5 feet 6 inches tall and weighs 105 pounds. The client has been taking laxatives
daily and self-induced vomiting after eating. Which is the priority nursing diagnosis for this
client?
A. Ineffective Denial
B. Disturbed Body Image
C. Low Self-esteem
D. Imbalanced Nutrition, Less than Body Requirements
Rationale:
A. The nursing diagnosis of ineffective denial may address a problem often
encounteredby clients experiencing eating disorders, but meeting these clients'
nutritional needs must be prioritized to maintain physiological integrity. Any other
psychological needs would be addressed after physiological stabilization.
B. The nursing diagnosis of disturbed body image may address a problem often
encountered by clients experiencing eating disorders, but meeting these clients'
nutritional needs must be prioritized to maintain physiological integrity. Any other
psychological needs would be addressed after physiological stabilization.
C. The nursing diagnosis of low self-esteem may address a problem often encountered
by clients experiencing eating disorders, but meeting these clients' nutritional needs
must be prioritized to maintain physiological integrity. Any other psychological
needs would be addressed after physiological stabilization.
D. CORRECT. This client is very malnourished and underweight due to self-induced
vomiting and laxative abuse. Nutritional status is compromised, and this problem
must be prioritized to establish physiological integrity.

, 8. A well-nourished college student tells the nurse in the student health clinic that she was
depressed over her social life and weight problems and has experienced numerous episodes
of purging. Which diagnosis would the nurse expect the physician to assign to this student?
A. Binge-eating disorder
B. Bulimia nervosaC. Anorexia nervosa
D. Body dysmorphic disorder
Rationale:
A. Binge-eating disorder is characterized by eating an amount of food that is larger than
most people would eat during a discrete period of time. Purging is not a
characteristic of binge-eating disorder.
B. CORRECT. Individuals diagnosed with bulimia nervosa frequently eat large
amounts of food and then purge. Purging is one criterion for bulimia nervosa.
C. Anorexia nervosa is characterized by significantly low body weight, below what
would be considered minimally normal .This student is well nourished and would
not meet the criteria for anorexia nervosa.
D. Body dysmorphic disorder is a preoccupation with an imagined defect in body
shapeand size. Purging is not a characteristic of body dysmorphic disorder.
9. A nurse is preparing to obtain a nursing history from a client who has a new diagnosis of
anorexia nervosa. Which of the following questions should the nurse include in the
assessment?
(Select all that apply.)
A. “What is your relationship like with your family?”
B. “Why do you want to lose weight?”
C. “Would you describe your current eating habits?”
D. “At what weight do you believe you will look better?”
E. “Can you discuss your feelings about your appearance?” Rationale:
A. A nursing history of a client who has anorexia nervosa should include an assessment of
family and interpersonal relationships.
B. Asking a “why” question promotes a defensive client response and it is therefore
nontherapeutic.
C. A nursing history of a client who has anorexia nervosa should include an assessment of
the client's current eating habits.
D. The questions promotes cognitive distortion, places the focus on weight, and implies that
the client’s current appearance is not acceptable.
E. A nursing history of a client who has anorexia nervosa should include an assessment of
the client’s perception of the issue.
10. A nurse is caring for an adolescent client who has anorexia nervosa with recent rapid weight
loss and a current weight of 90 lbs. Which of the following statements indicates the client is
experiencing the cognitive distortion of catastrophizing?
A. “Life isn’t worth living if I gain weight.”

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