Chapter 32: Eating Disorders: Nursing Care of Persons with Eating and Weight-Related Disorders

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Integrated Process: Communication/Documentation

Cognitive Level: Analyze

Objective: 5

Page and Header: 607, Guilt and Anger

1. While caring for a client diagnosed with anorexia nervosa, a nurse anticipates that the client would have difficulty making which comment?

A) “I’m mad at you because you won’t let me go on a pass unless I gain weight!”

B) “I need to have everything in its place and perfect.”

C) “If I gain a pound, I’ll just keep gaining weight.”

D) “I am very involved in preparing my food and counting calories.”

Page and Header: 610, Body Dissatisfaction

2. A nurse is performing an admission assessment for an adolescent client diagnosed with an eating disorder who is being admitted to the psychiatric unit. Which statement would the nurse interpret as most likely supporting the client’s diagnosis?

A) “My father was always very thin.”

B) “I’ve never really liked myself.”

C) “I have a lot of confidence in myself.”

D) “I feel really close to my parents and my brother.”

Page and Header: 615, Medication Interventions; 616, Box 32.7

3. A client diagnosed with bulimia nervosa is being treated at an outpatient clinic and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which of the following would the nurse include when teaching the client about the prescribed medication?

A) Closely monitor your fluid intake while taking this medication.

B) Stop taking this medication if it causes weight gain.

C) Expect menstrual irregularities, particularly if they’ve occurred previously.

D) Report any weight changes that occur during the first few weeks this medication is taken.

Page and Header: 615, Medication Interventions; 616, Box 32.7

4. A nurse is caring for several hospitalized clients with anorexia nervosa. The nurse would be especially alert for which if noted in the clients’ histories?

A) Paranoia

B) Primary insomnia

C) Depression

D) Aggression

Page and Header: 474, Establishing Mental Health and Wellness Goals

5. A nurse is preparing to discharge a client who has been hospitalized with anorexia nervosa. Which objective would the nurse include in the education plan?

A) Knowing the calorie content of numerous foods

B) Learning strategies to control impulses

C) Describing physiologic consequences of anorexia nervosa

D) Setting realistic goals

Page and Header: 482, Diagnostic Criteria

6. A client diagnosed with bulimia nervosa is scheduled for a visit to the clinic. Which assessment of the client would a nurse expect to find?

A) Impulsivity

B) Panic

C) Hyperactivity

D) Delusions

Page and Header: 627, Using Cognitive and Behavioral Interventions

7. A nurse is planning to explain the purpose of the behavioral therapy technique of self-monitoring to a client diagnosed with bulimia nervosa. The nurse would emphasize keeping a diary to record which item?

A) Feelings of hunger

B) Efforts at distraction

C) Environmental cues

D) Rigid rules about eating

Page and Header: 635, Social Theories

8. A psychiatric–mental health nurse working in the community is planning an educational program for fifth- and sixth-grade teachers. Which item would the nurse include?

A) Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders

B) Emphasis on the need for teachers to focus their prevention efforts on female students

C) Stressing the need to allow students to eat without undue attention or supervision in order to prevent inadvertently influencing eating patterns

D) Clarification that peer pressure is not typically problematic in children who are in the fifth and sixth grades

Page and Header: 625, Therapeutic Relationships

9. A nurse is initiating a group for adolescent girls diagnosed with anorexia nervosa. Many of the clients in the group are irritable and resent having to attend. One of them comments, “This is a stupid waste of time!” Which response by the nurse would be most appropriate?

A) “If you feel that way, then you can just leave.”

B) “You sound irritated; tell me about what is bothering you.”

C) “You were assigned to this group by your therapist, so you must participate.”

D) “Sit down and be quiet; your peers would appreciate some peace and quiet.”

Page and Header: 615, Nutritional Rehabilitation

10. A nurse is reviewing the plan of care for a client diagnosed with anorexia nervosa and notes a behavioral plan for increasing weight. The nurse correlates this intervention with which nursing diagnosis?

A) Disturbed body image

B) Anxiety

C) Imbalanced nutrition: less than body requirements

D) Ineffective coping

Page and Header: 622, Psychosocial Theories

11. A nurse is interviewing a client diagnosed with bulimia nervosa about family relationships. Which statement by the client would the nurse least likely associate with bulimia nervosa?

A) “My mother is my confidante for everything.”

B) “My mother’s happiness depends on me.”

C) “My family basically has very few rules.”

D) “My mother and I are close but not joined at the hip.”

Page and Header: 627, Using Cognitive and Behavioral Interventions

12. A nurse is developing a plan of care for a client newly diagnosed with bulimia nervosa. Which type of therapy would the nurse expect to implement in conjunction with pharmacologic therapy?

A) Behavioral therapy

B) Cognitive behavioral therapy

C) Interpersonal therapy

D) Family therapy

Page and Header: 627, Teaching About Symptoms/Box 32.13

13. When describing the similarities and differences between anorexia nervosa and bulimia nervosa, which characteristic would the nurse identify as specific to bulimia?

A) Boundary problems

B) Low self-esteem

C) Perfectionism

D) Obsessiveness

Page and Header: 634, Comorbidity

14. The psychiatric nurse is caring for a teenager with anorexia nervosa. The teenager has a body mass index of 15.2 kg/m². Which assessment would be the priority for this client?

A) Asking the client, “Do you ever think about hurting yourself?”

B) Checking the client for a Russell’s sign

C) Observing the client for obsessive–compulsive symptomology

D) Monitoring the client’s vital signs

Page and Header: 619, Inpatient; 613, Box 32.6

15. An adolescent client who is brought to the emergency department appears emaciated and pale. The parents tell the nurse that the client has been diagnosed with anorexia nervosa. A history, physical examination, and laboratory testing are completed. Which assessment finding would lead the nurse to suspect that the client will be admitted to the hospital? Select all that apply.

A) Blood pressure of 110/60 mm Hg

B) Elevated serum potassium concentration

C) Decreased serum magnesium concentration

D) Heart rate of 40 beats/min

E) Statements of being “hopeless”

Page and Header: 628, Binge Eating Disorder

16. A group of nursing students is reviewing the similarities and differences between bulimia nervosa and binge eating disorder (BED). The students demonstrate understanding when they identify which characteristics as specific to BED? Select all that apply.

A) Clients typically are obese during childhood.

B) Clients refrain from purging behaviors.

C) Binge eating periods are shorter.

D) Clients engage in overexercising.

E) Feelings of guilt do not occur after binging.

Page and Header: 620, Bulimia Nervosa/Diagnostic Criteria; 606, Box 32.1; 605, Anorexia Nervosa; 607, Diagnostic Criteria; 608, Key Diagnostic Characteristics 32.1

17. A nurse is preparing a presentation for a local middle school health class about eating disorders as a means for prevention and early detection. Which characteristic would the nurse incorporate into the presentation as being common to both anorexia nervosa and bulimia nervosa? Select all that apply.

A) Body dissatisfaction

B) Feelings of control

C) Obsessiveness

D) Boundary problems

E) Sexuality fears

F) Cognitive distortions

Page and Header: 619, Inpatient; 613, Box 32.6

18. A client diagnosed with an eating disorder is to be hospitalized. When reviewing the client’s medical record, which documentation would the nurse expect to find? Select all that apply.

A) Blood pressure of 100/60 mm Hg

B) Hypokalemia

C) Hyperphosphatemia

D) Heart rate of 44 beats/minute

E) Suicidal ideation

Page and Header: 618, Providing Family Education/Box 32.10

19. A nurse is conducting a class about eating disorders for a group of adolescents. One of the adolescents asks, ‘What can I do if I think my friend has an eating disorder?’ Which response by the nurse would be most appropriate? Select all that apply.

A) “Confront your friend and say, ‘You have an eating disorder.’”

B) “Try reaching out to an adult if your friend refuses help.”

C) “Frequently ask your friend about how many calories she or he is eating.”

D) “Try to talk about other things besides food and weight”

E) “If your friend won’t eat, be strong and force her to eat.”