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A client is being evaluated for an eating disorder. Which nursing assessment finding(s) is most indicative of a client with bulimia nervosa? Select all that apply.
- A. Younger onset than anorexia nervosa
- B. Denial of abnormal eating habits
- C. Overweight or normal weight
- D. Admits to purging and binging
- E. Eroded teeth enamel
- F. Appears thin but feels fat
Correct Answer: C,D,E
Rationale: In contrast to clients with anorexia nervosa, clients with bulimia nervosa are generally overweight or of normal weight, admit to their eating behavior of binging and purging, and often have erosion of teeth enamel from gastric acid contact. Bulimics are generally older at the onset of the disorder than anorexics. Anorexics are obsessed with thinness and view themselves as fat even when emaciated.
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What is a true statement regarding anorexia nervosa?
- A. More men are affected with anorexia nervosa.
- B. Increased serotonin levels contribute to overeating.
- C. Clients consume 600 to 900 calories/day.
- D. Due to the psychological impact, clients with anorexia do not feel hungry.
Correct Answer: C
Rationale: Not uncommonly, people with anorexia nervosa consume an average of 600 to 900 calories/day, often less. More women are affected than men. Increased serotonin levels contribute to restricted eating. They get hungry but control the urge to eat because of a morbid fear of becoming fat.
The nurse is providing a teaching seminar to a group of teenagers on the subject of healthy eating. A scale is used to calculate body mass index (BMI) for each individual participant. A participant asks the nurse if a BMI of 25 is normal.
- A. A BMI of 25 is normal.
- B. The BMI formula does not include ratio of fat to muscle mass.
- C. BMI is just one tool for healthy lifestyle.
- D. Keeping your BMI below 30 is ideal.
Correct Answer: C
Rationale: The healthy interpretation of BMI ranges from 18.5 to 24.9. Knowing that teenagers are very susceptible to eating disorders and desire for thinness, the nurse takes the focus off the number (25) and addresses healthy lifestyle. BMI is only one tool used for anthropometric data collection. Ratio of fat to lean muscle mass is not included in BMI. A BMI of 30 is indicative of obesity and would not be considered ideal.
When assessing for anorexia nervosa, the nurse would anticipate finding what characteristic(s)? Select all that apply.
- A. Is overweight
- B. Good academics
- C. Underachiever
- D. Teenage girl
- E. Wears tight-fitting clothes
- F. Social eater
Correct Answer: B,D
Rationale: Anorexia nervosa is characterized by an obsession for thinness that is achieved through self-starvation. It occurs more often in girls between the ages of 12 to 18 years and continues into adulthood. They are often high achievers and perfectionists. Many conceal their starvation by eating alone, disposing of food, and dressing in oversized, bulky clothing.
When taking a client's history, the client reports to the nurse inappropriate use of diuretics and laxatives, secreteating of high-calorie and high-carbohydrate foods, and alternately bingeing and fasting. Based on this information, which eating disorder should the nurse suspect?
- A. Bulimia nervosa
- B. Anorexia nervosa
- C. Binge eating
- D. Compulsive overeating
Correct Answer: A
Rationale: Behavioral signs and symptoms of bulimia nervosa include excessive exercise; use of diuretics, and laxatives, secret eating of high-calorie, high-carbohydrate foods, and alternately bingeing and fasting. Anorexia nervosa is characterized by behavioral signs and symptoms including restriction of food choices and intake, ritualistic handling of food (e.g., cutting into tiny pieces, arranging food in a certain way), weighing oneself frequently, and denial of hunger. Binge eating and compulsive overeating are characterized by frequent dieting, restricting activities because of embarrassment about weight, eating when not hungry, rapid eating, and eating alone.
The client has just been diagnosed with binge eating disorder. Which statement by the client is most indicative of this diagnosis?
- A. I eat even when I am not hungry.
- B. I always feel guilty after I overeat.
- C. I have gained a lot of weight.
- D. I eat slowly but consistently throughout the day.
Correct Answer: B
Rationale: Binge eating disorder is characterized by the inability to control overeating accompanied by a guilty feeling. Eating when not hungry is not specific to binge eating and is often a characteristic of compulsive overeating. Binge eaters eat very rapidly and often consume as much as 10,000 calories at one sitting. Many binge eaters are overweight as are compulsive overeaters.