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A client who is diagnosed with anorexia nervosa agrees to participate in a recovery program. Which comment by the client indicates the best understanding of the recovery process?
- A. Once I gain a few pounds, I will be fine.
- B. If I take antidepressants, my compulsive symptoms will resolve.
- C. Pulsive therapy could help me lose weight.
- D. I may need to work on this for the remainder of my life.
Correct Answer: D
Rationale: Multiple biologic, psychological, and social factors influence the development of eating disorders. Recovery is considered a long and costly process, with fewer than 50% of clients achieving recovery over 5 years. Counseling and involvement in self-help groups for several years are often indicated. Because there is a link between eating disorders and obsessive-compulsive disorder, this may be a lifelong recovery plan. Gaining a few pounds is an appropriate first step to recovery. Antidepressants are often used to control the serotonin levels associated with anorexia.
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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.
The nurse is preparing a teaching plan for a client diagnosed with bulimia nervosa. What would be included in the teaching plan?
- A. Change eating locations frequently
- B. Consume no more than 2000 to 3000 calories/day.
- C. Eat alone to concentrate on food intake.
- D. Consume high-caloric foods.
Correct Answer: B
Rationale: Included in the teaching plan should be that the client will consume no more than 2000 to 3000 calories/day divided among three meals plus or minus snacks. There should be a restriction of eating locations. Binging takes place when the client with bulimia is alone and when there is a low potential for being discovered. Consuming low-caloric foods may create less anxiety and reduce the potential for purging.
A teenager who is attending a clinic for eating disorders has shown improvement in weight, but the laboratory values remain poor. Which behavior would the nurse identify as the likely cause of this finding?
- A. Pushing food around the plate
- B. Inducing vomiting after meals
- C. Drinking water before weighing
- D. Disposing of food
Correct Answer: C
Rationale: Drinking large volumes of water prior to being weighed is manipulative behavior that is likely the cause of improved weight without improved laboratory values. Pushing food around the plate to distort amount of food eaten, inducing vomiting, and disposing of food are all forms of manipulation but would not account for improvement of weight.
The nurse is caring for a client who is struggling with weight loss issues, without apparent physical cause. Which is the most likely nursing assessment for this nutritional disorder in which normal body weight is not maintained?
- A. Bulimia
- B. Anorexia nervosa
- C. Kwashiorkor
- D. Crohn's disease
Correct Answer: B
Rationale: Anorexia nervosa is a nutritional disorder that is characterized by a refusal to maintain normal body weight in the absence of physical cause. Anorexia nervosa is considered a psychiatric disorder in a relentless pursuit of thinness. Bulimia is an eating disorder in which voracious appetite is followed by purging and is most likely found in normal to overweight individuals. Kwashiorkor is a severe protein deficiency associated with lack of protein in the diet. Crohn's disease can result in nutritional deficiencies but has apparent physiological cause.
The nurse is caring for a client with anorexia nervosa. What is the most important goal when planning care for this client?
- A. Regain lost weight.
- B. Restore fluid and electrolyte imbalances.
- C. Improve self-esteem and body image.
- D. Support healthy coping mechanisms.
Correct Answer: B
Rationale: In anorexia, electrolyte levels, especially potassium and sodium, are often dangerously low. Cardiac irregularities can be identified on electrocardiogram and are often directly linked to fluid and electrolyte imbalances that can lead to cardiac failure and death. Therefore, it is paramount to correct fluid and electrolyte imbalances. Regaining lost weight, supporting healthy coping mechanisms, and improving self-esteem are all goals that are significant in the management of anorexia.