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A group of nursing students is reviewing the similarities and differences between bulimia nervosa and binge-eating disorder. The students demonstrate understanding when they identify which characteristics as specific to binge-eating disorder? Select all that apply.
- A. Clients typically are obese.
- 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.
Correct Answer: A,B
Rationale: Binge-eating disorder (BED) is characterized by obesity (A) and no purging behaviors (B). Binge periods are not necessarily shorter (C), overexercising (D) is more common in bulimia, and guilt (E) is typical after binging in BED.
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An adolescent is brought to the emergency department by her parents because they were concerned about their daughter?s appearance. The client appears emaciated and pale. The parents tell the nurse that the client has been diagnosed with anorexia nervosa. A history and physical examination and laboratory testing are completed. Which of the following 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 level
- C. Decreased serum magnesium level
- D. Heart rate of 40 beats/min
- E. Statements of being hopeless
Correct Answer: C,D,E
Rationale: Decreased magnesium (C), heart rate of 40 (D), and hopelessness (E) indicate severe medical and psychological complications of anorexia nervosa, warranting hospitalization. Normal blood pressure (A) and elevated potassium (B) are less concerning.
A nurse is developing a plan of care for a client newly diagnosed with bulimia nervosa. Which of the following would the nurse expect to implement in conjunction with pharmacologic therapy?
- A. Behavioral therapy
- B. Cognitive behavioral therapy
- C. Interpersonal therapy
- D. Family therapy
Correct Answer: B
Rationale: Cognitive behavioral therapy (CBT) (B) is the most effective non-pharmacologic treatment for bulimia nervosa, addressing distorted thoughts and behaviors. Behavioral therapy (A) is less specific, interpersonal (C) and family (D) therapies are adjunctive.
A nurse is performing an admission assessment for an adolescent girl 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.
Correct Answer: B
Rationale: Low self-esteem (B) is a hallmark psychological feature of eating disorders, strongly supporting the diagnosis. A thin parent (A) is less specific, high confidence (C) contradicts typical traits, and close family ties (D) are not diagnostic.
A nurse is interviewing a client diagnosed with bulimia nervosa about her family and her relationship with her mother. 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.
Correct Answer: D
Rationale: A balanced, non-enmeshed relationship with the mother (D) is less associated with bulimia nervosa, which often involves enmeshed (A), dependent (B), or chaotic (C) family dynamics.
A client 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.
Correct Answer: D
Rationale: SSRIs for bulimia nervosa can cause weight changes, and reporting these early (D) is important for monitoring and adjusting treatment. Fluid intake (A) is not typically monitored, stopping for weight gain (B) is inappropriate, and menstrual irregularities (C) are not a primary concern.