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A nurse explains to the client that which of the following is a healthy BMI range?
- A. 7 to 16
- B. 16 to 18.5
- C. 18.5 to 24.9
- D. 25 to 32
Correct Answer: C
Rationale: A healthy BMI is 18.5 to 24.9. A BMI of 7 to 16 is categorized as anorectic. A BMI of 16 to 18 is considered underweight. A BMI of 25 to 32 is classified as overweight to obese.
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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.
Clients with anorexia nervosa frequently use methods to avoid eating or to prevent weight gain. Which documentation most accurately describes the behavior of a client with anorexia?
- A. Client observed to move food around the plate arranged in various patterns.
- B. Client stares frequently into space and has to be prompted to participate in the mealtime conversation.
- C. Client talks about food likes and dislikes and reminisces about holiday foods.
- D. Client states feeling depressed and does not feel like eating right now.
Correct Answer: A
Rationale: Clients with anorexia practice various rituals such as cutting food into small pieces and rearranging food on the plate without actually eating.
A nurse is assessing a female client who has recently drastically decreased the amount of food and number of calories consumed each day. Which assessment finding is most indicative of a client who is experiencing severe malnutrition?
- A. Amenorrhea
- B. Weight loss
- C. Body mass index (BMI) of 18
- D. High serum potassium level
Correct Answer: A
Rationale: Severe malnutrition causes the cessation of menstruation in females. Weight loss is expected with curtailing of calories but does not indicate severe malnutrition. BMI of 18 is low and indicates being underweight but not significant for severe malnutrition. In severe malnutrition, potassium levels are dangerously low.
The parents are struggling with the idea their child has anorexia and comment that the child 'often eats large quantities of food.' Which statement by the nurse best supports the diagnosis?
- A. There are many types of anorexia nervosa.
- B. Cycles of self-starvation, binging, purging, and exercising are common.
- C. Your child was probably disposing of the food, not eating it.
- D. It must be difficult for you to accept the fact your child has an eating disorder.
Correct Answer: B
Rationale: Bulimarexia is a type of anorexia in which extended periods of self-starvation is interrupted by binging, purging, and exercising. There are over twice as many persons with bulimarexia than those with simple anorexia nervosa.
The nurse is preparing to administer orlistat to a client with obesity. Which safety warning(s) should the nurse consider when administering this medication to the client? Select all that apply.
- A. Administer with meals, stagger administration with other drugs.
- B. Provide a vitamin supplement with the medication.
- C. Monitor liver function.
- D. Avoid caffeine.
- E. Avoid use among clients with heart disease, hypertension, and hyperthyroidism.
Correct Answer: A,B,C
Rationale: The safety warnings that the nurse should consider include administering orlistat with meals and staggering administration with other drugs, the requirement of vitamin supplementation due to nonabsorption of nutrients, and monitoring liver function. Avoiding caffeine and avoiding the use of the medication among clients with heart disease, hypertension, and hyperthyroidism are applicable to appetite suppressants such as benzphetamine, diethylpropion, phendimetrazine, and phentermine, not orlistat.