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.
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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 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 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.
The nurse understands that a client with an eating disorder will eat outside the range of normal. Which is the primary reason that eating disorders remain underreported?
- A. Eating disorders are poorly defined.
- B. Not reported as a medical problem
- C. Behaviors are kept secret.
- D. Body shapes vary.
Correct Answer: C
Rationale: Often, clients with eating disorders strive to keep their illness secret. Eating disorders range from extreme thinness to obesity with variations in body shapes and sizes. Many Americans are on some form of 'diet,' which makes it more difficult to identify a disorder. Even though the disorder may result in physiologic imbalances and medical complications, eating disorders are considered mental health disorders that are accompanied by anxiety and guilt.
The nurse is assisting a binge eater in establishing a dietary plan of care. What instruction is most likely to cause a relapse in behavior?
- A. Remember recovery is a day-by-day process.
- B. Attend a self-help group.
- C. Be cautious of sugar-free items.
- D. Stick to a strict diet plan.
Correct Answer: D
Rationale: Strict dieting or fasting is the leading cause of binging. The newer approach to weight management stresses that all foods are acceptable and strict avoidance of foods tends to worsen binge eating. Clients should attend self-help groups or group therapy. Being cautious of items that are labeled fat free and sugar free is encouraged because sugar free may not mean calorie free. Remember that recovery is a day-by-day process.
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