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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.
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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.
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 nursing instructor is reviewing the various theories related to anorexia nervosa. Which of the following would the instructor include when describing theories related to the biologic domain? Select all that apply.
- A. Genetic vulnerability
- B. Separation-individuation
- C. Role pressures
- D. Dieting leading to starvation
- E. Pursuit of thinness
- F. Decreased serotonin activity
Correct Answer: A,F
Rationale: Biologic theories for anorexia nervosa include genetic vulnerability (A) and decreased serotonin activity (F), linked to appetite and mood regulation. Separation-individuation (B), role pressures (C), and pursuit of thinness (E) are psychosocial, and dieting (D) is behavioral.
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.
The nurse is caring for several hospitalized clients with anorexia nervosa. The nurse would be especially alert for which of the following if noted in the clients? histories?
- A. Paranoia
- B. Primary insomnia
- C. Depression
- D. Aggression
Correct Answer: C
Rationale: Depression (C) is a common comorbidity in anorexia nervosa, increasing risk for self-harm and complicating treatment, warranting close attention. Paranoia (A), insomnia (B), and aggression (D) are less prevalent or specific.