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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.
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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.
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.
A nurse is reviewing the plan of care for a client with anorexia nervosa and notes a behavioral plan for increasing weight. The nurse correlates this intervention with which nursing diagnosis?
- A. Disturbed Body Image
- B. Anxiety
- C. Imbalanced Nutrition: Less Than Body Requirements
- D. Ineffective Coping
Correct Answer: C
Rationale: A behavioral plan for increasing weight directly addresses Imbalanced Nutrition: Less Than Body Requirements (C), the primary physical issue in anorexia nervosa. Body image (A), anxiety (B), and coping (D) are secondary concerns.
The nurse is initiating a group for adolescent girls diagnosed with anorexia nervosa. Many of the clients in the group are irritable and resent having to attend. One of them comments, This is a stupid waste of time! Which of the response by the nurse would be most appropriate?
- A. If you feel that way, then you can just leave.
- B. You sound irritated; tell me about what is bothering you.
- C. You were assigned to this group by your therapist, so you must participate.
- D. Sit down and be quiet; your peers would appreciate some peace and quiet.
Correct Answer: B
Rationale: Acknowledging the client?s irritation and inviting discussion (B) validates feelings and encourages engagement, therapeutic for anorexia nervosa group settings. Allowing leaving (A), enforcing participation (C), or silencing (D) dismisses emotions and hinders group progress.
A psychiatric mental health nurse working in the community is planning an educational program for fifth and sixth grade teachers. Which of the following would the nurse include?
- A. Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders
- B. Emphasis on the need for teachers to focus their prevention efforts on female students
- C. Stressing of the need to allow students to eat without undue attention or supervision to prevent inadvertently influencing eating patterns
- D. Clarification that peer pressure is not typically problematic in children who are in the fifth and sixth grades
Correct Answer: A
Rationale: The correct answer is A. Rationale: Discussing media?s role in promoting unrealistic body images addresses a key risk factor for eating disorders in young students. Focusing only on females (B) ignores males, unsupervised eating (C) may miss opportunities for intervention, and peer pressure (D) is significant at this age.