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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 preparing a presentation for a local middle school health class about eating disorders as a means for prevention and early detection. Which of the following would the nurse incorporate into the presentation as being common to both anorexia nervosa and bulimia nervosa? Select all that apply.
- A. Body dissatisfaction
- B. Feelings of control
- C. Obsessiveness
- D. Boundary problems
- E. Sexuality fears
- F. Cognitive distortions
Correct Answer: A,C,F
Rationale: Body dissatisfaction (A), obsessiveness (C), and cognitive distortions (F) are common to both anorexia and bulimia nervosa, reflecting distorted self-image and rigid thinking. Control (B) is more specific to anorexia, boundary problems (D) to bulimia, and sexuality fears (E) are less universal.
A client with bulimia nervosa is scheduled for a visit to the clinic. When assessing this client, which of the following would the nurse expect to find?
- A. Impulsivity
- B. Panic
- C. Hyperactivity
- D. Delusions
Correct Answer: A
Rationale: Impulsivity (A) is common in bulimia nervosa, manifesting in binge-purge cycles. Panic (B) and hyperactivity (C) are less specific, and delusions (D) are not typical, aligning more with psychotic disorders.
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 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 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.