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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.
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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.
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.
An adolescent is brought to the emergency department by her parents because they were concerned about their daughter?s appearance. The client appears emaciated and pale. The parents tell the nurse that the client has been diagnosed with anorexia nervosa. A history and physical examination and laboratory testing are completed. Which of the following would lead the nurse to suspect that the client will be admitted to the hospital? Select all that apply.
- A. Blood pressure of 110/60 mm Hg
- B. Elevated serum potassium level
- C. Decreased serum magnesium level
- D. Heart rate of 40 beats/min
- E. Statements of being hopeless
Correct Answer: C,D,E
Rationale: Decreased magnesium (C), heart rate of 40 (D), and hopelessness (E) indicate severe medical and psychological complications of anorexia nervosa, warranting hospitalization. Normal blood pressure (A) and elevated potassium (B) are less concerning.
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.
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.