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A nurse who works in an outpatient mental health facility understands that imbalances of serotonin and/or dopamine levels are linked to eating disorders. Which behavior problem is most likely to be associated with the fear of becoming fat?
- A. Panic disorder
- B. Agoraphobia
- C. Obsessive-compulsive disorder
- D. Conversion disorder
Correct Answer: C
Rationale: About one third of people with eating disorders have had previous symptoms of anxiety disorder known as obsessive-compulsive disorder. Having an obsessional fear of fat may precipitate the compulsive behavior to control the fear. Panic disorder and agoraphobia are forms of anxiety disorders not significant to eating disorder. Conversion disorder is a somatoform disorder not significant to eating disorders.
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Clients with anorexia nervosa frequently use methods to avoid eating or to prevent weight gain. Which documentation most accurately describes the behavior of a client with anorexia?
- A. Client observed to move food around the plate arranged in various patterns.
- B. Client stares frequently into space and has to be prompted to participate in the mealtime conversation.
- C. Client talks about food likes and dislikes and reminisces about holiday foods.
- D. Client states feeling depressed and does not feel like eating right now.
Correct Answer: A
Rationale: Clients with anorexia practice various rituals such as cutting food into small pieces and rearranging food on the plate without actually eating.
The nurse is preparing to administer orlistat to a client with obesity. Which safety warning(s) should the nurse consider when administering this medication to the client? Select all that apply.
- A. Administer with meals, stagger administration with other drugs.
- B. Provide a vitamin supplement with the medication.
- C. Monitor liver function.
- D. Avoid caffeine.
- E. Avoid use among clients with heart disease, hypertension, and hyperthyroidism.
Correct Answer: A,B,C
Rationale: The safety warnings that the nurse should consider include administering orlistat with meals and staggering administration with other drugs, the requirement of vitamin supplementation due to nonabsorption of nutrients, and monitoring liver function. Avoiding caffeine and avoiding the use of the medication among clients with heart disease, hypertension, and hyperthyroidism are applicable to appetite suppressants such as benzphetamine, diethylpropion, phendimetrazine, and phentermine, not orlistat.
The nurse is caring for a client who is struggling with weight loss issues, without apparent physical cause. Which is the most likely nursing assessment for this nutritional disorder in which normal body weight is not maintained?
- A. Bulimia
- B. Anorexia nervosa
- C. Kwashiorkor
- D. Crohn's disease
Correct Answer: B
Rationale: Anorexia nervosa is a nutritional disorder that is characterized by a refusal to maintain normal body weight in the absence of physical cause. Anorexia nervosa is considered a psychiatric disorder in a relentless pursuit of thinness. Bulimia is an eating disorder in which voracious appetite is followed by purging and is most likely found in normal to overweight individuals. Kwashiorkor is a severe protein deficiency associated with lack of protein in the diet. Crohn's disease can result in nutritional deficiencies but has apparent physiological cause.
The nurse is preparing a teaching plan for a client diagnosed with bulimia nervosa. What would be included in the teaching plan?
- A. Change eating locations frequently
- B. Consume no more than 2000 to 3000 calories/day.
- C. Eat alone to concentrate on food intake.
- D. Consume high-caloric foods.
Correct Answer: B
Rationale: Included in the teaching plan should be that the client will consume no more than 2000 to 3000 calories/day divided among three meals plus or minus snacks. There should be a restriction of eating locations. Binging takes place when the client with bulimia is alone and when there is a low potential for being discovered. Consuming low-caloric foods may create less anxiety and reduce the potential for purging.
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.