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A teenage client has been diagnosed with anorexia nervosa. What is a complication of anorexia nervosa?
- A. Damaged tooth enamel
- B. Fluid and electrolyte imbalance
- C. Premature osteoporosis
- D. Diarrhea
Correct Answer: C
Rationale: Low levels of serum estrogen also lead to osteopenia (low bone mass) and premature osteoporosis (severe demineralization of bones), both of which result in stress fractures, particularly of the spine and hips. Erosion of tooth enamel and fluid and electrolyte imbalance are related to bulimia nervosa. Constipation, not diarrhea, is associated with anorexia nervosa.
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When taking a client's history, the client reports to the nurse inappropriate use of diuretics and laxatives, secreteating of high-calorie and high-carbohydrate foods, and alternately bingeing and fasting. Based on this information, which eating disorder should the nurse suspect?
- A. Bulimia nervosa
- B. Anorexia nervosa
- C. Binge eating
- D. Compulsive overeating
Correct Answer: A
Rationale: Behavioral signs and symptoms of bulimia nervosa include excessive exercise; use of diuretics, and laxatives, secret eating of high-calorie, high-carbohydrate foods, and alternately bingeing and fasting. Anorexia nervosa is characterized by behavioral signs and symptoms including restriction of food choices and intake, ritualistic handling of food (e.g., cutting into tiny pieces, arranging food in a certain way), weighing oneself frequently, and denial of hunger. Binge eating and compulsive overeating are characterized by frequent dieting, restricting activities because of embarrassment about weight, eating when not hungry, rapid eating, and eating alone.
The client has just been diagnosed with binge eating disorder. Which statement by the client is most indicative of this diagnosis?
- A. I eat even when I am not hungry.
- B. I always feel guilty after I overeat.
- C. I have gained a lot of weight.
- D. I eat slowly but consistently throughout the day.
Correct Answer: B
Rationale: Binge eating disorder is characterized by the inability to control overeating accompanied by a guilty feeling. Eating when not hungry is not specific to binge eating and is often a characteristic of compulsive overeating. Binge eaters eat very rapidly and often consume as much as 10,000 calories at one sitting. Many binge eaters are overweight as are compulsive overeaters.
The nurse is assisting a binge eater in establishing a dietary plan of care. What instruction is most likely to cause a relapse in behavior?
- A. Remember recovery is a day-by-day process.
- B. Attend a self-help group.
- C. Be cautious of sugar-free items.
- D. Stick to a strict diet plan.
Correct Answer: D
Rationale: Strict dieting or fasting is the leading cause of binging. The newer approach to weight management stresses that all foods are acceptable and strict avoidance of foods tends to worsen binge eating. Clients should attend self-help groups or group therapy. Being cautious of items that are labeled fat free and sugar free is encouraged because sugar free may not mean calorie free. Remember that recovery is a day-by-day process.
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.