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A teenager who is attending a clinic for eating disorders has shown improvement in weight, but the laboratory values remain poor. Which behavior would the nurse identify as the likely cause of this finding?
- A. Pushing food around the plate
- B. Inducing vomiting after meals
- C. Drinking water before weighing
- D. Disposing of food
Correct Answer: C
Rationale: Drinking large volumes of water prior to being weighed is manipulative behavior that is likely the cause of improved weight without improved laboratory values. Pushing food around the plate to distort amount of food eaten, inducing vomiting, and disposing of food are all forms of manipulation but would not account for improvement of weight.
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The parents are struggling with the idea their child has anorexia and comment that the child 'often eats large quantities of food.' Which statement by the nurse best supports the diagnosis?
- A. There are many types of anorexia nervosa.
- B. Cycles of self-starvation, binging, purging, and exercising are common.
- C. Your child was probably disposing of the food, not eating it.
- D. It must be difficult for you to accept the fact your child has an eating disorder.
Correct Answer: B
Rationale: Bulimarexia is a type of anorexia in which extended periods of self-starvation is interrupted by binging, purging, and exercising. There are over twice as many persons with bulimarexia than those with simple anorexia nervosa.
When assessing for anorexia nervosa, the nurse would anticipate finding what characteristic(s)? Select all that apply.
- A. Is overweight
- B. Good academics
- C. Underachiever
- D. Teenage girl
- E. Wears tight-fitting clothes
- F. Social eater
Correct Answer: B,D
Rationale: Anorexia nervosa is characterized by an obsession for thinness that is achieved through self-starvation. It occurs more often in girls between the ages of 12 to 18 years and continues into adulthood. They are often high achievers and perfectionists. Many conceal their starvation by eating alone, disposing of food, and dressing in oversized, bulky clothing.
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.
The nurse is providing a teaching seminar to a group of teenagers on the subject of healthy eating. A scale is used to calculate body mass index (BMI) for each individual participant. A participant asks the nurse if a BMI of 25 is normal.
- A. A BMI of 25 is normal.
- B. The BMI formula does not include ratio of fat to muscle mass.
- C. BMI is just one tool for healthy lifestyle.
- D. Keeping your BMI below 30 is ideal.
Correct Answer: C
Rationale: The healthy interpretation of BMI ranges from 18.5 to 24.9. Knowing that teenagers are very susceptible to eating disorders and desire for thinness, the nurse takes the focus off the number (25) and addresses healthy lifestyle. BMI is only one tool used for anthropometric data collection. Ratio of fat to lean muscle mass is not included in BMI. A BMI of 30 is indicative of obesity and would not be considered ideal.
A teenager is being seen in the outpatient clinic after a fainting episode at home. The client's body mass index (BMI) is 16, and she reports no menses for the past 3 months. Which additional assessment finding would the nurse anticipate?
- A. Absence of hair on arm and legs
- B. Tachycardia
- C. Clubbing of fingers and toes
- D. Complaint of temperature intolerance
Correct Answer: D
Rationale: Severe malnutrition can result in temperature intolerance and feeling cold. Hypothermia is linked to the loss of subcutaneous fat. Lanugo may develop to assist in the maintenance of body temperature. Bradycardia is another physical symptom associated with anorexia nervosa. Clubbing of the fingers and toes is not indicated in eating disorders.