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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.
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The nurse is planning to explain the purpose of the behavioral therapy technique of self-monitoring to a client with bulimia nervosa. The nurse would emphasize keeping a diary to record which of the following?
- A. Feelings of hunger
- B. Efforts at distraction
- C. Environmental stimuli
- D. Rigid rules about eating
Correct Answer: C
Rationale: Self-monitoring in bulimia nervosa involves recording environmental stimuli (C) to identify triggers for binge-purge behaviors. Hunger (A), distraction (B), and rigid rules (D) are less directly tied to the core goal of trigger identification.
While talking with a client with an eating disorder, the client states, I?ve gained 2 pounds, so soon I?ll be over 100 pounds. The nurse interprets this as which of the following?
- A. Magnification
- B. Selective abstraction
- C. Overgeneralization
- D. Dichotomous thinking
Correct Answer: A
Rationale: The statement reflects magnification (A), exaggerating the significance of a 2-pound gain into a catastrophic outcome. Selective abstraction (B) focuses on one detail, overgeneralization (C) applies one event broadly, and dichotomous thinking (D) is all-or-nothing reasoning.
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.
The nurse is caring for several hospitalized clients with anorexia nervosa. The nurse would be especially alert for which of the following if noted in the clients? histories?
- A. Paranoia
- B. Primary insomnia
- C. Depression
- D. Aggression
Correct Answer: C
Rationale: Depression (C) is a common comorbidity in anorexia nervosa, increasing risk for self-harm and complicating treatment, warranting close attention. Paranoia (A), insomnia (B), and aggression (D) are less prevalent or specific.
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.