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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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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.
The nurse is initiating a group for adolescent girls diagnosed with anorexia nervosa. Many of the clients in the group are irritable and resent having to attend. One of them comments, This is a stupid waste of time! Which of the response by the nurse would be most appropriate?
- A. If you feel that way, then you can just leave.
- B. You sound irritated; tell me about what is bothering you.
- C. You were assigned to this group by your therapist, so you must participate.
- D. Sit down and be quiet; your peers would appreciate some peace and quiet.
Correct Answer: B
Rationale: Acknowledging the client?s irritation and inviting discussion (B) validates feelings and encourages engagement, therapeutic for anorexia nervosa group settings. Allowing leaving (A), enforcing participation (C), or silencing (D) dismisses emotions and hinders group progress.
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 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.
A nurse is performing an admission assessment for an adolescent girl with an eating disorder who is being admitted to the psychiatric unit. Which statement would the nurse interpret as most likely supporting the client?s diagnosis?
- A. My father was always very thin.
- B. I?ve never really liked myself.
- C. I have a lot of confidence in myself.
- D. I feel really close to my parents and my brother.
Correct Answer: B
Rationale: Low self-esteem (B) is a hallmark psychological feature of eating disorders, strongly supporting the diagnosis. A thin parent (A) is less specific, high confidence (C) contradicts typical traits, and close family ties (D) are not diagnostic.