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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.
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The nurse is differentiating between anorexia and bulimia. What clinical manifestation would correlate with anorexia?
- A. Frequent weight fluctuations
- B. Amenorrhea
- C. Swelling of the parotid glands
- D. Irregular menses
Correct Answer: B
Rationale: Clients diagnosed with anorexia may have amenorrhea. Clients with bulimia nervosa exhibit weight fluctuations, swelling of the parotid glands, and irregular menses.
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.
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 caring for a client with anorexia nervosa. What is the most important goal when planning care for this client?
- A. Regain lost weight.
- B. Restore fluid and electrolyte imbalances.
- C. Improve self-esteem and body image.
- D. Support healthy coping mechanisms.
Correct Answer: B
Rationale: In anorexia, electrolyte levels, especially potassium and sodium, are often dangerously low. Cardiac irregularities can be identified on electrocardiogram and are often directly linked to fluid and electrolyte imbalances that can lead to cardiac failure and death. Therefore, it is paramount to correct fluid and electrolyte imbalances. Regaining lost weight, supporting healthy coping mechanisms, and improving self-esteem are all goals that are significant in the management of anorexia.
Increases in which neurotransmitter contribute to restrictive eating?
- A. Serotonin
- B. Dopamine
- C. Norepinephrine
- D. Tryptophan
Correct Answer: A
Rationale: Increased serotonin levels contribute to restricted eating. Dopamine, norepinephrine, and tryptophan are not associated with restrictive eating.