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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.
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A nurse explains to the client that which of the following is a healthy BMI range?
- A. 7 to 16
- B. 16 to 18.5
- C. 18.5 to 24.9
- D. 25 to 32
Correct Answer: C
Rationale: A healthy BMI is 18.5 to 24.9. A BMI of 7 to 16 is categorized as anorectic. A BMI of 16 to 18 is considered underweight. A BMI of 25 to 32 is classified as overweight to obese.
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.
A client has been diagnosed with bulimia nervosa. Which assessment finding(s) contribute to this diagnosis? Select all that apply.
- A. Electrolyte imbalance
- B. Dehydration
- C. Chronic sore throat
- D. Pulmonary embolism
- E. Constipation
Correct Answer: A,B,C,E
Rationale: Self-induced vomiting and use of emetics such as ipecac damage teeth, cause chronic sore throat and risk of esophageal erosion and abuse of laxatives and enemas contributes to constipation. The non-prescribed use of diuretics and diet pills predisposes to liquid, electrolyte, and cardiac problems. Pulmonary embolism is not usually assessed for with bulimia nervosa.
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.
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.