Nokea
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.
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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.
The nurse is preparing to discharge a client who has been hospitalized with anorexia nervosa. Which of the following would the nurse include in the teaching plan?
- A. Knowing the calorie content of numerous foods
- B. Learning strategies to control impulses
- C. Describing physiologic consequences of anorexia nervosa
- D. Setting realistic goals
Correct Answer: D
Rationale: Setting realistic goals (D) supports recovery by promoting achievable steps toward healthy eating and weight restoration. Calorie knowledge (A) may reinforce obsessive behaviors, impulse control (B) is less specific, and describing consequences (C) is informative but not action-oriented.
A group of nursing students is reviewing the similarities and differences between bulimia nervosa and binge-eating disorder. The students demonstrate understanding when they identify which characteristics as specific to binge-eating disorder? Select all that apply.
- A. Clients typically are obese.
- B. Clients refrain from purging behaviors.
- C. Binge-eating periods are shorter.
- D. Clients engage in overexercising.
- E. Feelings of guilt do not occur after binging.
Correct Answer: A,B
Rationale: Binge-eating disorder (BED) is characterized by obesity (A) and no purging behaviors (B). Binge periods are not necessarily shorter (C), overexercising (D) is more common in bulimia, and guilt (E) is typical after binging in BED.
A nurse is developing a plan of care for a client newly diagnosed with bulimia nervosa. Which of the following would the nurse expect to implement in conjunction with pharmacologic therapy?
- A. Behavioral therapy
- B. Cognitive behavioral therapy
- C. Interpersonal therapy
- D. Family therapy
Correct Answer: B
Rationale: Cognitive behavioral therapy (CBT) (B) is the most effective non-pharmacologic treatment for bulimia nervosa, addressing distorted thoughts and behaviors. Behavioral therapy (A) is less specific, interpersonal (C) and family (D) therapies are adjunctive.
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.