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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.
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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 nurse is reviewing the plan of care for a client with anorexia nervosa and notes a behavioral plan for increasing weight. The nurse correlates this intervention with which nursing diagnosis?
- A. Disturbed Body Image
- B. Anxiety
- C. Imbalanced Nutrition: Less Than Body Requirements
- D. Ineffective Coping
Correct Answer: C
Rationale: A behavioral plan for increasing weight directly addresses Imbalanced Nutrition: Less Than Body Requirements (C), the primary physical issue in anorexia nervosa. Body image (A), anxiety (B), and coping (D) are secondary concerns.
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 caring for a client with anorexia nervosa, the nurse anticipates that the client would have difficulty making which of the following comments?
- A. I?m mad at you because you won?t let me go on a pass unless I gain weight!
- B. I need to have everything in its place and perfect.
- C. If I gain a pound, I?ll just keep gaining weight.
- D. I am very involved in preparing my food and counting calories.
Correct Answer: A
Rationale: Clients with anorexia nervosa often struggle to express anger directly (A) due to emotional suppression and fear of conflict. Statements about perfectionism (B), fear of weight gain (C), and food preoccupation (D) are typical and align with the disorder?s characteristics.
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.