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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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 nurse is interviewing a client diagnosed with bulimia nervosa about her family and her relationship with her mother. Which statement by the client would the nurse least likely associate with bulimia nervosa?
- A. My mother is my confidante for everything.
- B. My mother?s happiness depends on me.
- C. My family basically has very few rules.
- D. My mother and I are close but not joined at the hip.
Correct Answer: D
Rationale: A balanced, non-enmeshed relationship with the mother (D) is less associated with bulimia nervosa, which often involves enmeshed (A), dependent (B), or chaotic (C) family dynamics.
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 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.
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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