Nokea
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.
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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.
A teenager is being seen in the outpatient clinic after a fainting episode at home. The client's body mass index (BMI) is 16, and she reports no menses for the past 3 months. Which additional assessment finding would the nurse anticipate?
- A. Absence of hair on arm and legs
- B. Tachycardia
- C. Clubbing of fingers and toes
- D. Complaint of temperature intolerance
Correct Answer: D
Rationale: Severe malnutrition can result in temperature intolerance and feeling cold. Hypothermia is linked to the loss of subcutaneous fat. Lanugo may develop to assist in the maintenance of body temperature. Bradycardia is another physical symptom associated with anorexia nervosa. Clubbing of the fingers and toes is not indicated in eating disorders.
The parents are struggling with the idea their child has anorexia and comment that the child 'often eats large quantities of food.' Which statement by the nurse best supports the diagnosis?
- A. There are many types of anorexia nervosa.
- B. Cycles of self-starvation, binging, purging, and exercising are common.
- C. Your child was probably disposing of the food, not eating it.
- D. It must be difficult for you to accept the fact your child has an eating disorder.
Correct Answer: B
Rationale: Bulimarexia is a type of anorexia in which extended periods of self-starvation is interrupted by binging, purging, and exercising. There are over twice as many persons with bulimarexia than those with simple anorexia nervosa.
A teenage client has been diagnosed with anorexia nervosa. What is a complication of anorexia nervosa?
- A. Damaged tooth enamel
- B. Fluid and electrolyte imbalance
- C. Premature osteoporosis
- D. Diarrhea
Correct Answer: C
Rationale: Low levels of serum estrogen also lead to osteopenia (low bone mass) and premature osteoporosis (severe demineralization of bones), both of which result in stress fractures, particularly of the spine and hips. Erosion of tooth enamel and fluid and electrolyte imbalance are related to bulimia nervosa. Constipation, not diarrhea, is associated with anorexia nervosa.
The client has just been diagnosed with binge eating disorder. Which statement by the client is most indicative of this diagnosis?
- A. I eat even when I am not hungry.
- B. I always feel guilty after I overeat.
- C. I have gained a lot of weight.
- D. I eat slowly but consistently throughout the day.
Correct Answer: B
Rationale: Binge eating disorder is characterized by the inability to control overeating accompanied by a guilty feeling. Eating when not hungry is not specific to binge eating and is often a characteristic of compulsive overeating. Binge eaters eat very rapidly and often consume as much as 10,000 calories at one sitting. Many binge eaters are overweight as are compulsive overeaters.