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The nurse understands that a client with an eating disorder will eat outside the range of normal. Which is the primary reason that eating disorders remain underreported?
- A. Eating disorders are poorly defined.
- B. Not reported as a medical problem
- C. Behaviors are kept secret.
- D. Body shapes vary.
Correct Answer: C
Rationale: Often, clients with eating disorders strive to keep their illness secret. Eating disorders range from extreme thinness to obesity with variations in body shapes and sizes. Many Americans are on some form of 'diet,' which makes it more difficult to identify a disorder. Even though the disorder may result in physiologic imbalances and medical complications, eating disorders are considered mental health disorders that are accompanied by anxiety and guilt.
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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 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.
A nurse is assessing a female client who has recently drastically decreased the amount of food and number of calories consumed each day. Which assessment finding is most indicative of a client who is experiencing severe malnutrition?
- A. Amenorrhea
- B. Weight loss
- C. Body mass index (BMI) of 18
- D. High serum potassium level
Correct Answer: A
Rationale: Severe malnutrition causes the cessation of menstruation in females. Weight loss is expected with curtailing of calories but does not indicate severe malnutrition. BMI of 18 is low and indicates being underweight but not significant for severe malnutrition. In severe malnutrition, potassium levels are dangerously low.
The nurse is caring for a client with anorexia nervosa. What is the most important goal when planning care for this client?
- A. Regain lost weight.
- B. Restore fluid and electrolyte imbalances.
- C. Improve self-esteem and body image.
- D. Support healthy coping mechanisms.
Correct Answer: B
Rationale: In anorexia, electrolyte levels, especially potassium and sodium, are often dangerously low. Cardiac irregularities can be identified on electrocardiogram and are often directly linked to fluid and electrolyte imbalances that can lead to cardiac failure and death. Therefore, it is paramount to correct fluid and electrolyte imbalances. Regaining lost weight, supporting healthy coping mechanisms, and improving self-esteem are all goals that are significant in the management of anorexia.
A teenager who is attending a clinic for eating disorders has shown improvement in weight, but the laboratory values remain poor. Which behavior would the nurse identify as the likely cause of this finding?
- A. Pushing food around the plate
- B. Inducing vomiting after meals
- C. Drinking water before weighing
- D. Disposing of food
Correct Answer: C
Rationale: Drinking large volumes of water prior to being weighed is manipulative behavior that is likely the cause of improved weight without improved laboratory values. Pushing food around the plate to distort amount of food eaten, inducing vomiting, and disposing of food are all forms of manipulation but would not account for improvement of weight.