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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.
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When taking a client's history, the client reports to the nurse inappropriate use of diuretics and laxatives, secreteating of high-calorie and high-carbohydrate foods, and alternately bingeing and fasting. Based on this information, which eating disorder should the nurse suspect?
- A. Bulimia nervosa
- B. Anorexia nervosa
- C. Binge eating
- D. Compulsive overeating
Correct Answer: A
Rationale: Behavioral signs and symptoms of bulimia nervosa include excessive exercise; use of diuretics, and laxatives, secret eating of high-calorie, high-carbohydrate foods, and alternately bingeing and fasting. Anorexia nervosa is characterized by behavioral signs and symptoms including restriction of food choices and intake, ritualistic handling of food (e.g., cutting into tiny pieces, arranging food in a certain way), weighing oneself frequently, and denial of hunger. Binge eating and compulsive overeating are characterized by frequent dieting, restricting activities because of embarrassment about weight, eating when not hungry, rapid eating, and eating alone.
A client has been diagnosed with bulimia nervosa. Which assessment finding(s) contribute to this diagnosis? Select all that apply.
- A. Electrolyte imbalance
- B. Dehydration
- C. Chronic sore throat
- D. Pulmonary embolism
- E. Constipation
Correct Answer: A,B,C,E
Rationale: Self-induced vomiting and use of emetics such as ipecac damage teeth, cause chronic sore throat and risk of esophageal erosion and abuse of laxatives and enemas contributes to constipation. The non-prescribed use of diuretics and diet pills predisposes to liquid, electrolyte, and cardiac problems. Pulmonary embolism is not usually assessed for with bulimia nervosa.
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.
A nurse who works in an outpatient mental health facility understands that imbalances of serotonin and/or dopamine levels are linked to eating disorders. Which behavior problem is most likely to be associated with the fear of becoming fat?
- A. Panic disorder
- B. Agoraphobia
- C. Obsessive-compulsive disorder
- D. Conversion disorder
Correct Answer: C
Rationale: About one third of people with eating disorders have had previous symptoms of anxiety disorder known as obsessive-compulsive disorder. Having an obsessional fear of fat may precipitate the compulsive behavior to control the fear. Panic disorder and agoraphobia are forms of anxiety disorders not significant to eating disorder. Conversion disorder is a somatoform disorder not significant to eating disorders.
Eating disorders affect approximately 30 million people of all ages and genders in the United States. All are considered eating disorders except:
- A. Bulimia nervosa
- B. Binge eating
- C. Anorexia nervosa
- D. Obesity
Correct Answer: D
Rationale: Obesity is not considered an eating disorder but may be caused by an eating disorder. Bulimia, anorexia, and binge eating are eating disorders.