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What is a true statement regarding anorexia nervosa?
- A. More men are affected with anorexia nervosa.
- B. Increased serotonin levels contribute to overeating.
- C. Clients consume 600 to 900 calories/day.
- D. Due to the psychological impact, clients with anorexia do not feel hungry.
Correct Answer: C
Rationale: Not uncommonly, people with anorexia nervosa consume an average of 600 to 900 calories/day, often less. More women are affected than men. Increased serotonin levels contribute to restricted eating. They get hungry but control the urge to eat because of a morbid fear of becoming fat.
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The nurse is differentiating between anorexia and bulimia. What clinical manifestation would correlate with anorexia?
- A. Frequent weight fluctuations
- B. Amenorrhea
- C. Swelling of the parotid glands
- D. Irregular menses
Correct Answer: B
Rationale: Clients diagnosed with anorexia may have amenorrhea. Clients with bulimia nervosa exhibit weight fluctuations, swelling of the parotid glands, and irregular menses.
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.
The nurse is preparing a teaching plan for a client diagnosed with bulimia nervosa. What would be included in the teaching plan?
- A. Change eating locations frequently
- B. Consume no more than 2000 to 3000 calories/day.
- C. Eat alone to concentrate on food intake.
- D. Consume high-caloric foods.
Correct Answer: B
Rationale: Included in the teaching plan should be that the client will consume no more than 2000 to 3000 calories/day divided among three meals plus or minus snacks. There should be a restriction of eating locations. Binging takes place when the client with bulimia is alone and when there is a low potential for being discovered. Consuming low-caloric foods may create less anxiety and reduce the potential for purging.
The nurse is assisting a binge eater in establishing a dietary plan of care. What instruction is most likely to cause a relapse in behavior?
- A. Remember recovery is a day-by-day process.
- B. Attend a self-help group.
- C. Be cautious of sugar-free items.
- D. Stick to a strict diet plan.
Correct Answer: D
Rationale: Strict dieting or fasting is the leading cause of binging. The newer approach to weight management stresses that all foods are acceptable and strict avoidance of foods tends to worsen binge eating. Clients should attend self-help groups or group therapy. Being cautious of items that are labeled fat free and sugar free is encouraged because sugar free may not mean calorie free. Remember that recovery is a day-by-day process.
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.