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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.
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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.
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.
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.
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.
When assessing for anorexia nervosa, the nurse would anticipate finding what characteristic(s)? Select all that apply.
- A. Is overweight
- B. Good academics
- C. Underachiever
- D. Teenage girl
- E. Wears tight-fitting clothes
- F. Social eater
Correct Answer: B,D
Rationale: Anorexia nervosa is characterized by an obsession for thinness that is achieved through self-starvation. It occurs more often in girls between the ages of 12 to 18 years and continues into adulthood. They are often high achievers and perfectionists. Many conceal their starvation by eating alone, disposing of food, and dressing in oversized, bulky clothing.