While caring for a client with anorexia nervosa, the nurse anticipates that the client would have difficulty making which of the following comments?
- A. I?m mad at you because you won?t let me go on a pass unless I gain weight!
- B. I need to have everything in its place and perfect.
- C. If I gain a pound, I?ll just keep gaining weight.
- D. I am very involved in preparing my food and counting calories.
Correct Answer: A
Rationale: Clients with anorexia nervosa often struggle to express anger directly (A) due to emotional suppression and fear of conflict. Statements about perfectionism (B), fear of weight gain (C), and food preoccupation (D) are typical and align with the disorder?s characteristics.
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A client with bulimia nervosa is scheduled for a visit to the clinic. When assessing this client, which of the following would the nurse expect to find?
- A. Impulsivity
- B. Panic
- C. Hyperactivity
- D. Delusions
Correct Answer: A
Rationale: Impulsivity (A) is common in bulimia nervosa, manifesting in binge-purge cycles. Panic (B) and hyperactivity (C) are less specific, and delusions (D) are not typical, aligning more with psychotic disorders.
A nurse is preparing a presentation for a local middle school health class about eating disorders as a means for prevention and early detection. Which of the following would the nurse incorporate into the presentation as being common to both anorexia nervosa and bulimia nervosa? Select all that apply.
- A. Body dissatisfaction
- B. Feelings of control
- C. Obsessiveness
- D. Boundary problems
- E. Sexuality fears
- F. Cognitive distortions
Correct Answer: A,C,F
Rationale: Body dissatisfaction (A), obsessiveness (C), and cognitive distortions (F) are common to both anorexia and bulimia nervosa, reflecting distorted self-image and rigid thinking. Control (B) is more specific to anorexia, boundary problems (D) to bulimia, and sexuality fears (E) are less universal.
A psychiatric mental health nurse working in the community is planning an educational program for fifth and sixth grade teachers. Which of the following would the nurse include?
- A. Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders
- B. Emphasis on the need for teachers to focus their prevention efforts on female students
- C. Stressing of the need to allow students to eat without undue attention or supervision to prevent inadvertently influencing eating patterns
- D. Clarification that peer pressure is not typically problematic in children who are in the fifth and sixth grades
Correct Answer: A
Rationale: The correct answer is A. Rationale: Discussing media?s role in promoting unrealistic body images addresses a key risk factor for eating disorders in young students. Focusing only on females (B) ignores males, unsupervised eating (C) may miss opportunities for intervention, and peer pressure (D) is significant at this age.
A client with bulimia nervosa is being treated at an outpatient clinic and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which of the following would the nurse include when teaching the client about the prescribed medication?
- A. Closely monitor your fluid intake while taking this medication.
- B. Stop taking this medication if it causes weight gain.
- C. Expect menstrual irregularities, particularly if they?ve occurred previously.
- D. Report any weight changes that occur during the first few weeks this medication is taken.
Correct Answer: D
Rationale: SSRIs for bulimia nervosa can cause weight changes, and reporting these early (D) is important for monitoring and adjusting treatment. Fluid intake (A) is not typically monitored, stopping for weight gain (B) is inappropriate, and menstrual irregularities (C) are not a primary concern.
The nurse is planning to explain the purpose of the behavioral therapy technique of self-monitoring to a client with bulimia nervosa. The nurse would emphasize keeping a diary to record which of the following?
- A. Feelings of hunger
- B. Efforts at distraction
- C. Environmental stimuli
- D. Rigid rules about eating
Correct Answer: C
Rationale: Self-monitoring in bulimia nervosa involves recording environmental stimuli (C) to identify triggers for binge-purge behaviors. Hunger (A), distraction (B), and rigid rules (D) are less directly tied to the core goal of trigger identification.
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