Chapter 18 - Eating and Feeding Disorders Flashcards
Over the past year, a client has cooked gourmet meals for the family but eats only tiny servings. This person wears layered loose clothing and currently weighs 95 pounds, after a loss of 35 pounds. Which medical diagnosis is most likely?
a. Binge eating
b. Bulimia nervosa
c. Anorexia nervosa
d. Eating disorder not otherwise specified
c. Anorexia nervosa
Disturbed body image is a nursing diagnosis established for a client diagnosed with an eating disorder. Which outcome indicator is most appropriate to monitor?
a. Weight, muscle, and fat congruence with height, frame, age, and sex
b. Calorie intake is within required parameters of treatment plan
c. Weight reaches established normal range for the client
d. Client expresses satisfaction with body appearance
d. Client expresses satisfaction with body appearance
A client referred to the eating disorders clinic has lost 35 pounds during the past 3 months. To assess eating patterns, the nurse should ask the client which question?
a. “Do you often feel fat?”
b. “Who plans the family meals?”
c. “What do you eat in a typical day?”
d. “What do you think about your present weight?”
c. “What do you eat in a typical day?”
A client diagnosed with anorexia nervosa virtually stopped eating 5 months ago and lost 25% of body weight. A nurse asks, “Describe what you think about your present weight and how you look.” Which response by the client is most consistent with the diagnosis?
a. “I am fat and ugly.”
b. “What I think about myself is my business.”
c. “I’m grossly underweight, but that’s what I want.”
d. “I’m a few pounds’ overweight, but I can live with it.”
a. “I am fat and ugly.”
A client was diagnosed with anorexia nervosa. The history shows the client virtually stopped eating 5 months ago and lost 25% of body weight. The serum potassium is currently 2.7 mg/dL. Which nursing diagnosis applies?
a. Adult failure to thrive related to abuse of laxatives as evidenced by electrolyte imbalances and weight loss
b. Disturbed energy field related to physical exertion in excess of energy produced through caloric intake as evidenced by weight loss and hyperkalemia
c. Ineffective health maintenance related to self-induced vomiting as evidenced by swollen parotid glands and hyperkalemia
d. Imbalanced nutrition: less than body requirements related to reduced oral intake as evidenced by loss of 25% of body weight and hypokalemia
d. Imbalanced nutrition: less than body requirements related to reduced oral intake as evidenced by loss of 25% of body weight and hypokalemia
Outpatient treatment is planned for a client diagnosed with anorexia nervosa. What is the most important desired outcome related to the nursing diagnosis Imbalanced nutrition: less than body requirements that should be achieved within 1 week?
a. weighs self accurately using balanced scales.
b. limits exercise to less than 2 hours daily.
c. selects clothing that fits properly.
d. gains 1 to 2 pounds.
d. gains 1 to 2 pounds.
Which nursing intervention has the highest priority as a client diagnosed with anorexia nervosa begins to gain weight?
a. Assess for depression and anxiety.
b. Observe for adverse effects of refeeding.
c. Communicate empathy for the client’s feelings.
d. Help the client balance energy expenditures with caloric intake.
b. Observe for adverse effects of refeeding.
A client diagnosed with anorexia nervosa is resistant to weight gain. What is the rationale for establishing a contract with the client to participate in measures designed to produce a specified weekly weight gain?
a. Because severe anxiety concerning eating is expected, objective and subjective data may be unreliable.
b. Client involvement in decision making increases sense of control and promotes adherence to the plan of care.
c. Because of increased risk of physical problems with refeeding, the client’s permission is needed.
d. A team approach to planning the diet ensures that physical and emotional needs will be met.
b. Client involvement in decision making increases sense of control and promotes adherence to the plan of care.
The nursing care plan for a client diagnosed with anorexia nervosa includes the intervention “monitor for complications of refeeding.” Which system should a nurse closely monitor for dysfunction?
a. Renal
b. Endocrine
c. Integumentary
d. Cardiovascular
d. Cardiovascular
A psychiatric clinical nurse specialist uses cognitive-behavioral therapy for a client diagnosed with anorexia nervosa. Which statement by the staff nurse supports this type of therapy?
a. “What are your feelings about not eating foods that you prepare?”
b. “You seem to feel much better about yourself when you eat something.”
c. “It must be difficult to talk about private matters to someone you just met.”
d. “Being thin doesn’t seem to solve your problems. You are thin now but still unhappy.”
d. “Being thin doesn’t seem to solve your problems. You are thin now but still unhappy.”
What is an appropriate intervention for a client diagnosed with bulimia nervosa who binges, and purges is to teach the client?
a. to eat a small meal after purging.
b. not to skip meals or restrict food.
c. to increase oral intake after 4 PM daily.
d. the value of reading journal entries aloud to others
b. not to skip meals or restrict food.
A nurse provides care for an adolescent client diagnosed with an eating disorder. Which behavior by this nurse indicates that additional clinical supervision is needed?
a. The nurse interacts with the client in a protective fashion.
b. The nurse’s comments to the client are compassionate and nonjudgmental.
c. The nurse teaches the client to recognize signs of increasing anxiety and ways to intervene.
d. The nurse refers the client to a self-help group for individuals with eating disorders.
a. The nurse interacts with the client in a protective fashion.
A nursing diagnosis for a client diagnosed with bulimia nervosa is Ineffective coping related to feelings of loneliness as evidenced by overeating to comfort self, followed by self-induced vomiting. What is the best outcome related to this diagnosis that should be achieved within 2 weeks?
a. appropriately expressing angry feelings.
b. verbalizing two positive things about self.
c. verbalizing the importance of eating a balanced diet.
d. identifying two alternative methods of coping with loneliness.
d. identifying two alternative methods of coping with loneliness.
Which nursing intervention has the highest priority for a client diagnosed with bulimia nervosa?
a. Assist the client to identify triggers to binge eating.
b. Provide corrective consequences for weight loss.
c. Assess for signs of impulsive eating.
d. Explore needs for health teaching.
a. Assist the client to identify triggers to binge eating.
One bed is available on the inpatient eating-disorder unit. A client with which assessment data should be admitted to this bed?
a. Going from 150 to 100 pounds over a 4-month period. Vital signs are temperature, 35.9° C; pulse, 38 beats/min; blood pressure 60/40 mm Hg
b. Going from120 to 90 pounds over a 3-month period. Vital signs are temperature, 36° C; pulse, 50 beats/min; blood pressure 70/50 mm Hg
c. Going from110 to 70 pounds over a 4-month period. Vital signs are temperature
36.5° C; pulse, 60 beats/min; blood pressure 80/66 mm Hg
d. Going 90 to 78 pounds over a 5-month period. Vital signs are temperature, 36.7°
C; pulse, 62 beats/min; blood pressure 74/48 mm Hg
a. Going from 150 to 100 pounds over a 4-month period. Vital signs are temperature, 35.9° C; pulse, 38 beats/min; blood pressure 60/40 mm Hg
