1.
A 12-year-old girl is brought to the pediatrician for her annual physical examination. The nurse notes that the girl has lost 15 pounds over the past 6 months when she was last seen for bronchitis. The nurse asks the child if she has been dieting and the girl proudly responds yes. What would the nurse suspect of this child?
A) She has anorexia nervosa, restricting subtype.
B) She has anorexia nervosa, binge eating/purging subtype.
C) She has bulimia nervosa.
D) She has type I diabetes mellitus
2.
How does the DSM-IV-TR define binge eating?
A) Eating a great deal of food in a short period of time and then returning to normal intake.
B) Eating in a discrete period of time (usually less than 2 hours) an amount of food that is definitely larger than most people would eat under similar circumstances.
C) Eating an overabundance of a specific type of food (sweets, fruits, vegetables) in a short period of time.
D) Periodically overindulging in a specific type of food (usually sweets or fast food) in a short period of time and then returning to normal dietary intake.
3.
Binge eating in anorexia nervosa is usually followed by purging. A mental health nurse knows that purging is defined as what?
A) Use of laxatives on a daily basis
B) Evacuation of the digestive tract by eating until you vomit
C) Overuse of diuretics until fluid volume depletion occurs
D) Evacuation of the digestive tract by self-induced vomiting or excessive use of laxatives and diuretics
4.
A 14-year-old girl is brought to the clinic by her mother. Her mother tells the nurse that on several occasions, she has found her daughter during the night eating things like a whole pizza or a carton of ice cream. The nurse asks the girl about this behavior and the girl begins to cry. The nurse knows that this behavior is a symptom of what?
A) Anorexia nervosa, restricting subtype
B) Anorexia nervosa, binge eating/purging subtype
C) Bulimia nervosa
D) Type I diabetes mellitus
5.
When learning about bulimia nervosa, what would the student nurse learn is the second primary symptom of this disease?
A) Daily use of laxatives or diuretics
B) Vomiting until an electrolyte imbalance is induced
C) Shame and guilt over binging
D) Repeated use of inappropriate and risky methods of preventing weight gain
6.
The nurse is explaining the etiology of bulimia nervosa to the mother of a preteen newly diagnosed with the disorder. What would the nurse tell the mother the behaviors center on?
A) A dissatisfaction with body size and shape
B) An outward preoccupation with dieting
C) Limiting food intake with little or no alteration in weight or appearance
D) The shame and guilt of the behaviors
7.
A 12-year-old boy is diagnosed with bulimia nervosa. When providing client education to the parents of the client, the nurse points out that what is common in clients afflicted with bulimia nervosa?
A) Inpatient hospital treatment
B) Physical ailments related to extreme weight loss
C) Substance abuse
D) Aggression and violence
8.
A 24-year-old male client presents at the mental health clinic telling the nurse, I just cant seem to maintain any interpersonal relationships. On assessment, the nurse notes that the clients social skills appear inadequate. The client is subsequently diagnosed with bulimia nervosa. Knowing what you do about this disease process, why would the inadequate social skills and interpersonal relationship problems occur in this patient?
A) Because of the clients need to control
B) Because of the clients lying and hidden behaviors
C) Because of the clients obsession with the weight
D) Because of the clients binging and purging behaviors
9.
A male client in his late 20s is diagnosed with binge-eating disorder. What etiologic factors does the nurse know most individuals with this disorder have? (Mark all that apply.)
A) The client has maladaptive social skills.
B) The client is generally considered a loner.
C) The client is overweight at a young age.
D) The client has low self-image.
E) The client has impulsive behaviors.
10.
The etiology of anorexia nervosa begins before adolescence. Evidence usually reveals what in these clients?
A) The child is pushed to be independent.
B) They are raised to believe that looks are everything.
C) Unresolved family conflicts with inconsistent patterns of overprotective and rigid parenting.
D) Decisions are usually made with parents.
11.
As a nurse who works with clients diagnosed with eating disorders, you know that to elicit unbiased data from the client it is important for you to do what?
A) Confront the clients when you believe they are lying
B) Elicit data on how the clients view their body
C) Encourage the clients to discuss their needs with their families
D) Examine your own feelings about food, dieting, and body image
12.
When assessing a client, what data should be collected? (Mark all that apply.)
A) Intolerance to heat
B) Reports of insomnia
C) Intolerance to cold temperatures
D) Decreased fatigue
E) Increased anxiety level
13.
You are assessing clients on the eating disorder unit. You know that it is important to assess changes in bowel elimination or decreased urine output because they relate to what?
A) Multisystem organ failure related to excessive weight loss
B) Laxative or diuretic use
C) An acute physiologic response to the disease process
D) Kidney failure brought on by starvation
14.
You are the nurse in a pediatric clinic who is caring for a 16-year-old female client. When conducting the assessment, you note what signs that would indicate to you a possible eating disorder? (Mark all that apply.)
A) Normal skin turgor
B) Eroded tooth enamel
C) Weight/height WNL
D) Brittle dry nails
E) Decreased hair growth
15.
You are assessing a new client on the unit who has been admitted for observation after a motor vehicle accident. The client is a female, aged 22 years, appearing well nourished. Vital signs are WNL. Weight:height ratio is WNL. During your assessment, you note abrasions on the back of the clients hands. What would this indicate to you?
A) Possible recent fist fight
B) The client has a cat
C) Recent gardening work
D) Possible induced purging
16.
A client is admitted to the eating disorder unit. During the assessment, the client tells the nurse about having difficulties with constipation. What would be an appropriate nursing diagnosis for this client?
A) Fluid volume deficit
B) Body image disturbance
C) Anxiety
D) Altered bowel elimination
17.
A client newly admitted to the eating disorder unit is obsessed with exercise. What would be the most appropriate expected outcome for this client?
A) Participates in activity level appropriate for health maintenance
B) Participates in activity level appropriate for weight loss
C) Participates in activity level appropriate for steady weight gain
D) Participates in activity level appropriate for current intake level
18.
You are developing a plan of care for a client with a diagnosis of binge eating. What would be an appropriate outcome for this client?
A) Discusses present health problem with no one
B) Exhibits no self-destructive behaviors
C) Identifies ways to maintain the current means of weight control
D) Discusses the unimportance of appropriate eating pattern
19.
A client with an eating disorder is found to have altered oral mucous membranes. The mental health nurse would know that this is related to what?
A) Altered nutritional status
B) Periodontal disease
C) Frequent vomiting
D) Damage from induced purging
20.
Clients with eating disorders usually discover the onset of the disease to be triggered by childhood events. Based on this knowledge, which of the following are appropriate nursing diagnoses for these clients? (Mark all that apply.)
A) Body image disturbance
B) Powerfulness
C) Anxiety
D) Posttrauma response
E) Social gregarity
21.
When working with clients who have eating disorders, what roles may a nurse fill? (Mark all that apply.)
A) Meeting the physiologic needs of the client
B) Teaching
C) Being a group leader
D) Psychotherapist
E) Adjusting pharmacotherapeutic interventions
22.
The mental health nurse knows that an effective intervention for a client with an eating disorder is what?
A) Weigh the client daily, before breakfast, using the same scale.
B) Discuss the initiation of a behavior modification program that the client does not want.
C) Restrict time for meals to 15 minutes to reduce focus on food and eating.
D) Use a firm and supportive approach to all behaviors.
23.
A client on an eating disorder unit is scheduled to have a family therapy session tomorrow. The goal of the scheduled session is to educate the family. The family calls and tells the nurse that they cannot make it to the scheduled session. What is the most appropriate intervention for the nurse at this time?
A) Comfort the client.
B) Encourage the family to participate in education about the clients disorder and family processes.
C) Tell the family that they are impeding the clients recovery process.
D) Call the social worker to enlist his or her help with the family.
24.
A client with anorexia nervosa is talking with the nurse. The client states, How do I learn to be a normal person? When updating the clients plan of care, what would be the most important nursing action to include?
A) Use a firm and supportive approach to eating and related behaviors.
B) Provide ways to reinforce the clients strengths and positive attributes.
C) Assist the client in setting practical limits on expectations for self-standards.
D) Avoid discussions that focus on food and weight.
25.
Clients with eating disorders are generally not aware of how much or how little they are eating because of their altered perception of their bodys size and shape. What intervention by the nurse can assist these clients in recognizing what they are actually eating?
A) Initiate a behavior modification plan with privileges and restrictions based on food intake and weight gain.
B) Remind the client that tube feeding may be employed if nutritional status deteriorates.
C) Monitor vital signs on a regular basis.
D) Maintain a strict intake and output log.
26.
What outcome demonstrates a successful health status for a client with an eating disorder?
A) Absence of previous abnormal physical findings
B) The client embracing a realistic self-image
C) Ability to confront environmental stressors
D) Positive family interactions
27.
The evaluation process for a client with an eating disorder should include what?
A) Progress of the client toward a broader knowledge base
B) Progress of the client toward autonomy
C) Progress of the client toward dependent decision making
D) Progress of the client toward interacting with the family
28.
What would the nurse consider evaluation criteria for psychotherapeutic progress in the client with an eating disorder?
A) The client demonstrates a stable self-image.
B) The client demonstrates stable coping skills.
C) The client embraces a realistic self-image.
D) The client demonstrates an improved sense of dependence.
29.
You are caring for a client with anorexia nervosa, restricting subtype. As you evaluate the plan of care, you note that the client is now able to recognize the relationship between food, eating patterns, and the ill-fated journey of the disorder. You know that for the client to reach this goal, what had to happen?
A) Family relationships have been mended.
B) Reasonable expectations have been met.
C) An understanding of the disease process has been achieved.
D) Guilt and shame over previous behavior have been released.
30.
You are discharging a client home from the eating disorder unit and you provide the client with a referral to a support group. Why is the referral helpful to this client?
A) Aids in the prevention of a relapse
B) Provides support during the easy times
C) Aids in the reinforcement of treatment goals
D) Prevents a return to adaptive eating habits
Answer Key
1.
A
2.
B
3.
D
4.
C
5.
D
6.
A
7.
C
8.
B
9.
C, D, E
10.
C
11.
D
12.
B, C, E
13.
B
14.
B, D, E
15.
D
16.
D
17.
A
18.
B
19.
C
20.
A, C, D
21.
A, B, C
22.
A
23.
B
24.
C
25.
D
26.
A
27.
B
28.
C
29.
D
30.
A
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