Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. She wears layered, loose clothing and now has amenorrhea. Her current weight is 95 pounds, a loss of 35 pounds. Which medical diagnosis is most likely?
Anorexia nervosa
Binge eating disorder
Bulimia nervosa
Disturbed body image is the nursing diagnosis for a patient diagnosed with an eating disorder. Which outcome indicator is most appropriate to monitor?
Weight reaches the established normal range for the patient.
Patient expresses satisfaction with body appearance.
Calorie intake is within the required parameters of the treatment plan.
A patient who is referred to the eating disorders clinic has lost 35 pounds in the past 3 months. To assess the patient’s oral intake, the nurse should ask:
“What do you eat in a typical day?”
“Who plans the family meals?”
“Do you often feel fat?”
A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and has lost 25% of body weight. A nurse asks, “Describe what you think about your present weight and how you look.” Which response by the patient is most consistent with the diagnosis?
I am fat and ugly.”
“What I think about myself is my business.”
. “I am grossly underweight, but that’s what I want.”
A patient was diagnosed with anorexia nervosa. The history shows the patient virtually stopped eating 5 months ago and has lost 25% of body weight. The patient’s current serum potassium is 2.7 mg/dl. Which nursing diagnosis applies?
Imbalanced nutrition: less than body requirements, related to malnutrition as evidenced by loss of 25% of body weight and hypokalemia
. Ineffective health maintenance, related to self-induced vomiting as evidenced by swollen parotid glands and hyperkalemia
Disturbed energy field, related to physical exertion in excess of energy produced through caloric intake as evidenced by weight loss and hyperkalemia
Outpatient treatment is planned for a patient diagnosed with anorexia nervosa. Select the most important outcome related to the nursing diagnosis: Imbalanced nutrition: less than body requirements. Within 1 week, the patient will:
gain 1 to 2 pounds.
select clothing that fits properly.
weigh self accurately using balanced scales.
Which nursing intervention has priority as a patient diagnosed with anorexia nervosa begins to gain weight?
Observe for adverse effects of re-feeding.
Assess for depression and anxiety.
Communicate empathy for the patient’s feelings.
A patient diagnosed with anorexia nervosa is resistant to weight gain. What is the rationale for establishing a contract with the patient to participate in measures designed to produce a specified weekly weight gain?
Patient involvement in decision-making increases a sense of control and promotes compliance with the treatment.
Because severe anxiety concerning eating is expected, objective and subjective data must be routinely collected.
A team approach to planning the diet ensures that physical and emotional needs of the patient are met.
The nursing care plan for a patient diagnosed with anorexia nervosa includes the intervention “Monitor for complications of re-feeding.” Which body system should a nurse closely monitor for dysfunction?
Cardiovascular
central nervous system
endocrine
A psychiatric clinical nurse specialist uses cognitive therapy techniques with a patient diagnosed with anorexia nervosa. Which statement by the staff nurse supports this type of therapy?
“Being thin does not seem to solve your problems. You are thin now but still unhappy.”
“It must be difficult to talk about private matters to someone you just met.”
“You seem to feel much better about yourself when you eat something.”
An appropriate intervention for a patient diagnosed with bulimia nervosa who binges and purges is to teach the patient to:
avoid skipping meals or restricting food.
eat a small meal after purging.
concentrate oral intake after 4 PM daily.
What behavior by a nurse caring for a patient diagnosed with an eating disorder indicates the nurse needs supervision?
The nurse uses an authoritarian manner when interacting with the patient.
The nurse’s comments are nonjudgmental.
The nurse teaches the patient to recognize signs of increasing anxiety and ways to intervene.
A nursing diagnosis for a patient diagnosed with bulimia nervosa is: Ineffective coping, related to feelings of loneliness as evidenced by overeating to comfort self, followed by self-induced vomiting. The best outcome related to this diagnosis is, “Within 2 weeks the patient will:
. identify two alternative methods of coping with loneliness.”
verbalize the importance of eating a balanced diet.”
verbalize two positive things about self.”
Which nursing intervention has the highest priority for a patient diagnosed with bulimia nervosa?
. Assist the patient to identify triggers to binge eating.
Provide corrective consequences for weight loss.
Explore patient needs for health teaching.
One bed is available on the inpatient eating disorders unit. Which patient should be admitted? The patient whose weight dropped from
150 to 100 pounds over a 4-month period. Vital signs: temperature, 35.9° C; pulse, 38 beats/min; blood pressure, 60/40 mm Hg
120 to 90 pounds over a 3-month period. Vital signs: temperature, 36° C; pulse, 50 beats/min; blood pressure, 70/50 mm Hg
110 to 70 pounds over a 4-month period. Vital signs: temperature, 36.5° C; pulse, 60 beats/min; blood pressure, 80/66 mm Hg
While providing health teaching for a patient diagnosed with bulimia nervosa, a nurse should emphasize information about:
recognizing symptoms of hypokalemia.
. self-esteem maintenance.
establishing the desired daily weight gain.
As a patient admitted to the eating disorders unit undresses, a nurse observes that the patient’s body is covered by fine, downy hair. The patient weighs 70 pounds and is 5 feet, 4 inches tall. Which condition should be documented?
Lanugo
stupor
aleopeica
A patient being admitted to the eating disorders unit has a yellow cast to the skin and fine, downy hair covering the body. The patient weighs 70 pounds; height is 5 feet, 4 inches. The patient is quiet and says only, “I won’t eat until I look thin.” What is the priority initial nursing diagnosis?
Imbalanced nutrition: less than body requirements, related to self-starvation
Ineffective coping, related to lack of conflict resolution skills
Disturbed body image, related to weight loss
A nurse conducting group therapy on the eating disorders unit schedules the sessions immediately after meals for the primary purpose of:
processing the heightened anxiety associated with eating.
focusing on weight control mechanisms and food preparation.
shifting the patients’ focus from food to psychotherapy.
Physical assessment of a patient diagnosed with bulimia nervosa often reveals:
prominent parotid glands.
peripheral edema.
thin, brittle, hair
Which personality characteristic is a nurse most likely to assess in a patient diagnosed with anorexia nervosa?
Rigidity, perfectionism
carefree, flexibiility
Open displays of emotion
Which assessment finding for a patient diagnosed with an eating disorder meets a criterion for hospitalization?
Systolic blood pressure: 62 mm Hg
Serum potassium: 3.4 mEq/L
Pulse rate: 58 beats/min
Which statement is a nurse most likely to hear from a patient diagnosed with anorexia nervosa?
“I would be happy if I could lose 20 more pounds.”
My parents don’t pay much attention to me.”
“I’m thin for my height.”
Which nursing diagnosis is more applicable for a patient diagnosed with anorexia nervosa who restricts intake and is 20% below normal weight than for a 130-pound patient diagnosed with bulimia nervosa who purges?
Imbalanced nutrition: less than body requirements
disturbed body image
ineffective coping
An outpatient diagnosed with anorexia nervosa has begun re-feeding. Between the first and second appointments, the patient gained 8 pounds. The nurse should:
assess lung sounds and extremities.
suggest the use of an aerobic exercise program.
positively reinforce the patient for the weight gain.
. When a nurse finds a patient diagnosed with anorexia nervosa vigorously exercising before gaining the agreed-upon weekly weight, the nurse should state:
According to our agreement, no exercising is permitted until you have gained a specific amount of weight.”
“Let’s discuss the relationship between exercise and weight loss and how that affects your body.”
“It bothers me to see you exercising. You’ll lose more weight.”
A patient diagnosed with anorexia nervosa has a body mass index (BMI) of 14.8 kg/m2. Which assessment finding is most likely to accompany this value?
Cachexia
Leukocytosis
Hyperthermia
A patient referred to the eating disorders clinic has lost 35 pounds in 3 months and has developed amenorrhea. For which physical manifestations of anorexia nervosa should a nurse assess? Select all that apply.
Peripheral edema
Parotid swelling
hypertension
constipation
dental caries
luango
A patient diagnosed with anorexia nervosa is hospitalized for treatment. What features should the milieu provide? Select all that apply.
. Flexible mealtimes
unscheduled weight checks
adherance to a selected menu
Observation during and after meals
monitoring during bathroom trips
Privileges correlated with emotional expression
