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MH 433 Eating disorders

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Nursing Quiz on MH 433 Eating disorders, created by Kristi Breese on 05/12/2016.
Kristi Breese
Quiz by Kristi Breese, updated more than 1 year ago
Kristi Breese
Created by Kristi Breese almost 8 years ago
15
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Resource summary

Question 1

Question
The following are indicative of anorexia. Select all that apply.
Answer
  • Self-induced vomiting
  • Use of laxatives and diuretics
  • Judges self-worth by weight
  • Lanugo
  • Terror of gaining weight
  • Impulsive and compulsive
  • Binge eating
  • Cachetic
  • Peculiar handling of food

Question 2

Question
The following are indicative of bulimia. Select all that apply.
Answer
  • Impulsive and compulsive
  • Anxiety
  • Possible chemical dependency and shoplifting
  • Binge eating followed by purging
  • Depressive signs and symptoms
  • Lanugo
  • Undoes weight after bingeing
  • Terror of gaining weight

Question 3

Question
The cause of eating disorders is varied and complex. Eating disorders include a biological vulnerability or predisposition that is activated by psychological, environmental, and cultural factors.
Answer
  • True
  • False

Question 4

Question
Abnormalities are of the "the chicken or the egg" quality because we are not certain whether they cause the eating disorder or if the eating disorder causes them. Serotonin pathways are abnormal.
Answer
  • Neurobiologic or Neuroendocrine Models
  • Genetic Models
  • Cultural considerations

Question 5

Question
Individuals with eating disorders have a characteristic phenotype: Constellation of personality traits that have been shown to be moderately heritable.
Answer
  • Neurobiologicl or Neuroendocrine Models
  • Genetic Models
  • Psychologic Models

Question 6

Question
Female relatives of people with eating disorders are up to [blank_start]12[blank_end] times more likely to develop them as well.
Answer
  • 12

Question 7

Question
Core characteristics of eating disorders are thought to be low self-esteem and self-doubts about personal worth. Family theorists long believed that specific dynamics converge to create individuals with eating disorders.
Answer
  • Psychologic Models
  • Cultural considerations
  • Genetic Models

Question 8

Question
Eating disorders increase in societies where women have a choice in social roles.
Answer
  • Cultural considerations
  • Neurobiologic or Neuroendocrine Models
  • Psychologic Models

Question 9

Question
People with eating disorders have [blank_start]cognitive distortions[blank_end] that are the result of processing errors in the brain.
Answer
  • cognitive distortions

Question 10

Question
Eating disorders are connected to underlying emotions of:
Answer
  • Anxiety
  • Dysphoria
  • Low self-esteem
  • Feelings of lack of control
  • All of the above

Question 11

Question
Determining which cognitive distortions were present before the eating disorder and which ones are the result of semistarvation is important.
Answer
  • True
  • False

Question 12

Question
Risk factors for an eating disorder include interpersonal factors and social factors.
Answer
  • True
  • False

Question 13

Question
Interpersonal factors include: Select all that apply.
Answer
  • Troubled personal and family interactions
  • Difficulty expressing emotions and feelings
  • History of being teased or ridiculed based on size or weight
  • History of physical, emotional and/or sexual abuse
  • Media influence
  • "War on obesity"

Question 14

Question
Social factors include: Select all that apply.
Answer
  • Media influence
  • High focus on physical attributes
  • Occupational influence (sports/performing arts)
  • "War on obesity"
  • Acceptance of normative discontent and dieting as an accepted lifestyle choice
  • Troubled personal and family interactions
  • History of being teased or ridiculed based on size or weight

Question 15

Question
Signs and symptoms of an eating disorder include: Dramatic weight loss in a relatively short period of time Obsession with weight, calories, fat, food groups, exercise, recipes, cooking for others Frequent sore throats, swollen glands, and/or headaches Frequent trips to the bathroom after meals (often run water to mask sound) Isolation when eating Unusual eating habits (i.e cutting up food in tiny pieces, over-seasoning food, spitting out food, lots of water, small bites) Low self-esteem Constantly feeling cold Mood swings Hiding/stealing food Insomnia
Answer
  • True
  • False

Question 16

Question
Anorexia nervosa appears in
Answer
  • early to middle adolescence
  • late adolescence
  • adulthood

Question 17

Question
Bulimia nervosa appears in
Answer
  • early to middle adolescence
  • late adolescence
  • adulthood

Question 18

Question
For women aged 35-65 years, changes in appearance and role can potentially increase the risk of developing an eating disorder.
Answer
  • True
  • False

Question 19

Question
Eating disorders are almost never co-morbid with other psychiatric illnesses.
Answer
  • True
  • False

Question 20

Question
What are some assessment findings in anorexia nervosa? Select all that apply.
Answer
  • High suicide rate - Highest mortality rate of all DSM diagnoses
  • Refusal to maintain body weight above 85% of ideal
  • Intense fear of gaining weight
  • Body image distortion or denial of seriousness of low weight
  • Amenorrhea for three months
  • Two types: restricting or purging
  • Normal weight or overweight
  • High blood pressure
  • Sore throat

Question 21

Question
What are some assessment findings in bulimia nervosa? Select all that apply
Answer
  • Normal weight or overweight
  • High blood pressure
  • Swollen glands/Sore throat
  • Dental erosions and staining
  • Scars on knuckles of hands
  • Edema/Extremity weakness
  • Potential for gastric rupture during bingeing
  • Inflammation and possible rupture of esophagus
  • Electrolyte imbalance
  • Refusal to maintain body weight above 85% of ideal

Question 22

Question
What does the clinical picture of anorexia nervosa look like?
Answer
  • Orthostatic changes, bradycardia, cardiac murmur, sudden cardiac arrest
  • Prolonged QT interval, acrocyanosis, symptomatic hypotension, leukopenia, lymphocytosis, carotenemia
  • Hypokalemic alkalosis, electrolyte imbalances, osteoporosis, fatty degeneration of liver, elevated cholesterol levels
  • Amenorrhea, abnormal thyroid functioning, hematuria, proteinuria
  • All of the above

Question 23

Question
Refeeding syndrome is a potentially fatal shift in fluids and electrolytes that may occur due to prolonged malnourishment.
Answer
  • True
  • False

Question 24

Question
How does refeeding syndrome happen?
Answer
  • Despite food deprivation, body attempts to achieve homeostasis by essentially starving the cells of fluids and electrolytes in an effort to keep blood levels normal. Metabolism slows down to make the minimal nutrients in the body last as long as possible.
  • Once food is introduced back in the system, system is overloaded. Starved cells rapidly absorb water and electrolytes (Ph, K+, Mg2+) causing shift in fluid and electrolyte imbalance.
  • How the heck do I know?

Question 25

Question
How do we prevent refeeding syndrome?
Answer
  • Reintroduce food slowly and gradually
  • Assess cardiovascular status
  • Let the patient eat and drink as much as they want in one setting
  • By coloring pretty pictures

Question 26

Question
Refeeding syndrome is potentially fatal.
Answer
  • True
  • False

Question 27

Question
Why do we care about refeeding syndrome?
Answer
  • Abnormal sodium and fluid balance. Changes in glucose, protein and fat metabolism, thiamine deficiency, hypokalemia, hypomagnesaemia
  • Result is possible fluid overload, congestive cardiac failure, pulmonary edema, and cardiac arrhythmia
  • Because we were told to care

Question 28

Question
Characteristics of bulimia nervosa are: -Recurrent binge episodes (consumption of large amounts of food with loss of control) -Recurrent use of inappropriate behaviors to prevent weight gain (vomiting, laxatives, diuretics, exercise, diet pills) -Both bingeing and purging occur, on average, two times weekly for three months -Self-evaluation influenced by weight/shape
Answer
  • True
  • False

Question 29

Question
The clinical picture of bulimia nervosa looks like
Answer
  • Cardiomyopathy (ipecac toxicity), cardiac dysrhythmias, sinus bradycardia, sudden cardia arrest, orthostatic changes in pulse and blood pressure
  • Electrolyte imbalance, metabolic acidosis, hypochloremia, hypokalemia, dehydration and renal loss of potassium as a result of self-induced vomiting
  • Attrition and erosion of teeth, loss of dental arch, diminished chewing ability, parotic gland enlargement
  • Esophageal tears as a result of self-induced vomiting, gastric dilation, Russell sign
  • All of the above

Question 30

Question
Nursing care of patients with eating disorders include:
Answer
  • Assess for suicidal thoughts and self-injurious behaviors.
  • Acknowledge emotional and physical difficulties.
  • Monitor physiologic parameters (e.g., vital signs, electrolyte levels).
  • Weigh the patient using strict protocol.
  • Monitor during and after meals to prevent the throwing away or purging of food.
  • Recognize the patient’s distorted image and value of body shape.
  • Educate the patient regarding the ill effects of low weight and impaired health.
  • Assist in identifying strengths.
  • All of the above

Question 31

Question
Planning care in the acute phase of anorexia nervosa includes: Select all that apply.
Answer
  • Intensive care unit (ICU), critical care unit (CCU), ED unit (crisis state)
  • Establishment of trust
  • Monitoring of weight and eating
  • Countering distorted ideas
  • Milieu therapy, counseling, health teaching, and medications
  • Patient privileges linked to treatment plan compliance

Question 32

Question
Possible long-term treatment for anorexia nervosa includes
Answer
  • Periodic brief hospital stays
  • Outpatient psychotherapy
  • Medications
  • All of the above

Question 33

Question
Planning care in the acute phase of bulimia nervosa includes: Select all that apply.
Answer
  • Patient is admitted into an inpatient unit.
  • CBT is highly effective.
  • Binge and purge cycle is interrupted.
  • Eating habits are normalized.
  • Underlying conflicts and distortions are examined.
  • Co-morbid depression and substance abuse are treated.

Question 34

Question
For patient with bulimia nervosa, the patient is referred for long term care on discharge to solidify goals and to address attitudes and perceptions that maintain the eating disorder. Also, the patient and family benefit from connecting with the national network and often, psychotherapy is performed.
Answer
  • True
  • False

Question 35

Question
Evidence based research suggests multi-disciplinary approach to be the least effective form of treating for an eating disorder.
Answer
  • True
  • False

Question 36

Question
Treatment of eating disorders include: select all that apply
Answer
  • Milieu therapy
  • Health teaching
  • Health promotion
  • Singing songs
  • Psychotherapy
  • Cognitive Behavioral therapy (CBT) and dialectal-behavior therapy (DBT)
  • Psychodynamic therapy
  • Group and family therapy
  • Going to fat camp

Question 37

Question
What are some guidelines when communicating with a patient with an eating disorder?
Answer
  • Understand that the patient may feel shame and totally out of control.
  • Therapeutic alliance empathizes with the feelings of low self-esteem, unworthiness, and dysphoria.
  • Nurse may suspect dishonesty when the patient does not report bingeing and/or purging.
  • Accepting, having a nonjudgmental approach, and understanding the subjective experience of the patient will help build trust.
  • With bulimia, be aware that the patient is sensitive to the perceptions of others
  • Yelling, screaming, and telling the patient they are worthless

Question 38

Question
Long-term outpatient treatment helps patients: -maintain health weight -with individual, family, group therapy, psychopharmacology, and nutrition counseling -address depression, substance abuse, and/or personality disorders that interfere with quality of life
Answer
  • True
  • False

Question 39

Question
Self-worth and interpersonal functioning aren't issues that are useful to target
Answer
  • True
  • False

Question 40

Question
Which of the following is an example of all-or-nothing thinking, which is a frequent cognitive distortion of patients with an ED?
Answer
  • “If I allow myself to gain weight, I’ll be huge.”
  • “I’m unpopular because I’m fat.”
  • “When I’m thin, I’m powerful.”
  • “When people say I look better, they’re really thinking I look fat.”

Question 41

Question
Typical goals of inpatient hospitalization for a patient with anorexia do not include which of the following?
Answer
  • Stabilization of the patient’s immediate condition
  • Limited weight restoration
  • Determination of the causes for the ED
  • Restoration of normal electrolyte balance

Question 42

Question
Which medication is likely to be used in the treatment of patients with EDs?
Answer
  • SSRI, such as fluoxetine
  • Antipsychotic medication, such as risperidone
  • Anxiolytic medication, such as alprazolam
  • Anticonvulsant agent, such as carbamazepine
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