Anorexia nervosa
A patient with anorexia nervosa exhibits perfectionism traits, risk aversion, and obsessive adherence to rules. Which of the following subtypes might this patient also exhibit?
A. Rumination subtype
B. Avoidant/restrictive subtype
C. Night eating subtype
D. Binge eating and purging subtype
Answer: D. Binge eating and purging subtype
Rationale: Anorexia nervosa can have a binge eating and purging subtype, in addition to exhibiting perfectionism traits, risk aversion, and obsessive adherence to rules.
A nurse is assessing a patient with avoidant/restrictive food intake disorder. Which of the following symptoms is the nurse likely to observe?
A. Weight gain and increased appetite
B. Weight loss, nutritional deficits, and reliance on supplements
C. Excessive concern about body size and shape
D. Binge eating and purging behaviors
Answer: B. Weight loss, nutritional deficits, and reliance on supplements
Rationale: Avoidant/restrictive food intake disorder is characterized by a lack of interest in food, selective avoidance due to phobia fears, resulting in weight loss, nutritional deficits, and reliance on supplements.
A nurse is assessing a patient with bulimia nervosa. Which question is most important to ask to understand the patient's purging behavior?
A. "How often do you weigh yourself?"
B. "What types of food do you typically binge on?"
C. "What methods do you use to purge after binge eating?"
D. "Do you feel guilty after eating?"
**Answer: C. "What methods do you use to purge after binge eating?"
Rationale: Understanding the methods the patient uses to purge after binge eating is crucial for assessing the severity of the disorder and planning appropriate interventions and treatments.
A patient presents with a history of recurrent episodes of eating large amounts of food rapidly and until uncomfortably full, without engaging in extreme weight control behaviors. The patient often eats alone due to embarrassment and feels disgusted and guilty afterward. Which eating disorder does this describe?
A. Anorexia nervosa
B. Bulimia nervosa
C. Binge eating disorder
D. Avoidant/restrictive food intake disorde
Answer: C. Binge eating disorder
Rationale: Binge eating disorder is characterized by recurrent episodes of eating large amounts of food rapidly until uncomfortably full, feelings of loss of control, marked distress, and eating alone due to embarrassment, without engaging in extreme weight control behaviors.
A patient with severe anorexia nervosa is being treated in an inpatient setting. Which of the following interventions is essential for preventing refeeding syndrome?
A. Gradually increasing caloric intake and monitoring electrolytes
B. Providing unlimited access to high-calorie foods
C. Allowing the patient to eat as much as they want
D. Restricting fluid intake
Answer: A. Gradually increasing caloric intake and monitoring electrolytes
Rationale: Gradually increasing caloric intake and monitoring electrolytes is essential for preventing refeeding syndrome in patients with severe anorexia nervosa.
Which of the following is a defining characteristic of anorexia nervosa?
A. Excessive eating after the evening meal
B. Regurgitation and rechewing of food
C. Distorted body image and low body weight
D. Nighttime binge eating
Answer: C. Distorted body image and low body weight
Rationale: Anorexia nervosa is defined by a distorted body image, cognitive distortions about body size and shape, low body weight, and a fear of gaining weight.
A patient is diagnosed with night eating syndrome. Which of the following behaviors is consistent with this diagnosis?
A. Eating large amounts of food in the evening or upon awakening
B. Avoiding food due to a fear of choking or vomiting
C. Engaging in binge eating and purging behaviors
D. Focusing excessively on body size and shape
Answer: A. Eating large amounts of food in the evening or upon awakening
Rationale: Night eating syndrome involves excessive eating after the evening meal or upon awakening.
A patient with bulimia nervosa often uses enemas as part of their purging behavior. Which complication is most likely to result from this practice?
A. Dehydration and electrolyte imbalances
B. Severe weight loss and malnutrition
C. Hyperglycemia and insulin resistance
D. Increased bone density
Answer: A. Dehydration and electrolyte imbalances
Rationale: The use of enemas as part of purging behavior in bulimia nervosa can lead to dehydration and electrolyte imbalances, which can have serious health consequences.
A nurse is educating a patient with anorexia nervosa about the potential complications of the disorder. Which of the following complications should the nurse include?
A. Hyperthyroidism and increased energy
B. Dental caries and enamel erosion
C. Dry brittle skin and nails, anemia, and heart failure
D. Normal growth and development
Answer: C. Dry brittle skin and nails, anemia, and heart failure
Rationale: Complications of anorexia nervosa include dry brittle skin and nails, anemia, low heart rate, hypotension, dysrhythmia, heart failure, and other severe health issues.
A patient with an eating disorder is placed on purge precautions. Which intervention is most appropriate for this patient?
A. Allowing the patient to use the bathroom immediately after meals
B. Supervising the patient for 1 hour after meals
C. Encouraging the patient to exercise after eating
D. Restricting fluid intake during meals
Answer: B. Supervising the patient for 1 hour after meals
Rationale: Supervising the patient for 1 hour after meals helps prevent purging behaviors, such as vomiting, and is an important aspect of purge precautions.
Which of the following symptoms is least likely to be observed in a patient with avoidant/restrictive food intake disorder?
A. Fear of gaining weight
B. Weight loss
C. Nutritional deficits
D. Reliance on supplements
Answer: A. Fear of gaining weight
Rationale: Fear of gaining weight is not a typical symptom of avoidant/restrictive food intake disorder; it is more associated with anorexia nervosa.
A patient with an eating disorder presents with regurgitation, rechewing, and reswallowing of food. Which eating disorder does this describe?
A. Night eating syndrome
B. Rumination disorder
C. Avoidant/restrictive food intake disorder
D. Anorexia nervosa
Answer: B. Rumination disorder
Rationale: Rumination disorder is characterized by the regurgitation, rechewing, and reswallowing of food.
Which psychological factors are commonly associated with bulimia nervosa?
A. High self-esteem and confidence
B. Pervasive self-hatred, shame, and depressive mood states
C. Fear of gaining weight and obsessive adherence to rules
D. Lack of concern about body shape and weight
Answer: B. Pervasive self-hatred, shame, and depressive mood states
Rationale: Bulimia nervosa is often associated with pervasive self-hatred, shame, and depressive mood states, along with a strong influence of body shape and weight on self-evaluation.
A nurse is conducting an assessment of a patient with binge eating disorder. Which question is most important to ask to understand the patient's eating patterns?
A. "How often do you engage in purging behaviors?"
B. "Do you feel in control of your eating during a binge?"
C. "What types of food do you restrict from your diet?"
D. "Do you avoid social situations involving food?
**Answer: B. "Do you feel in control of your eating during a binge?"
Rationale: Understanding whether the patient feels in control of their eating during a binge is important for assessing the severity of binge eating disorder and planning appropriate interventions.
Which of the following is a key component of cognitive-behavioral therapy (CBT) for eating disorders?
A. Emphasizing rapid weight gain
B. Addressing perfectionism and depression
C. Restricting food intake
D. Administering diuretics to prevent fluid retention
Answer: B. Addressing perfectionism and depression
Rationale: CBT for eating disorders addresses perfectionism and depression, as well as cognitive distortions related to body image and self-worth.
A patient with anorexia nervosa has a cognitive distortion about their body size and shape. Which intervention is most appropriate for addressing this distortion?
A. Encouraging the patient to avoid mirrors
B. Administering antipsychotic medications
C. Cognitive-behavioral therapy (CBT) to address the distortion
D. Providing a high-calorie diet
Answer: C. Cognitive-behavioral therapy (CBT) to address the distortion
Rationale: Cognitive-behavioral therapy (CBT) is effective in addressing cognitive distortions about body size and shape in patients with anorexia nervosa.
A patient presents with atypical eating patterns that do not meet the full criteria for any specific eating disorder diagnosis. How would this be categorized?
A. Anorexia nervosa
B. Unspecified feeding or eating disorder
C. Rumination disorder
D. Avoidant/restrictive food intake disorder
Answer: B. Unspecified feeding or eating disorder
Rationale: Unspecified feeding or eating disorder includes atypical presentations that do not meet the full criteria for any other specific diagnosis.
A nurse is educating a patient about the complications associated with bulimia nervosa. Which of the following complications should the nurse emphasize?
A. Weight gain and obesity
B. Hypertension and diabetes
C. Dental caries and enamel erosion
D. Peripheral neuropathy
Answer: C. Dental caries and enamel erosion
Rationale: Dental caries and enamel erosion are common complications of bulimia nervosa due to the stomach acid exposure from frequent vomiting.
A patient with anorexia nervosa has a body weight less than 85% of the healthy weight for their age and height. What other criteria might indicate the need for hospitalization?
A. Heart rate less than 50 bpm, blood pressure less than 100/70 mmHg
B. Electrolyte imbalance, renal or cardiac impairment, suicidality
C. Increased appetite and hyperactivity
D. Normal vital signs but frequent episodes of binge eating
Answer: B. Electrolyte imbalance, renal or cardiac impairment, suicidality
Rationale: Hospitalization for anorexia nervosa is indicated when there are severe health risks such as electrolyte imbalance, renal or cardiac impairment, suicidality, and other life-threatening conditions.
A nurse is caring for a patient with severe anorexia nervosa who is beginning refeeding. Which of the following is a critical aspect of managing refeeding syndrome?
A. Rapidly increasing calorie intake to restore weight quickly
B. Limiting fluid intake to prevent overload
C. Monitoring and replenishing electrolytes, especially phosphorus
D. Administering diuretics to manage fluid retention
Answer: C. Monitoring and replenishing electrolytes, especially phosphorus
Rationale: Refeeding syndrome is characterized by electrolyte imbalances, particularly hypophosphatemia. Monitoring and replenishing electrolytes, especially phosphorus, is critical to managing refeeding syndrome.
A patient with anorexia nervosa is noted to have a low body weight and a restricted nutritional intake. Which of the following additional traits might the nurse observe?
A. Nighttime binge eating and excessive exercise
B. Perfectionism, risk aversion, and obsessive adherence to rules
C. Regurgitation and rechewing of food
D. Lack of interest in food despite availability
Answer: B. Perfectionism, risk aversion, and obsessive adherence to rules
Rationale: Anorexia nervosa is often associated with traits of perfectionism, risk aversion, and obsessive adherence to rules, along with low body weight and restricted nutritional intake.
A nurse is educating a patient with an unspecified feeding or eating disorder. Which statement is most appropriate?
A. "Your symptoms do not meet the criteria for a specific eating disorder, but they still need treatment."
B. "You do not have an eating disorder because your symptoms are atypical."
C. "Your eating patterns are normal and do not require any intervention."
D. "You should focus on increasing your food intake to address your symptoms."
Answer: A. "Your symptoms do not meet the criteria for a specific eating disorder, but they still need treatment."
Rationale: Unspecified feeding or eating disorder includes atypical presentations that do not meet the full criteria for other specific diagnoses but still require treatment.
A nurse is explaining the binge-purge cycle to a patient with bulimia nervosa. Which of the following best describes this cycle?
A. Strict dieting → Diet slips or difficult situation arises → Binge eating triggered → Purging to avoid weight gain → Feelings of self-hatred and shame
B. Excessive exercise → Binge eating → Strict dieting → Purging to avoid weight gain → Feelings of self-worth
C. Restricting fluid intake → Diet slips → Binge eating → Vomiting → Increased confidence
D. Avoiding social situations → Binge eating → Purging → Increased self-esteem
Answer: A. Strict dieting → Diet slips or difficult situation arises → Binge eating triggered → Purging to avoid weight gain → Feelings of self-hatred and shame
Rationale: The binge-purge cycle in bulimia nervosa typically involves strict dieting, followed by diet slips or difficult situations triggering binge eating, which is then followed by purging to avoid weight gain, and feelings of self-hatred and shame.
A patient with anorexia nervosa has a heart rate of 38 bpm and a blood pressure of 85/55 mmHg. Which of the following interventions is most appropriate?
A. Provide nutritional counseling
B. Initiate a high-calorie diet
C. Hospitalize the patient for stabilization
D. Encourage participation in a support group
Answer: C. Hospitalize the patient for stabilization
Rationale: Hospitalization is indicated for patients with anorexia nervosa when their heart rate is less than 40 bpm, blood pressure is less than 90/60 mmHg, or they have severe electrolyte imbalances, organ impairment, or other life-threatening conditions.
A nurse is setting goals for a patient with an eating disorder. Which of the following goals is the highest priority?
A. Improve self-esteem and body image
B. Stabilize physiological health
C. Educate the patient and family
D. Replace thought distortions with health-promoting ones
Answer: B. Stabilize physiological health
Rationale: Stabilizing physiological health is the highest priority goal for a patient with an eating disorder to ensure the patient's immediate safety and well-being.