Chapter 18: Eating Disorders My Nursing Test Banks

Chapter 18: Eating Disorders

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Which of the following are generally NOT associated with bulimia nervosa?

A.

Starvation

B.

Depression

C.

Erosion of teeth

D.

Sore throat

____ 2. Which statement is most true about anorexia nervosa?

A.

It is only found in females.

B.

A major symptom is loss of appetite.

C.

Overuse of laxatives is a common symptom.

D.

All of the above

____ 3. Your patient with anorexia nervosa is in the bathroom running in place at a rapid rate. What is the most likely reason for this behavior?

A.

She recently ate and wants to work off the calories to avoid gaining weight.

B.

She wants her heart rate increased so you will think she is having heart problems.

C.

She is a regular exerciser for good health.

D.

She is depressed and hopes this will make her feel more alert.

____ 4. How should you respond to the above patient?

A.

Encourage her to finish her exercise session.

B.

Interrupt her and have her weighed immediately.

C.

Tell her she is not allowed to exercise.

D.

Interrupt her and encourage her to take a walk with you.

____ 5. Which of the following is NOT a characteristic of a patient with anorexia nervosa?

A.

Male

B.

Slightly overweight

C.

Anxious

D.

Perfectionistic

____ 6. Which of the following interventions applies to all eating disorders?

A.

Encourage patients to identify the thoughts and feelings associated with eating.

B.

Do a strict intake, output, and calorie count for each shift.

C.

Keep patients in view for 1 to 2 hours after meals.

D.

Have a staff person monitoring each table during meals.

____ 7. Your first goal in the care of a patient with an eating disorder is:

A.

Reassure the patient that he or she is attractive.

B.

Teach the patient nutrition requirements for his or her age and height.

C.

Establish a trusting relationship with the patient.

D.

Ask the patient to explain why he or she will not eat.

____ 8. An appropriate goal for a patient who is on behavior modification for anorexia nervosa is:

A.

Gain 2 pounds per week.

B.

Eat all food at each meal.

C.

Discuss the meaning of food to the patient for 1 hour every day.

D.

Gain as much weight as possible in the first month of treatment to prevent serious complications of starvation.

____ 9. Mark is a male model who has been admitted for weight loss and dehydration. Mark tells you, I can eat anything I want and I dont gain weight. Isnt that great? After dinner you hear a noise and you observe Mark vomiting in the bathroom. You document this and suspect:

A.

Food poisoning.

B.

Anorexia nervosa.

C.

Bulimia nervosa.

D.

Bipolar disorder.

____ 10. Nurses know that the main difference between anorexia nervosa and bulimia nervosa is that the patient with bulimia nervosa:

A.

Is morbidly obese.

B.

Eats and purges in secret to keep the problem hidden.

C.

Gets pleasure from being able to control the urge to eat.

D.

Meal time is more stressful.

____ 11. A 14-year-old patient is diagnosed with anorexia nervosa. Nurses know this disorder is most associated with:

A.

Poor parenting.

B.

Anger at parents.

C.

Low self-esteem.

D.

Distorted body image.

____ 12. Rob, a 15-year-old, has lost 30 pounds in 3 months. Rob is 6 feet tall and weighs 110 pounds. He is aspiring to be a model and he tells you that he is fat: Just look at how puffy my feet and arms still are. I have to get rid of the fat there. The nursing diagnosis based on this information is:

A.

Body image disturbance: distorted perception.

B.

Knowledge deficit: nutritional requirements.

C.

Altered nutrition, more than body requirements.

D.

Potential for suicide.

____ 13. Nurses realize the importance of family relationships in the life of a patient with anorexia nervosa. As a nurse, you would expect which of the following attitudes or behaviors in the parents of an adolescent with anorexia nervosa?

A.

Indifferent and inattentive

B.

Permissive and providing loose boundaries

C.

Immature and concerned with themselves

D.

Perfectionistic and overly demanding

____ 14. When preparing a therapeutic milieu for a patient who has bulimia nervosa, the nurse should provide:

A.

Realistic limits and guidelines on behavior after eating.

B.

A strict regimen of activities to ease the patients anxiety.

C.

Constant focus on the correct type and amount of food to instill adequate nutrition.

D.

Sympathy for the patients condition.

____ 15. A 15-year-old female is 15 pounds underweight. She believes she is grossly overweight and exercises vigorously daily. She is a straight-A student in school and is the lead singer in her school choir and musical theater group. She is well liked by adults but has few friends her own age. Your nursing assessment of this patient leads you to the potential diagnosis of:

A.

Social anxiety disorder.

B.

Paranoid schizophrenia.

C.

Generalized anxiety disorder.

D.

Eating disorder.

____ 16. In addition to gastrointestinal disorders associated with eating disorders, nurses must be aware of and assess for other medical complications including:

A.

Electrolyte imbalances.

B.

Cardiac irregularities.

C.

Dehydration.

D.

All of the above.

____ 17. Ana is admitted to the medical surgical floor for severe weight loss. Her diagnosis is anorexia nervosa. She is 16 and looks about 8. Her daily intake is about eight cans of diet soda. Your initial nursing goal is:

A.

Establish trust.

B.

Request nutritional supplements from Dietary.

C.

Explore with her the rationale for refusing to eat.

D.

B and C

____ 18. As a nurse, you understand that anorexia nervosa in adolescents may be related to:

A.

Poor self-esteem.

B.

Fear of moving into adulthood.

C.

Anger at parents.

D.

A desire to die.

____ 19. Morbid obesity is defined as:

A.

Body weight over 200 pounds no matter how tall the person is.

B.

Body mass index (BMI) over 30.

C.

Whatever is determined by the individuals physician.

D.

BMI over 35.

____ 20. What do the initials BMI stand for?

A.

Basal metabolic inhibitor

B.

Body mass index

C.

Bodys metabolic index

D.

Basic mass indicator

____ 21. Bariatric surgery is now an accepted treatment for people with which of the following?

A.

Poor body image

B.

BMI over 40

C.

Untreatable bulimia

D.

BMI of 25 with diabetes

____ 22. Of the following observations, which is the most objective measure of improvement in your patient with anorexia nervosa?

A.

She eats all of her food on the tray at lunch.

B.

She gains 2 pounds from last week.

C.

She weighs herself daily.

D.

She tells you her friends are bringing her special foods.

Chapter 18: Eating Disorders

Answer Section

MULTIPLE CHOICE

1. ANS: A

Starvation is associated with anorexia nervosa. In bulimia nervosa, the patient is eating large amounts and then purging.

PTS: 1

REF: Chapter 18: Eating Disorders; Box 18-2, Behaviors, Signs, and Symptoms of Bulimia; page 291

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

2. ANS: C

Laxative abuse is often part of purging behaviors to promote weight loss. The disorder is found in men, and patients are often hungry while denying themselves food.

PTS: 1 REF: Chapter 18: Eating Disorders; Anorexia Nervosa; page 287-288

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts

3. ANS: A

Excessive exercise is a common behavior used by anorexics to purge calories after eating.

PTS: 1

REF: Chapter 18: Eating Disorders; Box 18-1, Behaviors, Signs and Symptoms of anorexia nervosa; page 288

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

4. ANS: D

Excessive exercise is not healthy in this patient. By encouraging her to walk with you, you are distracting her from this compulsion to exercise.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295

KEY: Integrated Processes: Nursing Process: Analysis/implementation | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

5. ANS: B

Anorexic patients are generally severely underweight, can be male or female, anxious, and perfectionistic. They would not be overweight.

PTS: 1 REF: Chapter 18: Eating Disorders; Anorexia Nervosa; page 288

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts

6. ANS: A

As a general rule, eating disorders are associated with anxiety around meal time, so understanding thoughts and feelings associated with food is important for treatment. The other interventions may be needed for some patients at times, but not for all.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

7. ANS: C

Establishing trust is key to the ongoing relationship. Response A is false reassurance. Response B is unrelated to the patients emotional issues. In response D the patient may not be aware of the etiology.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295

KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Establishing priorities

8. ANS: A

Slow, steady weight gain is associated with good outcomes physically and emotionally. Eating all food at each meal is unrealistic. The meaning of food would be difficult to discuss for the patient. This disorder has nothing to do with cooking techniques.

PTS: 1 REF: Chapter 18: Eating Disorders; Treatment of Anorexia Nervosa; page 289

KEY: Integrated Processes: Nursing Process: Analysis/planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Management of care: Establishing priorities

9. ANS: C

Bulimia nervosa is known to be common in men and women who feel pressure to keep their weight at a certain level. Self-induced vomiting is a frequent method of purging food.

PTS: 1 REF: Chapter 18: Eating Disorders; Bulimia; page 290

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

10. ANS: B

Bulimia nervosa is a secretive disorder where the individual is often normal weight or slightly overweight and binges and purges in secret. Pleasure from controlling the urge to eat is associated with anorexia nervosa. Meal time is stressful for other disorders. .

PTS: 1

REF: Chapter 18: Eating Disorders; Table 18-1, Comparison of anorexia nervosa and bulimia; page 292

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

11. ANS: D

Though responses A, B, and C may be present, distorted body image is the primary disturbance.

PTS: 1 REF: Chapter 18: Eating Disorders; Etiology of Anorexia Nervosa; page 289

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts

12. ANS: A

The patients view of self as fat indicates a distorted body image. This has nothing to do with knowledge about nutrition. Suicide is generally not viewed as a motivation in self-starvation.

PTS: 1

REF: Chapter 18: Eating Disorders; Nursing care of patients with eating disorders; page 292

KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

13. ANS: D

The parents of an adolescent with anorexia nervosa have often set very high standards that the child fears cannot be met.

PTS: 1 REF: Chapter 18: Eating Disorders; Anorexia Nervosa Etiology; page 289

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

14. ANS: A

Establishing realistic limits will give the patient a sense of control over his or her urge to binge and purge.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295

KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic environment

15. ANS: D

These are the classic symptoms for anorexia nervosa.

PTS: 1

REF: Chapter 18: Eating Disorders; Box 18-1, Behaviors, signs and symptoms of anorexia nervosa; page 288

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts

16. ANS: D

All of these responses are associated with anorexia nervosa and bulimia nervosa.

PTS: 1

REF: Chapter 18: Eating Disorders; Treatment of Anorexia Nervosa; page 289 and Treatment of Bulimia; page 291

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Physiological adaptation: Illness management

17. ANS: A

Though your first impulse might be one of the other responses, establishing trust is the initial goal.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295

KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

18. ANS: B

Anorexia nervosa is often associated with an unconscious fear of moving into adolescence and adulthood.

PTS: 1 REF: Chapter 18: Eating Disorders; Anorexia Nervosa Etiology; page 289

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

19. ANS: D

BMI of 35 takes into account height and weight. BMI of 30 is considered obese.

PTS: 1 REF: Chapter 18: Eating Disorders; Morbid Obesity; page 292

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders: Child, adolescent, adult health | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance

20. ANS: B

BMI is an approximation of body fat based on a calculation of weight divided by the square of ones height in adults.

PTS: 1 REF: Chapter 18: Eating Disorders; Morbid Obesity; page 292

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Child, adolescent, adult health | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance

21. ANS: B

BMI of 40 is generally accepted, though BMI of 35 with major health complications such as diabetes is also standard.

PTS: 1 REF: Chapter 18: Eating Disorders; Treatment of Morbid Obesity; page 293-294

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Child, adolescent, adult health | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance

22. ANS: B

Response B is the most objective to indicate improvement with an anorexia nervosa patient. Response A is a one-time observation, response C could be anxiety behavior, and response D could have many meanings.

PTS: 1

REF: Chapter 18: Eating Disorders; Anorexia Nervosa; Treatment of anorexia nervosa; page 289

KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

Leave a Reply