Chapter 21 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 21

Question 1

Type: MCSA

A client with an eating disorder is in the demographic group that represents those at highest risk for developing an eating disorder. The client is a/an:

1. Male.

2. Older adult.

3. Child.

4. Female.

Correct Answer: 4

Rationale 1: Clinical eating disorders are more commonly seen among females, with estimates of a malefemale ratio ranging from 1:6 to 1:10. However, screening and prevention programs should be aimed at adolescents and youth of all sexual orientations, ethnicities, and cultural groups as the Western shift toward glamorizing thinness is now being seen cross-culturally and is rising in young males, but is still outnumbered by 1:61:10 for males to females.

Rationale 2: Clinical eating disorders are more commonly seen among females, with estimates of a malefemale ratio ranging from 1:6 to 1:10. However, screening and prevention programs should be aimed at adolescents and youth of all sexual orientations, ethnicities, and cultural groups as the Western shift toward glamorizing thinness is now being seen cross-culturally and is rising in young males, but is still outnumbered by 1:61:10 for males to females.

Rationale 3: Clinical eating disorders are more commonly seen among females, with estimates of a malefemale ratio ranging from 1:6 to 1:10. However, screening and prevention programs should be aimed at adolescents and youth of all sexual orientations, ethnicities, and cultural groups as the Western shift toward glamorizing thinness is now being seen cross-culturally and is rising in young males, but is still outnumbered by 1:61:10 for males to females.

Rationale 4: Clinical eating disorders are more commonly seen among females, with estimates of a malefemale ratio ranging from 1:6 to 1:10. However, screening and prevention programs should be aimed at adolescents and youth of all sexual orientations, ethnicities, and cultural groups as the Western shift toward glamorizing thinness is now being seen cross-culturally and is rising in young males, but is still outnumbered by 1:61:10 for males to females.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the roles of culture and biology in the development of eating disorders.

Question 2

Type: MCSA

Which of the following groups is more accepting of the way they look which may serve as a protective factor against the development of eating disorders?

1. Asian Americans

2. Homosexual males

3. Latino women

4. African American women

Correct Answer: 4

Rationale 1: Current literature suggests that African American womens perception of beauty is less media-driven than that of their peers. African American women and men are more accepting about higher weights and body image.

Rationale 2: Current literature suggests that African American womens perception of beauty is less media-driven than that of their peers. African American women and men are more accepting about higher weights and body image.

Rationale 3: Current literature suggests that African American womens perception of beauty is less media-driven than that of their peers. African American women and men are more accepting about higher weights and body image.

Rationale 4: Current literature suggests that African American womens perception of beauty is less media-driven than that of their peers. African American women and men are more accepting about higher weights and body image.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the roles of culture and biology in the development of eating disorders.

Question 3

Type: MCMA

Which of the following neurotransmitters affect eating disorders?

Standard Text: Select all that apply.

1. Neuropeptide Y

2. Dopamine

3. Acetylcholine

4. Serotonin

5. Norepinephrine

Correct Answer: 1,2,4,5

Rationale 1: Neuropeptide Y increases eating behavior.

Rationale 2: Dopamine suppresses food intake.

Rationale 3: Acetylcholine stimulates the parasympathetic nervous system, thereby balancing thermoregulation, water intake, and motor function. There is no direct link to appetite/satiety or increased metabolic function.

Rationale 4: Serotonin decreases a persons satiety and thereby increases food intake.

Rationale 5: Norepinephrine increases eating behavior.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the roles of culture and biology in the development of eating disorders.

Question 4

Type: MCSA

Which of the following must the nurse consider when deciding appropriate boundaries for the client with eating disorders and their family members?

1. Family members of clients with anorexia become enmeshed

2. Family members of clients with bulimia are overly affectionate

3. Family members of individuals with bulimia tend to bond together

4. Family members of clients with anorexia are usually very autonomous

Correct Answer: 1

Rationale 1: Families of clients with anorexia become enmeshed: that is, the boundaries between the members are weak, interactions are intense, dependency on one another is high, and autonomy is minimal. Families of individuals with bulimia tend to isolate and are not overly affectionate.

Rationale 2: Families of clients with anorexia become enmeshed: that is, the boundaries between the members are weak, interactions are intense, dependency on one another is high, and autonomy is minimal. Families of individuals with bulimia tend to isolate and are not overly affectionate.

Rationale 3: Families of clients with anorexia become enmeshed: that is, the boundaries between the members are weak, interactions are intense, dependency on one another is high, and autonomy is minimal. Families of individuals with bulimia tend to isolate and are not overly affectionate.

Rationale 4: Families of clients with anorexia become enmeshed: that is, the boundaries between the members are weak, interactions are intense, dependency on one another is high, and autonomy is minimal. Families of individuals with bulimia tend to isolate and are not overly affectionate.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Compare and contrast the various theories for the causes of eating disorders.

Question 5

Type: MCSA

The most appropriate intervention for the nurse to use when integrating cognitive behavioral approaches into therapy for clients with bulimia nervosa is:

1. Individual interventions.

2. Behavior modification.

3. Family groups.

4. Client education.

Correct Answer: 4

Rationale 1: Education about the psychology of compulsive behavior and the physiologic effects of starvation and purging behaviors is usually incorporated into therapy. Cognitive behavioral education includes teaching new ways of thinking about issues, paired with new activities and behaviors to try. Behavior modification, family groups, and individual interventions may be included in client education.

Rationale 2: Education about the psychology of compulsive behavior and the physiologic effects of starvation and purging behaviors is usually incorporated into therapy. Cognitive behavioral education includes teaching new ways of thinking about issues, paired with new activities and behaviors to try. Behavior modification, family groups, and individual interventions may be included in client education.

Rationale 3: Education about the psychology of compulsive behavior and the physiologic effects of starvation and purging behaviors is usually incorporated into therapy. Cognitive behavioral education includes teaching new ways of thinking about issues, paired with new activities and behaviors to try. Behavior modification, family groups, and individual interventions may be included in client education.

Rationale 4: Education about the psychology of compulsive behavior and the physiologic effects of starvation and purging behaviors is usually incorporated into therapy. Cognitive behavioral education includes teaching new ways of thinking about issues, paired with new activities and behaviors to try. Behavior modification, family groups, and individual interventions may be included in client education.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Compare and contrast the various theories for the causes of eating disorders.

Question 6

Type: MCSA

From a psychoanalytic perspective, eating disorders are related to:

1. Conscious intrapersonal and interpersonal conflict.

2. Learned behavior regarding the affect of food.

3. Disturbance in the body system.

4. Regression to pubertal conflicts and repudiation of developing sexuality.

Correct Answer: 4

Rationale 1: Psychoanalytic theory considers eating disorders to be systematic of unconscious conflicts. Psychoanalytic theory relates eating disorders to regression to prepuberty and repudiation of developing sexuality. Clients with anorexia are hypothesized to fear sexual maturity and the budding physical changes that accompany puberty.

Rationale 2: Psychoanalytic theory considers eating disorders to be systematic of unconscious conflicts. Psychoanalytic theory relates eating disorders to regression to prepuberty and repudiation of developing sexuality. Clients with anorexia are hypothesized to fear sexual maturity and the budding physical changes that accompany puberty.

Rationale 3: Psychoanalytic theory considers eating disorders to be systematic of unconscious conflicts. Psychoanalytic theory relates eating disorders to regression to prepuberty and repudiation of developing sexuality. Clients with anorexia are hypothesized to fear sexual maturity and the budding physical changes that accompany puberty.

Rationale 4: Psychoanalytic theory considers eating disorders to be systematic of unconscious conflicts. Psychoanalytic theory relates eating disorders to regression to prepuberty and repudiation of developing sexuality. Clients with anorexia are hypothesized to fear sexual maturity and the budding physical changes that accompany puberty.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the various theories for the causes of eating disorders.

Question 7

Type: MCSA

Since purging and excessive exercise are not features of binge-eating disorders, these individuals often become:

1. Anorexic.

2. Emaciated.

3. Hungry.

4. Obese.

Correct Answer: 4

Rationale 1: Binge-eating disorder clients are almost universally obese, which is defined as having body weight that exceeds, by 30%, the recommended weight on standard weight and height tables. Clients who binge-eat are less likely to become anorexic, hungry, or emaciated.

Rationale 2: Binge-eating disorder clients are almost universally obese, which is defined as having body weight that exceeds, by 30%, the recommended weight on standard weight and height tables. Clients who binge-eat are less likely to become anorexic, hungry, or emaciated.

Rationale 3: Binge-eating disorder clients are almost universally obese, which is defined as having body weight that exceeds, by 30%, the recommended weight on standard weight and height tables. Clients who binge-eat are less likely to become anorexic, hungry, or emaciated.

Rationale 4: Binge-eating disorder clients are almost universally obese, which is defined as having body weight that exceeds, by 30%, the recommended weight on standard weight and height tables. Clients who binge-eat are less likely to become anorexic, hungry, or emaciated.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the various theories for the causes of eating disorders.

Question 8

Type: MCSA

To which of the following information sources for the client with an eating disorder should the nurse limit exposure because of the many societal influences on perceptions of attractiveness?

1. Information about coping behaviors

2. Articles about eating disorders

3. Programs that emphasize good nutrition

4. Media that glamorizes thinness

Correct Answer: 4

Rationale 1: Attractiveness is strongly equated with thinness, which is frequently glamorized in the media. Articles about eating disorders, programs that emphasize good nutrition, and information about coping behaviors would be beneficial to the client.

Rationale 2: Attractiveness is strongly equated with thinness, which is frequently glamorized in the media. Articles about eating disorders, programs that emphasize good nutrition, and information about coping behaviors would be beneficial to the client.

Rationale 3: Attractiveness is strongly equated with thinness, which is frequently glamorized in the media. Articles about eating disorders, programs that emphasize good nutrition, and information about coping behaviors would be beneficial to the client.

Rationale 4: Attractiveness is strongly equated with thinness, which is frequently glamorized in the media. Articles about eating disorders, programs that emphasize good nutrition, and information about coping behaviors would be beneficial to the client.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Illustrate how psychological and social pressures can influence the course of eating disorders.

Question 9

Type: MCSA

The nurse is assessing a male client who is suspected of having an eating disorder. What additional information should the nurse include in her assessment of this client?

1. Use of anabolic steroids

2. Relationship with family

3. Ethnic origin

4. History of illegal substance use

Correct Answer: 1

Rationale 1: It is common to see males with eating disorders use anabolic steroids to improve muscle tone and build strength. Ethnic origin, family relationships, and illegal substance use are not as commonly assessed.

Rationale 2: It is common to see males with eating disorders use anabolic steroids to improve muscle tone and build strength. Ethnic origin, family relationships, and illegal substance use are not as commonly assessed.

Rationale 3: It is common to see males with eating disorders use anabolic steroids to improve muscle tone and build strength. Ethnic origin, family relationships, and illegal substance use are not as commonly assessed.

Rationale 4: It is common to see males with eating disorders use anabolic steroids to improve muscle tone and build strength. Ethnic origin, family relationships, and illegal substance use are not as commonly assessed.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Illustrate how psychological and social pressures can influence the course of eating disorders.

Question 10

Type: MCSA

Which of the following behaviors should the nurse anticipate in the client with anorexia nervosa?

1. Positive self-image

2. Constant over-eating

3. Obsessive rituals

4. Little anxiety regarding food

Correct Answer: 3

Rationale 1: To control themselves and their environment, these individuals develop rigid rules. The rigidity often develops into obsessive rituals, particularly concerning eating and exercise.

Rationale 2: To control themselves and their environment, these individuals develop rigid rules. The rigidity often develops into obsessive rituals, particularly concerning eating and exercise.

Rationale 3: To control themselves and their environment, these individuals develop rigid rules. The rigidity often develops into obsessive rituals, particularly concerning eating and exercise.

Rationale 4: To control themselves and their environment, these individuals develop rigid rules. The rigidity often develops into obsessive rituals, particularly concerning eating and exercise.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Assess individual and family problems of clients with eating disorders.

Question 11

Type: MCSA

When assessing the client with dramatic weight loss or gain, the nurse should consider:

1. The focus of the assessment must be on the psychological findings.

2. There is usually a direct cause and effect.

3. The focus of the assessment must be on the physical findings.

4. Both can be caused by physical or mental conditions.

Correct Answer: 4

Rationale 1: Certain illnesses must be ruled out before an eating disorder diagnosis can be made. The cause of the eating disorder is often physical and psychological in nature. There may or may not be a direct cause and effect.

Rationale 2: Certain illnesses must be ruled out before an eating disorder diagnosis can be made. The cause of the eating disorder is often physical and psychological in nature. There may or may not be a direct cause and effect.

Rationale 3: Certain illnesses must be ruled out before an eating disorder diagnosis can be made. The cause of the eating disorder is often physical and psychological in nature. There may or may not be a direct cause and effect.

Rationale 4: Certain illnesses must be ruled out before an eating disorder diagnosis can be made. The cause of the eating disorder is often physical and psychological in nature. There may or may not be a direct cause and effect.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Assess individual and family problems of clients with eating disorders.

Question 12

Type: MCSA

Which of the following physical manifestations would the nurse expect in a client who is emaciated, has sunken eyes, and a skeletal appearance?

1. Tachycardia, arrhythmia, dry skin

2. Tachycardia, hypotension, and edema

3. Bradycardia, hypotension, arrhythmia

4. Bradycardia, hypertension, alopecia

Correct Answer: 3

Rationale 1: Physical symptoms include bradycardia, hypotension, arrhythmias, delayed gastric motility, and hypothyroid-like state. The symptoms of bradycardia and arrhythmias are what increase risk of death in individuals with anorexia. Tachycardia, hypertension, alopecia, and dry skin would not necessarily be expected in this client.

Rationale 2: Physical symptoms include bradycardia, hypotension, arrhythmias, delayed gastric motility, and hypothyroid-like state. The symptoms of bradycardia and arrhythmias are what increase risk of death in individuals with anorexia. Tachycardia, hypertension, alopecia, and dry skin would not necessarily be expected in this client.

Rationale 3: Physical symptoms include bradycardia, hypotension, arrhythmias, delayed gastric motility, and hypothyroid-like state. The symptoms of bradycardia and arrhythmias are what increase risk of death in individuals with anorexia. Tachycardia, hypertension, alopecia, and dry skin would not necessarily be expected in this client.

Rationale 4: Physical symptoms include bradycardia, hypotension, arrhythmias, delayed gastric motility, and hypothyroid-like state. The symptoms of bradycardia and arrhythmias are what increase risk of death in individuals with anorexia. Tachycardia, hypertension, alopecia, and dry skin would not necessarily be expected in this client.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Assess individual and family problems of clients with eating disorders.

Question 13

Type: MCSA

Which of the following questions would the nurse ask the client when assessing for a common condition thought to relate to the degree of stress that occurs with anorexia nervosa?

1. Has your hair been falling out?

2. Do you exercise after eating?

3. Has your menstrual period stopped?

4. Are you purging after you eat?

Correct Answer: 3

Rationale 1: Amenorrhea is very common and is thought to relate to the degree of stress the person is experiencing. Purging after eating, losing hair, or exercising are not related to the degree of stress that occurs from anorexia nervosa.

Rationale 2: Amenorrhea is very common and is thought to relate to the degree of stress the person is experiencing. Purging after eating, losing hair, or exercising are not related to the degree of stress that occurs from anorexia nervosa.

Rationale 3: Amenorrhea is very common and is thought to relate to the degree of stress the person is experiencing. Purging after eating, losing hair, or exercising are not related to the degree of stress that occurs from anorexia nervosa.

Rationale 4: Amenorrhea is very common and is thought to relate to the degree of stress the person is experiencing. Purging after eating, losing hair, or exercising are not related to the degree of stress that occurs from anorexia nervosa.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Assess individual and family problems of clients with eating disorders.

Question 14

Type: MCSA

Which of the following physical findings would lead the nurse to suspect that the client has bulimia nervosa?

1. A skeletal appearance

2. Lanugo growth on face and extremities

3. Abrasions and calluses on the knuckles

4. Sunken eyes

Correct Answer: 3

Rationale 1: Physical findings include abrasions and calluses on the knuckles, called Russells sign, from self-inducing vomiting. Sunken eyes, skeletal appearance, and lanugo growth are more commonly related to anorexia nervosa.

Rationale 2: Physical findings include abrasions and calluses on the knuckles, called Russells sign, from self-inducing vomiting. Sunken eyes, skeletal appearance, and lanugo growth are more commonly related to anorexia nervosa.

Rationale 3: Physical findings include abrasions and calluses on the knuckles, called Russells sign, from self-inducing vomiting. Sunken eyes, skeletal appearance, and lanugo growth are more commonly related to anorexia nervosa.

Rationale 4: Physical findings include abrasions and calluses on the knuckles, called Russells sign, from self-inducing vomiting. Sunken eyes, skeletal appearance, and lanugo growth are more commonly related to anorexia nervosa.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Assess individual and family problems of clients with eating disorders.

Question 15

Type: MCSA

Which of the following physical findings regarding the clients weight is consistent with binge-eating disorders?

1. The client is usually of normal or slightly above average weight.

2. Weight tends to fluctuate but is generally low.

3. All of the clients are overweight.

4. The client is generally underweight.

Correct Answer: 1

Rationale 1: The client is usually of normal or slightly above average weight, and some binge-eaters are obese. Appearance does not provide diagnostic clues, hence the term normal-weight bulimic.

Rationale 2: The client is usually of normal or slightly above average weight, and some binge-eaters are obese. Appearance does not provide diagnostic clues, hence the term normal-weight bulimic.

Rationale 3: The client is usually of normal or slightly above average weight, and some binge-eaters are obese. Appearance does not provide diagnostic clues, hence the term normal-weight bulimic.

Rationale 4: The client is usually of normal or slightly above average weight, and some binge-eaters are obese. Appearance does not provide diagnostic clues, hence the term normal-weight bulimic.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Assess individual and family problems of clients with eating disorders.

Question 16

Type: MCSA

A client with an eating disorder is trying to develop new coping skills. The process the nurse can use to help family members as they support the client is to:

1. Assist the family to explore their own coping strategies.

2. Encourage the family to avoid discussing their feelings about the clients illness.

3. Assist the family to challenge the clients behavior.

4. Teach the family how to manipulate the clients environment to avoid problem situations.

Correct Answer: 1

Rationale 1: Assist and encourage the family members to explore together their usual coping strategies to determine if any previously used strategies can be useful in the present situation, and identify those mechanisms, that may contribute to further dysfunction. It is not therapeutic to encourage the family to avoid discussion of feelings or be manipulative. The family should be supportive rather than challenging.

Rationale 2: Assist and encourage the family members to explore together their usual coping strategies to determine if any previously used strategies can be useful in the present situation, and identify those mechanisms, that may contribute to further dysfunction. It is not therapeutic to encourage the family to avoid discussion of feelings or be manipulative. The family should be supportive rather than challenging.

Rationale 3: Assist and encourage the family members to explore together their usual coping strategies to determine if any previously used strategies can be useful in the present situation, and identify those mechanisms, that may contribute to further dysfunction. It is not therapeutic to encourage the family to avoid discussion of feelings or be manipulative. The family should be supportive rather than challenging.

Rationale 4: Assist and encourage the family members to explore together their usual coping strategies to determine if any previously used strategies can be useful in the present situation, and identify those mechanisms, that may contribute to further dysfunction. It is not therapeutic to encourage the family to avoid discussion of feelings or be manipulative. The family should be supportive rather than challenging.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Partner with clients and their families in both the prevention and treatment of eating disorders.

Question 17

Type: MCSA

What factor contributes to a poor outcome for clients with anorexia nervosa?

1. Treatment approaches are fragmented and controversial.

2. The client with anorexia nervosa actively resents or refuses treatment.

3. There is no cure for anorexia nervosa.

4. Changes in the clients behavior are irreversible.

Correct Answer: 2

Rationale 1: The quest for thinness is the focus for clients with anorexia nervosa. These clients resent the attempts of others to influence them. They experience extreme denial that they have a problem and, therefore, they resist treatment. It is not true that changes in the clients behavior are irreversible or that anorexia is not curable. The treatment approach is not the predominant contributor to a poor outcome.

Rationale 2: The quest for thinness is the focus for clients with anorexia nervosa. These clients resent the attempts of others to influence them. They experience extreme denial that they have a problem and, therefore, they resist treatment. It is not true that changes in the clients behavior are irreversible or that anorexia is not curable. The treatment approach is not the predominant contributor to a poor outcome.

Rationale 3: The quest for thinness is the focus for clients with anorexia nervosa. These clients resent the attempts of others to influence them. They experience extreme denial that they have a problem and, therefore, they resist treatment. It is not true that changes in the clients behavior are irreversible or that anorexia is not curable. The treatment approach is not the predominant contributor to a poor outcome.

Rationale 4: The quest for thinness is the focus for clients with anorexia nervosa. These clients resent the attempts of others to influence them. They experience extreme denial that they have a problem and, therefore, they resist treatment. It is not true that changes in the clients behavior are irreversible or that anorexia is not curable. The treatment approach is not the predominant contributor to a poor outcome.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Formulate intermediate goals in the treatment of clients with eating disorders.

Question 18

Type: MCSA

Despite the fact that the patient is 56 and weighs 72 lbs, the patient reported feeling fat and overweight. What is the most appropriate nursing diagnosis for this patient?

1. Chronic Low Self-Esteem

2. Ineffective Coping

3. Altered Nutrition

4. Body Image Disturbance

Correct Answer: 4

Rationale 1: Clients with anorexia nervosa are unable to make realistic appraisal of their own body size, although they can accurately evaluate the size of others. They drastically overestimate their own body size. Altered Nutrition, Low Self-Esteem, and Ineffective Coping are not appropriate diagnoses.

Rationale 2: Clients with anorexia nervosa are unable to make realistic appraisal of their own body size, although they can accurately evaluate the size of others. They drastically overestimate their own body size. Altered Nutrition, Low Self-Esteem, and Ineffective Coping are not appropriate diagnoses.

Rationale 3: Clients with anorexia nervosa are unable to make realistic appraisal of their own body size, although they can accurately evaluate the size of others. They drastically overestimate their own body size. Altered nutrition, low self-esteem, and ineffective coping are not appropriate diagnoses.

Rationale 4: Clients with anorexia nervosa are unable to make realistic appraisal of their own body size, although they can accurately evaluate the size of others. They drastically overestimate their own body size. Altered Nutrition, Low Self-Esteem, and Ineffective Coping are not appropriate diagnoses.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Formulate intermediate goals in the treatment of clients with eating disorders.

Question 19

Type: MCSA

The client with binge-eating disorder reports a lack of involvement in activities, loss of interest in self-care activities, and oversleeping. The clients speech is filled with despondency. What nursing diagnosis is most appropriate for this client?

1. Hopelessness

2. Anxiety

3. Social Isolation

4. Knowledge Deficit

Correct Answer: 1

Rationale 1: Clients who compulsively overeat frequently experience feelings of hopelessness related to repeated failure to lose weight or to control their eating behavior. The client should be screened for depression, anxiety, and other comorbid psychological disorders. There is no data in the scenario to suggest a diagnosis of Anxiety, Knowledge Deficit, or Social Isolation.

Rationale 2: Clients who compulsively overeat frequently experience feelings of hopelessness related to repeated failure to lose weight or to control their eating behavior. The client should be screened for depression, anxiety, and other comorbid psychological disorders. There is no data in the scenario to suggest a diagnosis of Anxiety, Knowledge Deficit, or Social Isolation.

Rationale 3: Clients who compulsively overeat frequently experience feelings of hopelessness related to repeated failure to lose weight or to control their eating behavior. The client should be screened for depression, anxiety, and other comorbid psychological disorders. There is no data in the scenario to suggest a diagnosis of Anxiety, Knowledge Deficit, or Social Isolation.

Rationale 4: Clients who compulsively overeat frequently experience feelings of hopelessness related to repeated failure to lose weight or to control their eating behavior. The client should be screened for depression, anxiety, and other comorbid psychological disorders. There is no data in the scenario to suggest a diagnosis of Anxiety, Knowledge Deficit, or Social Isolation.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Formulate intermediate goals in the treatment of clients with eating disorders.

Question 20

Type: MCSA

Which medication should the nurse expect to administer to the client with bulimia nervosa?

1. Prozac

2. Prolixin

3. Benadryl

4. Ritalin

Correct Answer: 1

Rationale 1: Prozac (fluoxetine), an SSRI, is effective for clients with bulimia when given at the higher dose of 50 to 60 mg per day. Benadryl, Ritalin, and Prolixin are not first-line medications for clients with bulimia nervosa.

Rationale 2: Prozac (fluoxetine), an SSRI, is effective for clients with bulimia when given at the higher dose of 50 to 60 mg per day. Benadryl, Ritalin, and Prolixin are not first-line medications for clients with bulimia nervosa.

Rationale 3: Prozac (fluoxetine), an SSRI, is effective for clients with bulimia when given at the higher dose of 50 to 60 mg per day. Benadryl, Ritalin, and Prolixin are not first-line medications for clients with bulimia nervosa.

Rationale 4: Prozac (fluoxetine), an SSRI, is effective for clients with bulimia when given at the higher dose of 50 to 60 mg per day. Benadryl, Ritalin, and Prolixin are not first-line medications for clients with bulimia nervosa.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Formulate intermediate goals in the treatment of clients with eating disorders.

Question 21

Type: MCMA

What are suggested outcomes for the nursing diagnosis of Ineffective Individual Coping for a client with anorexia nervosa?

Standard Text: Select all that apply.

1. Actions to manage stressors that tax an individuals resources

2. Ability to self-restrain altered perceptions

3. Ability to self-restrain compulsive or impulsive behaviors

4. Ability to acquire, organize, and use information

5. Adequate nutrients taken into the body

Correct Answer: 1,3,4

Rationale 1: Actions to manage stressors that tax an individuals resources relates to coping, which is a NOC outcome related to Ineffective Individual Coping.

Rationale 2: Ability to self-restrain altered perceptions relates to Disturbed Body Image.

Rationale 3: Ability to self-restrain compulsive or impulsive behaviors relates to impulse control, which is a NOC outcome related to Ineffective Individual Coping.

Rationale 4: Ability to acquire, organize, and use information relates to information process, which is a NOC outcome related to Ineffective Individual Coping.

Rationale 5: Adequate nutrients taken into the body relates to Imbalanced Nutrition.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Formulate intermediate goals in the treatment of clients with eating disorders.

Question 22

Type: MCSA

The client with bulimia is experiencing anxiety. What action should the nurse take to assist the client to avoid binge eating and purging in response to the anxiety?

1. Assume a matter-of-fact attitude and positive expectations of the client.

2. Project a calm reassuring attitude and provide a quiet non-stimulating environment.

3. Contract for safety since the client is likely to engage in self-injurious behavior.

4. Maintain total control of the environment and project an attitude of authority.

Correct Answer: 2

Rationale 1: The goal is to assist the client to recognize events creating anxiety and to cope with them. A calm environment will decrease anxiety-producing situations. There is no indication the client is in imminent danger of self-harm. Projecting an attitude of authority or setting expectations may increase the clients anxiety.

Rationale 2: The goal is to assist the client to recognize events creating anxiety and to cope with them. A calm environment will decrease anxiety-producing situations. There is no indication the client is in imminent danger of self-harm. Projecting an attitude of authority or setting expectations may increase the clients anxiety.

Rationale 3: The goal is to assist the client to recognize events creating anxiety and to cope with them. A calm environment will decrease anxiety-producing situations. There is no indication the client is in imminent danger of self-harm. Projecting an attitude of authority or setting expectations may increase the clients anxiety.

Rationale 4: The goal is to assist the client to recognize events creating anxiety and to cope with them. A calm environment will decrease anxiety-producing situations. There is no indication the client is in imminent danger of self-harm. Projecting an attitude of authority or setting expectations may increase the clients anxiety.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Create a nursing plan of care for clients with eating disorders and their families.

Question 23

Type: MCSA

The client is diagnosed with bulimia nervosa. What is the most appropriate nursing intervention that focuses on purging behaviors?

1. Provide frequent small meals.

2. Weigh the client after eating.

3. Observe the client for at least one hour after meals.

4. Have the nurse eat with the client.

Correct Answer: 3

Rationale 1: Observe the client for at least one hour after meals to prevent purging. Eating with the client, weighing the client after eating, or providing frequent meals are not as effective as observation after meals.

Rationale 2: Observe the client for at least one hour after meals to prevent purging. Eating with the client, weighing the client after eating, or providing frequent meals are not as effective as observation after meals.

Rationale 3: Observe the client for at least one hour after meals to prevent purging. Eating with the client, weighing the client after eating, or providing frequent meals are not as effective as observation after meals.

Rationale 4: Observe the client for at least one hour after meals to prevent purging. Eating with the client, weighing the client after eating, or providing frequent meals are not as effective as observation after meals.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Create a nursing plan of care for clients with eating disorders and their families.

Question 24

Type: MCSA

An adolescent student tells the nurse, I lost ten pounds in the last three months. I believe I have anorexia. The nurses response should be based on the following understanding:

1. Since the student is willing to talk about the issue, the student is probably not anorexic.

2. The student may be anorexic if the weight loss has lead to maintenance body weight less than 85% of the expected.

3. The student is not anorexic because the students physical development has not been affected by nutritional status.

4. There is cause for alarm since most adolescent females experience anorexia.

Correct Answer: 2

Rationale 1: Weight loss leading to maintenance body weight less than 85% of the expected is part of the DSM-lV-TR Diagnostic Criteria for anorexia nervosa. Most adolescent females do not experience anorexia. The students willingness to talk about the issue does not mean the student is not anorexic. There is no information about the students physical development in the scenario.

Rationale 2: Weight loss leading to maintenance body weight less than 85% of the expected is part of the DSM-lV-TR Diagnostic Criteria for anorexia nervosa. Most adolescent females do not experience anorexia. The students willingness to talk about the issue does not mean the student is not anorexic. There is no information about the students physical development in the scenario.

Rationale 3: Weight loss leading to maintenance body weight less than 85% of the expected is part of the DSM-lV-TR Diagnostic Criteria for anorexia nervosa. Most adolescent females do not experience anorexia. The students willingness to talk about the issue does not mean the student is not anorexic. There is no information about the students physical development in the scenario.

Rationale 4: Weight loss leading to maintenance body weight less than 85% of the expected is part of the DSM-lV-TR Diagnostic Criteria for anorexia nervosa. Most adolescent females do not experience anorexia. The students willingness to talk about the issue does not mean the student is not anorexic. There is no information about the students physical development in the scenario.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Create a nursing plan of care for clients with eating disorders and their families.

Question 25

Type: MCSA

Which of the following interventions might facilitate the nurses understanding of how clients with eating disorders view their bodies?

1. Observe the clients interactions with other clients with eating disorders.

2. Assess the clients response to limit setting when eating.

3. Discuss the importance of food and exercise in maintaining body image.

4. Ask the clients to draw a picture of themselves as they are now and as they desire to be.

Correct Answer: 4

Rationale 1: Self-portraits give the nurse insight into the clients perception of their body image. Discussing the importance of food, observing the clients interactions with other clients, or response to limit setting when eating, is not as helpful as understanding how the clients see themselves.

Rationale 2: Self-portraits give the nurse insight into the clients perception of their body image. Discussing the importance of food, observing the clients interactions with other clients, or response to limit setting when eating, is not as helpful as understanding how the clients see themselves.

Rationale 3: Self-portraits give the nurse insight into the clients perception of their body image. Discussing the importance of food, observing the clients interactions with other clients, or response to limit setting when eating, is not as helpful as understanding how the clients see themselves.

Rationale 4: Self-portraits give the nurse insight into the clients perception of their body image. Discussing the importance of food, observing the clients interactions with other clients, or response to limit setting when eating, is not as helpful as understanding how the clients see themselves.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Create a nursing plan of care for clients with eating disorders and their families.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

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