Chapter 23 Eating Disorders

Chapter 23  Eating Disorders

Complete Chapter Questions And Answers
 

Sample Questions

Implementation of the nursing treatment plan for the client with bulimia may include which of the following?
A)
Increasing coping skills for anxiety
B)
Teaching good eating habits
C)
Encouraging isolation from peers for a time
D)
Meeting dependency needs
Ans:
A

Feedback:

Since clients with bulimia experience high anxiety levels and use the binge-purge cycle as a coping mechanism, increasing coping skills for anxiety is a high priority nursing intervention. The focus of treatment should be the underlying anxiety in specific situations instead of teaching about eating habits. Since the client already tends to isolate when bingeing and purging, increasing involvement with others would be a positive treatment modality. Meeting dependency needs is nontherapeutic; the nurse does not need to rescue the client but rather to teach the client to be less helpless.

2.
When working with the client with bulimia, the nurse should be aware that the nurse’s own feelings and needs may affect care. Feelings that may be aroused in the nurse may include what?
A)
Depression
B)
Anxiety
C)
Control
D)
Dependency
Ans:
C

Feedback:

Often, nurses feel the need to offer control for a client who is helpless in controlling food, anxiety, and life. This client should not evoke feelings of depression any more than any other client should. The client is likely to experience an accompanying depressed state. Although anxiety may arise in the nurse, this is not the best answer. The client is likely to be dependent in this hospital setting. Control or rescue issues are more likely to surface in the nurse.

3.
The reason why obesity is not categorized as an eating disorder in the DSM-IV-TR is what?
A)
Obesity is not treatable with psychotropic medications.
B)
Obesity is caused by the individual’s lack of will power.
C)
Obesity is not considered a health risk to the extent that would qualify it for diagnosis.
D)
Obesity is not associated consistently with any particular psychological or behavioral syndrome.
Ans:
D

Feedback:

The DSM-IV-TR does not identify obesity as a psychiatric diagnosis. Obesity is considered to be a general medical condition because a consistent association with a psychological or behavioral syndrome has not been established. When there is evidence that psychological factors are of importance in the etiology or course of a particular case of obesity, the diagnosis is listed under psychological factors affecting medical condition.

4.
The client with bulimia complains of feeling helpless and having a black future and says, “What’s the use?” As the nurse plans the client’s care, the most important priority diagnosis based on these data is what?
A)
Ineffective individual coping
B)
Anxiety
C)
Nutrition that is less than body requirements
D)
Risk for self-directed violence
Ans:
D

Feedback:

Ineffective individual coping is a very likely diagnosis, but this is not the priority diagnosis. Although anxiety is a factor in this illness, the data do not support this diagnosis. The diagnosis of altered nutrition does not directly address the patient’s current status. The verbalized helpless feelings, the use of the term black future, and the hopeless comment of “What’s the use?” may very likely support risk for suicide. Depression is often present in the client with bulimia; therefore, suicide potential should be addressed.

5.
A college student has been referred to the college clinic for evaluation for anorexia nervosa. The nursing assessment to substantiate this disorder should include what?
A)
Onset of symptoms in early adolescence
B)
Body weight significantly below ideal for her height and age
C)
Temper tantrums and sleep disturbance
D)
Oily skin and acne
Ans:
B

Feedback:

Diagnosis of anorexia nervosa is made if the client’s weight is 15% below ideal weight for age and height. Onset of symptoms may occur in early adolescence, but not always. Temper tantrums do not characterize anorexia nervosa. Skin is usually dry and flaky.