Question 1

A 16-year-old girl with a history of anorexia nervosa is admitted to the hospital with bradycardia, hypotension, and electrolyte imbalances. Which of the following interventions should be the nurse’s priority? A. Implementing behavioral contracts for weight gain B. Monitoring vital signs and electrolyte levels C. Encouraging participation in group therapy sessions D. Supervising meals and bathroom visits E. Administering antidepressant medication as prescribed

Correct Answer: B. Monitoring vital signs and electrolyte levels

Rationale: In a patient with anorexia nervosa, especially with signs of bradycardia, hypotension, and electrolyte imbalances, the priority is to monitor vital signs and electrolyte levels to prevent life-threatening complications such as cardiac arrhythmias or seizures. Behavioral contracts, therapy, supervised meals, and medication are important but secondary to stabilizing the patient’s physical condition.

Question 2

During an assessment of a 19-year-old female patient with anorexia nervosa, which of the following findings would the nurse expect? A. Increased body temperature B. Lanugo hair C. Hypertension D. Edema E. Polyuria

Correct Answer: B. Lanugo hair

Rationale: Lanugo hair is a fine, downy hair that develops on the face and body of individuals with anorexia nervosa as a physiological response to maintain body heat due to significant weight loss and decreased body fat. The other options are not typically associated with anorexia nervosa. Hypertension, edema, and polyuria are not common findings and increased body temperature contradicts the usual hypothermic state due to reduced metabolism.

Question 3

A nurse is planning care for a client diagnosed with anorexia nervosa. Which of the following goals is most appropriate for the initial stage of treatment? A. The client will express satisfaction with body image. B. The client will gain 2 to 3 pounds per week. C. The client will identify healthy coping mechanisms. D. The client will participate in group therapy sessions. E. The client will demonstrate an understanding of the nutritional value of food.

Correct Answer: B. The client will gain 2 to 3 pounds per week.

Rationale: For a client with anorexia nervosa, the most immediate concern is to address the physical health risks associated with severe weight loss and malnutrition. Therefore, a realistic and measurable goal such as gaining 2 to 3 pounds per week is appropriate for the initial stage of treatment. While addressing body image, identifying healthy coping mechanisms, participating in therapy, and understanding nutritional value are important long-term goals, they are secondary to stabilizing the client’s physical health.

Question 4

A nurse is conducting a health education session about anorexia nervosa at a local high school. Which of the following statements by a student would indicate a need for further teaching? A. “People with anorexia often have a distorted body image.” B. “Anorexia can lead to severe health issues like heart problems.” C. “Laxative abuse is a common method used to lose weight in anorexia.” D. “Anorexia is primarily a problem with food and eating habits.” E. “Men cannot develop anorexia; it’s a female disorder.”

Correct Answer: E. “Men cannot develop anorexia; it’s a female disorder.”

Rationale: This statement indicates a misunderstanding and a need for further teaching. Anorexia nervosa can affect individuals of any gender. While it is more commonly diagnosed in females, males can and do suffer from anorexia as well. This misconception may prevent males with anorexia from seeking help due to stigma or the belief that they cannot have an eating disorder.

Question 5

The nurse is providing discharge teaching for a client recovering from anorexia nervosa. Which of the following statements made by the client indicates an understanding of the discharge instructions? A. “I should avoid exercise until reaching a healthy weight.” B. “I will plan all meals in advance to avoid anxiety about eating.” C. “I must weigh myself daily to ensure I am maintaining my weight.” D. “It’s okay to skip meals if I’m not hungry.” E. “I will follow up with my healthcare provider as scheduled and attend all therapy sessions.”

Correct Answer: E. “I will follow up with my healthcare provider as scheduled and attend all therapy sessions.”

Rationale: This statement indicates an understanding of the importance of ongoing medical supervision and psychological support in the recovery from anorexia nervosa. Regular follow-ups with healthcare providers and participation in therapy sessions are crucial for monitoring health status, providing support, and addressing underlying psychological issues. The other statements indicate potential misunderstandings about healthy recovery practices.

Question 6

A nurse is assessing a client with anorexia nervosa. Which of the following symptoms would the nurse expect to find? (Select all that apply.) A. Bradycardia B. Warm, flushed skin C. Amenorrhea D. High blood pressure E. Dry, brittle hair

Correct Answers: A. Bradycardia, C. Amenorrhea, E. Dry, brittle hair

Rationale: Bradycardia, amenorrhea, and dry, brittle hair are common findings in individuals with anorexia nervosa due to malnutrition and the body’s adaptation to a state of starvation. Warm, flushed skin and high blood pressure are not typically associated with anorexia nervosa.

Question 7

A client with anorexia nervosa makes a statement about body image. Which of the following responses by the nurse is most therapeutic? A. “Why do you think you’re overweight when you’re clearly underweight?” B. “Let’s focus on how you feel inside rather than on your external appearance.” C. “Most people are not satisfied with their body image; you’re not alone.” D. “You must eat more to gain weight and improve your health.” E. “It’s all in your mind; you just need to stop thinking that way.”

Correct Answer: B. “Let’s focus on how you feel inside rather than on your external appearance.”

Rationale: This response is therapeutic because it shifts the focus from external appearance to internal feelings, recognizing the complexity of anorexia nervosa as a disorder that involves emotional and psychological factors, not just physical appearance. It encourages the client to explore and discuss their feelings in a supportive environment. The other responses may seem dismissive, confrontational, or oversimplify the disorder.

Question 8

A nurse is preparing a care plan for a client with anorexia nervosa. Which of the following interventions should be included to address the risk of impaired skin integrity? A. Apply moisturizer to dry areas of the skin. B. Encourage intake of high-calorie meals. C. Monitor for signs of infection in pressure areas. D. Provide supplements high in protein. E. Schedule regular weight checks.

Correct Answer: A. Apply moisturizer to dry areas of the skin.

Rationale: Applying moisturizer to dry areas can help maintain skin integrity for a client with anorexia nervosa, who may have dry, brittle skin due to malnutrition. While encouraging high-calorie meals, monitoring for infections, providing protein supplements, and scheduling weight checks are important, they do not directly address the immediate risk of impaired skin integrity as effectively as moisturizing does.

Question 9

A client diagnosed with anorexia nervosa is being treated in an outpatient setting. Which of the following outcomes indicates progress in treatment? A. The client strictly adheres to a self-imposed calorie limit. B. The client verbalizes understanding of the consequences of anorexia. C. The client exercises for 30 minutes daily. D. The client skips breakfast to save calories for dinner. E. The client has a decreased preoccupation with body weight and shape.

Correct Answer: E. The client has a decreased preoccupation with body weight and shape.

Rationale: A decreased preoccupation with body weight and shape is a positive indication of progress in the treatment of anorexia nervosa. It suggests a shift away from the obsessive thoughts that typically characterize the disorder towards a healthier perspective on body image and eating. Strict calorie limits, excessive exercise, and skipping meals to save calories are behaviors associated with anorexia that indicate a need for further intervention.

Question 10

When teaching a client recovering from anorexia nervosa about healthy eating habits, which of the following guidelines should the nurse include? A. Avoid all fats and sugars in the diet. B. Eat only when hungry and stop when full. C. Follow a strict meal plan with predetermined calories. D. Include a variety of foods from all food groups. E. Limit fluid intake during meals.

Correct Answer: D. Include a variety of foods from all food groups.

Rationale: Encouraging the inclusion of a variety of foods from all food groups helps ensure that the client receives a balanced diet, providing essential nutrients needed for recovery and long-term health. Avoiding all fats and sugars, eating only when hungry, following a strict calorie meal plan, and limiting fluid intake may perpetuate disordered eating patterns and do not promote a healthy relationship with food.