C HAPTER 18: E ATING AND F EEDING
D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. A nurse provides care for an adolescent client diagnosed with an eating
disorder. Which behavior by this nurse indicates that additional clinical
supervision is needed?
a. The nurse interacts with the client in a protective fashion.
b. The nurse’s comments to the client are compassionate and
nonjudgmental.
c. The nurse teaches the client to recognize signs of increasing anxiet y
and ways to intervene.
d. The nurse refers the client to a self -help group for individuals with
eating disorders.
ANS: A
In the effort t o motivate the client and take advantage of the decision
to seek help and be healthier, the nurse must take care not to cross the
line toward authoritarianism and assumption of a parental role.
Protective behaviors are part of the parent’s role. The helpfu l nurse
uses a problem-solving approach and focuses on the client’s feelings of
shame and low self -esteem. Referring a client to a self -help group is an
appropriate intervention.
, PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: E valuation MSC: Client Needs:
Psychosocial Integrity
2. A nursing diagnosis for a client diagnosed with bulimia nervosa is
Ineffective coping related to feelings of loneliness as evidenced by
overeating to comfort self, followed by self -induced vomiting. What is the
best outcome related to this diagnosis that should be achieved within 2
weeks?
a. appropriatel y expressing angry feelings.
b. verbalizing two positive things about self.
c. verbalizing the importance of eating a balanced diet.
d. identifying two alternative m ethods of coping with loneliness.
ANS: D
The outcome of identifying alternative coping strategies is most
directl y related to the diagnosis of Ineffective coping. Verbalizing
positive characteristics of self and verbalizing the importance of eating
a balanced diet are outcomes that might be used for other nursing
diagnoses. Appropriatel y expressing angry feelings is not measurable.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Outcomes Identification MSC:
Client Needs: Psychos ocial Integrit y
3. Which nursing intervention has the highest priorit y for a client diagnosed
with bulimia nervosa?
a. Assist the client to identify triggers to binge eating.
b. Provide corrective consequences for weight loss.
, c. Assess for signs of impulsive eating.
d. Explore needs for health teaching.
ANS: A
For most clients with bulimia nervosa, certain situations trigger the
urge to binge; purging then follows. Often the triggers are anxiet y -
producing situations. Identification of triggers makes it possible to
break the binge–purge cycle. Because binge eating and purging directl y
affect physical status, the need to promote physical safet y assumes
highest priorit y.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) TOP:
Nursing Process: Planning MSC: Client Needs: P sychosocial
Integrit y
4. One bed is available on the inpatient eating -disorder unit. A client with
which assessment data should be admitted to this bed?
a. Going from 150 to 100 pounds over a 4 -month period. Vital signs
are temperature, 35.9° C; pulse, 38 beats /min; blood pressure 60/40
mm Hg
b. Going from120 to 90 pounds over a 3 -month period. Vital signs are
temperature, 36° C; pulse, 50 beats/min; blood pressure 70/50 mm
Hg
c. Going from110 to 70 pounds over a 4 -month period. Vital signs are
temperature 36.5° C; pulse, 60 beats/min; blood pressure 80/66 mm
Hg
d. Going 90 to 78 pounds over a 5 -month period. Vital signs are
temperature, 36.7° C; pulse, 62 beats/min; blood pressure 74/48 mm
Hg
D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. A nurse provides care for an adolescent client diagnosed with an eating
disorder. Which behavior by this nurse indicates that additional clinical
supervision is needed?
a. The nurse interacts with the client in a protective fashion.
b. The nurse’s comments to the client are compassionate and
nonjudgmental.
c. The nurse teaches the client to recognize signs of increasing anxiet y
and ways to intervene.
d. The nurse refers the client to a self -help group for individuals with
eating disorders.
ANS: A
In the effort t o motivate the client and take advantage of the decision
to seek help and be healthier, the nurse must take care not to cross the
line toward authoritarianism and assumption of a parental role.
Protective behaviors are part of the parent’s role. The helpfu l nurse
uses a problem-solving approach and focuses on the client’s feelings of
shame and low self -esteem. Referring a client to a self -help group is an
appropriate intervention.
, PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: E valuation MSC: Client Needs:
Psychosocial Integrity
2. A nursing diagnosis for a client diagnosed with bulimia nervosa is
Ineffective coping related to feelings of loneliness as evidenced by
overeating to comfort self, followed by self -induced vomiting. What is the
best outcome related to this diagnosis that should be achieved within 2
weeks?
a. appropriatel y expressing angry feelings.
b. verbalizing two positive things about self.
c. verbalizing the importance of eating a balanced diet.
d. identifying two alternative m ethods of coping with loneliness.
ANS: D
The outcome of identifying alternative coping strategies is most
directl y related to the diagnosis of Ineffective coping. Verbalizing
positive characteristics of self and verbalizing the importance of eating
a balanced diet are outcomes that might be used for other nursing
diagnoses. Appropriatel y expressing angry feelings is not measurable.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Outcomes Identification MSC:
Client Needs: Psychos ocial Integrit y
3. Which nursing intervention has the highest priorit y for a client diagnosed
with bulimia nervosa?
a. Assist the client to identify triggers to binge eating.
b. Provide corrective consequences for weight loss.
, c. Assess for signs of impulsive eating.
d. Explore needs for health teaching.
ANS: A
For most clients with bulimia nervosa, certain situations trigger the
urge to binge; purging then follows. Often the triggers are anxiet y -
producing situations. Identification of triggers makes it possible to
break the binge–purge cycle. Because binge eating and purging directl y
affect physical status, the need to promote physical safet y assumes
highest priorit y.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) TOP:
Nursing Process: Planning MSC: Client Needs: P sychosocial
Integrit y
4. One bed is available on the inpatient eating -disorder unit. A client with
which assessment data should be admitted to this bed?
a. Going from 150 to 100 pounds over a 4 -month period. Vital signs
are temperature, 35.9° C; pulse, 38 beats /min; blood pressure 60/40
mm Hg
b. Going from120 to 90 pounds over a 3 -month period. Vital signs are
temperature, 36° C; pulse, 50 beats/min; blood pressure 70/50 mm
Hg
c. Going from110 to 70 pounds over a 4 -month period. Vital signs are
temperature 36.5° C; pulse, 60 beats/min; blood pressure 80/66 mm
Hg
d. Going 90 to 78 pounds over a 5 -month period. Vital signs are
temperature, 36.7° C; pulse, 62 beats/min; blood pressure 74/48 mm
Hg
