Chapter 18: Eating and Feeding Disorders |Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition

MULTIPLE CHOICE 1. Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. This person wears layered loose clothing. Her current weight is 95 pounds, a loss of 35 pounds. Which medical diagnosis is most likely? a. Binge eating b. Bulimia nervosa c. Anorexia nervosa d. Eating disorder not otherwise specified ANS: C Overly controlled eating behaviors, extreme weight loss, preoccupation with food, and wearing several layers of loose clothing to appear larger are part of the clinical picture of an individual with anorexia nervosa. The individual with bulimia usually is near normal weight. The binge eater is often overweight. The patient with eating disorder not otherwise specified may be obese. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 18-67 (Box 18-1) TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity 2. Disturbed body image is a nursing diagnosis established for a patient diagnosed with an eating disorder. Which outcome indicator is most appropriate to monitor? a. Weight, muscle, and fat congruence with height, frame, age, and sex b. Calorie intake is within required parameters of treatment plan c. Weight reaches established normal range for the patient d. Patient expresses satisfaction with body appearance ANS: D Body image disturbances are considered improved or resolved when the patient is consistently satisfied with his or her own appearance and body function. This is a subjective consideration. The other indicators are more objective but less related to the nursing diagnosis. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 18-13, 58 (Table 18-3) TOP: Nursing Process: Outcomes Identification MSC: Client Needs: Psychosocial Integrity 3. A patient referred to the eating disorders clinic has lost 35 pounds during the past 3 months. To assess eating patterns, the nurse should ask the patient: a. Do you often feel fat?‖ b. Who plans the family meals?‖ c. What do you eat in a typical day?‖ d. What do you think about your present weight?‖ ANS: C Although all the questions might be appropriate to ask, only ―What do you eat in a typical day?‖ focuses on the eating patterns. Asking if the patient often feels fat focuses on distortions in body image. Questions about family meal planning are unrelated to eating patterns. Asking for the patient‘s thoughts on present weight explores the patient‘s feelings about weight. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 18-12, 19 (Case Study and Nursing Care Plan) TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity 4. A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and lost 25% of body weight. A nurse asks, ―Describe what you think about your present weight and how you look.‖ Which response by the patient is most consistent with the diagnosis? a. I am fat and ugly.‖ b. What I think about myself is my business.‖ c. I‘m grossly underweight, but that‘s what I want.‖ d. I‘m a few pounds‘ overweight, but I can live with it.‖