Varcarolis Ch. 14: Eating Disorders
Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings.
She wears layered, loose clothing and now has amenorrhea. Her current weight is 95 pounds, a
loss of 35 pounds. Which medical diagnosis is most likely?
a. Binge eating disorder
b. Anorexia nervosa
c. Bulimia nervosa
d. Pica - Answer- b. Anorexia nervosa
Overly controlled eating behaviors, extreme weight loss, amenorrhea, 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. Pica refers to eating nonfood items.
Disturbed body image is the nursing diagnosis for a patient diagnosed with an eating disorder.
Which outcome indicator is most appropriate to monitor?
a. Weight, muscle, and fat are congruent with height, frame, age, and sex.
b. Calorie intake is within the required parameters of the treatment plan.
c. Weight reaches the established normal range for the patient.
d. Patient expresses satisfaction with body appearance. - Answer- d. Patient expresses
satisfaction with body appearance.
Body image disturbances are considered improved or resolved when the patient is consistently
satisfied with his or her own appearance and body function. This consideration is subjective. The
other indicators are more objective but less related to the nursing diagnosis.
A patient who is referred to the eating disorders clinic has lost 35 pounds in the past 3 months. To
assess the patients oral intake, the nurse should ask:
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? - Answer- c. What do you eat in a typical day?
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
patients thoughts on present weight explores the patients feelings about weight.
A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and has 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 am grossly underweight, but thats what I want.
d. I am a few pounds overweight, but I can live with it. - Answer- a. I am fat and ugly.
, Patients diagnosed with anorexia nervosa do not recognize their thinness. They perceive
themselves to be overweight and unattractive. The patient with anorexia will usually disclose
perceptions about self to others. The patient with anorexia will persist in trying to lose more weight.
A patient was diagnosed with anorexia nervosa. The history shows the patient virtually stopped
eating 5 months ago and has lost 25% of body weight. The patients current serum potassium is
2.7 mg/dl. Which nursing diagnosis applies?
a. Adult failure to thrive, related to abuse of laxatives as evidenced by electrolyte imbalances and
weight loss
b. Disturbed energy field, related to physical exertion in excess of energy produced through caloric
intake as evidenced by weight loss and hyperkalemia
c. Ineffective health maintenance, related to self-induced vomiting as evidenced by swollen parotid
glands and hyperkalemia
d. Imbalanced nutrition: less than body requirements, related to malnutrition as evidenced by loss
of 25% of body weight and hypokalemia - Answer- d. Imbalanced nutrition: less than body
requirements, related to malnutrition as evidenced by loss of 25% of body weight and hypokalemia
The patients history and laboratory results support the correct nursing diagnosis. Available data do
not confirm that the patient uses laxatives, induces vomiting, or exercises excessively. The patient
has hypokalemia rather than hyperkalemia.
Outpatient treatment is planned for a patient diagnosed with anorexia nervosa. Select the most
important outcome related to the nursing diagnosis: Imbalanced nutrition: less than body
requirements. Within 1 week, the patient will:
a. weigh self accurately using balanced scales.
b. limit exercise to less than 2 hours daily.
c. select clothing that fits properly.
d. gain 1 to 2 pounds. - Answer- d. gain 1 to 2 pounds.
Only the outcome of a gain of 1 to 2 pounds can be accomplished within 1 week when the patient
is an outpatient. The focus of an outcome is not on the patient weighing self. Limiting exercise and
selecting proper clothing are important, but weight gain takes priority.
Which nursing intervention has priority as a patient diagnosed with anorexia nervosa begins to
gain weight?
a. Assess for depression and anxiety.
b. Observe for adverse effects of re-feeding.
c. Communicate empathy for the patients feelings.
d. Help the patient balance energy expenditure and caloric intake. - Answer- b. Observe for
adverse effects of re-feeding.
The nursing intervention of observing for adverse effects of re-feeding most directly relates to
weight gain and is a priority. Assessing for depression and anxiety and communicating empathy
relate to coping. Helping the patient balance energy expenditure and caloric intake is an
inappropriate intervention.
A patient diagnosed with anorexia nervosa is resistant to weight gain. What is the rationale for
establishing a contract with the patient to participate in measures designed to produce a specified
weekly weight gain?
Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings.
She wears layered, loose clothing and now has amenorrhea. Her current weight is 95 pounds, a
loss of 35 pounds. Which medical diagnosis is most likely?
a. Binge eating disorder
b. Anorexia nervosa
c. Bulimia nervosa
d. Pica - Answer- b. Anorexia nervosa
Overly controlled eating behaviors, extreme weight loss, amenorrhea, 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. Pica refers to eating nonfood items.
Disturbed body image is the nursing diagnosis for a patient diagnosed with an eating disorder.
Which outcome indicator is most appropriate to monitor?
a. Weight, muscle, and fat are congruent with height, frame, age, and sex.
b. Calorie intake is within the required parameters of the treatment plan.
c. Weight reaches the established normal range for the patient.
d. Patient expresses satisfaction with body appearance. - Answer- d. Patient expresses
satisfaction with body appearance.
Body image disturbances are considered improved or resolved when the patient is consistently
satisfied with his or her own appearance and body function. This consideration is subjective. The
other indicators are more objective but less related to the nursing diagnosis.
A patient who is referred to the eating disorders clinic has lost 35 pounds in the past 3 months. To
assess the patients oral intake, the nurse should ask:
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? - Answer- c. What do you eat in a typical day?
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
patients thoughts on present weight explores the patients feelings about weight.
A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and has 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 am grossly underweight, but thats what I want.
d. I am a few pounds overweight, but I can live with it. - Answer- a. I am fat and ugly.
, Patients diagnosed with anorexia nervosa do not recognize their thinness. They perceive
themselves to be overweight and unattractive. The patient with anorexia will usually disclose
perceptions about self to others. The patient with anorexia will persist in trying to lose more weight.
A patient was diagnosed with anorexia nervosa. The history shows the patient virtually stopped
eating 5 months ago and has lost 25% of body weight. The patients current serum potassium is
2.7 mg/dl. Which nursing diagnosis applies?
a. Adult failure to thrive, related to abuse of laxatives as evidenced by electrolyte imbalances and
weight loss
b. Disturbed energy field, related to physical exertion in excess of energy produced through caloric
intake as evidenced by weight loss and hyperkalemia
c. Ineffective health maintenance, related to self-induced vomiting as evidenced by swollen parotid
glands and hyperkalemia
d. Imbalanced nutrition: less than body requirements, related to malnutrition as evidenced by loss
of 25% of body weight and hypokalemia - Answer- d. Imbalanced nutrition: less than body
requirements, related to malnutrition as evidenced by loss of 25% of body weight and hypokalemia
The patients history and laboratory results support the correct nursing diagnosis. Available data do
not confirm that the patient uses laxatives, induces vomiting, or exercises excessively. The patient
has hypokalemia rather than hyperkalemia.
Outpatient treatment is planned for a patient diagnosed with anorexia nervosa. Select the most
important outcome related to the nursing diagnosis: Imbalanced nutrition: less than body
requirements. Within 1 week, the patient will:
a. weigh self accurately using balanced scales.
b. limit exercise to less than 2 hours daily.
c. select clothing that fits properly.
d. gain 1 to 2 pounds. - Answer- d. gain 1 to 2 pounds.
Only the outcome of a gain of 1 to 2 pounds can be accomplished within 1 week when the patient
is an outpatient. The focus of an outcome is not on the patient weighing self. Limiting exercise and
selecting proper clothing are important, but weight gain takes priority.
Which nursing intervention has priority as a patient diagnosed with anorexia nervosa begins to
gain weight?
a. Assess for depression and anxiety.
b. Observe for adverse effects of re-feeding.
c. Communicate empathy for the patients feelings.
d. Help the patient balance energy expenditure and caloric intake. - Answer- b. Observe for
adverse effects of re-feeding.
The nursing intervention of observing for adverse effects of re-feeding most directly relates to
weight gain and is a priority. Assessing for depression and anxiety and communicating empathy
relate to coping. Helping the patient balance energy expenditure and caloric intake is an
inappropriate intervention.
A patient diagnosed with anorexia nervosa is resistant to weight gain. What is the rationale for
establishing a contract with the patient to participate in measures designed to produce a specified
weekly weight gain?
