Barkley PMHNP CHaPter Quiz 17:
FeediNg aNd eatiNg disorders –
CoMPreHeNsive exaMiNatioN a well
detailed oNe writteN aNd
graded a+ uPgraded
Target Audience: Psychiatric-Mental Health Nurse Practitioner (PMHNP) candidates and
professionals preparing for certification examinations
Difficulty Level: Advanced/Hard
Total Questions: 150 multiple-choice questions
Instructions: Select the single best answer for each question. Each question includes the correct
answer and a detailed rationale.
Section 1: Epidemiology and Etiology (Questions 1–15)
1. Which demographic group has the highest lifetime prevalence rate of anorexia nervosa?
• A) Adolescent males
• B) Older adult females
• C) Young adult females
• D) Middle-aged males
Correct Answer: C
Rationale: Anorexia nervosa has the highest lifetime prevalence among young adult females,
with rates approximately 0.5–1% in this population. The disorder is significantly more common
,in females than males, with a female-to-male ratio of approximately 10:1. Onset typically occurs
during adolescence or young adulthood.
2. Which of the following genetic factors is most strongly associated with the development of
eating disorders?
• A) Single gene mutation on chromosome 4
• B) Heritability estimates of 40–60% for anorexia nervosa
• C) Autosomal dominant inheritance pattern
• D) Mitochondrial DNA transmission
Correct Answer: B
Rationale: Twin and family studies demonstrate that eating disorders have significant
heritability, with estimates of 40–60% for anorexia nervosa and 30–80% for bulimia nervosa.
The inheritance pattern is complex and polygenic, not attributable to a single gene or simple
Mendelian inheritance.
3. Which neurotransmitter system is most implicated in the pathophysiology of anorexia
nervosa?
• A) Dopaminergic system
• B) Serotonergic system
• C) GABAergic system
• D) Cholinergic system
Correct Answer: B
Rationale: The serotonergic system is most strongly implicated in anorexia nervosa
pathophysiology. Alterations in serotonin (5-HT) function are associated with the characteristic
features of anorexia, including obsessive-compulsive behaviors, anxiety, and altered appetite
regulation. Elevated cerebrospinal fluid 5-HIAA levels and postsynaptic 5-HT2A receptor
abnormalities have been documented.
4. Which of the following is a known premorbid risk factor for the development of an eating
disorder?
• A) Low socioeconomic status
• B) Childhood obesity
• C) Urban upbringing
, • D) Large family size
Correct Answer: B
Rationale: Childhood obesity is a well-established risk factor for the development of eating
disorders, particularly bulimia nervosa and binge-eating disorder. Other risk factors include
perfectionism, negative body image, childhood sexual abuse, and familial history of eating
disorders.
5. The female-to-male ratio for bulimia nervosa is approximately:
• A) 2:1
• B) 5:1
• C) 10:1
• D) 20:1
Correct Answer: C
Rationale: The female-to-male ratio for bulimia nervosa is approximately 10:1. While eating
disorders are more common in females, the gender gap has been narrowing somewhat in
recent years, particularly for binge-eating disorder where the ratio is closer to 3:2.
6. Which cultural factor is associated with increased risk of eating disorders?
• A) Collectivist cultural values
• B) Western cultural ideals of thinness
• C) Rural living environment
• D) Traditional dietary practices
Correct Answer: B
Rationale: Western cultural ideals emphasizing thinness and appearance are strongly associated
with increased risk of eating disorders. The prevalence of eating disorders is higher in cultures
where thinness is idealized, and rates increase with acculturation to Western cultural norms.
7. Which of the following personality traits is most commonly associated with anorexia
nervosa?
• A) Impulsivity
• B) Harm avoidance
• C) Novelty seeking
, • D) Extroversion
Correct Answer: B
Rationale: Harm avoidance, characterized by excessive worry, pessimism, and inhibition, is the
personality trait most strongly associated with anorexia nervosa. This trait may contribute to the
rigid, perfectionistic, and anxiety-prone temperament observed in individuals with anorexia
nervosa.
8. The estimated heritability of binge-eating disorder is approximately:
• A) 10–20%
• B) 30–40%
• C) 40–60%
• D) 70–80%
Correct Answer: C
Rationale: Binge-eating disorder has heritability estimates of approximately 40–60%, similar to
other eating disorders. Genetic factors contribute significantly to the vulnerability to binge-
eating disorder, though environmental factors also play a substantial role.
9. Which of the following neurobiological findings is associated with bulimia nervosa?
• A) Decreased opioid activity
• B) Reduced serotonin transporter binding
• C) Increased dopamine D2 receptor availability
• D) Normal hypothalamic-pituitary-adrenal axis function
Correct Answer: B
Rationale: Reduced serotonin transporter binding has been documented in individuals with
bulimia nervosa. This finding suggests serotonergic dysfunction contributes to the impulsive and
dysregulated eating behaviors characteristic of bulimia.
10. The peak age of onset for anorexia nervosa is:
• A) 8–10 years
• B) 14–18 years
• C) 25–30 years
• D) 35–40 years
FeediNg aNd eatiNg disorders –
CoMPreHeNsive exaMiNatioN a well
detailed oNe writteN aNd
graded a+ uPgraded
Target Audience: Psychiatric-Mental Health Nurse Practitioner (PMHNP) candidates and
professionals preparing for certification examinations
Difficulty Level: Advanced/Hard
Total Questions: 150 multiple-choice questions
Instructions: Select the single best answer for each question. Each question includes the correct
answer and a detailed rationale.
Section 1: Epidemiology and Etiology (Questions 1–15)
1. Which demographic group has the highest lifetime prevalence rate of anorexia nervosa?
• A) Adolescent males
• B) Older adult females
• C) Young adult females
• D) Middle-aged males
Correct Answer: C
Rationale: Anorexia nervosa has the highest lifetime prevalence among young adult females,
with rates approximately 0.5–1% in this population. The disorder is significantly more common
,in females than males, with a female-to-male ratio of approximately 10:1. Onset typically occurs
during adolescence or young adulthood.
2. Which of the following genetic factors is most strongly associated with the development of
eating disorders?
• A) Single gene mutation on chromosome 4
• B) Heritability estimates of 40–60% for anorexia nervosa
• C) Autosomal dominant inheritance pattern
• D) Mitochondrial DNA transmission
Correct Answer: B
Rationale: Twin and family studies demonstrate that eating disorders have significant
heritability, with estimates of 40–60% for anorexia nervosa and 30–80% for bulimia nervosa.
The inheritance pattern is complex and polygenic, not attributable to a single gene or simple
Mendelian inheritance.
3. Which neurotransmitter system is most implicated in the pathophysiology of anorexia
nervosa?
• A) Dopaminergic system
• B) Serotonergic system
• C) GABAergic system
• D) Cholinergic system
Correct Answer: B
Rationale: The serotonergic system is most strongly implicated in anorexia nervosa
pathophysiology. Alterations in serotonin (5-HT) function are associated with the characteristic
features of anorexia, including obsessive-compulsive behaviors, anxiety, and altered appetite
regulation. Elevated cerebrospinal fluid 5-HIAA levels and postsynaptic 5-HT2A receptor
abnormalities have been documented.
4. Which of the following is a known premorbid risk factor for the development of an eating
disorder?
• A) Low socioeconomic status
• B) Childhood obesity
• C) Urban upbringing
, • D) Large family size
Correct Answer: B
Rationale: Childhood obesity is a well-established risk factor for the development of eating
disorders, particularly bulimia nervosa and binge-eating disorder. Other risk factors include
perfectionism, negative body image, childhood sexual abuse, and familial history of eating
disorders.
5. The female-to-male ratio for bulimia nervosa is approximately:
• A) 2:1
• B) 5:1
• C) 10:1
• D) 20:1
Correct Answer: C
Rationale: The female-to-male ratio for bulimia nervosa is approximately 10:1. While eating
disorders are more common in females, the gender gap has been narrowing somewhat in
recent years, particularly for binge-eating disorder where the ratio is closer to 3:2.
6. Which cultural factor is associated with increased risk of eating disorders?
• A) Collectivist cultural values
• B) Western cultural ideals of thinness
• C) Rural living environment
• D) Traditional dietary practices
Correct Answer: B
Rationale: Western cultural ideals emphasizing thinness and appearance are strongly associated
with increased risk of eating disorders. The prevalence of eating disorders is higher in cultures
where thinness is idealized, and rates increase with acculturation to Western cultural norms.
7. Which of the following personality traits is most commonly associated with anorexia
nervosa?
• A) Impulsivity
• B) Harm avoidance
• C) Novelty seeking
, • D) Extroversion
Correct Answer: B
Rationale: Harm avoidance, characterized by excessive worry, pessimism, and inhibition, is the
personality trait most strongly associated with anorexia nervosa. This trait may contribute to the
rigid, perfectionistic, and anxiety-prone temperament observed in individuals with anorexia
nervosa.
8. The estimated heritability of binge-eating disorder is approximately:
• A) 10–20%
• B) 30–40%
• C) 40–60%
• D) 70–80%
Correct Answer: C
Rationale: Binge-eating disorder has heritability estimates of approximately 40–60%, similar to
other eating disorders. Genetic factors contribute significantly to the vulnerability to binge-
eating disorder, though environmental factors also play a substantial role.
9. Which of the following neurobiological findings is associated with bulimia nervosa?
• A) Decreased opioid activity
• B) Reduced serotonin transporter binding
• C) Increased dopamine D2 receptor availability
• D) Normal hypothalamic-pituitary-adrenal axis function
Correct Answer: B
Rationale: Reduced serotonin transporter binding has been documented in individuals with
bulimia nervosa. This finding suggests serotonergic dysfunction contributes to the impulsive and
dysregulated eating behaviors characteristic of bulimia.
10. The peak age of onset for anorexia nervosa is:
• A) 8–10 years
• B) 14–18 years
• C) 25–30 years
• D) 35–40 years
