NUR3535C EXAM 3 2026/2027 | NURSING STUDY GUIDE, PRACTICE
QUESTIONS, ANSWERS & EXAM REVIEW
Anorexia Nervosa - ANS ✔✔±Intense fear of gaining weight
±Experience significant differences in sensation of taste, appetite, Satiety (feeling of being fed or full)
±These unique, unpleasant sensations help to perpetuate the disorder, leading to restriction and
sometimes purging
±restrict their intake and will often exercise extreme amounts.
±At times they may purge in other ways.
What do we mean by the term purging when we talk about anorexia nervosa?
A.Vomiting
B.Excessive exercise
C.Using stimulants or thyroid medications
D.All of the above - ANS ✔✔D
anorexia nervosa DSM-5 Criteria - ANS ✔✔°Restricting energy intake to below requirements
°Significant loss of weight and malnourishment
°Intense fear of weight gain or persistent interference with weight gain
°Disturbance of body image
°Self-evaluation linked to body weight or shape
anorexia nervosa restricting type - ANS ✔✔During the last 3 months, the individual has not engaged in
recurrent episodes of binge-eating or purging behavior
anorexia nervosa Binge-eating/purging type - ANS ✔✔During the last 3 months, the individual has
engaged in recurrent episodes of binge-eating or purging behavior
anorexia nervosa risk factors - ANS ✔✔- Biological Factors: Researchers found genetic correlations
between anorexia, major depressive disorder, anxiety disorders, obsessive-compulsive disorder, and
schizophrenia. They also found a correlation between anorexia and variations in glucose and lipid
metabolism.
- Cognitive Factors: Anorexia nervosa is an ego-syntonic disorder. That is, individuals value their disorder.
Although they know that their actions are potentially harmful, they believe that the benefits outweigh
the harm.
- Environmental: Anorexia nervosa is associated with cultures that value thinness.
Hypercarotenemia - ANS ✔✔- a condition caused by the accumulation of carotenoids in the adipose
tissue, causing the skin to appear yellow-orange
- occurs with anorexia nervosa
Refeeding Syndrome - ANS ✔✔When nutrients are restored, insulin stimulates glycogen, fat, and protein
synthesis, a process that requires minerals such as phosphate and magnesium. In severely malnourished
patients a refeeding syndrome may occur. This potentially lethal complication may result in fluid-balance
abnormalities, abnormal glucose metabolism, hypophosphatemia, hypomagnesemia, and hypokalemia.
Thiamine deficiency can also occur. Reintroduction of nutrients are given slowly to avoid this syndrome.
,anorexia nervosa tx - ANS ✔✔±Biological Treatments: Pharmacotherapy (not for core symptoms)
±Integrative Medicine: Yoga, massage, acupuncture, bright light therapy
±Psychological Therapies: Insight-oriented individual therapy, Adolescent-focused therapy (AFT), Family
therapy (F-BT), Cognitive-behavioral therapy (CBT)
Bulimia Nervosa DSM-5 Criteria - ANS ✔✔°Recurrent episodes of binge eating
°Recurrent inappropriate compensatory behavior
°Both occur, on average, at least once a week for 3 months
°Self-evaluation is unduly influenced by body shape and weight
°Disturbance does not occur exclusively during episodes of anorexia nervosa
bulimia nervosa comorbitities - ANS ✔✔°Depressive disorders
°Anxiety disorders
°Bipolar disorder
°Alcohol and substance use disorders
°PTSD and other trauma-based disorders
°Borderline personality disorder
bulimia nervosa risk factors - ANS ✔✔°Genetic (60%)
°Neurobiological
°Cognitive Factors: Attachment challenges, Self-evaluation based on weight and shape, Environmental
Factors
±Internalization of a thin body ideal
±Bullying
bulimia nervosa tx - ANS ✔✔±Biological Treatment: Pharmacotherapy, Antidepressants: Fluoxetine
(Prozac), Other antidepressants
±Advanced Practice Interventions: Cognitive-behavioral therapy (CBT), Mixed-method approach for
refractory cases, dialectical behavioral therapy (DBT), interpersonal therapy (IPT), and acceptance and
commitment therapy (ACT)
Binge Eating Disorder DSM-5 Criteria - ANS ✔✔°Recurrent episodes of binge eating: Eating, in a discrete
period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what
most people would eat in a similar period of time under similar circumstances; A sense of lack of control
over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much
one is eating).
°Marked distress over binge eating
°Occurs at least 1X/week for 3 months & is not associated with other disorders
binge eating episodes are associated with three (or more) of the following: - ANS ✔✔°Eating much more
rapidly than normal.
°Eating until feeling uncomfortably full.
°Eating large amounts of food when not feeling physically hungry.
°Eating alone because of feeling embarrassed by how much one is eating.
°Feeling disgusted with oneself, depressed, or very guilty afterward.
binge eating comorbidity - ANS ✔✔°Specific phobia (37%)
, °Social phobia (32%)
°Post-traumatic stress disorder (26%)
°Alcohol abuse or dependence (21%)
binge eating risk factors - ANS ✔✔°Genetic: Heritability 41-57%. Studies are limited, May be an
associated between binge eating and alcohol abuse
°Neurobiological: Similar to Bulimia
°Cognitive Factors: Individuals with high impulsivity and reward sensitivity may experience an addictive
response to certain foods, as in the case of substance use disorders (Schulte et al., 2016). The foods that
seem to be particularly addictive are high-sugar and high-fat foods. Body dissatisfaction, low self-esteem,
and difficulty coping with feelings can also contribute to binge-eating disorder.
°Environmental Factors: Social pressures to be thin, which are typically influenced through media, can
trigger emotional eating. Social weight stigma, which is stereotyping or discrimination based on a
person's body, is common in the US and perpetuates the cycle of binging. Other factors include a history
of trauma, particularly emotional neglect, and a history of food insecurity, which is the result of not
having reliable access to a sufficient quantity of nutritious and affordable food.
binge eating tx pharmocotherapy - ANS ✔✔°SSRIs: Weight tends to return after treatment
°SNRIs
°Lisdexamfetamine: Lowered relapse risk
°Other stimulants: Phentermine - often used for weight loss
binge eating surgery - ANS ✔✔bariatric surgery
binge eating psychological therapy - ANS ✔✔°Cognitive-behavioral therapy
°Dialectical behavior therapy
°Interpersonal therapy
Pica - ANS ✔✔°Eating nonfood items well past toddlerhood
°Not part of other illness
Rumination - ANS ✔✔°Regurgitation with rechewing, reswallowing, or spitting
°No medical or mental reason
Avoidant/restrictive food intake - ANS ✔✔°Starts in childhood
°Note: 40% of "picky" eaters resolve on their own
°Low BMI
°No distorted body image
Hypoalbuminemia in a patient with an eating disorder would produce which assessment finding?
A.Lanugo
B.Jaundice
C.Amenorrhea
D.Peripheral edema - ANS ✔✔D
±A client referred to the eating disorders clinic has lost 35 pounds in 3 months. For which physical
manifestations of anorexia nervosa should a nurse assess? (Select all that apply.)
QUESTIONS, ANSWERS & EXAM REVIEW
Anorexia Nervosa - ANS ✔✔±Intense fear of gaining weight
±Experience significant differences in sensation of taste, appetite, Satiety (feeling of being fed or full)
±These unique, unpleasant sensations help to perpetuate the disorder, leading to restriction and
sometimes purging
±restrict their intake and will often exercise extreme amounts.
±At times they may purge in other ways.
What do we mean by the term purging when we talk about anorexia nervosa?
A.Vomiting
B.Excessive exercise
C.Using stimulants or thyroid medications
D.All of the above - ANS ✔✔D
anorexia nervosa DSM-5 Criteria - ANS ✔✔°Restricting energy intake to below requirements
°Significant loss of weight and malnourishment
°Intense fear of weight gain or persistent interference with weight gain
°Disturbance of body image
°Self-evaluation linked to body weight or shape
anorexia nervosa restricting type - ANS ✔✔During the last 3 months, the individual has not engaged in
recurrent episodes of binge-eating or purging behavior
anorexia nervosa Binge-eating/purging type - ANS ✔✔During the last 3 months, the individual has
engaged in recurrent episodes of binge-eating or purging behavior
anorexia nervosa risk factors - ANS ✔✔- Biological Factors: Researchers found genetic correlations
between anorexia, major depressive disorder, anxiety disorders, obsessive-compulsive disorder, and
schizophrenia. They also found a correlation between anorexia and variations in glucose and lipid
metabolism.
- Cognitive Factors: Anorexia nervosa is an ego-syntonic disorder. That is, individuals value their disorder.
Although they know that their actions are potentially harmful, they believe that the benefits outweigh
the harm.
- Environmental: Anorexia nervosa is associated with cultures that value thinness.
Hypercarotenemia - ANS ✔✔- a condition caused by the accumulation of carotenoids in the adipose
tissue, causing the skin to appear yellow-orange
- occurs with anorexia nervosa
Refeeding Syndrome - ANS ✔✔When nutrients are restored, insulin stimulates glycogen, fat, and protein
synthesis, a process that requires minerals such as phosphate and magnesium. In severely malnourished
patients a refeeding syndrome may occur. This potentially lethal complication may result in fluid-balance
abnormalities, abnormal glucose metabolism, hypophosphatemia, hypomagnesemia, and hypokalemia.
Thiamine deficiency can also occur. Reintroduction of nutrients are given slowly to avoid this syndrome.
,anorexia nervosa tx - ANS ✔✔±Biological Treatments: Pharmacotherapy (not for core symptoms)
±Integrative Medicine: Yoga, massage, acupuncture, bright light therapy
±Psychological Therapies: Insight-oriented individual therapy, Adolescent-focused therapy (AFT), Family
therapy (F-BT), Cognitive-behavioral therapy (CBT)
Bulimia Nervosa DSM-5 Criteria - ANS ✔✔°Recurrent episodes of binge eating
°Recurrent inappropriate compensatory behavior
°Both occur, on average, at least once a week for 3 months
°Self-evaluation is unduly influenced by body shape and weight
°Disturbance does not occur exclusively during episodes of anorexia nervosa
bulimia nervosa comorbitities - ANS ✔✔°Depressive disorders
°Anxiety disorders
°Bipolar disorder
°Alcohol and substance use disorders
°PTSD and other trauma-based disorders
°Borderline personality disorder
bulimia nervosa risk factors - ANS ✔✔°Genetic (60%)
°Neurobiological
°Cognitive Factors: Attachment challenges, Self-evaluation based on weight and shape, Environmental
Factors
±Internalization of a thin body ideal
±Bullying
bulimia nervosa tx - ANS ✔✔±Biological Treatment: Pharmacotherapy, Antidepressants: Fluoxetine
(Prozac), Other antidepressants
±Advanced Practice Interventions: Cognitive-behavioral therapy (CBT), Mixed-method approach for
refractory cases, dialectical behavioral therapy (DBT), interpersonal therapy (IPT), and acceptance and
commitment therapy (ACT)
Binge Eating Disorder DSM-5 Criteria - ANS ✔✔°Recurrent episodes of binge eating: Eating, in a discrete
period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what
most people would eat in a similar period of time under similar circumstances; A sense of lack of control
over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much
one is eating).
°Marked distress over binge eating
°Occurs at least 1X/week for 3 months & is not associated with other disorders
binge eating episodes are associated with three (or more) of the following: - ANS ✔✔°Eating much more
rapidly than normal.
°Eating until feeling uncomfortably full.
°Eating large amounts of food when not feeling physically hungry.
°Eating alone because of feeling embarrassed by how much one is eating.
°Feeling disgusted with oneself, depressed, or very guilty afterward.
binge eating comorbidity - ANS ✔✔°Specific phobia (37%)
, °Social phobia (32%)
°Post-traumatic stress disorder (26%)
°Alcohol abuse or dependence (21%)
binge eating risk factors - ANS ✔✔°Genetic: Heritability 41-57%. Studies are limited, May be an
associated between binge eating and alcohol abuse
°Neurobiological: Similar to Bulimia
°Cognitive Factors: Individuals with high impulsivity and reward sensitivity may experience an addictive
response to certain foods, as in the case of substance use disorders (Schulte et al., 2016). The foods that
seem to be particularly addictive are high-sugar and high-fat foods. Body dissatisfaction, low self-esteem,
and difficulty coping with feelings can also contribute to binge-eating disorder.
°Environmental Factors: Social pressures to be thin, which are typically influenced through media, can
trigger emotional eating. Social weight stigma, which is stereotyping or discrimination based on a
person's body, is common in the US and perpetuates the cycle of binging. Other factors include a history
of trauma, particularly emotional neglect, and a history of food insecurity, which is the result of not
having reliable access to a sufficient quantity of nutritious and affordable food.
binge eating tx pharmocotherapy - ANS ✔✔°SSRIs: Weight tends to return after treatment
°SNRIs
°Lisdexamfetamine: Lowered relapse risk
°Other stimulants: Phentermine - often used for weight loss
binge eating surgery - ANS ✔✔bariatric surgery
binge eating psychological therapy - ANS ✔✔°Cognitive-behavioral therapy
°Dialectical behavior therapy
°Interpersonal therapy
Pica - ANS ✔✔°Eating nonfood items well past toddlerhood
°Not part of other illness
Rumination - ANS ✔✔°Regurgitation with rechewing, reswallowing, or spitting
°No medical or mental reason
Avoidant/restrictive food intake - ANS ✔✔°Starts in childhood
°Note: 40% of "picky" eaters resolve on their own
°Low BMI
°No distorted body image
Hypoalbuminemia in a patient with an eating disorder would produce which assessment finding?
A.Lanugo
B.Jaundice
C.Amenorrhea
D.Peripheral edema - ANS ✔✔D
±A client referred to the eating disorders clinic has lost 35 pounds in 3 months. For which physical
manifestations of anorexia nervosa should a nurse assess? (Select all that apply.)
