2026/2027 Jersey College
NUR 227 FINAL EXAM — PSYCHIATRIC NURSING — JERSEY COLLEGE
CHAPTER 1 — EATING DISORDERS
Q1. Which finding in a patient with anorexia nervosa requires the
highest priority intervention?
A) Heart rate of 38/min with dizziness
B) Fear of gaining weight
C) Wearing oversized clothing
D) Exercising daily
Correct Answer: A) Heart rate of 38/min with dizziness
Rationale: Severe bradycardia with dizziness can reflect cardiovascular
instability associated with profound malnutrition.
Q2. A patient with anorexia nervosa is admitted with severe
malnutrition. Which assessment is most important before
aggressive nutritional rehabilitation begins?
A) Favorite foods
B) Electrolytes and cardiovascular status
C) Preferred exercise routine
D) Clothing size
Correct Answer: B) Electrolytes and cardiovascular status
Rationale: Severely malnourished patients are vulnerable to electrolyte
abnormalities and cardiac complications during nutritional restoration.
Q3. Which laboratory abnormality is especially concerning during
refeeding of a severely malnourished patient?
A) Mildly increased cholesterol
B) Slightly elevated glucose
C) Markedly decreased phosphate
D) Mildly increased sodium
Correct Answer: C) Markedly decreased phosphate
Rationale: Refeeding can cause dangerous intracellular shifts of phosphate
and other electrolytes, potentially resulting in cardiac, neurologic, and
respiratory complications.
,Q4. Which meal-related intervention is appropriate for a
hospitalized patient with anorexia nervosa?
A) Allow unlimited unsupervised exercise after meals
B) Permit the patient to determine whether meals are necessary
C) Discuss calories throughout the entire meal
D) Provide structured meals and monitor the patient according to the
treatment plan
Correct Answer: D) Provide structured meals and monitor the patient
according to the treatment plan
Rationale: Consistent meal structure and observation can support
nutritional restoration and reduce compensatory behaviors.
Q5. Which finding is commonly associated with anorexia nervosa?
A) Distorted perception of body size despite being significantly underweight
B) Accurate perception of severe malnutrition in every patient
C) Persistent overeating without concern about weight
D) Absence of any fear related to weight gain
Correct Answer: A) Distorted perception of body size despite being
significantly underweight
Rationale: Disturbance in body image and intense fear of weight gain are
central features of anorexia nervosa.
Q6. A patient with bulimia nervosa reports frequent self-induced
vomiting. Which complication should be monitored closely?
A) Hypercalcemia
B) Hypokalemia
C) Polycythemia
D) Hypermagnesemia
Correct Answer: B) Hypokalemia
Rationale: Recurrent vomiting can cause potassium loss, increasing the risk
of weakness and dangerous cardiac dysrhythmias.
Q7. Which physical finding is associated with recurrent self-induced
vomiting?
A) Clubbing of the fingers
B) Severe jaundice
, C) Dental enamel erosion
D) Enlarged pupils
Correct Answer: C) Dental enamel erosion
Rationale: Repeated exposure of the teeth to gastric acid can damage
dental enamel.
Q8. A patient admits to binge eating followed by vomiting several
times each week but has a body weight within the expected range.
Which disorder is most consistent with this pattern?
A) Anorexia nervosa only
B) Avoidant/restrictive food intake disorder
C) Binge-eating disorder
D) Bulimia nervosa
Correct Answer: D) Bulimia nervosa
Rationale: Bulimia involves recurrent binge eating followed by
compensatory behaviors and may occur at normal or above-normal body
weight.
Q9. Which nursing response is most therapeutic when a patient with
an eating disorder says, “I feel huge after eating lunch”?
A) “Tell me what you are feeling about your body right now.”
B) “You are obviously not overweight.”
C) “You should stop thinking about your weight.”
D) “You look perfectly fine.”
Correct Answer: A) “Tell me what you are feeling about your body right now.”
Rationale: Exploring the patient's feelings encourages discussion without
arguing about distorted body-image perceptions.
Q10. A patient with binge-eating disorder asks about treatment.
Which approach is appropriate?
A) Encourage severe food restriction between binges
B) Address binge triggers and develop more adaptive eating and coping
patterns
C) Recommend purging after large meals
D) Require daily prolonged fasting