NSG 121 FINAL EXAM QUESTIONS WITH VERIFIED
ANSWERS
eating disorders - Answers - a serious psychiatric illness with devastating and
potentially fatal medical conditions
have the highest mortality rate of all mental illnesses - Answers - eating disorders
eating disorder categories - Answers - anorexia nervosa type I, anorexia nervosa type
II, bulimia nervosa, binge eating disorder
anorexia nervosa - Answers - individual engages in self-starvation. expresses fear of
gaining weight. has a disturbance in how they evaluate their weight
anorexia nervosa type I - Answers - restricts intake of food
anorexia nervosa type II - Answers - engages in binge eating and/or purging
bulimia nervosa - Answers - person engages in repeated episodes of binge eating
followed by inappropriate compensatory behaviors
binge eating disorder - Answers - person engages in repeated episodes of binge eating,
after which they feel distressed
physique of those with binge eating disorder - Answers - clearly overweight
anorexia type II vs bulimia - Answers - diagnosis depends on belief system. anorexia
type II is egosyntonic (believing it's okay) whereas bulimia is egodystonic (knowing it's
wrong)
the number of individuals with eating disorders - Answers - unknown
estimate of females with anorexia - Answers - 1%
estimate of males with anorexia - Answers - 0.3%
estimate of females with bulimia - Answers - 1.5%
estimate of males with bulimia - Answers - 0.5%
what we want to address with eating disorders - Answers - the underlying emotions.
why are they doing what they're doing? what's driving the behavior?
,sports with an increase of eating disorders - Answers - wrestling, gymnastics,
cheerleading, boxing
when anorexia appears - Answers - in early to mid adolescence
when bulimia appears - Answers - typically in late adolescence
amount of individuals with anorexia who have a concurrent psychiatric disorder -
Answers - 50%
amount of individuals with bulimia who have a concurrent psychiatric disorder - Answers
- 95%
theories of etiology for eating disorders - Answers - neurobiological, genetics,
psychological
neurobiological theory for eating disorders - Answers - there is an alteration in serotonin
receptors and transporters
genetics theory for eating disorders - Answers - genetic vulnerability
psychological theory for eating disorders - Answers - psychological determinants such
as low self-esteem and control issues play a role
sociocultural influences on eating disorders - Answers - globalization has exposed
minorities and non-western societies to the 'value' of the thin ideal beauty
points from the therapeutic alliance for eating disorders - Answers - must remember that
the client does not choose this behavior. do not assume a parental role. be aware of
counter transference. remember the goal of treatment is the client's greatest fear
signs and symptoms of anorexia - Answers - extreme fear of obesity and gaining
weight. preoccupation with/constant thoughts of food. view of self as fat even when
emaciated. judges self worth by his/her weight. peculiar handling of food, enjoys being
around food. controls what he/she eats to feel powerful. possible development of
rigorous exercise routine. possible self induced vomiting. use of diuretics or laxatives.
loss of at least 25% of original body weight. refusal to maintain minimal body weight.
amenorrhea
signs and symptoms of bulimia nervosa - Answers - binge eating behaviors (usually in
solitude). increased mood while eating; decreased mood when stops. generally sleeps
after eating. self induced vomiting (or laxative or diuretic use after binging) when binge
is over. history of anorexia. depressive signs and symptoms. problems with
interpersonal relationships, self concept and impulsivity. increased anxiety. possible
chemical dependency. possible impulsive stealing. attempts to control weight due to
feelings of 'emptiness'
,eating disorders and other psychiatric disorders - Answers - higher percentage of those
with bulimia who also have other psychiatric disorders
some medical complications that can result from anorexia nervosa - Answers -
bradycardia. orthostatic changes in pulse rate or blood pressure. cardiac murmur - 1/3
with mitral valve prolapse. sudden cardiac arrest caused by profound electrolyte
disturbances. prolonged QT interval on electrocardiogram. acrocyanosis. symptomatic
hypotension. leukopenia. lymphocytosis. carotenemia (elevated carotene levels in
blood), which produces skin with yellow pallor. hypokalemic alkalosis (with self-induced
vomiting or use of laxatives and diuretics). elevated serum potassium levels,
hypochloremia, and hypokalemia. electrolyte imbalances, which lead to fatigue,
weakness, and lethargy. osteoporosis, indicated by low bone density. fatty degeneration
of liver, indicated by elevation of serum enzyme levels. elevated cholesterol levels.
amenorrhea. abnormal thyroid functioning. hematuria. proteinuria
some medical complications that can result from bulimia nervosa - Answers -
cardiomyopathy (rare occurrence due to diminished protein synthesis, malnutrition).
cardiac dysrhythmias. sinus bradycardia. sudden cardiac arrest as a result of profound
electrolyte disturbances. orthostatic changes in pulse rate or blood pressure. cardiac
murmur; mitral valve prolapse. electrolyte imbalances. elevated serum bicarbonate
levels (although can be low, which indicates metabolic acidosis). hypochloremia.
hypokalemia. dehydration, which results in volume depletion, leading to stimulation of
aldosterone production, which in turn stimulates further potassium excretion from
kidneys; thus there can be an indirect renal loss of potassium as well as a direct loss
through self-induced vomiting. severe attrition and erosion of teeth producing irritating
sensitivity and exposing the pulp of the teeth. loss of dental arch. diminished chewing
ability. parotid gland enlargement associated with elevated serum amylase levels.
esophageal tears caused by self-induced vomiting. severe abdominal pain indicative of
gastric dilation. Russell's sign (callus on knuckles from self-induced vomiting)
physical criteria for hospital admission of individuals with eating disorders - Answers -
weight loss >30% over 6 months. rapid decline in weight. inability to gain weight with
outpatient treatment. severe hypothermia caused by loss of subcutaneous tissue or
dehydration (body temperature lower than 36C or 96.8F). heart rate <40 bpm. systolic
blood pressure <70 mmHg. hypokalemia (<3 mEq/L) or other electrolyte disturbances
not corrected by oral supplementation. electrocardiographic changes (especially
dysrhythmias)
psychiatric criteria for hospital admission of individuals with eating disorders - Answers -
suicidal or severely irrepressible, self-mutilating behaviors. uncontrolled depression.
uncontrollable use/overuse of laxatives, emetics, diuretics, or street drugs. failure to
comply with treatment contract. severe depression, psychosis. family crisis or
dysfunction
, interventions for the hospitalized patient with an eating disorder - Answers - help client
express feelings and thoughts. constantly assess for suicidal behavior. help client
understand that their thinking is distorted
goal for hospitalized patient with an eating disorder - Answers - to restore minimal
weight or help with weight gain
expected outcomes for eating disorders - Answers - adequate intake of nutrients.
appropriate body weight. effective coping; stop binging, purging, restriction. return of
menses
refeeding syndrome - Answers - risk for cardiovascular collapse with reinstituting
feeding due to the sudden intake of fluids and electrolytes after being on a starvation
diet
cognitive distortions in eating disorders - Answers - e.g. overgeneralizations, all-or-
nothing. surface when re-feeding begins. must be addressed consistently with all team
members. connected to low self-esteem, anxiety and feelings of lack of control
types of psychotherapy for eating disorders - Answers - cognitive behavioral therapy,
dialectical behavioral therapy, interpersonal psychotherapy, group therapy, family
therapy
binge eating disorder - Answers - individuals repeatedly eat a large amount of food in a
short amount of time and then feel guilty or shameful afterwards. they do not engage in
compensatory behaviors afterwards. there is a high incidence of mood disorders among
this group; it is an atypical type of depression as they eat when they feel down whereas
generally those with depression do not feel like eating
pharmacologic therapies for anorexia - Answers - Olanzapine (Zyprexa) [SGA]-> may
help with the underlying anxiety
pharmacologic therapies for bulimia - Answers - Fluoxetine (Prozac) -> may help with
he binge eating and purging. used as a stabilizer
personality - Answers - an ingrained, enduring pattern of behaving and relating to self,
others and the environment that does not change easily. a "style" that a person adopts
to deal with the world
personality disorder - Answers - when personality traits become inflexible and
maladaptive and significantly interfere with how a person functions in society or causes
the person emotional distress
personality traits in personality disorders - Answers - tend to be inflexible and
unpredictable
ANSWERS
eating disorders - Answers - a serious psychiatric illness with devastating and
potentially fatal medical conditions
have the highest mortality rate of all mental illnesses - Answers - eating disorders
eating disorder categories - Answers - anorexia nervosa type I, anorexia nervosa type
II, bulimia nervosa, binge eating disorder
anorexia nervosa - Answers - individual engages in self-starvation. expresses fear of
gaining weight. has a disturbance in how they evaluate their weight
anorexia nervosa type I - Answers - restricts intake of food
anorexia nervosa type II - Answers - engages in binge eating and/or purging
bulimia nervosa - Answers - person engages in repeated episodes of binge eating
followed by inappropriate compensatory behaviors
binge eating disorder - Answers - person engages in repeated episodes of binge eating,
after which they feel distressed
physique of those with binge eating disorder - Answers - clearly overweight
anorexia type II vs bulimia - Answers - diagnosis depends on belief system. anorexia
type II is egosyntonic (believing it's okay) whereas bulimia is egodystonic (knowing it's
wrong)
the number of individuals with eating disorders - Answers - unknown
estimate of females with anorexia - Answers - 1%
estimate of males with anorexia - Answers - 0.3%
estimate of females with bulimia - Answers - 1.5%
estimate of males with bulimia - Answers - 0.5%
what we want to address with eating disorders - Answers - the underlying emotions.
why are they doing what they're doing? what's driving the behavior?
,sports with an increase of eating disorders - Answers - wrestling, gymnastics,
cheerleading, boxing
when anorexia appears - Answers - in early to mid adolescence
when bulimia appears - Answers - typically in late adolescence
amount of individuals with anorexia who have a concurrent psychiatric disorder -
Answers - 50%
amount of individuals with bulimia who have a concurrent psychiatric disorder - Answers
- 95%
theories of etiology for eating disorders - Answers - neurobiological, genetics,
psychological
neurobiological theory for eating disorders - Answers - there is an alteration in serotonin
receptors and transporters
genetics theory for eating disorders - Answers - genetic vulnerability
psychological theory for eating disorders - Answers - psychological determinants such
as low self-esteem and control issues play a role
sociocultural influences on eating disorders - Answers - globalization has exposed
minorities and non-western societies to the 'value' of the thin ideal beauty
points from the therapeutic alliance for eating disorders - Answers - must remember that
the client does not choose this behavior. do not assume a parental role. be aware of
counter transference. remember the goal of treatment is the client's greatest fear
signs and symptoms of anorexia - Answers - extreme fear of obesity and gaining
weight. preoccupation with/constant thoughts of food. view of self as fat even when
emaciated. judges self worth by his/her weight. peculiar handling of food, enjoys being
around food. controls what he/she eats to feel powerful. possible development of
rigorous exercise routine. possible self induced vomiting. use of diuretics or laxatives.
loss of at least 25% of original body weight. refusal to maintain minimal body weight.
amenorrhea
signs and symptoms of bulimia nervosa - Answers - binge eating behaviors (usually in
solitude). increased mood while eating; decreased mood when stops. generally sleeps
after eating. self induced vomiting (or laxative or diuretic use after binging) when binge
is over. history of anorexia. depressive signs and symptoms. problems with
interpersonal relationships, self concept and impulsivity. increased anxiety. possible
chemical dependency. possible impulsive stealing. attempts to control weight due to
feelings of 'emptiness'
,eating disorders and other psychiatric disorders - Answers - higher percentage of those
with bulimia who also have other psychiatric disorders
some medical complications that can result from anorexia nervosa - Answers -
bradycardia. orthostatic changes in pulse rate or blood pressure. cardiac murmur - 1/3
with mitral valve prolapse. sudden cardiac arrest caused by profound electrolyte
disturbances. prolonged QT interval on electrocardiogram. acrocyanosis. symptomatic
hypotension. leukopenia. lymphocytosis. carotenemia (elevated carotene levels in
blood), which produces skin with yellow pallor. hypokalemic alkalosis (with self-induced
vomiting or use of laxatives and diuretics). elevated serum potassium levels,
hypochloremia, and hypokalemia. electrolyte imbalances, which lead to fatigue,
weakness, and lethargy. osteoporosis, indicated by low bone density. fatty degeneration
of liver, indicated by elevation of serum enzyme levels. elevated cholesterol levels.
amenorrhea. abnormal thyroid functioning. hematuria. proteinuria
some medical complications that can result from bulimia nervosa - Answers -
cardiomyopathy (rare occurrence due to diminished protein synthesis, malnutrition).
cardiac dysrhythmias. sinus bradycardia. sudden cardiac arrest as a result of profound
electrolyte disturbances. orthostatic changes in pulse rate or blood pressure. cardiac
murmur; mitral valve prolapse. electrolyte imbalances. elevated serum bicarbonate
levels (although can be low, which indicates metabolic acidosis). hypochloremia.
hypokalemia. dehydration, which results in volume depletion, leading to stimulation of
aldosterone production, which in turn stimulates further potassium excretion from
kidneys; thus there can be an indirect renal loss of potassium as well as a direct loss
through self-induced vomiting. severe attrition and erosion of teeth producing irritating
sensitivity and exposing the pulp of the teeth. loss of dental arch. diminished chewing
ability. parotid gland enlargement associated with elevated serum amylase levels.
esophageal tears caused by self-induced vomiting. severe abdominal pain indicative of
gastric dilation. Russell's sign (callus on knuckles from self-induced vomiting)
physical criteria for hospital admission of individuals with eating disorders - Answers -
weight loss >30% over 6 months. rapid decline in weight. inability to gain weight with
outpatient treatment. severe hypothermia caused by loss of subcutaneous tissue or
dehydration (body temperature lower than 36C or 96.8F). heart rate <40 bpm. systolic
blood pressure <70 mmHg. hypokalemia (<3 mEq/L) or other electrolyte disturbances
not corrected by oral supplementation. electrocardiographic changes (especially
dysrhythmias)
psychiatric criteria for hospital admission of individuals with eating disorders - Answers -
suicidal or severely irrepressible, self-mutilating behaviors. uncontrolled depression.
uncontrollable use/overuse of laxatives, emetics, diuretics, or street drugs. failure to
comply with treatment contract. severe depression, psychosis. family crisis or
dysfunction
, interventions for the hospitalized patient with an eating disorder - Answers - help client
express feelings and thoughts. constantly assess for suicidal behavior. help client
understand that their thinking is distorted
goal for hospitalized patient with an eating disorder - Answers - to restore minimal
weight or help with weight gain
expected outcomes for eating disorders - Answers - adequate intake of nutrients.
appropriate body weight. effective coping; stop binging, purging, restriction. return of
menses
refeeding syndrome - Answers - risk for cardiovascular collapse with reinstituting
feeding due to the sudden intake of fluids and electrolytes after being on a starvation
diet
cognitive distortions in eating disorders - Answers - e.g. overgeneralizations, all-or-
nothing. surface when re-feeding begins. must be addressed consistently with all team
members. connected to low self-esteem, anxiety and feelings of lack of control
types of psychotherapy for eating disorders - Answers - cognitive behavioral therapy,
dialectical behavioral therapy, interpersonal psychotherapy, group therapy, family
therapy
binge eating disorder - Answers - individuals repeatedly eat a large amount of food in a
short amount of time and then feel guilty or shameful afterwards. they do not engage in
compensatory behaviors afterwards. there is a high incidence of mood disorders among
this group; it is an atypical type of depression as they eat when they feel down whereas
generally those with depression do not feel like eating
pharmacologic therapies for anorexia - Answers - Olanzapine (Zyprexa) [SGA]-> may
help with the underlying anxiety
pharmacologic therapies for bulimia - Answers - Fluoxetine (Prozac) -> may help with
he binge eating and purging. used as a stabilizer
personality - Answers - an ingrained, enduring pattern of behaving and relating to self,
others and the environment that does not change easily. a "style" that a person adopts
to deal with the world
personality disorder - Answers - when personality traits become inflexible and
maladaptive and significantly interfere with how a person functions in society or causes
the person emotional distress
personality traits in personality disorders - Answers - tend to be inflexible and
unpredictable
