C HAPTER 18: E ATING AND F EEDING
D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Which nursing intervention has the highest priorit y for a patient diagnosed
with bulimia nervosa?
a. Assist the patient to identify triggers to binge eating.
b. Provide corrective consequences for weight loss.
c. Assess for signs of impulsive eating.
d. Explore need s for health teaching.
ANS: A
For most patients with bulimia nervosa, certain situations trigger the
urge to binge; purging then follows. Often the triggers are anxiet y -
producing situations. Identification of triggers makes it possible to
break the binge - purge cycle. Because binge eating and purging
directl y affect physical status, the need to promote physical safet y
assumes highest priorit y.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 346
TOP: Nursing Process: Planning MSC: Client Needs:
Psychosocial Integrity
,2. One bed is available on the inpatient eating disorders unit. Which patient
should be admitted to this bed? The patient whose weight decreased from:
a. 150 to 100 pounds over a 4 -month period. Vital signs are
temperature, 35.9 C; pulse, 38 beats/min; blood pressure 60/40 mm
Hg
b. 120 to 90 pounds over a 3 -month period. Vital signs are
temperature, 36 C; pulse, 50 beats/min; blood pressure 70/50 mm
Hg
c. 110 to 70 pounds over a 4 -month period. Vital signs are temperature
36.5 C; pulse, 60 beats/ min; blood pressure 80/66 mm Hg
d. 90 to 78 pounds over a 5 -month period. Vital signs are temperature,
36.7 C; pulse, 62 beats/min; blood pressure 74/48 mm Hg
ANS: A
Physical criteria for hospitalization include weight loss of more than
30% of body weight within 6 months, temperature below 36 C
(hypothermia), heart rate less than 40 beats/min, and systolic blood
pressure less than 70 mm Hg.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 334
TOP: Nursing Process: Assessment MSC: Client Needs:
Safe, Effective Care Environment
3. A nurse provides health teaching for a patient diagnosed with binge -purge
bulimia. Priorit y information the nurse should provide relates to:
a. self-monitoring of dail y food and fluid intake.
b. establishing the desired dail y weight gain.
c. how to recognize hypokalemia.
d. self-esteem maintenance.
, ANS: C
Hypokalemia results from potassium loss associated with vomiting.
Physiological integrity can be maintained if the patient can self -
diagnose potassium deficiency and adjust the diet or seek medical
assistance. Self - monitoring of dail y food and fluid intake is not useful
if the patient purges. Dail y weight gain may not be desirable for a
patient with bulimia nervosa. Self -esteem is an identifiable problem
but is of lesser priority than t he dangers associated with hypokalemia.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 334 TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity
4. As a patient admitted to the eating disorders unit undresses, a nurse
observes that the patients body is covered by fine, downy hair. The patient
weighs 70 pounds and is 5 feet 4 inches tall. Which term should be
documented?
a. Amenorrhea
b. Alopecia
c. Lanugo
d. Stupor
ANS: C
The fine, downy hair noted by the nurse is called lanugo . It is
frequentl y seen in patients with anorexia nervosa None of the other
conditions can be supported by the data the nurse has gathered.
D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Which nursing intervention has the highest priorit y for a patient diagnosed
with bulimia nervosa?
a. Assist the patient to identify triggers to binge eating.
b. Provide corrective consequences for weight loss.
c. Assess for signs of impulsive eating.
d. Explore need s for health teaching.
ANS: A
For most patients with bulimia nervosa, certain situations trigger the
urge to binge; purging then follows. Often the triggers are anxiet y -
producing situations. Identification of triggers makes it possible to
break the binge - purge cycle. Because binge eating and purging
directl y affect physical status, the need to promote physical safet y
assumes highest priorit y.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 346
TOP: Nursing Process: Planning MSC: Client Needs:
Psychosocial Integrity
,2. One bed is available on the inpatient eating disorders unit. Which patient
should be admitted to this bed? The patient whose weight decreased from:
a. 150 to 100 pounds over a 4 -month period. Vital signs are
temperature, 35.9 C; pulse, 38 beats/min; blood pressure 60/40 mm
Hg
b. 120 to 90 pounds over a 3 -month period. Vital signs are
temperature, 36 C; pulse, 50 beats/min; blood pressure 70/50 mm
Hg
c. 110 to 70 pounds over a 4 -month period. Vital signs are temperature
36.5 C; pulse, 60 beats/ min; blood pressure 80/66 mm Hg
d. 90 to 78 pounds over a 5 -month period. Vital signs are temperature,
36.7 C; pulse, 62 beats/min; blood pressure 74/48 mm Hg
ANS: A
Physical criteria for hospitalization include weight loss of more than
30% of body weight within 6 months, temperature below 36 C
(hypothermia), heart rate less than 40 beats/min, and systolic blood
pressure less than 70 mm Hg.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 334
TOP: Nursing Process: Assessment MSC: Client Needs:
Safe, Effective Care Environment
3. A nurse provides health teaching for a patient diagnosed with binge -purge
bulimia. Priorit y information the nurse should provide relates to:
a. self-monitoring of dail y food and fluid intake.
b. establishing the desired dail y weight gain.
c. how to recognize hypokalemia.
d. self-esteem maintenance.
, ANS: C
Hypokalemia results from potassium loss associated with vomiting.
Physiological integrity can be maintained if the patient can self -
diagnose potassium deficiency and adjust the diet or seek medical
assistance. Self - monitoring of dail y food and fluid intake is not useful
if the patient purges. Dail y weight gain may not be desirable for a
patient with bulimia nervosa. Self -esteem is an identifiable problem
but is of lesser priority than t he dangers associated with hypokalemia.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 334 TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity
4. As a patient admitted to the eating disorders unit undresses, a nurse
observes that the patients body is covered by fine, downy hair. The patient
weighs 70 pounds and is 5 feet 4 inches tall. Which term should be
documented?
a. Amenorrhea
b. Alopecia
c. Lanugo
d. Stupor
ANS: C
The fine, downy hair noted by the nurse is called lanugo . It is
frequentl y seen in patients with anorexia nervosa None of the other
conditions can be supported by the data the nurse has gathered.
