1.

The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is that bulimic individuals a. have episodic binge eating and purging b. have repeated attempts to stabilize their weight c. have peculiar food handling patterns d. have threatened self-esteem

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Answer: (A) have episodic binge eating and purging Bulimia is characterized by binge eating which is characterized by taking in a large amount of food over a short period of time. B and C are characteristics of a client with anorexia nervosa D. Low esteem is noted in both eating disorders

2. A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating habits. The goal for this problem is: a. Patient will learn problem solving skills b. Patient will have decreased symptoms of anxiety. c. Patient will perform self care activities daily. d. Patient will verbalize how to set limits on others.

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Answer: (A) Patient will learn problem solving skills if the client learns problem solving skills she will gain a sense of control over her life. (B) Anxiety is caused by powerlessness. (C) Performing self care activities will not decrease ones powerlessness (D) Setting limits to control imposed by others is a necessary skill but problem solving skill is the priority.

3. In the management of bulimic patients, the following nursing interventions will promote a therapeutic relationship EXCEPT: a. Establish an atmosphere of trust b. Discuss their eating behavior. c. Help patients identify feelings associated with binge-purge behavior d. Teach patient about bulimia nervosa

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Answer: (B) Discuss their eating behavior. The client is often ashamed of her eating behavior. Discussion should focus on feelings. A,C and D promote a therapeutic relationship

4. The nurse is caring for a client who has been binge eating. Which of the following descriptions of the clients behavior is most appropriate? a. The client has been slowly consuming a large amount of food over 3 hours. b. The client has been rapidly consuming a large amount of food. c. The client became extremely hungry and then consumed a large amount of food. d. The client is extremely thin but still highly concerned about her weight.

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Answer: (B) The client has been rapidly consuming a large amount of food. Binge eating is the rapid consumption of a large amount of food over a given period of time. Hunger doesnt directly affect binge eating associated with mental health disorders. Bulimic people arent necessarily thin; in fact,theyre usually of normal body size and, in many cases, slightly overweight prior to onset of the disorder.

5. The nurse is caring for a client diagnosed with bulimia and notices the Russell sign. What did the nurse notice? a. Dental enamel erosions b. Facial ecchymoses c. Pharyngitis d. Bruised knuckles

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Answer: (D) Bruised knuckles. In many cases, bulimic clients have bruised knuckles due to self-induced vomiting. This is called Russel sign.

6. The nurse is caring for bulimia. What would be the most common metabolic complication for this client? a. Metabolic alkalosis b. Respiratory alkalosis c. Respiratory acidosis d. Metabolic acidosis

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Answer: (A) Metabolic alkalosis. With repeated emesis, the client loses stomach acids, thus becoming alkalotic. Respiratory pH disturbances arent directly related to bulimia.

7. The nurse is caring for a client who has an eating disorder. Which nursing intervention would be appropriate for this client? a. Weigh the client once or twice a week, and contract for amount of food to be eaten. b. Weigh the client daily, and allow the client to use the bathroom one-half hour after eating, c. Provide one-on-one support before meals

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Answer: (A) Weighing the client more often than once or twice per week reinforces the clients excessive emphasis on weight. The client shouldnt be allowed to use the bathroom any sooner than two hours after eating without supervision. One-on-one support for the client must be undertaken before,during and after meals- not just before meals.

8. The nurse is caring for a client with bingeeating-purging disorder. What physical findings would the nurse expect? a. Parotid and salivary gland swelling, pharyngitis b. Facial ecchymoses, bruised knuckles, and excessive torso fat stores c. Depression, parotid gland swelling d. Depression, bruised knuckles

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Answer: (A) All findings listed, except excessive torso fat, are characteristic of bulimic clients. Depression, however, is a psychosocial-not a physical-finding.

9. The nurse is caring for a client with bulimia. Strict management of dietary intake is necessary. Which intervention is also important? a. Fill out the clients menu and make sure she eats at least half of whats on her tray b. Let the client eat her meals in private then engage her in social activities for at least 2 hours after each meal. c. Let the client choose her own food. If she eats everything she orders, then stay with her for 1 hour each meal. d. Let the client eat food brought in by the family but keep a strict calorie count.

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Answer: (C) Allowing the client to select her own food from the menu will her her feel some sense of control. Remaining with the client at least 1 hour after eating will prevent purging.

10. A characteristic that would suggest to Nurse Anne that an adolescent may have bulimia would be: a. Frequent regurgitation & re-swallowing of food b. Previous history of gastritis c. Badly stained teeth d. Positive body image

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Answer: (C) . Dental enamel erosion occurs from repeated self-induced vomiting.