EATING DISORDERS:

1. Which structure in the brain contains the appetite regulation center?

1. Thalamus.
2. Amygdala.
3. Hypothalamus.
4. Medulla.

2. The nurse is teaching about factors that influence eating patterns. Which of the following statements indicate that
learning has occurred? Select all that apply.
1. “Factors such as taste and texture can affect appetite.”
2. “The function of my digestive organs affects my eating behaviors.”
3. “High socioeconomic status determines nutritious eating patterns.”
4. “Social interaction contributes little to eating patterns.”
5. “Society and culture influence eating patterns.”

3. Which anorexia nervosa etiology is from a neuroendocrine perspective?

1. Anorexia nervosa is more common among sisters and mothers of clients with the disorder than among the general
population.
2. Altered structure and function of the thalamus is implicated in the diagnosis of anorexia nervosa.
3. There is a higher-than-expected frequency of mood disorders among first-degree relatives of clients diagnosed
with anorexia nervosa.
4. Clients diagnosed with anorexia nervosa have elevated cerebrospinal fluid cortisol levels and possible alterations
in the regulation of dopamine.

4. Which etiological implication for obesity is from a physiological perspective?

1. Eighty percent of offspring of two obese parents become obese.
2. Individuals who are obese have unresolved dependency needs and are fixed in the oral stage of development.
3. Hyperthyroidism interferes with metabolism and may lead to obesity.
4. Lesions in the appetite and satiety centers in the hypothalamus lead to overeating and obesity.
Nursing Process—Assessment
5. A client is being admitted to the in-patient psychiatric unit with a diagnosis of bulimia nervosa. The nurse would
expect this client to fall within which age range?
1. 5 to 10 years old.
2. 10 to 14 years old.
3. 18 to 22 years old.
4. 40 to 45 years old.

6. Which individual would be at highest risk for obesity?

1. A poor black woman.
2. A rich white woman.
3. A rich white man.
4. A well-educated black man.

7. A client with a long history of bulimia nervosa is seen in the emergency department. The client is seeing things
that others do not, is restless, and has dry mucous membranes. Which is most likely the cause of this client’s
symptoms?
1. Mood disorders, which often accompany the diagnosis of bulimia nervosa.
2. Nutritional deficits, which are characteristic of bulimia nervosa.
3. Vomiting, which may lead to dehydration and electrolyte imbalance.
4. Binging, which causes abdominal discomfort.

8. An 18 year-old female client weighs 95 pounds and is 70 inches tall. She has not had a period in 4 months and
states, “I am so fat!” Which statement is reflective of this client’s symptoms?
1. The client meets the criteria for a diagnosis of bulimia nervosa.
2. The client meets the criteria for a diagnosis of anorexia nervosa.
3. The client needs further assessment to be diagnosed.
4. The client is exhibiting normal developmental tasks according to Erikson.

9. The nurse is assessing a client with a body mass index (BMI) of 35. The nurse would suspect this client to be at
risk for which of the following conditions? Select all that apply.
1. Hypoglycemia.
2. Rheumatoid arthritis.
3. Angina.
4. Respiratory insufficiency.
5. Hyperlipidemia.

10. The family of a client diagnosed with anorexia nervosa has cancelled the past two family counseling sessions.
Which of the following could be reasons for this nonadherence? Select all that apply.
1. The family is fearful of the social stigma of having a family member with emotional problems.
2. The family is dealing with feelings of guilt because of the perception that they have contributed to the disorder.
3. There may be a pattern of conflict avoidance, and the family fears conflict would surface in the sessions.
4. The family may be attempting to maintain family equilibrium by keeping the client in the sick role.
5. The client is now maintaining adequate nutrition, and the sessions are no longer necessary.

11. Which anorexia nervosa symptom is physical in nature?

1. Dry, yellow skin.
2. Perfectionism.
3. Frequent weighing.
4. Preoccupation with food.

12. Which of the following statements are true as they relate to obesity? Select all that apply.
1. Obesity is a psychiatric disorder, and diagnostic criteria are similar to other eating disorders.
2. Binge-eating disorder is described as an eating disorder in the Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM-5), and this disorder can lead to obesity.
3. Obesity is currently evaluated for all clients as a psychological factor affecting medical conditions.
4. Obesity is not classified as an eating disorder but can be considered as a psychological factor affecting other
medical conditions.
5. The World Health Organization defines obesity as a BMI of 30.0 or greater.

13. After a routine dental examination on an adolescent, the dentist reports to the parents that bulimia nervosa is
suspected. On which of the following assessment data would the dentist base this determination? Select all that
apply.
1. Extreme weight loss.
2. Amenorrhea.
3. Discoloration of dental enamel.
4. Bruises of the palate and posterior pharynx.
5. Dental enamel dysplasia.
Nursing Process—Diagnosis
14. A client diagnosed with anorexia nervosa has a short-term outcome that states, “The
client will gain 2 pounds in 1 week.” Which nursing diagnosis reflects the problem
that this outcome addresses?
1. Ineffective coping R/T lack of control.
2. Altered nutrition: less than body requirements R/T decreased intake.
3. Self-care deficit: feeding R/T fatigue.
4. Anxiety R/T feelings of helplessness.
15. A client with cachexia states, “I don’t care what you say; I am horribly fat and will
continue to diet.” The client is experiencing arrhythmias and bradycardia. Based on
this client’s symptoms, which nursing diagnosis takes priority?
1. Ineffective denial.
2. Imbalanced nutrition: less than body requirements.
3. Disturbed body image.
4. Ineffective coping.
Nursing Process—Planning
16. A client is leaving the in-patient psychiatric facility after 1 month of treatment for
anorexia nervosa. Which outcome is appropriate during discharge planning for this
client?
1. Client will accept refeeding as part of a daily routine.
2. Client will perform nasogastric tube feeding independently.
3. Client will verbalize recognition of “fat” body misperception.
4. Client will discuss importance of monitoring weight daily.

17. A client diagnosed with anorexia nervosa has a nursing diagnosis of imbalanced
nutrition: less than body requirements. Which long-term, correctly written outcome
addresses client problem improvement?
1. The client’s BMI will be 20 by the 6-month follow-up appointment.
2. The client will be free of signs and symptoms of malnutrition and dehydration.
3. The client will use one healthy coping mechanism during a time of stress by
discharge.
4. The client will understand a previous dependency role by 3-month follow-up visit.
Nursing Process—Implementation
18. Which nursing intervention would directly assist a hospitalized client diagnosed with
bulimia nervosa in avoiding the urge to purge after discharge?
1. Locking the door to the client’s bathroom.
2. Holding a mandatory group after mealtime to assist in exploration of feelings.
3. Discussing preplanned meals to decrease anxiety around eating.
4. Educating the family to recognize purging side effects.
19. A client diagnosed with anorexia nervosa is newly admitted to an in-patient
psychiatric unit. Which intervention takes priority?
1. Assessment of family issues and health concerns.
2. Assessment of early disturbances in mother-infant interactions.
3. Assessment of the client’s knowledge of selective serotonin reuptake inhibitors
(SSRIs) used in treatment.
4. Assessment and monitoring of vital signs and lab values to recognize and anticipate
medical problems.
20. When using a behavioral modification approach for the treatment of eating disorders,
which nursing intervention would be most likely to produce positive results?
1. Take a matter-of-fact, directive approach with the input of the entire treatment team.
2. Clients should perceive that they are in control of clearly communicated treatment
choices.
3. Appropriate treatment choices are presented to the client’s family for
consideration.
4. The treatment team develops a system of rewards and privileges that can be earned
by the client.
21. A nurse sitting with a client diagnosed with anorexia nervosa notices that the
client has eaten 80% of lunch. The client asks the nurse, “What do you like better,
hamburgers or spaghetti?” Which is the best response by the nurse?
1. “I’m Italian, so I really enjoy a large plate of spaghetti.”
2. “I’ll weigh you after your meal.”
3. “Let’s focus on your continued improvement. You ate 80% of your lunch.”
4. “Why do you always talk about food? Let’s talk about swimming.”
22. A client on an in-patient psychiatric unit has been diagnosed with bulimia nervosa.
The client states, “I’m going to the bathroom and will be back in a few minutes.”
Which nursing response is most appropriate?
1. “Thanks for checking in.”
2. “I will accompany you to the bathroom.”
3. “Let me know when you get back to the dayroom.”
4. “I’ll stand outside your door to give you privacy.”
23. A client diagnosed with binge-eating disorder has a nursing diagnosis of low
self-esteem. Which nursing intervention would address this client’s problem?
1. Offer independent decision-making opportunities.
2. Review previously successful coping strategies.
3. Provide a quiet environment with decreased stimulation.
4. Allow the client to remain in a dependent role throughout treatment.

24. Imbalanced nutrition: less than body requirements R/T altered body perception AEB
client’s being 5 feet 4 inches tall, weighing 75 pounds, is assigned to a client diagnosed
with anorexia nervosa. Which nursing intervention would address this client’s
problem?
1. Encourage the client to keep a diary of food intake.
2. Plan exercise tailored to individual choice.
3. Help the client to identify triggers to self-induced purging.
4. Monitor physician-ordered nasogastric tube feedings.
Nursing Process—Evaluation
25. The instructor is teaching nursing students about the psychodynamic influences of
eating disorders. Which statement indicates that more teaching is necessary?
1. “Eating disorders result from very early and profound disturbances in father-infant
interactions.”
2. “Disturbances in mother-infant interactions may result in retarded ego
development.”
3. “When a mother meets the physical and emotional needs of a child by providing
food, this behavior contributes to the child’s ego development.”
4. “Poor self-image leads to a perceived lack of control. The client compensates for
this perceived lack of control by controlling behaviors related to eating.”
26. Which of the following nursing evaluations of a client diagnosed with anorexia
nervosa would lead the treatment team to consider discharge? Select all that apply.
1. The client participates in individual therapy.
2. The client has a BMI of 16.
3. The client consumes adequate calories as determined by the dietitian.
4. The client is dependent on his or her mother for most basic needs.
5. The client states, “I realize that I can’t be perfect.”
Psychopharmacology
27. A client diagnosed with bulimia nervosa has responded well to citalopram (Celexa).
Which is the possible cause for this response?
1. There is an association between bulimia nervosa and dilated blood vessels and
inactive alpha-adrenergic and serotoninergic receptors.
2. There is an association between bulimia nervosa and the neurotransmitter
dopamine.
3. There is an association between bulimia nervosa and the neurotransmitters
serotonin and norepinephrine.
4. There is an association between bulimia nervosa and a malfunction of the
thalamus.
28. Which medication is used most often in the treatment of clients diagnosed with
anorexia nervosa?
1. Fluphenazine (Prolixin).
2. Clozapine (Clozaril).
3. Fluoxetine (Prozac).
4. Methylphenidate (Ritalin).
29. Structures of the brain impact eating disorders. Identify the following structures of
the brain on the provided diagram.
1. _____ Thalamus.
2. _____ Amygdala.
3. _____ Hypothalamus.
4. _____ Hippocampus.

30. A client diagnosed with anorexia nervosa is admitted with dehydration. An IV of

D5W is ordered to run at 150 cc/hr. Using tubing that delivers 15 gtts/cc, the nurse
should adjust the rate of flow to _____ gtts/min.