Kristi Breese
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Nursing Quiz on MH 433 Eating disorders, created by Kristi Breese on 05/12/2016.

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Kristi Breese
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MH 433 Eating disorders

Question 1 of 42

1

The following are indicative of anorexia. Select all that apply.

Select one or more of the following:

  • Self-induced vomiting

  • Use of laxatives and diuretics

  • Judges self-worth by weight

  • Lanugo

  • Terror of gaining weight

  • Impulsive and compulsive

  • Binge eating

  • Cachetic

  • Peculiar handling of food

Explanation

Question 2 of 42

1

The following are indicative of bulimia. Select all that apply.

Select one or more of the following:

  • Impulsive and compulsive

  • Anxiety

  • Possible chemical dependency and shoplifting

  • Binge eating followed by purging

  • Depressive signs and symptoms

  • Lanugo

  • Undoes weight after bingeing

  • Terror of gaining weight

Explanation

Question 3 of 42

1

The cause of eating disorders is varied and complex. Eating disorders include a biological vulnerability or predisposition that is activated by psychological, environmental, and cultural factors.

Select one of the following:

  • True
  • False

Explanation

Question 4 of 42

1

Abnormalities are of the "the chicken or the egg" quality because we are not certain whether they cause the eating disorder or if the eating disorder causes them. Serotonin pathways are abnormal.

Select one of the following:

  • Neurobiologic or Neuroendocrine Models

  • Genetic Models

  • Cultural considerations

Explanation

Question 5 of 42

1

Individuals with eating disorders have a characteristic phenotype: Constellation of personality traits that have been shown to be moderately heritable.

Select one of the following:

  • Neurobiologicl or Neuroendocrine Models

  • Genetic Models

  • Psychologic Models

Explanation

Question 6 of 42

1

Fill the blank space to complete the text.

Female relatives of people with eating disorders are up to times more likely to develop them as well.

Explanation

Question 7 of 42

1

Core characteristics of eating disorders are thought to be low self-esteem and self-doubts about personal worth. Family theorists long believed that specific dynamics converge to create individuals with eating disorders.

Select one of the following:

  • Psychologic Models

  • Cultural considerations

  • Genetic Models

Explanation

Question 8 of 42

1

Eating disorders increase in societies where women have a choice in social roles.

Select one of the following:

  • Cultural considerations

  • Neurobiologic or Neuroendocrine Models

  • Psychologic Models

Explanation

Question 9 of 42

1

Fill the blank space to complete the text.

People with eating disorders have that are the result of processing errors in the brain.

Explanation

Question 10 of 42

1

Eating disorders are connected to underlying emotions of:

Select one of the following:

  • Anxiety

  • Dysphoria

  • Low self-esteem

  • Feelings of lack of control

  • All of the above

Explanation

Question 11 of 42

1

Determining which cognitive distortions were present before the eating disorder and which ones are the result of semistarvation is important.

Select one of the following:

  • True
  • False

Explanation

Question 12 of 42

1

Risk factors for an eating disorder include interpersonal factors and social factors.

Select one of the following:

  • True
  • False

Explanation

Question 13 of 42

1

Interpersonal factors include: Select all that apply.

Select one or more of the following:

  • Troubled personal and family interactions

  • Difficulty expressing emotions and feelings

  • History of being teased or ridiculed based on size or weight

  • History of physical, emotional and/or sexual abuse

  • Media influence

  • "War on obesity"

Explanation

Question 14 of 42

1

Social factors include: Select all that apply.

Select one or more of the following:

  • Media influence

  • High focus on physical attributes

  • Occupational influence (sports/performing arts)

  • "War on obesity"

  • Acceptance of normative discontent and dieting as an accepted lifestyle choice

  • Troubled personal and family interactions

  • History of being teased or ridiculed based on size or weight

Explanation

Question 15 of 42

1

Signs and symptoms of an eating disorder include:

Dramatic weight loss in a relatively short period of time
Obsession with weight, calories, fat, food groups, exercise, recipes, cooking for others
Frequent sore throats, swollen glands, and/or headaches
Frequent trips to the bathroom after meals (often run water to mask sound)
Isolation when eating
Unusual eating habits (i.e cutting up food in tiny pieces, over-seasoning food, spitting out food, lots of water, small bites)
Low self-esteem
Constantly feeling cold
Mood swings
Hiding/stealing food
Insomnia

Select one of the following:

  • True
  • False

Explanation

Question 16 of 42

1

Anorexia nervosa appears in

Select one of the following:

  • early to middle adolescence

  • late adolescence

  • adulthood

Explanation

Question 17 of 42

1

Bulimia nervosa appears in

Select one of the following:

  • early to middle adolescence

  • late adolescence

  • adulthood

Explanation

Question 18 of 42

1

For women aged 35-65 years, changes in appearance and role can potentially increase the risk of developing an eating disorder.

Select one of the following:

  • True
  • False

Explanation

Question 19 of 42

1

Eating disorders are almost never co-morbid with other psychiatric illnesses.

Select one of the following:

  • True
  • False

Explanation

Question 20 of 42

1

What are some assessment findings in anorexia nervosa? Select all that apply.

Select one or more of the following:

  • High suicide rate - Highest mortality rate of all DSM diagnoses

  • Refusal to maintain body weight above 85% of ideal

  • Intense fear of gaining weight

  • Body image distortion or denial of seriousness of low weight

  • Amenorrhea for three months

  • Two types: restricting or purging

  • Normal weight or overweight

  • High blood pressure

  • Sore throat

Explanation

Question 21 of 42

1

What are some assessment findings in bulimia nervosa? Select all that apply

Select one or more of the following:

  • Normal weight or overweight

  • High blood pressure

  • Swollen glands/Sore throat

  • Dental erosions and staining

  • Scars on knuckles of hands

  • Edema/Extremity weakness

  • Potential for gastric rupture during bingeing

  • Inflammation and possible rupture of esophagus

  • Electrolyte imbalance

  • Refusal to maintain body weight above 85% of ideal

Explanation

Question 22 of 42

1

What does the clinical picture of anorexia nervosa look like?

Select one of the following:

  • Orthostatic changes, bradycardia, cardiac murmur, sudden cardiac arrest

  • Prolonged QT interval, acrocyanosis, symptomatic hypotension, leukopenia, lymphocytosis, carotenemia

  • Hypokalemic alkalosis, electrolyte imbalances, osteoporosis, fatty degeneration of liver, elevated cholesterol levels

  • Amenorrhea, abnormal thyroid functioning, hematuria, proteinuria

  • All of the above

Explanation

Question 23 of 42

1

Refeeding syndrome is a potentially fatal shift in fluids and electrolytes that may occur due to prolonged malnourishment.

Select one of the following:

  • True
  • False

Explanation

Question 24 of 42

1

How does refeeding syndrome happen?

Select one or more of the following:

  • Despite food deprivation, body attempts to achieve homeostasis by essentially starving the cells of fluids and electrolytes in an effort to keep blood levels normal. Metabolism slows down to make the minimal nutrients in the body last as long as possible.

  • Once food is introduced back in the system, system is overloaded. Starved cells rapidly absorb water and electrolytes (Ph, K+, Mg2+) causing shift in fluid and electrolyte imbalance.

  • How the heck do I know?

Explanation

Question 25 of 42

1

How do we prevent refeeding syndrome?

Select one or more of the following:

  • Reintroduce food slowly and gradually

  • Assess cardiovascular status

  • Let the patient eat and drink as much as they want in one setting

  • By coloring pretty pictures

Explanation

Question 26 of 42

1

Refeeding syndrome is potentially fatal.

Select one of the following:

  • True
  • False

Explanation

Question 27 of 42

1

Why do we care about refeeding syndrome?

Select one or more of the following:

  • Abnormal sodium and fluid balance. Changes in glucose, protein and fat metabolism, thiamine deficiency, hypokalemia, hypomagnesaemia

  • Result is possible fluid overload, congestive cardiac failure, pulmonary edema, and cardiac arrhythmia

  • Because we were told to care

Explanation

Question 28 of 42

1

Characteristics of bulimia nervosa are:

-Recurrent binge episodes (consumption of large amounts of food with loss of control)
-Recurrent use of inappropriate behaviors to prevent weight gain (vomiting, laxatives, diuretics, exercise, diet pills)
-Both bingeing and purging occur, on average, two times weekly for three months
-Self-evaluation influenced by weight/shape

Select one of the following:

  • True
  • False

Explanation

Question 29 of 42

1

The clinical picture of bulimia nervosa looks like

Select one of the following:

  • Cardiomyopathy (ipecac toxicity), cardiac dysrhythmias, sinus bradycardia, sudden cardia arrest, orthostatic changes in pulse and blood pressure

  • Electrolyte imbalance, metabolic acidosis, hypochloremia, hypokalemia, dehydration and renal loss of potassium as a result of self-induced vomiting

  • Attrition and erosion of teeth, loss of dental arch, diminished chewing ability, parotic gland enlargement

  • Esophageal tears as a result of self-induced vomiting, gastric dilation, Russell sign

  • All of the above

Explanation

Question 30 of 42

1

Nursing care of patients with eating disorders include:

Select one of the following:

  • Assess for suicidal thoughts and self-injuriousbehaviors.

  • Acknowledge emotional and physical difficulties.

  • Monitor physiologic parameters (e.g., vital signs, electrolyte levels).

  • Weigh the patient using strict protocol.

  • Monitor during and after meals to prevent the throwing away or purging of food.

  • Recognize the patient’s distorted image andvalue of body shape.

  • Educate the patient regarding the ill effects of low weight and impaired health.

  • Assist in identifying strengths.

  • All of the above

Explanation

Question 31 of 42

1

Planning care in the acute phase of anorexia nervosa includes: Select all that apply.

Select one or more of the following:

  • Intensive care unit (ICU), critical care unit (CCU), ED unit (crisis state)

  • Establishment of trust

  • Monitoring of weight and eating

  • Countering distorted ideas

  • Milieu therapy, counseling, health teaching, and medications

  • Patient privileges linked to treatment plan compliance

Explanation

Question 32 of 42

1

Possible long-term treatment for anorexia nervosa includes

Select one of the following:

  • Periodic brief hospital stays

  • Outpatient psychotherapy

  • Medications

  • All of the above

Explanation

Question 33 of 42

1

Planning care in the acute phase of bulimia nervosa includes: Select all that apply.

Select one or more of the following:

  • Patient is admitted into an inpatient unit.

  • CBT is highly effective.

  • Binge and purge cycle is interrupted.

  • Eating habits are normalized.

  • Underlying conflicts and distortions are examined.

  • Co-morbid depression and substance abuse are treated.

Explanation

Question 34 of 42

1

For patient with bulimia nervosa, the patient is referred for long term care on discharge to solidify goals and to address attitudes and perceptions that maintain the eating disorder. Also, the patient and family benefit from connecting with the national network and often, psychotherapy is performed.

Select one of the following:

  • True
  • False

Explanation

Question 35 of 42

1

Evidence based research suggests multi-disciplinary approach to be the least effective form of treating for an eating disorder.

Select one of the following:

  • True
  • False

Explanation

Question 36 of 42

1

Treatment of eating disorders include: select all that apply

Select one or more of the following:

  • Milieu therapy

  • Health teaching

  • Health promotion

  • Singing songs

  • Psychotherapy

  • Cognitive Behavioral therapy (CBT) and dialectal-behavior therapy (DBT)

  • Psychodynamic therapy

  • Group and family therapy

  • Going to fat camp

Explanation

Question 37 of 42

1

What are some guidelines when communicating with a patient with an eating disorder?

Select one or more of the following:

  • Understand that the patient may feel shame and totally out of control.

  • Therapeutic alliance empathizes with the feelings of low self-esteem, unworthiness, and dysphoria.

  • Nurse may suspect dishonesty when the patient does not report bingeing and/or purging.

  • Accepting, having a nonjudgmental approach, and understanding the subjective experience of the patient will help build trust.

  • With bulimia, be aware that the patient is sensitive to the perceptions of others

  • Yelling, screaming, and telling the patient they are worthless

Explanation

Question 38 of 42

1

Long-term outpatient treatment helps patients:
-maintain health weight
-with individual, family, group therapy, psychopharmacology, and nutrition counseling
-address depression, substance abuse, and/or personality disorders that interfere with quality of life

Select one of the following:

  • True
  • False

Explanation

Question 39 of 42

1

Self-worth and interpersonal functioning aren't issues that are useful to target

Select one of the following:

  • True
  • False

Explanation

Question 40 of 42

1

Which of the following is an example of all-or-nothing thinking, which is a frequent cognitive distortion of patients with an ED?

Select one of the following:

  • “If I allow myself to gain weight, I’ll be huge.”

  • “I’m unpopular because I’m fat.”

  • “When I’m thin, I’m powerful.”

  • “When people say I look better, they’re really thinking I look fat.”

Explanation

Question 41 of 42

1

Typical goals of inpatient hospitalization for a patient with anorexia do not include which of the following?

Select one of the following:

  • Stabilization of the patient’s immediate condition

  • Limited weight restoration

  • Determination of the causes for the ED

  • Restoration of normal electrolyte balance

Explanation

Question 42 of 42

1

Which medication is likely to be used in the treatment of patients with EDs?

Select one of the following:

  • SSRI, such as fluoxetine

  • Antipsychotic medication, such as risperidone

  • Anxiolytic medication, such as alprazolam

  • Anticonvulsant agent, such as carbamazepine

Explanation

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