Anorexia and Bulimia Nervosa (10 Questions)

1. You are admitting Mme Leclerc, a 19-year-old female transferred from the emergency department with a diagnosis of Anorexia Nervosa. Her BMI is 13.5. The physician has prescribed strict bed rest and cardiac monitoring. Upon entering the room, you find Mme Leclerc doing jumping jacks beside her bed.

Question:
What is your priority intervention? *

Explain to Ms. Leclerc that exercise increases her caloric expenditure and hinders weight gain.

Calmly ask Ms. Leclerc to stop and return to bed, then assess her vital signs immediately.

Ask Ms. Leclerc why she feels the need to exercise when she is so exhausted.

Close the door to provide privacy and allow her to finish her routine to reduce anxiety.

2. Mr. Jacques, 22 years old, is being treated for severe Anorexia Nervosa. He has been started on continuous nasogastric tube feeding as prescribed by the doctor. On day 3 of treatment, he complains of weakness and shortness of breath. You note mild edema in his ankles.

Question:
Which electrolyte imbalance do you suspect is occurring, requiring immediate notification of the physician? *

Hyperkalemia (High Potassium)

Hypophosphatemia (Low Phosphorus)

Hypernatremia (High Sodium)

Hypercalcemia (High Calcium)

3. You are caring for Ms. Tremblay, 17 years old, hospitalized for Anorexia Nervosa. While getting dressed, she looks in the mirror and says, "I am so disgusting and fat. Look at my stomach." You observe that she is cachectic (emaciated).

Question:
What is the most appropriate therapeutic response? *

"You are not fat, Ms. Tremblay, You are actually very underweight."

"Let's discuss what makes you feel anxious today instead of focusing on your body."

"I understand that you see yourself that way, but the medical data indicates you have lost a dangerous amount of weight."

"Don't worry, once you start eating, you will feel better about yourself."

4. Mme Rousseau, 24 years old, is admitted for Bulimia Nervosa. She admits to purging up to 6 times a day. The doctor has prescribed electrolyte replacement therapy. During your physical assessment, she complains of heart palpitations.

Question:
Apart from cardiac monitoring, which physical assessment finding is most consistent with her diagnosis and current complaint? *

Lanugo on the back and arms.

Calluses on knuckles and erosion of dental enamel.

Amenorrhea for the past 6 months.

Severe constipation and abdominal distension.

5. The psychiatrist has prescribed Fluoxetine (Prozac) 60 mg PO daily for Mme Gagnon, a patient with Bulimia Nervosa. Mme Gagnon asks, "Why am I taking an antidepressant? I'm here for an eating disorder."

Question:
What is the nurse’s best explanation regarding the rationale for this medication? *

"This medication is primarily to sedate you so you don't feel the urge to purge."

"Higher doses of this medication have been shown to help reduce the frequency of binge-eating and purging behaviors."

"The doctor prescribed it because you are obviously depressed about your weight."

"This medication will speed up your metabolism so you won't worry about gaining weight."

6. You are supervising lunch for a group of patients with Anorexia Nervosa. You notice Mme Dubois cutting her food into tiny pieces, rearranging them on the plate, and drinking large amounts of water between bites.

Question:
What is the most appropriate nursing intervention? *

Immediately remove the water and take the plate away to show strict limits.

Ignore the behavior to avoid giving her negative attention.

Remind Mme Dubois of the unit protocols regarding time limits and water consumption during meals.

Sit with Mme Dubois and feed her to ensure caloric intake.

7. Mme Giroux, diagnosed with Bulimia Nervosa, has just finished her lunch. Five minutes later, she approaches the nursing station and asks to use the bathroom.

Question:
Which action adheres to the standard standard of care for this client? *

Allow her to use the bathroom but instruct her not to flush.

Inform her that she must remain in the common area for observation for at least 1 hour.

Accompany her to the bathroom and wait outside the door.

Ask her if she feels the urge to vomit, and if she says no, allow her to go.

8. Mme Pelletier, 28 years old with Bulimia Nervosa, collapses in the hallway. She is conscious but lethargic. Her chart reveals a history of abusing laxatives. The physician orders stat blood work.

Question:
Which laboratory result would be most concerning and consistent with laxative abuse? *

Serum Potassium 2.9 mmol/L

Serum Sodium 140 mmol/L

Serum Glucose 5.5 mmol/L

Serum Creatinine 70 µmol/L

9. You are preparing Mme Fournier (Anorexia Nervosa) for discharge. Her mother says, "I'm so glad she is coming home. I will make sure to cook all her favorite rich meals and watch her eat every bite so she doesn't get sick again."

Question:
How should the nurse interpret this statement to plan discharge education? *

The mother is supportive, and this will ensure the patient's recovery.

The mother is expressing controlling behavior that may trigger a relapse.

The mother needs recipes for high-calorie supplements.

The mother understands the dietary requirements well.

10. Mme Hébert is admitted with Anorexia Nervosa. She is bargaining with the team, stating she will only eat if she is allowed to walk for 2 hours a day. The doctor has prescribed limited activity.

Question:
What is the purpose of establishing a "behavioral contract" with Mme Hébert? *

To punish Mme Hébert if she does not eat her meals.

To provide a framework where privileges are earned based on weight gain and compliance.

To allow Mme Hébert to dictate her own care plan to increase her self-esteem.

To ensure the nurse has legal protection if the patient loses weight.