Chapter 18: Feeding, Eating, and Elimination Disorders

Chapter 18: Feeding, Eating, and Elimination Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. This person wears layered loose clothing.  Her current weight is 95 pounds, a loss of 35 pounds. Which medical diagnosis is most likely?

a.	Binge eating
b.	Bulimia nervosa
c.	Anorexia nervosa
d.	Eating disorder not otherwise specified

 

 

ANS:  C

Overly controlled eating behaviors, extreme weight loss, preoccupation with food, and wearing several layers of loose clothing to appear larger are part of the clinical picture of an individual with anorexia nervosa. The individual with bulimia usually is near normal weight. The binge eater is often overweight. The patient with eating disorder not otherwise specified may be obese. See relationship to audience response question.

 

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 343-344 (Box 18-1)                 TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity

 

2. Disturbed body image is a nursing diagnosis established for a patient diagnosed with an eating disorder. Which outcome indicator is most appropriate to monitor?

a.	Weight, muscle, and fat congruence with height, frame, age, and sex
b.	Calorie intake is within required parameters of treatment plan
c.	Weight reaches established normal range for the patient
d.	Patient expresses satisfaction with body appearance

 

 

ANS:  D

Body image disturbances are considered improved or resolved when the patient is consistently satisfied with his or her own appearance and body function. This is a subjective consideration. The other indicators are more objective but less related to the nursing diagnosis.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 348 | Page 354                         TOP:   Nursing Process: Outcomes Identification

MSC:  Client Needs: Psychosocial Integrity

 

3. A patient referred to the eating disorders clinic has lost 35 pounds during the past 3 months. To assess eating patterns, the nurse should ask the patient:

a.	“Do you often feel fat?”
b.	“Who plans the family meals?”
c.	“What do you eat in a typical day?”
d.	“What do you think about your present weight?”

 

 

ANS:  C

Although all the questions might be appropriate to ask, only “What do you eat in a typical day?” focuses on the eating patterns. Asking if the patient often feels fat focuses on distortions in body image. Questions about family meal planning are unrelated to eating patterns. Asking for the patient’s thoughts on present weight explores the patient’s feelings about weight.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 349-350 (18-1 Case Study and Nursing Care Plan)

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

 

4. A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and lost 25% of body weight. A nurse asks, “Describe what you think about your present weight and how you look.” Which response by the patient is most consistent with the diagnosis?

a.	“I am fat and ugly.”
b.	“What I think about myself is my business.”
c.	“I’m grossly underweight, but that’s what I want.”
d.	“I’m a few pounds overweight, but I can live with it.”

 

 

ANS:  A

Untreated patients with anorexia nervosa do not recognize their thinness. They perceive themselves to be overweight and unattractive. The patient with anorexia will usually tell people perceptions of self. The patient with anorexia does not recognize his or her thinness and will persist in trying to lose more weight.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 344 | Page 349-350 (18-1 Case Study and Nursing Care Plan)

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Psychosocial Integrity

 

5. A patient was diagnosed with anorexia nervosa. The history shows the patient virtually stopped eating 5 months ago and lost 25% of body weight. The serum potassium is currently 2.7 mg/dL. Which nursing diagnosis applies?

a.	Adult failure to thrive related to abuse of laxatives as evidenced by electrolyte imbalances and weight loss
b.	Disturbed energy field related to physical exertion in excess of energy produced through caloric intake as evidenced by weight loss and hyperkalemia
c.	Ineffective health maintenance related to self-induced vomiting as evidenced by swollen parotid glands and hyperkalemia
d.	Imbalanced nutrition: less than body requirements related to reduced oral intake as evidenced by loss of 25% of body weight and hypokalemia

 

 

ANS:  D

The patient’s history and lab result support the nursing diagnosis Imbalanced nutrition: less than body requirements. Data are not present that the patient uses laxatives, induces vomiting, or exercises excessively. The patient has hypokalemia rather than hyperkalemia.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 348 | Page 350 (18-1 Case Study and Nursing Care Plan)

TOP:   Nursing Process: Analysis/Diagnosis

MSC:   Client Needs: Physiological Integrity