A nurse is caring for a 22-year-old female client who has bulimia nervosa and frequently self-induces vomiting. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY)
Amenorrhea
Dental erosion
Dry oral mucosa
Icteric sclera
Presence of lanugo
Correct Answer : A,B,C,E
The correct answer is
a. Amenorrhea
b. Dental erosion
c. Dry oral mucosa
e. Presence of lanugo
Choice A Reason:
Amenorrhea is the absence of menstruation. It is a common finding in individuals with bulimia nervosa due to hormonal imbalances caused by malnutrition and extreme weight loss. The body’s reproductive system can be significantly affected by the lack of essential nutrients, leading to disruptions in the menstrual cycle. Additionally, the stress and anxiety associated with bulimia can further contribute to amenorrhea. In clinical practice, amenorrhea is often used as an indicator of the severity of an eating disorder and the need for medical intervention.
Choice B Reason:
Dental erosion is another expected finding in clients with bulimia nervosa. Frequent self-induced vomiting exposes the teeth to stomach acid, which can erode the enamel and lead to significant dental problems. Over time, this acid exposure can cause the teeth to become sensitive, discolored, and more prone to cavities and decay. Dental erosion is often one of the first physical signs that healthcare providers notice in individuals with bulimia, and it can serve as a critical clue in diagnosing the disorder. Regular dental check-ups and proper oral hygiene are essential for managing this condition.
Choice C Reason:
Dry oral mucosa is a common symptom in individuals with bulimia nervosa. The frequent vomiting and dehydration associated with the disorder can lead to a dry mouth. Additionally, the use of diuretics and laxatives, which are sometimes abused by individuals with bulimia, can further contribute to dehydration and dry oral mucosa. This condition can cause discomfort, difficulty swallowing, and an increased risk of oral infections. Proper hydration and oral care are crucial for managing dry oral mucosa in clients with bulimia nervosa.
Choice D Reason:
Icteric sclera refers to the yellowing of the whites of the eyes, typically associated with liver dysfunction or jaundice. This is not a common finding in individuals with bulimia nervosa and is not directly related to the disorder. While bulimia can have various physical effects on the body, icteric sclera is not one of the expected findings. If a client with bulimia presents with icteric sclera, it would warrant further investigation to determine the underlying cause, which may be unrelated to the eating disorder.
Choice E Reason:
Presence of lanugo is the growth of fine, soft hair on the body, which is a common finding in individuals with eating disorders, including bulimia nervosa. Lanugo develops as the body’s response to extreme weight loss and malnutrition, as it attempts to conserve heat and energy. This fine hair can appear on the face, arms, and other areas of the body. The presence of lanugo is a sign of severe malnutrition and indicates the need for immediate medical intervention to address the underlying eating disorder and restore proper nutrition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is b. It’s not my fault.
Choice A Reason: I just don’t remember doing it
This statement might be used by someone trying to avoid responsibility, but it is not as characteristic of antisocial personality disorder (ASPD) as outright denial of fault. Individuals with ASPD often exhibit a lack of accountability and may lie or manipulate to avoid consequences. However, claiming memory loss is less direct than denying responsibility altogether.
Choice B Reason: It’s not my fault
This statement is highly characteristic of antisocial personality disorder. Individuals with ASPD often refuse to take responsibility for their actions and may blame others or external circumstances. This lack of accountability and tendency to deflect blame is a core feature of the disorder, making this the most expected comment.
Choice C Reason: I’m really sorry about all the people I’ve hurt
This statement is unlikely for someone with antisocial personality disorder. People with ASPD typically lack empathy and remorse for their actions. Expressing genuine sorrow and concern for others is not consistent with the typical behavior of someone with this disorder.
Choice D Reason: I’m too ashamed to talk about it
This statement suggests a level of self-awareness and guilt that is not typical of antisocial personality disorder. Individuals with ASPD generally do not experience shame or guilt in the same way as others. They are more likely to be indifferent or dismissive about the consequences of their actions.
Correct Answer is A
Explanation
a. Cardiac dysrhythmia resulting in cardiac arrest
Explanation of Choices
Choice A Reason: Cardiac Dysrhythmia Resulting in Cardiac Arrest
Cardiac dysrhythmias, or irregular heartbeats, are a significant health complication associated with anorexia nervosa. These dysrhythmias can result from electrolyte imbalances, particularly low potassium levels (hypokalemia), which are common in individuals with anorexia due to malnutrition and purging behaviors. Severe dysrhythmias can lead to cardiac arrest, making this one of the most critical and potentially fatal complications of anorexia nervosa. The heart muscle can weaken due to prolonged malnutrition, leading to a condition known as myocardial atrophy, which further increases the risk of cardiac complications.
Choice B Reason: Endocrine Imbalance Causing Amenorrhea
Amenorrhea, or the absence of menstruation, is a common endocrine complication in females with anorexia nervosa. This condition occurs due to the body’s response to severe weight loss and malnutrition, which disrupts the normal production of reproductive hormones. While amenorrhea is a significant health issue, it is not as immediately life-threatening as cardiac dysrhythmias. Amenorrhea can lead to long-term complications such as infertility and osteoporosis but does not typically result in acute medical emergencies.
Choice C Reason: Decreased Metabolism Causing Cold Intolerance
Decreased metabolism and cold intolerance are common symptoms in individuals with anorexia nervosa. The body reduces its metabolic rate in response to prolonged starvation to conserve energy. This can lead to a lower body temperature and increased sensitivity to cold. While uncomfortable and indicative of severe malnutrition, decreased metabolism and cold intolerance are not as immediately dangerous as cardiac dysrhythmias. These symptoms reflect the body’s adaptation to a state of energy deficiency but do not pose an immediate threat to life.
Choice D Reason: Glucose Intolerance Resulting in Hypoglycemia
Hypoglycemia, or low blood sugar, can occur in individuals with anorexia nervosa due to inadequate food intake. However, glucose intolerance and hypoglycemia are less common and less severe complications compared to cardiac dysrhythmias. Hypoglycemia can cause symptoms such as dizziness, confusion, and fainting, but it is typically manageable with appropriate nutritional support. It does not carry the same immediate risk of fatality as cardiac dysrhythmias.
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