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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

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A Reason: Childhood Depression

Childhood depression is characterized by persistent sadness, irritability, and a lack of interest in activities. While it can lead to behavioral issues, it does not typically include the aggressive and antisocial behaviors described in the scenario. The symptoms of childhood depression include changes in sleep patterns, appetite, and energy levels, but these do not align with the client’s history of running away and abusive behavior towards parents.

Choice B Reason: Oppositional Defiant Disorder (ODD)

ODD is marked by a pattern of angry, irritable mood, argumentative, defiant behavior, or vindictiveness. While children with ODD may be defiant and hostile towards authority figures, the behaviors described in the scenario, such as running away and engaging in illegal activities like prostitution, are more severe and align more closely with Conduct Disorder. ODD does not typically involve the violation of societal norms to the extent seen in this case.

Choice C Reason: Conduct Disorder

Conduct Disorder is characterized by a repetitive and persistent pattern of behavior that violates the rights of others or major age-appropriate societal norms or rules. This includes aggressive behavior towards people and animals, destruction of property, deceitfulness or theft, and serious violations of rules. The client’s history of running away, abusive behavior towards parents, and involvement in illegal activities like prostitution strongly suggests Conduct Disorder. This diagnosis is supported by the presence of multiple behavioral issues that are severe and pervasive.

Choice D Reason: Autism Spectrum Disorder (ASD)

ASD is a developmental disorder that affects communication and behavior. Individuals with ASD may have difficulty with social interactions, exhibit repetitive behaviors, and have restricted interests. While ASD can sometimes be associated with challenging behaviors, it does not typically include the antisocial and aggressive behaviors described in the scenario. The client’s history of running away and abusive behavior is not characteristic of ASD.

A. Family history B. Weight C. Sedentary lifestyle D. Alcohol consumption

Correct Answer is ["B"]

Explanation

Choice A Reason: Family history

Family history is not a modifiable risk factor. It refers to the genetic predisposition to certain health conditions based on the medical history of one’s family. While it is important to be aware of family history to understand potential risks, it cannot be changed or modified through lifestyle adjustments.

Choice B Reason: Weight

Weight is a modifiable risk factor. Maintaining a healthy weight through diet and exercise can significantly reduce the risk of various health conditions, including heart disease, diabetes, and hypertension. Weight management is crucial for overall health and can be controlled through lifestyle changes.

Choice C Reason: Sedentary lifestyle

A sedentary lifestyle is a modifiable risk factor. Increasing physical activity and reducing sedentary behavior can improve cardiovascular health, enhance mental well-being, and reduce the risk of chronic diseases. Encouraging regular exercise and active living is essential for health improvement.

Choice D Reason: Alcohol consumption

Alcohol consumption is a modifiable risk factor. Limiting or avoiding alcohol can reduce the risk of liver disease, certain cancers, and other health issues. Moderation in alcohol intake is important for maintaining good health and preventing related complications.

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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)

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