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 A
Explanation
Choice A Reason: Their full therapeutic potential may not be reached until 4 weeks
This statement is correct. Tricyclic antidepressants (TCAs) often take several weeks to reach their full therapeutic effect. Patients may start to notice some improvement within one to two weeks, but it can take up to four weeks or longer for the full benefits to be realized1. This delayed onset is due to the time it takes for the medication to build up in the system and exert its effects on neurotransmitter levels.
Choice B Reason: Aged cheese should not be eaten while taking them
This statement is incorrect. The dietary restriction of avoiding aged cheese is associated with monoamine oxidase inhibitors (MAOIs), not tricyclic antidepressants. MAOIs can cause dangerous interactions with tyramine, a substance found in aged cheese and other foods, leading to hypertensive crises. TCAs do not have this dietary restriction.
Choice C Reason: They should not be given with antianxiety agents
This statement is incorrect. Tricyclic antidepressants can be used in conjunction with antianxiety agents under medical supervision. However, it is important to monitor for potential interactions and side effects. The combination can be beneficial for patients with comorbid depression and anxiety disorders.
Choice D Reason: They may cause hypomania or recent memory impairment
This statement is partially correct but not the best indicator of understanding. While TCAs can cause side effects such as memory impairment and, in rare cases, hypomania, these are not the primary concerns when teaching about the medication. The focus should be on understanding the therapeutic timeline and common side effects.
Correct Answer is C
Explanation
The correct answer is c. Be consistent in staff limit setting.
Choice A Reason: Provide Positive Reinforcement for Acting-Out Behavior
Providing positive reinforcement for acting-out behavior is counterproductive, especially for clients with antisocial personality disorder (ASPD). Positive reinforcement would encourage the continuation of manipulative and disruptive behaviors, which are characteristic of ASPD. Instead, interventions should focus on promoting positive behaviors and discouraging negative ones.
Choice B Reason: Discourage the Client from Discussing Feelings of Fear and Inferiority
Discouraging clients from discussing their feelings is not a therapeutic approach. Clients with ASPD may have underlying issues that contribute to their behavior, and discussing these feelings can be an important part of therapy. Open communication can help in understanding the root causes of their behavior and developing effective treatment plans.
Choice C Reason: Be Consistent in Staff Limit Setting
Consistency in staff limit setting is crucial when dealing with clients with ASPD. These individuals often test boundaries and manipulate situations to their advantage. Consistent limit setting helps establish clear expectations and consequences, which can reduce manipulative behaviors and promote a more structured environment4. This approach helps clients understand that their actions have predictable outcomes, which is essential for behavior modification.
Choice D Reason: Ignore, Rather than Confront Inappropriate Behavior
Ignoring inappropriate behavior can lead to an escalation of such behaviors. Clients with ASPD may interpret this as a lack of consequences, reinforcing their manipulative actions. Confronting inappropriate behavior in a consistent and structured manner is necessary to address and modify these behaviors effectively.
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