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 and has a loss of 35 pounds. Which medical diagnosis is most likely?

Anorexia nervosa

Binge eating

Eating disorder not otherwise specified

Bulimia nervosa

Answer and Explanation

The Correct Answer is A

A. Key features include severe weight loss, distorted body image, restrictive eating, and preoccupation with food (e.g., cooking for others but eating very little). Wearing loose layers to hide weight is also typical.

B. This disorder involves recurrent episodes of eating large amounts of food, often rapidly, which is not described here.

C. This category is used when symptoms do not fully meet criteria for anorexia or bulimia; the patient’s presentation fits anorexia nervosa criteria.

D. Bulimia involves bingeing and compensatory behaviors like vomiting or laxative use; no binge episodes are described in this case.

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Correct Answer is C

Explanation

A. Regression is reverting to earlier developmental behaviors (e.g., thumb-sucking under stress). The patient is not showing childlike behaviors.

B. Projection involves attributing one’s own unacceptable feelings to others. The patient is not blaming others for symptoms.

C. Denial is refusing to acknowledge a painful reality. Despite clear symptoms and diagnostic testing, the patient minimizes illness by attributing it to "just a stubborn chest cold."

D. Displacement is redirecting emotions onto a safer target (e.g., yelling at spouse instead of boss). Not evident here.

A. "My family will be better off without me." B. "Life is not worth living." C. "I wish I were dead." D. "I have a plan that will fix everything"

Correct Answer is A

Explanation

A. "My family will be better off without me" is an indirect or covert suicidal statement (passive ideation) that suggests the patient believes others would be better off if they were gone. Such remarks require immediate assessment of suicide risk (ask directly about thoughts, intent, plan, access to means) and appropriate safety interventions.
B. "Life is not worth living" is an explicit expression of hopelessness and indicates suicidal ideation, but it is more overt than covert. It still warrants urgent assessment, but the question asked specifically for the covert message.
C. "I wish I were dead" is a direct statement of suicidal desire (overt) rather than a covert hint.
D. "I have a plan that will fix everything" is the most concerning because it indicates a specific plan (high lethality risk), but it is overt rather than covert.

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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 and has a loss of 35 pounds. Which medical diagnosis is most likely?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient undergoing diagnostic tests says. "Nothing is wrong with me except a stubborn chest cold." The spouse reports the patient smokes, coughs daily. lost 15 pounds and is easily fatigued. Which defense mechanism is the patient using?

Correct Answer is C

Explanation

A nurse assesses a patient who reports a 3-week history of depression and periods of uncontrolled crying. The patient says. "My business is bankrupt and was served with divorce papers." Which subsequent statement by the patient alerts the nurse to a covert suicidal message?

Correct Answer is A

Explanation

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