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 D

Explanation

A. Tranylcypromine sulfate (Parnate) is a monoamine oxidase inhibitor (MAOI) that carries a high risk of toxicity in overdose and is generally avoided in patients with a history of suicide attempts.

B. Amitriptyline (Elavil) is a tricyclic antidepressant (TCA), which can be lethal in overdose, making it unsafe for patients at high risk for suicide.

C. Desipramine (Norpramin) is also a TCA and poses a similar overdose risk as amitriptyline, so it is not preferred for suicidal patients.

D. Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI), which has a much lower lethality in overdose compared to TCAs or MAOIs, making it the preferred choice for patients with a history of suicidal behavior.

A. Antipsychotic drugs B. Benzodiazepines C. Mood stabilizers D. Tricyclic antidepressants

Correct Answer is B

Explanation

A. Antipsychotics are used for psychosis (e.g., schizophrenia, delusions, hallucinations), not for acute anxiety.

B. Benzodiazepines (e.g., lorazepam, diazepam, alprazolam) are the treatment of choice for acute anxiety or panic attacks because they act quickly (within minutes to hours) by enhancing GABA neurotransmission, providing rapid relief.

C. Mood stabilizers (e.g., lithium, valproate) are used in bipolar disorder, not for acute situational anxiety.

D. Tricyclic antidepressants (e.g., amitriptyline) are used for long-term management of depression and some anxiety disorders, but their onset is delayed (2–6 weeks), making them ineffective for acute anxiety.

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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

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