Eating Disorders

~ Exam ~

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1. Which of the following is criterion for the diagnosis of anorexia nervosa, according to the American Psychiatric Association?
  a. The person recognizes she is extremely thin and needs professional help.
  b. The person has no interest in food.
  c. Intense fear of gaining weight or becoming fat, even though underweight.
  d. Weight loss of at least 5% of original body weight.

2. Which of the following is criterion for the diagnosis of bulimia, according to the American Psychiatric Association?
  a. The person is able to control her binges and stop eating when she wants to.
  b. The person regularly engages in either self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise in order to prevent weight gain.
  c. Occasionally eating large amounts of food without concern.

  d. Both a and c.

3. Which of the following describes characteristic behavior(s) of a bulimic?
  a. Their binge-purge behavior is almost always carried on in private.

  b. They binge in the presence of others, such as at parties or holiday dinners.

  c. They may vomit up to 20 times daily or take up to 50 doses of laxatives per day.

  d. The person is able to control this behavior.

  e. Both a and c.

4. Which of the following describes characteristic behavior(s) of an anorexic?
  a. The person is ashamed of her emaciated body.

  b. The person has a poor appetite.
  c. She is not likely to exercise.

  d. She is completely preoccupied with food and eating.
5. In regards to the correlation between fat and health risks, which of the following is/are true?
  a. Researchers have found that the medical risks of obesity have been greatly exaggerated and misunderstood.

  b. Obesity causes high blood pressure, heart disease and diabetes.

  c. Genetics play an important role in the development of disease.

  d. Both a and c.

6. The following is a greater health risk than simple obesity:
  a. using diet products.

  b. the weight cycling caused by repeated dieting.
  c. over-exercising.

7. An appropriate treatment for obese individuals would be:
  a. to focus on overall good health and self-acceptance.

  b. to prescribe a weight loss diet.

  c. to encourage a rigorous exercise program to induce weight loss.
8. Many recent studies have shown that restrictive diets:
  a. are an effective and permanent weight loss solution.

  b. are not an effective and permanent weight loss solution.

  c. should be prescribed to all obese individuals.

9. Set point can be defined as:
  a. the body’s attempt to defend a physiologically programmed weight level.

  b. the number of calories a person must ingest in order to lose weight.

  c. an individual’s appropriate weight according to insurance company charts.

10. The net effect of dieting is actually paradoxical to the intent, as evidenced by which of the following statements?
  a. Metabolism speeds up with weight loss so that calories are used more efficiently.

  b. The longer one diets the more the metabolism slows down.

  c. The dieter must restrict intake more and more as she continues dieting.

  d. Both b and c.

11. Which of the following is/are true of the binge-purge cycle?
  a. The patient is able to achieve her desired result of weight loss.

  b. The patient gains weight due to the cycling which makes it harder and harder to lose weight.

  c. The bulimic will only lose weight if she also exercises excessively.

12. The Minnesota study showed that when subjects were starved they:
  a. become completely preoccupied with food.

  b. would become silent and socially isolated while devoting their attention to a meal.
  c. experienced severe changes emotionally, physically, cognitively, socially and sexually.

  d. all of the above.

13. Which of the following is a true statement regarding the use of laxatives and diuretics?
  a. These agents have been found to be effective in controlling absorption of calories.

  b. These agents are helpful in achieving weight loss because they encourage fluid loss.

  c. The use of these agents to aid in weight loss is a myth.
14. Which of the following is considered a psychological precipitant to an eating disorder?
  a. Body image distortion.

  b. Low self-esteem.

  c. Depression.

  d. All of the above.

15. Anorexics tend to be from families who:
  a. are extremely controlling.
  b. do not allow for the individual identities of each family member.

  c. express true feelings well in therapy.

  d. both a and b.

16. Individuals with an eating disorder were, as children, generally viewed as:
  a. trouble-makers.

  b. not trying very hard to achieve.

  c. model children.
  d. very assertive.

17. The crisis period for bulimics appears to be:
  a. the transition from childhood to adolescence.
  b. at the onset of their menses.

  c. the transition from adolescence to adulthood.

18. The bulimic’s attitude towards the traditional feminine role is:
  a. one of abhorrence.

  b. something they are very committed to.

  c. highly influenced by a mother who represents the traditional female role.

  d. both b and c.

19. Which of the following is not a typical characteristic of a bulimic?
  a. Dependent.

  b. High self-esteem.

  c. Perfectionism.

  d. Feelings of inadequacy and helplessness.

20. Precursors to bingeing are:
  a. rejection.

  b. confrontation.
  c. anxiety.

  d. all of the above.

21. Which of the following is a false statement regarding the demographic background of an eating disorder patient?
  a. Females from upper income families are typically affected.

  b. Only recently have there been reports of eating disorders in children from other than white western backgrounds.

  c. Cases have been reported in underdeveloped countries.

22. In regards to biological precipitants of eating disorders, which of the following is false?
  a. Hypothalamic dysfunction is a proven cause of anorexia.

  b. There is confusion as to whether certain medical complications of eating disorders are not in fact, precipitants of the illness.

  c. It has been difficult to establish clear-cut data regarding the biological causes of an eating disorder.
23. Which of the following explains the difficulty in establishing clear-cut data regarding the physiological causes of an eating disorder?
  a. These patients are secretive and hide their symptoms out of shame.
  b. Eating disorder patients have so many physical complications that it is difficult to isolate out the cause of each symptom.
  c. Patients present for treatment after their illness has been in full swing for some time, and the physician often has no base-line data prior to the illness.

24. Which of the following electrocardiographic abnormalities is of most concern to the anorexic patient?
  a. Arrhythmias, including supra-ventricular premature beats and ventricular tachycardia.

  b. Bradycardia.

  c. T wave inversions.

  d. T segment depression.

25. Which of the following is not a medical complication of anorexia?
  a. Severe weight loss.

  b. Unusual sensitivity to cold.

  c. Anemia.

  d. High basal metabolism.

  e. Neuro-endocrine dysfunction.

26. The predisposition of anorexic women to osteoporosis is due to:
  a. the decreased levels of calcium in their diets.

  b. the change in hormones which leads to amenorrhea and decreased bone density.

  c. excessive exercise.

27. Which of the following represent the three characteristic symptoms of bulimia which can be easily detected?
  a. Hypertrophy of the salivary glands, abdominal bloating and depression.

  b. Russell’s sign, perimolysis and irregular menses.

  c. Russell’s sign, hypertrophy of the salivary glands and perimolysis.

  d. All of the above.

28. Which of the following is considered the most frequent and debilitating consequence of binge/purge behavior?
  a. Depression.

  b. Headaches and dizziness.

  c. Dental problems.

  d. Hiatal hernia.

29. Hypokalemia, due to purging can result in:
  a. muscle fatigue.

  b. weakness.

  c. kidney damage.

  d. arrhythmias.

  e. all of the above.

30. The most important task of the first five minutes of the assessment interview is:
  a. to obtain as much information about the patient as possible.

  b. to reduce the patients anxiety about presenting for treatment.

  c. to convey to the patient that the clinician is interested in a collaborative inquiry, rather than in inquisition into the patient’s personal history.

  d. all of the above.

31. The primary task(s) of questioning related to body image is/are:
  a. to assess the level of body image distortion.

  b. to uncover the psychological adaptation it may be serving.

  c. to investigate the extent to which it interferes with life adjustment.

  d. all of the above.

32. When questioning about purge behavior it is recommended that the interviewer:
  a. ask vague leading questions so as not to offend the patient.

  b. be detailed and direct.

  c. not ask about purging at all, but wait for the patient to mention it.

33. Which of the following are defensive characteristics common to eating disorder patients?
  a. Projection.

  b. Borderline personality disorder.

  c. Denial.
  d. All of the above.

  e. Both a and c.

34. The family dynamics which should be explored would include:
  a. cohesiveness.

  b. conflict resolution.

  c. behavior control.

  d. all of the above.

35. Which of the following is true of bulimics and unstructured alone time:
  a. bulimics like to be alone so they can carry out their behavior in private.

  b. bulimics use alone time to reflect on their behavior and make change.

  c. unstructured alone time causes bulimics to feel lost, abandoned and panicky.

36. Components of “normal eating” include:
  a. eating when you are hungry.
  b. eating until you are satisfied.
  c. not being so restrictive that you miss out on pleasurable foods.

  d. all of the above.

37. How is exercise viewed as part of the treatment plan?
  a. Pleasurable physical activity is beneficial for reducing stress, allowing free time and improving overall good health.

  b. Exercise is contraindicated for the treatment of eating disorders.

  c. Exercise should be a rigorous cardiovascular workout.

38. Two important areas of focus in the pre-binge state are:
  a. to help the patient commit to never bingeing or purging again.

  b. to help the patient give up dieting and establish a normal eating pattern.

  c. to help her learn to deal with stress in a more positive manner.

  d. all of the above

  e. both b and c.

39. The amount of calories prescribed in establishing a normal diet depends upon:
  a. the patient’s weight

  b. metabolic conditions.

  c. the patient’s tolerance for change.

  d. all of the above.

40. In regards to so-called “forbidden” foods:
  a. they are strictly contraindicated in establishing a normal diet.

  b. the patient should be encouraged to incorporate small amounts of these foods into her daily diet.

  c. the patient should eat large amounts of these foods during unstructured time alone.

41. Which of the following are emotional themes that make patients vulnerable to bingeing?
  a. Anger, self-nurturance, vanity.

  b. Problem solving, passive-aggressive behavior, perfectionism.

  c. Absence of social support, problem solving, anger.

42. In order to break the post-binge cycle, once the patient has relapsed, the best thing to do is:
  a. fast for 24 hours.

  b. continue the next meal exactly as planned.

  c. exercise rigorously for one hour.

  d. none of the above.

43. In helping patients to establish goals it is important to:
  a. set them very high so the patient has something to strive towards.

  b. make them meaningful and not so unrealistic as to insure failure.

  c. acknowledge any small success, as the patient will minimize these.

  d. both b and c.

44. An important task for the anorexic in psychotherapy is to:
  a. learn how to please her parents.

  b. discover a sense of self.

  c. learn to appreciate a more feminine figure.

45. The therapist can help the bulimic patient by:
  a. assisting her in identifying her “red flag” issues.

  b. helping her to develop more positive problem-solving strategies.

  c. helping her learn to use painful thoughts and feelings as a catalyst for growth and change.

  d. all of the above.

46. Which of the following is/are true of pharmacotherapy in treating eating disorders?
  a. Controlled trials of antidepressants have found a significant reduction in the frequency of behaviors associated with bulimia.
  b. Antidepressants appear to be as effective in treating bulimic patients who are non-depressed as well as those who are depressed.

  c. The mechanism of action with antidepressants in treating bulimic patients may in fact be due to their effect on neurotransmitters.
  d. All of the above.

47. Which of the following is considered criteria for hospitalization?
  a. Significant weight loss.

  b. Lack of outpatient facilities.

  c. Demoralized, non functioning family.

  d. Thoughts of suicide.

  e. All of the above.

48. Which of the following might be required treatment for extreme cachexia?
  a. Bed rest.

  b. IV fluids.

  c. NG tube feeding.

  d. Hyperalimentation therapy.

  e. All of the above.
49. Since patients with eating disorders tend to be manipulative and split staff, it is important for staff to:
  a. be cohesive with each other.

  b. have staff support meetings in which to express their frustration and anger.

  c. be consistent in the way they interact with the patient.

  d. all of the above.

50. Which of the following is not something recommended as part of the nurse’s role in dealing with eating disordered patients?
  a. Monitor vital signs, weight and behavior.

  b. Confront the patient with her unhealthy eating behavior by simply “naming” the behavior when it is noticed.

  c. Forcing the patient to stop bingeing by taking food away.

  d. Approach the patient with empathy and warmth.