Chapter 23: Eating and Sleeping Disorders Nursing School Test Banks

Chapter 23: Eating and Sleeping Disorders
Test Bank

MULTIPLE CHOICE

1. Trends that have contributed to the recent increase in eating disorders in the United States include a(n):
a. More competitive workplace
b. Increase in the number of divorces
c. Focus on being thin as a measure of attractiveness
d. Increase in the number of nonnutritional foods consumed
ANS: C
In most modern societies, a high value is placed on a slim body.

DIF: Cognitive Level: Knowledge REF: p. 261 OBJ: 1
TOP: Eating Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

2. What is the main issue for adolescents with anorexia?
a. Anxiety
b. Control
c. Body image
d. Appropriate behavior
ANS: B
The main issue for teenage anorectics is control.

DIF: Cognitive Level: Knowledge REF: p. 263 OBJ: 2
TOP: Anorexia Nervosa KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

3. Which disorder is associated with persons with a body weight that is normal or even slightly above average?
a. Pica
b. Bulimia
c. Obesity
d. Anorexia nervosa
ANS: B
Often, a bulimic has a body weight that is normal or even slightly above average. Pica is a disorder in which the individual is eating abnormal substances. Obese individuals are above normal weight, and individuals with anorexia nervosa have less than normal weight.

DIF: Cognitive Level: Knowledge REF: p. 264 OBJ: 2
TOP: Bulimia KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

4. The persistent eating of nonfood items such as clay, laundry starch, insects, leaves, or pebbles that lasts for longer than 1 month is called:
a. Pica
b. Bulimia
c. Rumination
d. Regurgitation
ANS: A
Pica is the persistent eating of nonfood items that persists longer than 1 month and often is associated with a severe vitamin or mineral deficiency. Bulimia refers to an eating disorder that is commonly characterized by bingeing and purging; rumination is a rare disorder that refers to regurgitation and rechewing of food; regurgitation refers to partially digested food brought up into the mouth.

DIF: Cognitive Level: Knowledge REF: p. 267 OBJ: 1
TOP: Other Eating Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

5. The main focus of medical management for anorexia is to:
a. Encourage rapid weight gain.
b. Encourage the client to eat voluntarily.
c. Teach more appropriate food choices.
d. Keep the client from developing additional problems.
ANS: B
The main focus is to encourage the client to consume food voluntarily because this will allow for continued normal food consumption. Too rapid weight gain will lead to a feeling of loss of control, which could induce inappropriate eating behaviors again. Teaching appropriate food choices and keeping the client from developing additional problems occur as a part of the psychological management of the disorder.

DIF: Cognitive Level: Comprehension REF: p. 267 OBJ: 5
TOP: Treatments and Therapies KEY: Nursing Process Step: Planning
MSC: Client Needs: Psychosocial Integrity

6. Although all age groups can be affected, sleep disorders occur most frequently in:
a. Adolescence
b. Later childhood
c. Older adulthood
d. Middle adulthood
ANS: C
Sleep disorders occur more frequently in older adults.

DIF: Cognitive Level: Knowledge REF: p. 268 OBJ: 7
TOP: Sleep Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

7. The inability to fall asleep or stay asleep is called:
a. Insomnia
b. Narcolepsy
c. Hypersomnia
d. Nocturnal myoclonus
ANS: A
Insomnia is a disorder of not falling asleep or sustaining sound sleep. Narcolepsy refers to a condition in which an individual repeatedly experiences periods of sleep, regardless of activity or the situation; hypersomnia refers to prolonged sleep episodes; and nocturnal myoclonus refers to an individual who moves limbs involuntarily during sleep and has symptoms or problems related to this movement.

DIF: Cognitive Level: Knowledge REF: p. 270 OBJ: 8
TOP: Dyssomnias KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

8. A disorder that interrupts normal sleep patterns and is characterized by repeated, brief jerks of the arms and legs that occur every 20 to 60 seconds during the beginning of sleep is called:
a. Insomnia
b. Narcolepsy
c. Hypersomnia
d. Nocturnal myoclonus
ANS: D
Nocturnal myoclonus consists of repeated, brief jerks, most often in the legs, that occur at the beginning of sleep and disrupts the normal sleep pattern. These movements generally decrease during stage 4 NREM sleep.

DIF: Cognitive Level: Knowledge REF: p. 271 OBJ: N/A
TOP: Dyssomnias KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

9. Sleep disorders that are characterized by abnormal behavioral or physical events during sleep are called:
a. Insomnia
b. Dyssomnias
c. Hypersomnia
d. Parasomnias
ANS: D
Sleep disorders characterized by abnormal behavioral or physical events during sleep are called parasomnias and are caused by inappropriate activation of certain centers of the brain that control physical and emotional functions. Insomnia is the inability to fall asleep; dyssomnias are sleep disorders characterized by abnormal amounts, quality, or timing of sleep; and hypersomnia is an abnormally increased amount of sleep.

DIF: Cognitive Level: Knowledge REF: p. 271 OBJ: 7
TOP: Parasomnias KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

10. Sleep terrors usually occur only once a night, during stages 3 and 4 of NREM sleep. They are often accompanied by which physical sign?
a. Intense stress
b. Sexual arousal
c. Physical strength
d. Intense motor activity
ANS: A
Sleep terrors often are accompanied by physical signs of intense stress, such as increased heart rate, respirations, and muscle tone.

DIF: Cognitive Level: Knowledge REF: p. 271 OBJ: 8
TOP: Parasomnias KEY: Nursing Process Step: Planning
MSC: Client Needs: Psychosocial Integrity

11. The first step in the treatment of sleep disorders is to:
a. Teach prevention.
b. Give hypnotics for sleep.
c. Evaluate sleeping patterns.
d. Teach clients to retire early.
ANS: A
The first step in the treatment of sleep disorders is to teach prevention. Giving the client hypnotics is a last resort because these substances can be habit forming and/or may affect the quality of sleep; evaluating sleeping patterns is a diagnostic tool; and teaching clients to retire early may not be feasible.

DIF: Cognitive Level: Application REF: p. 272 OBJ: 9
TOP: Guidelines for Intervention KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

12. The collection of perceptions, thoughts, feelings, and behaviors that relate to ones size and appearance is called:
a. Body image
b. Self-esteem
c. Self-concept
d. Body parameters
ANS: A
This is the definition of body image.

DIF: Cognitive Level: Knowledge REF: p. 261 OBJ: 1
TOP: Eating Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

13. The average age for onset of anorexia nervosa is _____ years old.
a. 13
b. 17
c. 33
d. 40
ANS: B
Anorexia nervosa usually is not seen before puberty, with an average age of onset of 17 years. This disorder is seldom seen after the age of 40 years.

DIF: Cognitive Level: Knowledge REF: p. 263 OBJ: 2
TOP: Eating Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

14. The nurse who is caring for a 23-year-old client with bulimia knows that the most common method of purging to monitor this client for is:
a. Vomiting
b. Starvation
c. Excessive enema use
d. Use of syrup of ipecac
ANS: A
Vomiting and the use of diuretics and laxatives are the most common methods of purging. Less often used are enemas and syrup of ipecac. Starvation is a typical behavior of anorexia nervosa.

DIF: Cognitive Level: Application REF: p. 264 OBJ: 2
TOP: Bulimia KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

15. The nurse who works in a sleep clinic knows that approximately _____% of adults suffer from insomnia.
a. 10 to 20
b. 30 to 40
c. 50 to 60
d. 70 to 80
ANS: B
Thirty to forty percent of the adult population suffers from insomnia, and the incidence increases with age and in women.

DIF: Cognitive Level: Knowledge REF: p. 270 OBJ: 8
TOP: Dyssomnias KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

16. During an episode of binge eating, what type of food is usually taken in large amounts?
a. Fruits
b. Red meat
c. Fried or high fat content foods
d. Cakes, donuts, or sweets
ANS: D
Binge eating is defined as consuming an amount of food that is definitely larger than most individuals would eat in similar circumstances. During a binge an individual consumes large quantities of certain foods, usually carbohydrates.

DIF: Cognitive Level: Application REF: p. 264 OBJ: 2
TOP: Bulimia KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

17. A client with a diagnosis of anorexia is admitted to an inpatient setting. Which therapeutic intervention is used with caution prior to stabilization and weight gain?
a. Establish rapport and trust
b. IV or tube feeding
c. Administering antidepressants
d. Daily weights
ANS: C
Administering antidepressants to clients with anorexia before they regain weight may be hazardous if the individual has a history of cardiac problems or presently has a low serum potassium level. Be sure to check the laboratory results of clients with eating disorders.

DIF: Cognitive Level: Application REF: p. 268 OBJ: 6
TOP: Guidelines for Intervention KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

18. Which of the following persons is most likely a candidate for primary hypersomnia?
a. A 50-year-old who has wakeful periods during the night and naps during the day following the death of her husband
b. A 6-year-old who wakes up in the middle of the night after having a nightmare and is tired the next day
c. An obese 40-year-old who has snoring and periods of apnea at night and is tired the next day
d. An 18-year-old college student whose mother complains he sleeps all night and still naps during the day
ANS: D
Primary hypersomnia begins between 15 and 30 years of age. Nighttime sleep may last from 8 to 12 hours and daytime naps may last for more than 1 hour, and are not caused by any other physical or mental health disorder.

DIF: Cognitive Level: Application REF: p. 270 OBJ: 8
TOP: Dyssomnias KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

19. A police officer complains of feeling tired and not able to sleep for an extended period of time after being assigned to work the night shift. He is most likely suffering from:
a. Circadian rhythm sleep disorder
b. Primary hypersomnia
c. Narcolepsy
d. Obstructive sleep apnea syndrome
ANS: A
Circadian rhythm sleep disorder is a sleep disruption that results from a mismatch between body rhythms and environmental demands. Primary hypersomnia occurs when a person sleeps during the night, but naps during the day. Narcolepsy results in repeated attacks of sleep, and obstructive sleep apnea is a breathing-related sleep disorder and not a change in sleep time.

DIF: Cognitive Level: Application REF: p. 270 OBJ: 8
TOP: Dyssomnias KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

20. Which of the following conditions are eating disorders? (Select all that apply.)
a. Pica
b. Purging
c. Cataplexy
d. Binge eating
e. Hypersomnia
f. Nocturnal myoclonus
ANS: A, B, D
These are types of eating disorders. The other options describe sleeping disorders.

DIF: Cognitive Level: Knowledge REF: p. 262 OBJ: 2
TOP: Eating Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

21. Which are key features of anorexia nervosa? (Select all that apply.)
a. Excessive laxative use
b. Purging
c. Severe weight loss
d. Introverted personality
e. Hunger is denied
ANS: C, D, E
These are some of the key features of anorexia nervosa. Excessive laxative use and purging are characteristic of bulimia.

DIF: Cognitive Level: Knowledge REF: p. 263 OBJ: 2
TOP: Anorexia Nervosa KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

22. What are the criteria for the diagnosis of bulimia? (Select all that apply.)
a. Occasional episodes of binge eating
b. Refusal to maintain body weight that is more than 15% below normal
c. Excessive emphasis placed on body shape and weight
d. Eating binges at least twice per week for at least 3 months
ANS: C, D
These are two of the four criteria for the diagnosis of bulimia. Bulimia criteria include recurring episodes of binge eating rather than only occasional episodes; refusal to maintain body weight that is more than 15% below normal is a criterion for the diagnosis of anorexia nervosa.

DIF: Cognitive Level: Knowledge REF: p. 264 OBJ: 2
TOP: Bulimia KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

23. The death rate from anorexia is higher than any other mental illness. Death usually results from: (Select all that apply.)
a. Dehydration
b. Loss of critical muscle mass
c. Diabetes
d. Electrolyte imbalances
e. Suicide
ANS: A, B, D, E
The mortality rate for anorexia due to complications of starvation, cardiac arrest, or suicide is approximately 5% per decade of follow-up. Death usually results from dehydration, loss of critical muscle mass, electrolyte imbalances, or suicide, because often clients are not seen by health professionals until the disorder has resulted in some physical problems.

DIF: Cognitive Level: Application REF: p. 263 OBJ: 3
TOP: Anorexia Nervosa KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

COMPLETION

24. The medical term for a sleep test is a __________.

ANS:
polysomnogram
This test involves measurements of brain wave activity, muscle movement, and eye movement during sleep.

DIF: Cognitive Level: Knowledge REF: p. 269 OBJ: 7
TOP: Sleep Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Physiological Integrity

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