A 46-year-old woman with a BMI of 35 reports episodes of feeling "out of control" with eating. She says that during these episodes, she eats an extremely large quantity of food in a short period of time. She eats quickly and past the point of being full, which leaves her feeling physically uncomfortable. After these episodes, she feels ashamed. She has been hiding this behavior from her friends and family for about 4 months. What is the most appropriate diagnosis?
Bulimia nervosa
Atypical eating disorder
Binge eating disorder
Avoidant-restrictive food pattern
The Correct Answer is C
Choice A reason: Bulimia nervosa involves binge eating followed by compensatory behaviors (e.g., vomiting, laxatives, excessive exercise). This patient does not engage in compensatory behaviors, ruling out bulimia.
Choice B reason: Atypical eating disorder is a vague term not defined in DSM-5. This diagnosis is not specific enough to describe her behavior.
Choice C reason: This is the correct answer. Binge eating disorder is characterized by recurrent binge episodes with a sense of loss of control, eating rapidly, and feelings of shame, without compensatory behaviors. Her BMI and 4-month history fit these criteria.
Choice D reason: Avoidant-restrictive food intake disorder involves avoidance or restriction of food intake leading to nutritional deficiency or weight loss. The patient’s issue is overeating, not restriction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: ADHD typically presents with persistent symptoms of inattention, hyperactivity, and impulsivity across multiple settings. This patient’s symptoms are situational and associated with a recent stressor, making ADHD less likely.
Choice B reason: This is the correct answer. Adjustment disorder with mixed anxiety and mood occurs when an individual develops emotional or behavioral symptoms in response to a stressor, such as a family illness. The boy’s worry about his grandfather, sadness, restlessness, sleep disturbance, and decline in school performance fit this diagnosis.
Choice C reason: Separation anxiety disorder involves excessive fear or anxiety concerning separation from attachment figures, usually in younger children. While the boy is concerned about his grandfather, the anxiety is not centered on separation from a caregiver, making this diagnosis less fitting.
Choice D reason: Generalized anxiety disorder involves chronic, excessive worry across multiple domains for at least six months. This patient’s anxiety is linked to a specific stressor over a short period, so GAD criteria are not met.
Correct Answer is B
Explanation
Choice A reason: This is incorrect because autism-specific screening is recommended to begin as early as 18 months. Waiting until after 24 months could delay early identification and intervention, which are crucial for improving developmental outcomes.
Choice B reason: This is correct. Evidence-based guidelines recommend universal autism screening at 18 and 24 months during routine pediatric visits. Early identification allows for timely referral to developmental services and behavioral interventions that significantly improve outcomes for children with autism spectrum disorder.
Choice C reason: This is incorrect because autism can occur regardless of family history. Relying solely on family history risks missing early signs in children without a known familial predisposition.
Choice D reason: This is incorrect because pediatricians may not always identify subtle signs of autism during routine well visits. Proactive screening at recommended ages ensures that potential developmental concerns are systematically assessed.
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