A nurse is assessing an adolescent female client who has anorexia nervosa. Which of the following findings should the nurse expect?

Metrorrhagia.

Tachycardia.

Hyperkalemia.

Constipation.

Answer and Explanation

The Correct Answer is D

The correct answer is Choice D

Choice A rationale: Metrorrhagia, or irregular uterine bleeding, is not typically associated with anorexia nervosa. Instead, amenorrhea is more common due to hypothalamic suppression from low body fat and caloric intake. The hypothalamus reduces gonadotropin-releasing hormone (GnRH), leading to decreased luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which suppresses ovulation and menstruation. Estrogen levels fall below normal (typically 30–400 pg/mL), disrupting endometrial stability. Thus, bleeding is less likely than complete menstrual cessation.

Choice B rationale: Tachycardia is not expected in anorexia nervosa; bradycardia is more common due to metabolic adaptation and reduced cardiac workload. The body conserves energy by lowering heart rate, often below 60 bpm. Malnutrition leads to decreased thyroid hormone (T3), reduced sympathetic tone, and myocardial atrophy. Electrolyte imbalances and hypovolemia further depress cardiac output. Tachycardia may occur in refeeding syndrome or acute stress, but chronically, the heart rate is typically slow due to adaptive mechanisms.

Choice C rationale: Hyperkalemia is rare in anorexia nervosa; hypokalemia is far more common due to purging behaviors, vomiting, and diuretic or laxative abuse. Potassium levels often fall below the normal range of 3.5–5.0 mEq/L. Losses through the gastrointestinal tract and renal excretion lead to muscle weakness, arrhythmias, and fatigue. Intracellular shifts during starvation also contribute to low serum potassium. Hyperkalemia may occur transiently during tissue breakdown or renal failure but is not a hallmark finding.

Choice D rationale: Constipation is a frequent finding in anorexia nervosa due to decreased caloric intake, slowed gastrointestinal motility, and reduced fiber consumption. Starvation suppresses parasympathetic activity, leading to delayed colonic transit. Electrolyte imbalances, especially hypokalemia, further impair smooth muscle contraction. Normal bowel frequency ranges from three times per week to three times per day; anorexic clients often fall below this due to systemic hypometabolism. Constipation may also be exacerbated by dehydration and laxative dependence.

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Correct Answer is D

Explanation

The correct answer is choice D: Continuous worry about the undiagnosed presence of an illness.

Choice A rationale:

Sudden unexplained loss of peripheral sensation is not typically associated with illness anxiety disorder. This symptom may be indicative of a neurological condition and would require further medical evaluation to determine the cause.

Choice B rationale:

Obsession over a fictitious defect in physical appearance is more characteristic of body dysmorphic disorder, not illness anxiety disorder. Individuals with body dysmorphic disorder are preoccupied with one or more perceived defects or flaws in their physical appearance, which are not observable or appear slight to others.

Choice C rationale:

Having prior physical health followed by the need for two surgeries within the last three months does not necessarily indicate illness anxiety disorder. This choice does not provide enough context to link it to illness anxiety disorder, as it could be related to many other health conditions.

Choice D rationale:

Continuous worry about the undiagnosed presence of an illness is a key finding in illness anxiety disorder. Individuals with this disorder are excessively concerned with and preoccupied by the belief that they have, or are in danger of developing, a serious undiagnosed illness despite medical reassurance.

A. The client states she wants to go home to be with her children and partner. B. The client has begun playing basketball with several other clients during the past month. C. The client has demonstrated increased impulsive behaviors in the past few weeks. D. The client identifies with problems expressed by other clients.

Correct Answer is C

Explanation

Choice A rationale:

While wanting to go home to be with loved ones can be a sign of distress, it doesn't necessarily indicate an immediate risk of suicide. Many individuals express a desire to be with family when feeling down, and this statement alone is not a definitive indicator of suicide risk.

Choice B rationale:

Engaging in social activities like playing basketball with others is generally a positive sign, as it indicates some level of interaction and engagement. This choice is less likely to indicate an immediate suicide risk.

Choice C rationale:

The client demonstrating increased impulsive behaviors is a concerning sign. Rapid and impulsive actions can potentially lead to self-harm or dangerous situations. Increased impulsivity can indicate a lack of consideration for consequences, which may elevate the risk of suicidal behaviors.

Choice D rationale:

Identifying with problems expressed by other clients is not a specific indicator of suicide risk. While it may suggest empathy and shared experiences, it doesn't directly address the immediate risk factors related to the client's bipolar disorder.

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A nurse is assessing an adolescent female client who has anorexia nervosa. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has illness anxiety disorder. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A nurse in an acute care mental health facility is assessing a client who has bipolar disorder. The nurse recognizes that which of the following findings indicates the client is at risk for suicide?

Correct Answer is C

Explanation

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