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The nurse is aware that the major health complication associated with anorexia nervosa is:

Cardiac dysrhythmia resulting in cardiac arrest

Endocrine imbalance causing amenorrhea

Decreased metabolism causing cold intolerance

Glucose intolerance resulting in hypoglycemia

Answer and Explanation

The Correct Answer is A

a. Cardiac dysrhythmia resulting in cardiac arrest

Explanation of Choices

Choice A Reason: Cardiac Dysrhythmia Resulting in Cardiac Arrest

Cardiac dysrhythmias, or irregular heartbeats, are a significant health complication associated with anorexia nervosa. These dysrhythmias can result from electrolyte imbalances, particularly low potassium levels (hypokalemia), which are common in individuals with anorexia due to malnutrition and purging behaviors. Severe dysrhythmias can lead to cardiac arrest, making this one of the most critical and potentially fatal complications of anorexia nervosa. The heart muscle can weaken due to prolonged malnutrition, leading to a condition known as myocardial atrophy, which further increases the risk of cardiac complications.

Choice B Reason: Endocrine Imbalance Causing Amenorrhea

Amenorrhea, or the absence of menstruation, is a common endocrine complication in females with anorexia nervosa. This condition occurs due to the body’s response to severe weight loss and malnutrition, which disrupts the normal production of reproductive hormones. While amenorrhea is a significant health issue, it is not as immediately life-threatening as cardiac dysrhythmias. Amenorrhea can lead to long-term complications such as infertility and osteoporosis but does not typically result in acute medical emergencies.

Choice C Reason: Decreased Metabolism Causing Cold Intolerance

Decreased metabolism and cold intolerance are common symptoms in individuals with anorexia nervosa. The body reduces its metabolic rate in response to prolonged starvation to conserve energy. This can lead to a lower body temperature and increased sensitivity to cold. While uncomfortable and indicative of severe malnutrition, decreased metabolism and cold intolerance are not as immediately dangerous as cardiac dysrhythmias. These symptoms reflect the body’s adaptation to a state of energy deficiency but do not pose an immediate threat to life.

Choice D Reason: Glucose Intolerance Resulting in Hypoglycemia

Hypoglycemia, or low blood sugar, can occur in individuals with anorexia nervosa due to inadequate food intake. However, glucose intolerance and hypoglycemia are less common and less severe complications compared to cardiac dysrhythmias. Hypoglycemia can cause symptoms such as dizziness, confusion, and fainting, but it is typically manageable with appropriate nutritional support. It does not carry the same immediate risk of fatality as cardiac dysrhythmias.

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Correct Answer is D

Explanation

Choice A Reason: Anchovies

Anchovies are a type of small, oily fish that are often used in various dishes for their strong flavor. They are rich in omega-3 fatty acids and other nutrients. However, there is no known interaction between anchovies and disulfiram. Disulfiram specifically interacts with alcohol and alcohol-containing products, causing unpleasant reactions. Therefore, anchovies are not a food item that needs to be avoided while taking disulfiram.

Choice B Reason: Spinach

Spinach is a leafy green vegetable that is high in vitamins, minerals, and antioxidants. It is generally considered a healthy food and does not have any known interactions with disulfiram. Patients taking disulfiram do not need to avoid spinach as it does not contain alcohol or any substances that would cause a reaction with the medication.

Choice C Reason: Grapefruit Juice

Grapefruit juice is known to interact with various medications by affecting the enzymes that metabolize these drugs in the liver. However, there is no specific interaction between grapefruit juice and disulfiram. While grapefruit juice can affect the metabolism of certain medications, it does not cause the same type of reaction that alcohol does when taken with disulfiram. Therefore, it is not necessary for patients on disulfiram to avoid grapefruit juice.

Choice D Reason: Alcoholic Beverages

Alcoholic beverages are the primary substance that must be avoided while taking disulfiram. Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, which is involved in metabolizing alcohol. When alcohol is consumed, acetaldehyde accumulates in the body, leading to unpleasant symptoms such as nausea, vomiting, headache, and flushing. This reaction is intended to deter individuals from drinking alcohol. Therefore, it is crucial for patients taking disulfiram to avoid all forms of alcohol, including alcoholic beverages, to prevent these adverse reactions.

A. Their full therapeutic potential may not be reached until 4 weeks. B. Aged cheese should not be eaten while taking them. C. They should not be given with antianxiety agents. D. They may cause hypomania or recent memory impairment.

Correct Answer is A

Explanation

Choice A Reason: Their full therapeutic potential may not be reached until 4 weeks

This statement is correct. Tricyclic antidepressants (TCAs) often take several weeks to reach their full therapeutic effect. Patients may start to notice some improvement within one to two weeks, but it can take up to four weeks or longer for the full benefits to be realized1. This delayed onset is due to the time it takes for the medication to build up in the system and exert its effects on neurotransmitter levels.

Choice B Reason: Aged cheese should not be eaten while taking them

This statement is incorrect. The dietary restriction of avoiding aged cheese is associated with monoamine oxidase inhibitors (MAOIs), not tricyclic antidepressants. MAOIs can cause dangerous interactions with tyramine, a substance found in aged cheese and other foods, leading to hypertensive crises. TCAs do not have this dietary restriction.

Choice C Reason: They should not be given with antianxiety agents

This statement is incorrect. Tricyclic antidepressants can be used in conjunction with antianxiety agents under medical supervision. However, it is important to monitor for potential interactions and side effects. The combination can be beneficial for patients with comorbid depression and anxiety disorders.

Choice D Reason: They may cause hypomania or recent memory impairment

This statement is partially correct but not the best indicator of understanding. While TCAs can cause side effects such as memory impairment and, in rare cases, hypomania, these are not the primary concerns when teaching about the medication. The focus should be on understanding the therapeutic timeline and common side effects.

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The nurse is aware that the major health complication associated with anorexia nervosa is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing discharge instructions to the client taking disulfiram. Which of the following items should the nurse teach the client to avoid?

Correct Answer is D

Explanation

The nurse assesses that medication teaching about tricyclic antidepressants was understood when the client states:

Correct Answer is A

Explanation

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