CHO/Nurse Monika is assessing a 16-year-old adolescent female who reports weight loss, amenorrhea, and depression. Which of the following additional information reported by the woman indicates that she has an eating disorder?

1. A

   Wearing tight-fitting clothes

2. B

   Periodic and ritualistic exercise

3. C

   Skin appears oily

4. D

   Increased blood pressure

Appeared in: MP CHO - 2022

Explanation

• The patient's presenting symptoms of weight loss, amenorrhea, and depression are a classic triad for Anorexia Nervosa.
• Compulsive, excessive, or ritualistic exercise is a hallmark compensatory behavior used to purge calories and control weight in individuals with eating disorders.
• This behavior is driven by an intense fear of gaining weight and a distorted body image, which are core features of Anorexia Nervosa.

Why Other Options Were Wrong

• Option A: Individuals with anorexia nervosa typically have a distorted body image and are often ashamed of their low weight, leading them to wear loose or baggy clothing to hide their body shape.
• Option C: Malnutrition and dehydration in anorexia nervosa lead to dermatological changes like dry skin (xerosis) and the growth of fine, downy hair (lanugo) as the body tries to conserve heat.
• Option D: The state of starvation in anorexia causes a slowing of the body's metabolism, leading to cardiovascular signs such as hypotension (low blood pressure) and bradycardia (slow heart rate).

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Clinical manifestations of Anorexia Nervosa to guide bedside assessment, documentation, and the next nursing action.
• Nurses play a crucial role in identifying eating disorders by conducting thorough assessments of physical signs (vital signs, weight, skin changes) and psychosocial symptoms (body image, fear of weight gain, exercise patterns).
• Monitoring for cardiovascular instability (hypotension, bradycardia, arrhythmias) is a priority nursing intervention, as these are life-threatening complications of anorexia.
• Building a therapeutic, non-judgmental relationship is essential to encourage the patient to discuss sensitive topics and engage in treatment, which requires a multidisciplinary team approach (medical, psychiatric, nutritional).

How to Approach the Question

• First, analyze the patient's profile and presenting symptoms in the stem: a 16-year-old female with weight loss, amenorrhea, and depression. Recognize this as the classic triad for Anorexia Nervosa.
• Second, understand the question is asking for an additional sign that confirms an eating disorder.
• Third, evaluate each option against the known pathophysiology and clinical presentation of Anorexia Nervosa.
• Fourth, identify that compulsive or ritualistic exercise is a well-documented compensatory behavior used for weight control in this disorder.
• Finally, eliminate the other options by recalling that they are clinically opposite to the expected findings (e.g., patients have hypotension, not hypertension; dry skin, not oily skin; and tend to wear baggy clothes).

Concept Tested & Keywords

• Concept Tested: Clinical manifestations of Anorexia Nervosa
• Stem keywords: 16-year-old, adolescent female, weight loss, amenorrhea, depression
• Lead-in keywords: indicates, eating disorder
• Clinical cues: The combination of weight loss, amenorrhea, and depression in an adolescent is a classic triad for Anorexia Nervosa.

Question ID

QGf-uji8nJYT3V-BDIh_ka

Copy ID

Reference Book

E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 185-187

E6 Medicine Harrison 22e Part 2 p. 1575-1577