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

• Ritualistic or compulsive exercise is a classic behavioral sign in eating disorders, especially anorexia nervosa and bulimia nervosa.
• Adolescents with anorexia nervosa often engage in excessive, rigid, and ritualistic exercise routines to control weight and reduce anxiety about body image.
• This behavior is often secretive and persistent, even when underweight or medically compromised.
• Textbook sources confirm that ritualistic exercise is a prominent feature in anorexia nervosa and is used as a compensatory behavior in bulimia nervosa as well.
• The key differentiator is that this behavior is not just normal exercise, but is compulsive, excessive, and tied to weight/shape concerns.

Why Other Options Were Wrong

• Option A: Wearing tight-fitting clothes is not a typical sign of eating disorders. In fact, individuals with anorexia nervosa often prefer loose or baggy clothing to hide weight loss.
• Option C: Oily skin is not a recognized feature of eating disorders. Anorexia nervosa is more commonly associated with dry skin and lanugo (fine hair).
• Option D: Increased blood pressure is not typical in eating disorders. Most patients with anorexia nervosa have low blood pressure due to malnutrition and dehydration.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Behavioral and physical signs of eating disorders in adolescents to guide bedside assessment, documentation, and the next nursing action.
• Nurses must assess for ritualistic or compulsive exercise when evaluating adolescents with suspected eating disorders.
• Early identification of these behaviors can prompt timely intervention and prevent severe complications.
• What if? If the adolescent reported binge eating and purging instead of ritualistic exercise, bulimia nervosa would be more likely, and the nurse would focus on different assessment and interventions.

How to Approach the Question

• Identify the core clinical features in the stem (weight loss, amenorrhea, depression in an adolescent female).
• Recall the classic behavioral and physical signs of eating disorders.
• Eliminate options that do not fit the typical profile of anorexia or bulimia.
• Focus on behaviors that are compensatory or ritualistic, as these are hallmark features.
• Use process of elimination to select the option most strongly linked to eating disorders.

Concept Tested & Keywords

• Concept Tested: Behavioral and physical signs of eating disorders in adolescents
• Stem keywords: adolescent female, weight loss, amenorrhea, depression, eating disorder
• Lead-in keywords: indicates, eating disorder
• Clinical cues: 16-year-old female
• Clinical cues: weight loss

Question ID

QGf-uji8nJYT3V-BDIh_ka

Copy ID

Reference Book

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1498-1500

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 313-315