RAK Nursing Officer - 2019
Mental Health Nursing
Medium
Which of the following symptoms is not characteristics manifestation of anorexia nervosa?
Appeared in: RAK Nursing Officer - 2019
Explanation
- Menorrhagia, which is abnormally heavy or prolonged menstrual bleeding, is not a symptom of anorexia nervosa.
- The characteristic menstrual disturbance in anorexia nervosa is amenorrhea (absence of menstruation) or oligomenorrhea (infrequent or very light periods).
- This occurs because severe malnutrition and low body fat suppress the hypothalamic-pituitary-gonadal axis, leading to decreased levels of estrogen required for the menstrual cycle.
- Therefore, expecting heavy periods in a patient with anorexia nervosa is contrary to the known pathophysiology of the disorder.
Why Other Options Were Wrong
- Option A: Hypotension (low blood pressure) is a very common finding in anorexia nervosa. It results from dehydration, cardiac muscle wasting, and bradycardia (slow heart rate) as the body tries to conserve energy.
- Option C: Pallor (paleness of the skin) is a frequent sign. It is often caused by anemia, which develops due to deficiencies in iron, folate, and vitamin B12 from severe dietary restriction.
- Option D: Constipation is a classic gastrointestinal complaint in anorexia nervosa. It is caused by reduced food intake, dehydration, slowed gut motility, and weakened abdominal muscles.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of Anorexia Nervosa as background academic context rather than a clinical decision trigger.
- Nurses play a critical role in assessing and monitoring the physical complications of anorexia nervosa. This includes regular monitoring of vital signs (blood pressure, heart rate), assessing for skin changes like pallor, and inquiring about bowel and menstrual history.
- Recognizing amenorrhea as a key diagnostic criterion and a sign of severe physiological distress is crucial for patient education and treatment planning.
- Patient safety is paramount. Hypotension and bradycardia can lead to syncope (fainting) and falls, requiring safety precautions. Severe electrolyte imbalances can cause life-threatening cardiac arrhythmias, necessitating close monitoring.
How to Approach the Question
- First, identify the core subject of the question, which is 'anorexia nervosa'.
- Next, notice the negative framing: 'is NOT a characteristic manifestation'. This means you are looking for the outlier, the symptom that doesn't fit.
- Recall the pathophysiology of anorexia nervosa: it is a state of starvation where the body slows down and conserves energy.
- Evaluate each option based on this principle:
- Hypotension (low BP): Fits the 'slowing down' model.
- Pallor (paleness): Fits with malnutrition and anemia.
Concept Tested & Keywords
- Concept Tested: Clinical manifestations of Anorexia Nervosa
- Stem keywords: symptoms, characteristics manifestation, anorexia nervosa
- Lead-in keywords: not
- Negative lead-in flag: This question uses a negative lead-in ('not'), asking you to identify the symptom that is NOT a characteristic of anorexia nervosa. This means three options will be typical signs, and one will be the exception.
Question ID
QbynR05-OQVW0jNT1O1Wnp
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1501-1503
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 6936-6938
Practise the full RAK Nursing Officer - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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