Clients with bulimia nervosa are not as undernourished as clients ...

[bucstennis@aim.com]

Clients with bulimia nervosa are not as undernourished as clients who have anorexia nervosa. They are, however, a challenge for nutrition therapy. What eating strategy may be appropriate for clients with bulimia nervosa?
 
  A) Use finger foods.
  B) Eat quickly.
  C) Avoid forbidden or problem foods associated with bingeing.
  D) Record intake before eating.

Question 2

Mr. T is a 68-year-old client diagnosed with chronic renal failure who will be starting dialysis in several weeks.
 
  When reviewing his lab results, the nurse notices elevated levels of C-reactive protein and tumor necrosis factor, both markers of an inflammatory process. What would be the best action the nurse could take next? 1. Instruct the client to use a low-protein diet.
   2. Suggest vitamin supplements.
   3. Assess the client for signs of wasting syndrome.
   4. Refer the client to rheumatology.

[harveenkau8139]

Answer to Question 1

D
Feedback:
Initially, nutrition therapy for bulimia is structured and relatively inflexible to promote the client's sense of control. Having the client record intake before eating adds to a sense of control.

Answer to Question 2

3

Rationale: Elevated levels of C-reactive protein and tumor necrosis factor are markers for an inflammatory state common among clients with chronic kidney disease and contribute to anorexia and wasting syndrome. Protein stores are depleted in clients on dialysis due to the loss of amino acids into the dialysis fluid, and can result in compromised nutritional health. The benefit of vitamin supplementation for clients with chronic kidney disease is not well established, but may be beneficial in replacing
water-soluble vitamins lost during dialysis. Markers for inflammation are also present in clients with arthritis, but since this client is already diagnosed with chronic kidney disease it is most likely that is the cause.