Comprehensive exams for Mental Health Q 129
A client whose husband just left her has a recurrence of anorexia nervosa. Nurse Vic caring for her realizes that this exacerbation of anorexia nervosa results from the client’s effort to:
A. Manipulate her husband.
B. Gain control of one part of her life.
C. Commit suicide.
D. Live up to her mother’s expectations.
Correct Answer: B. Gain control of one part of her life
By refusing to eat, a client with anorexia nervosa is unconsciously attempting to gain control over the only part of her life she feels she can control. Assist the patient to confront changes associated with puberty and sexual fears. Provide sex education as necessary. Encourage personal development program, preferably in a group setting. Provide information about the proper application of makeup and grooming. Learning about methods to enhance personal appearance may be helpful to a long-range sense of self-esteem and image. Feedback from others can promote feelings of self-worth.
Option A: This eating disorder doesn’t represent an attempt to manipulate others or live up to their expectations (although anorexia nervosa has a high incidence in families that emphasize achievement). Assist the patient to assume control in areas other than dieting and weight loss such as management of their own daily activities, work, and leisure choices. Feelings of personal ineffectiveness, low self-esteem, and perfectionism are often part of the problem. The patient feels helpless to change and requires assistance to problem-solve methods of control in life situations.
Option C: The client isn’t attempting to commit suicide through starvation; rather, by refusing to eat, she is expressing feelings of despair, worthlessness, and hopelessness. Help the patient formulate goals for self (not related to eating) and create a manageable plan to reach those goals, one at a time, progressing from simple to more complex. Patients need to recognize the ability to control other areas in life and may need to learn problem-solving skills to achieve this control. Setting realistic goals fosters success.
Option D: Encourage patients to take charge of their own lives in a more healthful way by making their own decisions and accepting self as she or he is at this moment (including inadequacies and strengths). Patient often does not know what she or he may want for themselves. Parents (mother) often make decisions for the patient. Patient may also believe she or he has to be the best in everything and holds self-responsible for being perfect.