Eating Disorders Practice Questions
20 free Eating Disorders practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
Which finding is most characteristic of a client with Anorexia Nervosa?
- A Frequent binge-eating episodes followed by laxative use
- B Body weight significantly less than expected for age and height
- C Dental enamel erosion and swollen salivary glands
- D Excessive daytime sleepiness and obesity
Correct answer: Body weight significantly less than expected for age and height
Anorexia nervosa is defined by significantly low body weight due to restriction of intake and intense fear of gaining weight.
Which physical sign would you expect in a client with Bulimia Nervosa?
- A Lanugo (fine downy hair) on the shoulders and back
- B Enlarged parotid glands and knuckle calluses (Russell's sign)
- C Persistent amenorrhea lasting longer than six months
- D Body mass index below 17 kg/m²
Correct answer: Enlarged parotid glands and knuckle calluses (Russell's sign)
Bulimia typically involves binge-eating followed by purging; physical findings often include swollen parotid glands and knuckle calluses from induced vomiting.
What is a key cognitive feature of anorexia nervosa?
- A Excessive guilt after binge-episodes
- B Feeling unable to stop eating large quantities of food
- C Persistent fear of gaining weight and distorted body image
- D Use of diuretics only, without purging or vomiting
Correct answer: Persistent fear of gaining weight and distorted body image
In anorexia nervosa, a distorted body image and an intense fear of gaining weight are central features.
In planning care for a client with bulimia nervosa, which nursing outcome is most appropriate?
- A Client will exercise at least 90 minutes daily to prevent weight gain
- B Client will maintain a body mass index below 17 kg/m²
- C Client will use healthy coping skills instead of purging after meals
- D Client will skip meals in order to slow the binge cycle
Correct answer: Client will use healthy coping skills instead of purging after meals
For bulimia, an important goal is replacing maladaptive compensatory behaviors (like purging) with healthier coping skills.
Which laboratory finding is most likely in a client who has been self-inducing vomiting in bulimia?
- A Hyperkalemia
- B Metabolic alkalosis
- C Elevated T3 and T4 levels
- D Hypercalcemia
Correct answer: Metabolic alkalosis
Repeated vomiting leads to loss of gastric acid and can result in metabolic alkalosis and hypokalemia.
A key difference between anorexia nervosa (restricting type) and bulimia nervosa is:
- A Only bulimia involves a distorted body image
- B Only anorexia involves binge-eating and purging behaviors
- C Anorexia causes very low weight; bulimia often near-normal weight
- D Bulimia nervosa occurs almost exclusively in males
Correct answer: Anorexia causes very low weight; bulimia often near-normal weight
Anorexia often results in dangerously low weight; bulimia clients often are at normal or near‐normal weight despite the purging behaviors.
What is the most serious potential complication of anorexia nervosa?
- A Erosion of the dental enamel
- B Mallory-Weiss esophageal tears
- C Cardiac arrhythmias and sudden death
- D Gallstones (cholelithiasis) formation
Correct answer: Cardiac arrhythmias and sudden death
Severe weight loss and electrolyte disturbances in anorexia can precipitate life-threatening cardiac arrhythmias and sudden death.
Which nursing approach is most therapeutic when caring for a client with an eating disorder?
- A Ignoring the client’s statements about weight and diet to avoid reinforcement
- B Encouraging the client to talk about feelings and participate in meal planning
- C Prescribing a strict diet without involving the client’s input
- D Confronting the client repeatedly about their distortions of body image
Correct answer: Encouraging the client to talk about feelings and participate in meal planning
In care of clients with eating disorders, therapeutic communication plus involving them in treatment planning helps promote trust and ownership of recovery.
A client with bulimia nervosa says, “I know I’ll gain weight if I don’t purge.” What should the nurse do?
- A “You must stop purging immediately or you’ll die.”
- B “Tell me what you are thinking when you decide to purge.”
- C “You’re right — purging is necessary.”
- D “You should restrict first and then decide.”
Correct answer: “Tell me what you are thinking when you decide to purge.”
Exploring the client’s thought process helps reveal underlying cognitive distortions and supports therapeutic interventions.
A client with anorexia nervosa has a heart rate of 40 beats/min and blood pressure of 70/40 mmHg. What is the nurse’s most appropriate action?
- A Encourage the client to go for a brisk walk
- B Call for immediate medical evaluation and monitoring
- C Provide the client with laxatives to regulate bowel movement
- D Let the client choose their meal plan independently
Correct answer: Call for immediate medical evaluation and monitoring
Severe bradycardia and hypotension signal a medical emergency in anorexia nervosa and require immediate evaluation and potential transfer to higher level of care.
Which psychological therapy is considered first-line for bulimia nervosa?
- A Electroconvulsive therapy (ECT)
- B Cognitive-behavioral therapy (CBT)
- C Transcranial magnetic stimulation (TMS)
- D Psychoanalysis only
Correct answer: Cognitive-behavioral therapy (CBT)
Cognitive-behavioral therapy (CBT) is the evidence-based treatment of choice for bulimia nervosa.
A nursing care plan for a client with anorexia nervosa should include which short-term goal?
- A Client will eat 100% of the meal tray at each meal within 3 days
- B Client will purge after each meal to relieve mealtime anxiety
- C Client will exercise vigorously for at least 2 hours every day
- D Client will fast for 24 hours and then resume normal eating
Correct answer: Client will eat 100% of the meal tray at each meal within 3 days
A measurable short-term goal for anorexia is improved nutritional intake; consuming the full meal tray is a realistic goal in early recovery.
Which statement by a client would most likely indicate denial of the severity of anorexia nervosa?
- A “I feel tired all the time and I don’t know why.”
- B “I never think about food; I just eat what I like.”
- C “I am overweight even though my clothes are loose.”
- D “My heart sometimes skips a beat; I wonder what that means.”
Correct answer: “I am overweight even though my clothes are loose.”
Clients with anorexia often have a distorted body image, believing they are overweight despite being underweight.
What is a common behavioral indicator of bulimia nervosa that a nurse might observe?
- A Avoidance of exercise at all costs
- B Frequent trips to the bathroom immediately after meals
- C Only eating certain foods and extreme food restriction
- D Weight loss to less than 85% of expected body weight
Correct answer: Frequent trips to the bathroom immediately after meals
In bulimia the binge-purge cycle often leads to trips to the bathroom after meals to induce vomiting, which is a behavioral cue for nursing assessment.
A client with anorexia nervosa complains of feeling cold all the time, has fine downy hair (lanugo), and brittle nails. What do these signs reflect?
- A Purging behaviors only
- B Effects of malnutrition and starvation
- C Effects of excessive binge-eating
- D A normal variation in healthy dieting
Correct answer: Effects of malnutrition and starvation
These physical signs are consequences of severe nutritional deficiency and starvation in anorexia nervosa.
In a client with bulimia nervosa, the nurse notes a low potassium level. What is the most likely cause?
- A Excessive intake of potassium supplements
- B Frequent vomiting or laxative misuse
- C Increased potassium intake in diet
- D Dehydration from inadequate fluid intake only
Correct answer: Frequent vomiting or laxative misuse
Vomiting and laxative abuse cause loss of potassium and lead to hypokalemia, a serious complication in bulimia.
What distinguishes the restricting type and the binge-eating/purging type of anorexia nervosa?
- A The restricting type involves purging but no food restriction
- B The binge/purge type adds bingeing or purging to food restriction
- C Only the restricting type of anorexia is medically serious
- D The binge/purge type only occurs in bulimia nervosa, not anorexia
Correct answer: The binge/purge type adds bingeing or purging to food restriction
The DSM-5 subtypes of anorexia nervosa include restricting type (no binge/purge behaviors) and binge-eating/purging type (with bingeing or purging in addition to restriction).
What indicates correct understanding in a client recovering from anorexia nervosa during discharge teaching?
- A “Once I reach a normal weight, there’s no chance of relapse.”
- B “I’ll continue to monitor my eating patterns and body image feelings.”
- C “It’s okay to skip meals if I don’t feel hungry.”
- D “Purging occasionally won’t harm me because I’m eating now.”
Correct answer: “I’ll continue to monitor my eating patterns and body image feelings.”
Ongoing monitoring of eating patterns and body image is crucial, as eating disorders carry a risk of relapse despite weight restoration.
When assessing for comorbid conditions in a client with an eating disorder, common additional diagnoses include:
- A Schizophrenia and bipolar I disorder exclusively
- B Anxiety disorders, depression and obsessive-compulsive features
- C No other disorders are likely
- D Only substance use, but not mood disorders
Correct answer: Anxiety disorders, depression and obsessive-compulsive features
Eating disorders often co-occur with mood disorders, anxiety, obsessive-compulsive traits, and substance use.
What best represents the concept of 'body image disturbance' in eating disorders?
- A A clear and accurate perception of body size and shape
- B A disturbance in the way one’s body weight or shape is experienced
- C Only a fear of weight gain without any behavioral change
- D Reluctance to attend therapy sessions
Correct answer: A disturbance in the way one’s body weight or shape is experienced
Body image disturbance means a distorted perception or experience of one’s body shape/weight; it is a core feature of disorders like anorexia and bulimia.