CDN Eating Disorder Treatment 3 — Questions and Answers
Question 1: Which criterion differentiates purging disorder from bulimia nervosa?
- Purging disorder involves compensatory behaviors after normal-sized meals, not binges (Correct answer)
- Purging disorder requires a BMI below 18.5
- Purging disorder only involves laxative use, not vomiting
- Purging disorder occurs exclusively in males
Correct answer: Purging disorder involves compensatory behaviors after normal-sized meals, not binges
In purging disorder, compensatory behaviors (vomiting, laxatives) occur after regular meals without objective binge episodes.
Question 2: Motivational interviewing (MI) is particularly useful early in eating disorder treatment because:
- It provides detailed meal plans immediately
- It addresses ambivalence and builds intrinsic motivation to change (Correct answer)
- It directly challenges cognitive distortions
- It focuses on trauma resolution
Correct answer: It addresses ambivalence and builds intrinsic motivation to change
MI helps patients explore their own ambivalence about recovery, which is essential before they are ready to engage in behavioral change.
Question 3: Which nutrition intervention is recommended when initiating refeeding in a hospitalized anorexia patient to reduce refeeding syndrome risk?
- Start at full caloric requirements (2000–2500 kcal/day)
- Begin at 1000–1200 kcal/day and advance slowly (Correct answer)
- Initiate total parenteral nutrition first
- Provide high-protein supplements only
Correct answer: Begin at 1000–1200 kcal/day and advance slowly
Conservative caloric initiation (typically 1000–1200 kcal/day) with gradual advancement reduces the risk of refeeding syndrome.
Question 4: A patient with bulimia nervosa reports feeling 'numb' and turning to bingeing to cope with emotional distress. Which therapy is best suited for targeting emotion regulation deficits?
- Cognitive processing therapy
- Dialectical behavior therapy (DBT) (Correct answer)
- Acceptance and commitment therapy
- Prolonged exposure therapy
Correct answer: Dialectical behavior therapy (DBT)
DBT specifically targets emotion dysregulation through distress tolerance, emotion regulation, and mindfulness skills.
Question 5: Dental erosion on the lingual surfaces of maxillary teeth is a clinical sign most consistent with:
- Chronic laxative use
- Frequent self-induced vomiting (Correct answer)
- Excessive use of diet pills
- Prolonged food restriction
Correct answer: Frequent self-induced vomiting
Gastric acid from self-induced vomiting erodes the lingual (tongue-side) surfaces of upper front teeth, a finding called perimolysis.
Question 6: In the stepped-care model for eating disorder treatment, which level of care is appropriate for a medically stable patient with moderate symptoms who cannot attend day treatment?
- Inpatient hospitalization
- Residential treatment
- Intensive outpatient program (IOP) (Correct answer)
- Unstructured self-help only
Correct answer: Intensive outpatient program (IOP)
IOP (typically 3–5 days/week, 3 hours/day) bridges the gap for medically stable patients who need more support than weekly outpatient therapy.
Question 7: A CDN is asked to assess a patient's readiness for change. According to the transtheoretical model, a patient who says 'I know I have a problem but I'm not ready to do anything about it' is in which stage?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Action
Correct answer: Contemplation
Contemplation is characterized by awareness of a problem with ambivalence — acknowledging the issue but not yet committed to action.
CDN Eating Disorder Treatment 3
Which criterion differentiates purging disorder from bulimia nervosa?