During a well-child physical,a 16-year-old girl has a normal history and physical except for an excessive amount of tooth enamel erosion,
a greater-than-normal number of filled cavities,and calluses on the back of her hand.Her body mass index is in the 50th to 75th percentile for her age. The nurse would be most concerned about
1. anorexia nervosa.
2. kwashiorkor.
3. bulimia nervosa.
4. marasmus.
Answer:3
Rationale: The erosion of tooth enamel,dental caries,and calluses on the back of her hand all most likely are due to frequent vomiting of gastric acids,which is common with this disorder as part of a "binge–purge"cycle. Anorexia nervosa is an eating disorder where adolescents literally starve themselves to prevent weight gain,also exercising excessively and using laxatives and diuretics to lose weight. Anorexia usually manifests as extreme weight loss and an obsession with food.Kwashiorkor is a protein deficiency,usually from malnutrition,that manifests as generalized edema.Marasmus is a lack of energy-producing calories that can be seen in anorexia,and this causes emaciation,decreased energy levels, and retarded development.
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ANS:
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