👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Psychosocial Integrity🔖 Free to read, print, and share
Also known as: anorexia · not eating · starving self · fear of gaining weight · eating disorder restricting
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Use this quick-reference guide to spot, treat, and prevent Anorexia Nervosa on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
🩺 Signs
Distorted body image, fears fat
Severe restriction, amenorrhea
Lanugo, bradycardia, cold intol
🧪 Labs
↓ K+, ↓ Na+, ↓ HR, ↓ BP
Electrolyte imbalance = arrhythmia
✅ Do
Supervise meals + 1hr after
Slow refeeding, set meal limits
🚩 Report
Refeeding syndrome: ↓ phos, ↓ K+
Cardiac changes = top mortality
📚 Anorexia Nervosa — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Anorexia nervosa is an eating disorder characterized by severe restriction of intake, intense fear of weight gain, and a distorted body image leading to dangerously low body weight. Self-worth is tied to control over eating. It carries the highest mortality of any psychiatric illness due to cardiac and electrolyte complications, including refeeding syndrome.
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Key points
Understand these first
Clients are significantly underweight yet perceive themselves as overweight (distorted body image).
Restricting intake, excessive exercise, and sometimes purging maintain low weight.
Physical signs include amenorrhea, bradycardia, hypotension, hypothermia, lanugo, and electrolyte imbalance.
Behaviors include rigid rituals, control issues, perfectionism, and food preoccupation.
Refeeding syndrome with hypophosphatemia can be fatal when nutrition is restarted too quickly.
Severe starvation causes life-threatening cardiac arrhythmias and bradycardia.
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Nursing priorities
What to do, in order
Monitor vital signs, weight, intake/output, and electrolytes for medical instability.
Establish a structured eating plan and observe the client during and after meals.
Prevent purging by supervising for at least one hour after eating.
Refeed slowly and watch for refeeding syndrome (declining phosphorus, potassium, magnesium).
Address distorted thinking and self-esteem without focusing solely on food and weight.
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Red flags — report now
Escalate immediately
Refeeding syndrome (falling phosphorus, potassium, magnesium; fluid overload) is life-threatening - report and slow nutrition.
Bradycardia, hypotension, and arrhythmias indicate cardiac compromise requiring immediate attention.
Severe hypokalemia from restriction or purging can trigger fatal dysrhythmias.
Refusal of food with rapidly worsening vitals may require involuntary medical stabilization.
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Labs & values
Numbers to know
Potassium 3.5-5.0 mEq/L (often low)
Phosphorus 3.0-4.5 mg/dL (drops dangerously in refeeding)
Magnesium 1.5-2.5 mg/dL (often low)
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Patient teaching
What patients must know
Restart nutrition gradually under supervision to avoid refeeding complications.
Recovery focuses on health and coping, not just weight; engage with therapy and support.
Family-based support and avoiding power struggles over food aid recovery.
❓ Anorexia Nervosa: NCLEX FAQs
What are the priority nursing interventions for Anorexia Nervosa?
Monitor vital signs, weight, intake/output, and electrolytes for medical instability. Establish a structured eating plan and observe the client during and after meals. Prevent purging by supervising for at least one hour after eating. Refeed slowly and watch for refeeding syndrome (declining phosphorus, potassium, magnesium).
What are the warning signs of Anorexia Nervosa a nurse must report?
Refeeding syndrome (falling phosphorus, potassium, magnesium; fluid overload) is life-threatening - report and slow nutrition. Bradycardia, hypotension, and arrhythmias indicate cardiac compromise requiring immediate attention. Severe hypokalemia from restriction or purging can trigger fatal dysrhythmias. Refusal of food with rapidly worsening vitals may require involuntary medical stabilization.
What do I need to know about Anorexia Nervosa for the NCLEX?
Clients are significantly underweight yet perceive themselves as overweight (distorted body image). Restricting intake, excessive exercise, and sometimes purging maintain low weight. Physical signs include amenorrhea, bradycardia, hypotension, hypothermia, lanugo, and electrolyte imbalance. Behaviors include rigid rituals, control issues, perfectionism, and food preoccupation.
What patient teaching is important for Anorexia Nervosa?
Restart nutrition gradually under supervision to avoid refeeding complications. Recovery focuses on health and coping, not just weight; engage with therapy and support. Family-based support and avoiding power struggles over food aid recovery.
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Quick Tip
Clients are significantly underweight yet perceive themselves as overweight (distorted body image).