NU609 Unit 8 DQ 1: eating disorder history and exam
Discuss how you would approach the history and physical exam for an office patient with anorexia or bulimia, and identify the specific subjective and objective data you would obtain and why each matters.
Editorial process
Last reviewed · August 14, 2026
You are examining for complications, not for a diagnosis
The prompt puts you in an office visit, so the approach matters as much as the content. A patient with anorexia or bulimia frequently does not present with it — they present with fatigue, amenorrhoea, reflux, dental problems, constipation or a request for a sports physical — and they may actively minimise. So describe how you would open: privacy from a parent or partner for at least part of the visit, non-judgemental and behaviour-specific questions rather than labels, weighing blind and with permission because the number is a trigger, and a validated screen such as SCOFF or the EDE-Q rather than an unstructured impression. Say why the sequence is what it is. Rapport built in the first three minutes determines whether the purging history is disclosed at all, and an undisclosed purging history is the difference between an outpatient plan and a missed hypokalaemia. That reasoning is the part of this DQ an assessor cannot get from a textbook list.
For the data itself, tie every item to a complication rather than listing an exam by system. Subjective: weight history and its trajectory, restriction, binge and purge behaviours with method and frequency, laxative, diuretic and diet-pill use, exercise volume, menstrual history, syncope, palpitations, cold intolerance, reflux and dental pain, mood, self-harm and suicidality, and the patient's own view of their body. Objective: weight and height with BMI or percentile, orthostatic vital signs, bradycardia and hypothermia, dry skin, lanugo, hair loss, parotid swelling, dental erosion, Russell's sign on the knuckles, oedema, and a cardiac exam. Then explain the link, because the link is what is being marked here: orthostatic change and bradycardia are what drive the decision about whether this patient can safely go home, parotid swelling and dental erosion are objective evidence of the purging a patient has just denied, and the indication for electrolytes and an ECG follows from that purging history rather than from the number on the scale.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Describe an interview approach that makes disclosure of restricting or purging likely.
- 02Select subjective data items that map to the complications of eating disorders.
- 03Select objective findings that evidence behaviours the patient may not report.
- 04Explain which findings drive the level-of-care decision.
Read the full question
Review every instruction before using the planning guidance that follows.
Course-wide instructions that accompany this question
ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. NU609-7C Unit 8 DQ 1 I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Turn the brief into deliverables
- 01How you would approach the history and physical exam for this patient.
- 02Specific subjective data to obtain, with rationale.
- 03Specific objective data to obtain, with rationale.
- 04How each item relates to the eating disorder rather than to a general exam.
- 05APA citations from course material, websites and the literature.
- 06Replies to at least two classmates.
Subjective, objective, and why each item earns its place
The presentation you will actually see
Fatigue, amenorrhoea, reflux or a sports physical rather than a stated concern.
Setting up the interview
Privacy, non-judgemental phrasing, blind weighing, a validated screen.
Subjective data
Weight history, restriction, binge and purge, compensatory behaviours, menses, cardiac symptoms, mood.
Objective data
Vitals and orthostatics, BMI, skin and hair, parotids, dentition, Russell's sign, cardiac exam.
What the findings change
Which results trigger labs, an ECG, or a referral for higher-level care.
Documentation and follow-up
What to record, what to repeat at the next visit, who else to involve.
Guidelines that specify what to screen and measure
Recommended databases
- StatPearls, NCBI Bookshelf
- American Academy of Pediatrics
- PubMed
- MedlinePlus
Search sequence
- 1.Read the StatPearls overview of eating disorders for the complication list.
- 2.Read the anorexia nervosa entry for the physical findings and their causes.
- 3.Check the AAP clinical report for screening and medical-instability criteria.
- 4.Note which findings are cited as indications for hospitalisation.
- 5.Match each subjective question to one complication before you write.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
Eating Disorders
StatPearls, NCBI Bookshelf, National Library of Medicine · 2023
Diagnostic criteria and the complication list the exam is aimed at.
- 02
Anorexia Nervosa
StatPearls, NCBI Bookshelf, National Library of Medicine · 2023
Physical findings — bradycardia, hypothermia, lanugo — and what causes each.
- 03
Identification and Management of Eating Disorders in Children and Adolescents
Pediatrics, American Academy of Pediatrics · 2021
Screening approach, confidentiality in adolescent visits, and criteria for escalation.
- 04
Binge Eating Disorder
StatPearls, NCBI Bookshelf · 2023
Separates binge behaviour from purging so the history distinguishes the two.
Review before submission
Common mistakes
- Reproducing a head-to-toe exam with no link to eating-disorder complications.
- Skipping the interview approach and answering only with a data list.
- Interviewing an adolescent entirely in front of a parent.
- Omitting purging behaviours because the patient's weight looks normal.
- Leaving out orthostatics, which is the finding that most often changes disposition.
- Treating the diagnosis as the goal when the visit is about safety and complications.
Submission checklist
- The interview approach is described, including privacy and a validated screen.
- Subjective items are listed with the complication each is asked about.
- Objective findings include orthostatics, cardiac findings and oral or hand signs.
- The link between purging history and electrolyte or ECG testing is stated.
- At least one criterion for escalating care is named.
- APA citations and references are included.
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