A 16-year-old client has anorexia nervosa. She has lost 50 pounds during the past 3 months and is about 20 pounds under the weight that is normal for her height. She has dry skin with poor turgor, hair breakage, and brittle nails. The nurse can anticipate that when giving information about her menstrual history, the client is likely to report:

Correct Answer: B

Rationale: The correct answer is B: amenorrhea. In anorexia nervosa, severe weight loss can disrupt the hormonal balance, leading to the cessation of menstruation, known as amenorrhea. This is due to the body conserving energy and prioritizing essential functions over reproductive processes. The client's significant weight loss and physical symptoms indicate a state of malnutrition, further supporting the likelihood of amenorrhea. The other choices (heavy menstrual flow, premenstrual syndrome, dysmenorrhea) are less likely because they are not typically associated with anorexia nervosa and severe weight loss. Amenorrhea is a common manifestation of anorexia nervosa and reflects the impact of malnutrition on reproductive health.

Correct Answer: B

Rationale: The correct answer is B: Bulimia. Bulimia is often difficult to detect as individuals may engage in secretive binge eating and purging behaviors. Unlike anorexia nervosa where visible weight loss may be noticeable, individuals with bulimia may maintain a normal weight, making it harder to identify. Bulimia also tends to be associated with feelings of shame and guilt, leading individuals to hide their behaviors. Pica (A) involves eating non-food items and can be more easily observed. Obesity (C) is often noticeable due to visible weight gain. Anorexia nervosa (D) is also easier to detect as individuals may exhibit extreme weight loss and visible physical symptoms.

Correct Answer: A

Rationale: The correct answer is A: denial. Patients with anorexia nervosa often deny the seriousness of their low weight, distorted body image, or the potential health consequences of their eating behaviors. This denial helps them avoid facing their underlying issues and enables them to continue harmful behaviors. Choice B (projection) involves attributing one's own thoughts or feelings onto others, not relevant to anorexia. Choice C (introjection) involves internalizing external beliefs or values, not a common maladaptive coping mechanism in anorexia. Choice D (rationalization) involves creating logical explanations to justify inappropriate behaviors, not the primary defense mechanism in anorexia.

Correct Answer: B

Rationale: The correct answer is B because it demonstrates that parents are actively engaged and interested in learning about healthier eating patterns for their children, aligning with the objective of preventing childhood eating problems. This outcome indicates a willingness to make positive changes in the family's approach to nutrition. A: While providing structured meal times and snacks is important, this choice does not necessarily reflect an understanding of healthier eating patterns or prevention of eating problems. C: Using food as a reward can actually contribute to unhealthy eating habits and does not align with the goal of preventing childhood eating problems. D: Keeping a diary to record signs of hunger is useful, but it does not directly address the objective of learning about healthier eating patterns.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.