What is a common consequence of long-term purging in patients with bulimia nervosa?

Correct Answer: B

Rationale: The correct answer is B because long-term purging in patients with bulimia nervosa can lead to increased risk of dehydration and electrolyte imbalances. Purging behaviors such as vomiting or laxative abuse can disrupt the body's fluid and electrolyte balance, potentially causing dehydration and electrolyte imbalances. These imbalances can have serious health consequences, including cardiac arrhythmias, muscle weakness, and kidney damage. Incorrect choices: A: Improved digestive health and better nutrient absorption - Purging does not improve digestive health or nutrient absorption; rather, it can lead to nutrient deficiencies. C: Improved self-esteem and body image - Purging behaviors are harmful and do not lead to improved self-esteem or body image. D: Decreased risk of cardiovascular problems and hypertension - Purging behaviors can actually increase the risk of cardiovascular problems due to electrolyte imbalances and dehydration.

Correct Answer: C

Rationale: The correct answer is C because it acknowledges the unique challenges of working with individuals with paranoid personality disorder. The response emphasizes the importance of being realistic about the patient's mistrust and suggests a neutral yet courteous approach. This approach recognizes the need to build trust gradually and not rush into being overly caring or empathetic, which could further trigger the patient's paranoia. Choice A is incorrect because adopting a cynical and aloof attitude is not conducive to building rapport with individuals with paranoid personality disorder. Humor may also be perceived as mocking or dismissive. Choice B is incorrect because it suggests backing off completely before trying a caring and empathetic approach again. This approach may not effectively address the patient's needs for support and may reinforce their feelings of isolation. Choice D is incorrect because it suggests continuing with the caring and empathetic approach without acknowledging the need for a more cautious and neutral approach with individuals who are mistrustful. This approach may not effectively address the patient's specific needs and could potentially worsen the

Correct Answer: C

Rationale: The correct answer is C. This statement indicates progress because the patient is demonstrating insight into their emotions, seeking help, and utilizing a coping strategy by reaching out for support instead of engaging in self-harm. Choice A does not provide information about progress in treatment. Choice B reflects a negative attitude towards the doctor. Choice D does not offer any insight into the patient's emotional state or progress in managing their behaviors.

Correct Answer: B

Rationale: The correct answer is B: Monitoring the patient closely for signs of refeeding syndrome. Refeeding syndrome is a potentially life-threatening condition that can occur when a malnourished individual is fed too quickly. Monitoring for signs such as electrolyte imbalances, fluid shifts, and organ dysfunction is crucial to prevent complications. Providing a high-calorie diet immediately (A) can exacerbate refeeding syndrome. Promoting independence in meal choices (C) may not be appropriate if the patient needs close monitoring. Encouraging exercise (D) can be harmful during the refeeding phase as the body needs time to recover and regain strength.

Correct Answer: B

Rationale: The correct initial treatment goal for a patient with anorexia nervosa is to restore the patient's nutritional balance through gradual weight gain. This approach is crucial as rapid weight gain can lead to refeeding syndrome, a potentially life-threatening complication. Gradual weight gain allows the body to adjust to increased caloric intake safely. Addressing body image issues is important but can be more effectively tackled after nutritional balance is restored. Group therapy can be beneficial but should not be the primary focus initially. Thus, choice B is the most appropriate initial treatment goal.