What is the correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors?

Correct Answer: A

Rationale: The correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors is to observe for parotid gland enlargement and dehydration. Parotid gland enlargement is a common physical manifestation due to repeated vomiting, and dehydration can result from purging behaviors. This assessment is crucial in monitoring the patient's physical health and identifying potential complications. Assessing for fluid retention and leg swelling (Choice B) is more typical in conditions like heart failure. Performing weight checks (Choice C) may not accurately reflect the patient's health status due to fluid shifts. Evaluating for signs of hyperactivity and poor sleep (Choice D) are not directly related to the immediate physical consequences of purging behaviors.

Correct Answer: C

Rationale: The correct answer is C because it indicates a misunderstanding of anorexia nervosa. Patients with anorexia often see food as the enemy, which is a distorted perception. Understanding that food is necessary for nourishment and health is crucial in recovery. Choice A shows an unhealthy weight goal, choice B shows awareness of low weight, and choice D shows willingness to work with the healthcare team, all of which are positive signs.

Correct Answer: C

Rationale: The correct answer is C because compliance with the behaviors specified in the contract is a key goal of behavior modification. This outcome focuses on specific, observable behaviors that the client agrees to follow. This approach helps in setting clear expectations and consequences, which is beneficial for individuals with antisocial personality disorder. Explanation for why the other choices are incorrect: A: Learning how to avoid punishment may not necessarily lead to behavior change or compliance with the contract terms. B: Explaining why he breaks rules may not necessarily result in actual behavior change or adherence to the contract. D: Developing empathy is a more complex and long-term goal that may not directly relate to compliance with the contract terms.

Correct Answer: B

Rationale: The correct answer is B because offering frequent, supportive counseling to address underlying issues is the most effective strategy for preventing relapse in patients with anorexia nervosa. Counseling helps patients explore and work through the root causes of their disorder, such as body image issues, low self-esteem, or past trauma. It also provides ongoing support and guidance in developing healthy coping mechanisms and behaviors. Choice A is incorrect because providing a strict, rigid meal plan can exacerbate feelings of control and restriction, which are common triggers for relapse in individuals with anorexia nervosa. Choice C is incorrect as solely focusing on self-monitoring food intake may not address the psychological and emotional factors contributing to the disorder, which are crucial for long-term recovery. Choice D is incorrect because reassuring the patient that their weight will stabilize without further intervention ignores the complexities of anorexia nervosa and does not address the underlying issues that need to be resolved for sustained recovery.

Correct Answer: B

Rationale: The correct answer is B: Cardiovascular instability and electrolyte imbalances. Anorexia nervosa can lead to severe malnutrition, causing cardiovascular issues like low heart rate and blood pressure. Electrolyte imbalances occur due to inadequate nutrient intake. Hypertension and hyperglycemia (choice A) are not common in anorexia. Insulin resistance and weight gain (choice C) are more associated with conditions like obesity. Severe dehydration and frequent urination (choice D) are not typical manifestations of anorexia.