When a patient with anorexia nervosa expresses a fear of weight gain, the nurse should respond by:

Correct Answer: C

Rationale: The correct response is C: Explaining that weight gain is part of the treatment plan. This answer is correct because in treating anorexia nervosa, it is essential for patients to understand that weight gain is necessary for recovery and overall health improvement. By explaining this, the nurse can help the patient develop a more positive attitude towards weight gain and recognize it as a crucial aspect of the treatment process. Choices A, B, and D are incorrect: A: Minimizing the patient's concerns may invalidate their feelings and hinder therapeutic communication. B: Encouraging weight loss would be counterproductive and reinforce the patient's negative behaviors and beliefs. D: Simply agreeing with the patient's view on body image without addressing the need for weight gain would not promote positive change or support the patient's recovery.

Correct Answer: A

Rationale: The correct answer is A because journal writing can help individuals with personality disorders recognize and better understand their emotions, leading to improved self-awareness and emotional regulation. This can be a useful tool in therapy and self-management. Choice B is incorrect because individuals with personality disorders often struggle with interpersonal relationships and might benefit from seeking support or guidance rather than attempting to solve problems independently. Choice C is incorrect because avoidance does not address the underlying issues and can lead to isolation and maladaptive coping mechanisms. Choice D is incorrect because simply trying to alleviate problematic behaviors without addressing the underlying emotional issues may not lead to long-term improvement in relationships.

Correct Answer: A

Rationale: The correct answer is A: Severe dehydration and electrolyte imbalances. Untreated bulimia nervosa involves recurrent episodes of binge-eating followed by compensatory behaviors like purging. Purging can lead to fluid loss and electrolyte imbalances, causing dehydration. This can result in serious health complications such as cardiac arrhythmias and kidney damage. Rapid weight gain and fluid retention (B) are more associated with binge-eating disorder, not bulimia nervosa. Chronic constipation and digestive issues (C) are more commonly seen in anorexia nervosa. Severe malnutrition and organ failure (D) are potential complications of anorexia nervosa rather than 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: A

Rationale: The correct answer is A because referring patient requests and questions about care to the primary nurse promotes patient independence and helps establish boundaries. This intervention empowers the patient to take responsibility for their care and reduces the reliance on manipulation of others. Choice B is incorrect because negative reinforcement may exacerbate the behavior and lead to further manipulation. Choice C is incorrect because ignoring inappropriate behavior does not address the underlying issue of ineffective coping and may reinforce the behavior. Choice D is incorrect because encouraging the patient to discuss feelings of fear and inferiority may be helpful, but it does not directly address the manipulation of others, which is the main concern in this nursing diagnosis.