Correct Answer: A,C,D,F

Rationale: A. Purging is a behavior associated with bulimia nervosa, where individuals engage in self-induced vomiting, misuse of laxatives, diuretics, or enemas to compensate for binge eating episodes. C. Night eating disorder is characterized by recurrent episodes of night eating, typically waking up from sleep to consume food, often accompanied by a lack of appetite in the morning and a significant portion of daily caloric intake occurring after the evening meal. D. Pica is a disorder characterized by persistent eating of non-nutritive substances, such as clay, dirt, chalk, or paper. Pica involves eating non-food substances and is recognized as an eating disorder due to the potential harm it can cause. F. Binge eating disorder involves recurrent episodes of consuming large amounts of food within a discrete period, accompanied by a sense of loss of control over eating behavior. Unlike bulimia nervosa, individuals with binge eating disorder do not engage in purging behaviors. B. Cataplexy is a symptom of narcolepsy, characterized by sudden episodes of muscle weakness or loss of muscle tone, often triggered by strong emotions. E. Nocturnal myoclonus, also known as periodic limb movement disorder, involves involuntary muscle contractions or jerks during sleep, which can disrupt sleep but is not related to eating behaviors.

Correct Answer: D

Rationale: While this is an important goal for improving self-esteem and mood, it may not be the highest priority when the client's safety is at risk. This goal focuses on future planning and motivation, which is important for recovery but may not be as urgent as ensuring immediate safety. Understanding one's grief process is important for emotional healing, but it is not typically as critical as ensuring safety in the immediate term. This goal addresses the immediate safety and well-being of the client. Depression, especially severe depression, can increase the risk of suicidal ideation and behaviors. It is crucial to ensure the client's safety and have measures in place for her to reach out for help if she feels overwhelmed or unsafe.

Correct Answer: D

Rationale: Dissociative fugue involves sudden, unexpected travel away from home or one's customary place of activities, accompanied by an inability to recall one's past. It is usually associated with amnesia for personal information and is not characterized by depersonalization symptoms. DID involves the presence of two or more distinct personality states or identities within an individual, which alternate and take control of behavior. Each identity may have its own unique way of perceiving and interacting with the environment, which differs from the symptoms described in the scenario. Dissociative amnesia involves the inability to recall important personal information, usually related to stressful or traumatic events. While depersonalization symptoms can occur in dissociative amnesia, the hallmark feature is memory loss rather than the feeling of detachment from one's body. Depersonalization disorder is a dissociative disorder where individuals feel detached from themselves, as if they are observing their own thoughts, feelings, sensations, or actions from outside their body. This can lead to a sense of unreality or detachment from the environment or one's own experiences. It is often triggered by stressful events or trauma, and it can occur in individuals experiencing grief or loss, such as the surviving husband in this scenario.

Correct Answer: C,D

Rationale: C. Hypochondriasis can strain interpersonal relationships due to excessive preoccupation with health concerns, frequent doctor visits, and seeking reassurance from others. D. Hypochondriasis often follows a chronic course with periods of intense anxiety about health alternating with periods of relative calm. Despite reassurances and negative medical tests, individuals with hypochondriasis may continue to worry about their health. A. Hypochondriasis typically develops in adulthood rather than childhood. It involves persistent anxiety about health and the interpretation of normal bodily sensations as signs of serious illness. Childhood is less commonly associated with the onset of hypochondriasis. B. While stress can exacerbate symptoms of hypochondriasis, it is not typically diagnosed immediately following a specific stressor. The disorder often develops gradually over time due to a combination of factors, including anxiety, personality traits, and past experiences with illness. E. There is no consistent evidence suggesting that exposure to serious illness in childhood predisposes individuals to hypochondriasis. The disorder is more associated with individual psychological factors, cognitive biases, and anxiety sensitivity rather than childhood illness exposure.

Correct Answer: A

Rationale: This response acknowledges the client's feelings of helplessness, which can validate her experience and promote further discussion about her emotions and challenges related to her eating disorder. It shows empathy and encourages the client to explore her feelings. While this question is open-ended and invites the client to explore the underlying reasons for her behavior, it might inadvertently suggest that the client should have insights or control over her behavior that she may not currently possess. It could potentially make the client feel blamed or misunderstood if she cannot provide a clear answer. This response is directive and judgmental, which can lead to the client feeling criticized or defensive. It does not acknowledge the complexity of the client's experience and may not be effective in building rapport or promoting trust between the nurse and client. This response acknowledges the client's self-awareness and validates her recognition of the problem, which can be empowering and supportive. However, it does not directly address her expressed feelings of helplessness, making it less therapeutic in this context.