A nurse in a provider's office is collecting data from a client.
Which of the following findings should the nurse identify as a risk factor for depression? (Select all that apply.)

Choice A rationale

Bulimia nervosa can be difficult to detect because individuals with the disorder often maintain a normal weight or may even be slightly overweight. Their eating and purging behaviors are often carried out in secret, and they may not appear outwardly ill or underweight, unlike individuals with anorexia nervosa.

Choice B rationale

People with bulimia nervosa engage in episodes of binge eating, consuming a large amount of food in a short period, followed by compensatory behaviors to prevent weight gain. Therefore, they do not eat an average amount of food on a daily basis; their intake is characterized by extremes.

Choice C rationale

Vomiting is one, but not the only, compensatory behavior associated with bulimia nervosa. Individuals may also use other methods such as misuse of laxatives, diuretics, excessive exercise, or fasting to counteract the effects of binge eating. The absence of vomiting does not rule out bulimia nervosa.

Choice D rationale

While bulimia nervosa has significant physical health consequences, the direct risk of developing diabetes mellitus is not a primary complication. Eating disorders can lead to various metabolic disturbances, but diabetes is more directly linked to factors like obesity, genetics, and insulin resistance. Electrolyte imbalances, esophageal damage, and cardiac arrhythmias are more immediate risks. .

Choice A rationale

A client repeatedly requesting anxiety medication should be assessed, but their behavior does not indicate an immediate safety risk to themselves or others. While their anxiety needs attention, other clients may have more urgent needs. The nurse should acknowledge their request and address it in a timely manner, but not necessarily as the absolute first priority.

Choice B rationale

A client yelling obscenities and throwing clothes is exhibiting escalating and potentially aggressive behavior. This situation poses an immediate risk to the client's safety and the safety of others on the unit. The nurse must intervene promptly to de-escalate the situation, ensure the client's well-being, and prevent potential harm to themselves or others. This behavior indicates a loss of control and requires immediate attention.

Choice C rationale

A client with bipolar disorder who is continuously pacing is displaying psychomotor agitation, which is characteristic of a manic episode. While this behavior warrants assessment and intervention, it does not present the same level of immediate risk as the client who is actively yelling and throwing objects. The pacing client should be monitored and offered interventions to help manage their agitation, but they are not the highest priority in this scenario.

Choice D rationale

A client screaming at other clients in the dayroom is exhibiting aggressive verbal behavior that is disruptive and potentially threatening to others. This situation requires the nurse's intervention to de-escalate the situation, ensure the safety and comfort of the other clients, and address the yelling client's behavior. However, the client actively throwing objects in their room poses a more immediate and direct safety risk.