A nurse is assessing a client who has bulimia nervosa. Which of the following findings should the nurse expect?

Choice A reason: Systematic desensitization is a behavioral therapy technique used to reduce phobias or anxiety by gradually exposing the client to the feared stimulus while teaching relaxation strategies. It does not involve acting out scenarios or practicing new behaviors in a group setting.

Choice B reason: Role playing is the correct answer because it involves acting out scenarios and practicing new behaviors in a safe environment. This technique allows clients to rehearse adaptive responses, gain confidence, and receive feedback. It is widely used in behavioral therapy and group education to promote skill acquisition and behavioral change.

Choice C reason: Biofeedback involves using monitoring devices to provide clients with information about physiological processes such as heart rate or muscle tension. Clients learn to control these processes voluntarily. While effective for stress reduction, it does not involve acting out scenarios or practicing interpersonal behaviors.

Choice D reason: Cognitive restructuring is a cognitive-behavioral technique focused on identifying and challenging distorted thoughts. It helps clients replace maladaptive thinking patterns with healthier ones. While important in therapy, it does not involve role enactment or practicing behaviors in scenarios.

Choice A reason: Allowing the client to eat in their room is not appropriate because clients with anorexia nervosa often isolate themselves and may attempt to avoid eating or hide food. Supervised meals in a communal or monitored setting are necessary to ensure adequate intake and prevent food avoidance behaviors.

Choice B reason: Obtaining vital signs only once per day is insufficient. Clients with anorexia nervosa are at risk for severe complications such as bradycardia, hypotension, hypothermia, and electrolyte imbalances. Frequent monitoring is required to detect early signs of medical instability. Once daily vital signs would miss important changes.

Choice C reason: Weighing the client daily after the first voiding is the correct intervention. This ensures consistency and accuracy in monitoring weight trends, as voiding eliminates the variable of bladder volume. Daily weights are essential for tracking progress, evaluating treatment effectiveness, and identifying rapid changes that may indicate medical risk.

Choice D reason: Allowing the client to determine their daily calorie intake is inappropriate because individuals with anorexia nervosa often severely restrict calories. Nutritional intake must be carefully planned and supervised by the healthcare team to promote gradual weight restoration and prevent refeeding syndrome.