A nurse is assisting to provide an in-service to a group of nurses on medications used to treat the progression of dementia. Which of the following medications should the nurse include in the teaching?

A. Determining whether the client has entered an alter personality is relevant to dissociative identity disorder, not factitious disorder. In factitious disorder, the client intentionally produces or feigns symptoms, often for attention or care, but they do not have distinct personalities that take control. When a client expresses suicidal thoughts, focusing on diagnostic differentiation is secondary to immediate safety.

B. Encouraging relaxation techniques, such as deep breathing or mindfulness, may be helpful in managing anxiety or stress in the long term, but it is not the prioritywhen a client expresses suicidal ideation. Focusing on relaxation first could delay critical safety interventions.

C. Any statement such as “Maybe I should just end it all” is a serious warning sign. The nurse’s priority is to assess the client for suicidal ideation and self-harm. This includes asking direct questions about thoughts, plans, intent, and access to means. A thorough assessment allows the nurse to determine the immediate level of risk and implement safety measures, such as one-to-one observation, removing dangerous items, or involving mental health providers. This action aligns with the nursing principle of client safety as the top priority.

D. While group therapy can be a valuable component of long-term psychiatric treatment, it is not an immediate interventionwhen a client expresses potential suicidal thoughts. The nurse must first ensure the client’s safety and stabilize risk before moving on to therapy or skill-building activities.

A. Bulimia nervosa is characterized by recurrent episodes of binge eating followed by compensatory behaviorssuch as self-induced vomiting, misuse of laxatives, or excessive exercise. The statement, “I have binged and purged for years without my family or friends knowing,” reflects secretive binge-purge behavior, which is a hallmark of bulimia nervosa.

B. Feeling a sense of power by restricting food intakeis more characteristic of anorexia nervosa, particularly the restricting subtype, rather than bulimia nervosa.

C. Using laxatives only for constipation does not indicate a disorder. In bulimia nervosa, laxatives are used to compensate for binge eating, not for routine bowel regulation.

D. While some individuals may report emotional relief after binge-purge episodes, describing an “emotional high” is less specific than secretive behaviors. The key diagnostic featureis the cycle of bingeing and compensatory behavior, often done in secrecy.