A nurse is observing a group therapy session.
Which of the following client statements should the nurse identify as an indication of bulimia nervosa?

Choice A rationale

Illness anxiety disorder involves preoccupation with having or acquiring a serious illness, with somatic symptoms being absent or mild. The client's behavior of intentionally breaking bones is a deliberate act of self-harm or deception, which is inconsistent with the primary fear-driven preoccupation of illness anxiety disorder.

Choice B rationale

Factitious disorder is characterized by the falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception. The client's purposeful breaking of bones aligns with the diagnostic criteria, as they are intentionally causing harm to themselves for the purpose of assuming the sick role.

Choice C rationale

Functional neurological symptom disorder, also known as conversion disorder, involves neurological symptoms incompatible with recognized neurological or medical conditions. The symptoms are not intentionally produced or feigned. Intentionally breaking bones is a volitional act, distinguishing it from the non-volitional nature of conversion disorder symptoms.

Choice D rationale

Dissociative amnesia involves an inability to recall important personal information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. It is a memory disturbance and does not involve the intentional self-infliction of physical injury as seen in the client's behavior.

Choice A rationale

A speech therapist, or speech-language pathologist, is a specialist who diagnoses and treats communication disorders. Their role involves assessing speech, language, and swallowing difficulties, and implementing therapeutic interventions. A nurse's scope of practice does not include providing specialized speech therapy.

Choice B rationale

A legal representative, such as a lawyer or guardian, is authorized to act on behalf of another person in legal matters. This role is outside the scope of nursing practice, which focuses on providing direct patient care and advocating for health and well-being within ethical and professional guidelines.

Choice C rationale

A diagnostician, typically a physician or other licensed healthcare professional, is responsible for identifying and naming diseases or conditions based on signs, symptoms, and diagnostic tests. While nurses contribute to the diagnostic process through assessment, they do not independently establish medical diagnoses.

Choice D rationale

An advocate is a crucial role for a nurse working with a client who has a communication disorder. The nurse acts as a liaison, ensuring the client's needs are understood, facilitating communication with other healthcare providers, and empowering the client to express themselves and participate in their care decisions.