A patient who is experiencing auditory hallucinations has become increasingly agitated throughout the day. The patient suddenly kicks over an empty trash can and shouts “I WILL KILL YOU ALL!” at the wall. In response, the nurse should (Select all that apply).

Choice A:
This statement describes a behavior more closely associated with bulimia nervosa, where individuals engage in compensatory behaviors such as vomiting to prevent weight gain after overeating. Binge eating disorder (BED) does not involve regular purging behaviors.
Choice B:
This statement indicates a focus on healthy eating and calorie counting, which is not characteristic of binge eating disorder. BED involves episodes of eating large quantities of food with a sense of loss of control, not controlled eating habits.
Choice C:
This statement reflects weight loss and improved body image, which does not align with the symptoms of binge eating disorder. BED is characterized by recurrent episodes of eating large amounts of food and feeling a lack of control over eating.
Choice D:
This statement aligns with the diagnostic criteria for binge eating disorder. Individuals with BED often eat large amounts of food and feel uncomfortably full, accompanied by feelings of disgust or guilt. This behavior is a key indicator of BED, as it involves eating beyond the point of fullness and experiencing negative emotions afterward.

A: Placing the difficulty in understanding on yourself by saying, “I’m having trouble following you,” is a therapeutic communication technique. It helps to reduce the patient’s anxiety and encourages them to clarify their thoughts without feeling judged. This approach fosters a supportive environment and can help the patient organize their thoughts better.

B: Letting the patient think you understand to minimize their anxiety is not an effective strategy. It can lead to further confusion and does not help the patient improve their communication. Honesty and clarity are important in therapeutic interactions.

C: Using reality testing to help the patient clarify their statements can be useful, but it may not be the best initial approach. It requires the patient to have some level of insight and ability to engage in reality testing, which may not be possible in severe cases of associative looseness.

D: Telling the patient they are not making any sense can be perceived as judgmental and may increase the patient’s anxiety and frustration. It is not a supportive or therapeutic approach and can hinder effective communication.