Which of the following explanations should the nurse include when teaching parents why it is difficult to diagnose a child or adolescent exhibiting symptoms of bipolar disorder? Select all that apply.

Choice A reason: Focusing conversations on nutritious food can be positive, but it does not directly indicate a change in behavior related to bulimia nervosa.

Choice B reason: Gaining weight may be a positive sign, but it is not sufficient on its own to indicate a behavioral change, as weight can fluctuate for various reasons.

Choice C reason: Demonstrating healthy coping mechanisms that decrease anxiety is a strong indicator of positive behavioral change in a client with bulimia nervosa, as it suggests the client is developing strategies to manage the disorder.

Choice D reason: While verbalizing an understanding of the disorder's etiology is beneficial, it does not necessarily reflect a change in behavior.

Choice A reason: Coping patterns can influence an individual's ability to handle stress and may contribute to suicide risk if they are maladaptive.

Choice B reason: Alcohol use can increase impulsivity and lower inhibitions, potentially increasing the risk of suicide.

Choice C reason: Socioeconomic status can impact access to resources and support, which may affect an individual's suicide risk.

Choice D reason: Support systems can provide emotional support and connection, which are protective factors against suicide.

Choice E reason: Identifying suicide risk is essential in assessing the immediate danger and the need for interventions.