A client who has been diagnosed as having bulimia nervosa is hospitalized for treatment of elec-trolyte imbalance. Just before lunch is finished, the client leaves the table and walks quickly in the direction of the bathroom. The nurse should say:
1. "No one is allowed to leave the dining room during meals."
2. "I must accompany you when you go to the bathroom."
3. "I think I understand your plan, and I cannot permit you to carry it out."
4. "Wouldn't it be preferable to exercise rather than vomit?"
ANS: 2
Patients with bulimia nervosa induce vomiting to prevent weight gain. Close observation for at least an hour after meals should be part of the treatment plan. Option 1 does not account for the fact that the client might actually need to void or defecate. Option 3 engages in one-upmanship behavior. It's like saying, "Ha ha! I caught you being bad!" 4. This suggestion is grossly non-therapeutic.
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