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A client with anorexia nervosa engages in manipulative behavior. She tells the nurse, 'I can't get weighed this morning, because I drank a glass of juice a few minutes before breakfast.' The best approach by the nurse would be:

  • A. I'm pleased that you took in some calories.'
  • B. We can get around this, if you'll eat a doughnut, too.'
  • C. The rule is 'weigh before eating'; now we have to put it off until tomorrow.'
  • D. This is weight day. Please step on the scale.'
Correct Answer: D

Rationale: Step 1: The correct answer is D because it sets clear boundaries and enforces consistency by reminding the client of the established protocol.
Step 2: By stating "This is weight day. Please step on the scale," the nurse maintains the structure and accountability in the treatment plan.
Step 3: This response avoids reinforcing manipulative behavior and emphasizes the importance of following the agreed-upon rules for accurate monitoring.
Step 4: Other choices like A may inadvertently validate the manipulation, B suggests giving in to the client's avoidance tactic, and C delays the weighing without addressing the manipulation directly.