A nurse is caring for a client who has anorexia nervosa. Which of the following findings should the nurse expect?

A. Functional neurological symptom disorder. This condition involves neurological symptoms, such as paralysis or seizures, that cannot be explained by medical findings. The symptoms are not related to fear of disease or body checking, making this option irrelevant in this scenario.
B. Illness anxiety disorder. This disorder is characterized by excessive worry about having or acquiring a serious illness, often accompanied by behaviors like repeated body checking. Clients misinterpret normal bodily sensations as signs of severe disease, which aligns with the client's described symptoms.
C. Somatic symptom disorder. This disorder involves experiencing physical symptoms that cause significant distress or impairment, but the focus is on the symptoms themselves rather than an excessive fear of disease. The behaviors described in the question are more indicative of illness anxiety disorder.
D. Factitious disorder. This involves intentionally producing or feigning symptoms for the purpose of assuming the sick role, rather than from a fear of disease. The client’s fear and checking behaviors do not fit this disorder's criteria.

A. "I'm going to ignore your lack of self-care because it is an aspect of the disorder." Ignoring the client’s hygiene neglect does not support their well-being or promote self-care. While poor self-care is a symptom of schizophrenia, the nurse should encourage hygiene rather than dismiss it.
B. "Do you really think it is ok not to bathe? What is going on with you?" This confrontational statement may make the client feel judged or defensive, potentially worsening their resistance to self-care. Clients with schizophrenia may have impaired insight and motivation, making supportive guidance more effective.
C. "It is now time for you to bathe. Do you want to wear the red or green shirt?" Providing a structured directive while offering a simple choice promotes autonomy and encourages adherence to hygiene. Clients with schizophrenia benefit from clear instructions and limited choices, reducing decision-making stress and increasing cooperation.
D. "This is it! You are getting a bath! There are three of us here to bathe you!" Using forceful or coercive language can cause distress and escalate resistance. Encouraging hygiene should be done through therapeutic communication and gentle prompts rather than threats or intimidation.