A nurse is caring for a client who has binge-eating disorder. Which of the following actions should the nurse plan to take during the termination phase of the nurse-client relationship?

A. "My parents divorced when I was 13 years old." Divorce is recognized as an adverse childhood experience (ACE) because it can create emotional instability, financial stress, and changes in family dynamics, potentially affecting long-term mental health outcomes.
B. "We always had plenty of food in the house to eat." Having consistent access to food suggests a stable home environment, which is not classified as an ACE. Adverse experiences often include neglect, which involves a lack of basic needs such as food, shelter, or medical care.
C. "I was teased at school for wearing dirty clothes every day for weeks." Persistent neglect, such as not having clean clothing, can indicate parental neglect—one of the recognized ACEs. This can contribute to feelings of shame, social isolation, and long-term psychological distress.
D. "My parents would get in physical altercations." Witnessing domestic violence is a significant ACE that can lead to long-term emotional trauma, increased risk of anxiety, depression, and difficulty forming healthy relationships later in life.
E. "My parent went to prison when I was 12 years old." Parental incarceration is a recognized ACE, as it can cause emotional distress, economic hardship, and social stigma, increasing the child's risk for mental health disorders and substance use.
F. "My parent would swear often at my sibling and I." Verbal abuse, including frequent swearing or demeaning language, is a form of emotional abuse. Emotional abuse is a major ACE that can contribute to low self-esteem, difficulty regulating emotions, and increased vulnerability to mental health conditions.

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.