A nurse is caring for a client who has major depressive disorder and attempted suicide. The client tells the nurse, "I should have died because I am totally worthless." Which of the following responses should the nurse make?

A. Praise the client for looking at herself in a mirror.

While body image concerns are common in anorexia nervosa, praising the client for looking at herself in a mirror may inadvertently reinforce the focus on appearance and body image, which can be counterproductive.

B. Ask the client to agree to talk to a nurse whenever she feels the urge to exercise.

Explanation: For a client with anorexia nervosa, overexercising can be part of the unhealthy behaviors associated with the disorder. Collaborative communication is important in addressing and managing these behaviors. Asking the client to agree to talk to a nurse whenever the urge to exercise arises is a supportive approach. It allows the nurse to provide emotional support, explore the client's motivations and triggers for overexercising, and work together on finding healthier coping strategies.

C. Reprimand the client about the potential damage that has occurred due to overexercising her body.

Reprimanding the client may lead to feelings of guilt and shame, which are counterproductive in supporting recovery. A more empathetic and supportive approach is needed.

D. Restrict the client from being weighed.

Restricting the client from being weighed might exacerbate anxiety around weight gain and contribute to the client's preoccupation with weight. However, monitoring weight under the supervision of healthcare professionals is important in managing anorexia nervosa.

A. "Using nontraditional treatments is not a good idea. I'd rather you avoid that route."

This response is directive and dismissive of the client's choice. It does not promote open communication or respect for the client's autonomy and beliefs.

B. "Your provider is very knowledgeable. If he prescribes chemotherapy, it's the best treatment for you."

While healthcare providers have expertise, this response doesn't address the client's concerns or give them an opportunity to express their feelings. It may come across as authoritarian and not respecting the client's wishes.

C. "A lot of people think nontraditional treatments will work, and they find out too late that they made the wrong choice."

This response uses scare tactics and doesn't address the client's individual needs or concerns. It does not foster a trusting and respectful nurse-client relationship.

D. "Tell me more about your concerns about taking chemotherapy."

This is the most appropriate response. It demonstrates active listening, empathy, and a willingness to understand the client's perspective. By asking the client to share more about their concerns, the nurse can engage in a meaningful conversation and provide information and support based on the client's needs.