A nurse is caring for an adolescent client who has a recent diagnosis of conduct disorder.
The client has demonstrated episodic aggression toward animals and humans, and has been known to threaten individuals with a knife and has sexually assaulted another adolescent.
Nurses' Notes: - 09:00: Client showed signs of agitation during group therapy.
- 13:00: Client had a verbal altercation with another client.
- 17:00: Client participated in one-on-one counseling, showed some signs of remorse.
Medical History: - Numerous instances of property destruction (breaking windows, damaging cars, and setting small fires) of family members as well as neighbors.
- Guardians are fearful of the client being around their other children.
Select the three findings that indicate the client is experiencing positive outcomes from the prescribed treatment:

Choice A rationale:

This statement is accusatory and blaming, rather than promoting understanding and problem-solving. It focuses on the negative behavior of the sibling and seeks external validation for the speaker's feelings, rather than attempting to address the underlying issue directly with the sibling.

It uses "should" language, which can come across as judgmental and critical, potentially escalating conflict.

It does not express the speaker's own feelings or needs, making it difficult for the other person to understand and respond effectively.

Choice B rationale:

While this statement demonstrates a willingness to take responsibility for actions, it does not directly address the communication between the family members. It focuses on redirecting the father's anger rather than exploring the underlying reasons for the conflict.

It could be interpreted as silencing the children's voices and potentially reinforcing a hierarchical dynamic within the family, where one parent holds authority over the others.

Choice C rationale:

This statement is manipulative and threatening, using a fear of exposure to control the other person's behavior. It undermines trust and safety within the family, making it difficult to have open and honest communication.

It does not address the core issue at hand and instead escalates conflict by using a "tit-for-tat" approach.

Choice D rationale:

This statement effectively demonstrates several key principles of effective communication: It expresses curiosity and a genuine desire to understand the other person's perspective.

It avoids accusations or assumptions, instead inviting open dialogue.

It focuses on specific behaviors and events ("each time you go to the mall") rather than making sweeping generalizations about the person's character.

It uses "I" language to express the speaker's own feelings and concerns, inviting empathy and understanding.

It creates an opportunity for the other person to share their perspective and work towards a resolution together.

Choice A rationale:

Personality disorders are not typically considered to be comorbidities of eating disorders. While some personality traits, such as perfectionism and obsessiveness, may be more common in individuals with eating disorders, these traits do not necessarily

constitute a personality disorder. Additionally, the presence of a personality disorder does not typically increase the risk of developing an eating disorder.

Choice B rationale:

Depression is one of the most common comorbidities associated with eating disorders. Studies have shown that up to 50% of individuals with eating disorders also experience depression. The relationship between eating disorders and depression is complex and bidirectional. Depression can contribute to the development of an eating disorder, and the behaviors associated with eating disorders can also worsen depression.

Choice C rationale:

Breathing-related sleep disorders, such as obstructive sleep apnea, are not typically associated with eating disorders. While some individuals with eating disorders may experience sleep disturbances, these disturbances are more likely to be related to other factors, such as anxiety or depression.

Choice D rationale:

Obsessive-compulsive disorder (OCD) is another common comorbidity of eating disorders. Studies have shown that up to 30% of individuals with eating disorders also have OCD. The symptoms of OCD, such as obsessive thoughts and compulsive behaviors, can overlap with the symptoms of eating disorders. For example, an individual with OCD may have obsessive thoughts about food and weight, and they may engage in compulsive behaviors related to eating, such as calorie counting or food restriction.

Choice E rationale:

Schizophrenia is not typically associated with eating disorders. While some individuals with schizophrenia may experience disturbances in eating behavior, these disturbances are more likely to be related to other symptoms of the disorder, such as delusions or hallucinations.

Choice F rationale:

Anxiety is another common comorbidity of eating disorders. Studies have shown that up to 60% of individuals with eating disorders also experience anxiety disorders. Anxiety can contribute to the development of an eating disorder, and the behaviors associated with eating disorders can also worsen anxiety.