A nurse is providing teaching to a client who is pregnant and is vegan. The nurse should instruct the client that which of the following foods is a reliable source of Vitamin B12?

A. It reflects a desire to improve physical fitness, which is a common and generally positive goal. However, if this statement were accompanied by an excessive focus on weight loss or extreme measures to achieve fitness, it could indicate a problem, but on its own, this statement is not clearly indicative of cognitive distortion.
B. It reflects "all-or-nothing thinking," a common cognitive distortion in eating disorders. This pattern of thinking involves seeing things in black and white, where a small lapse in diet is perceived as a complete failure, leading to excessive and irrational behavior, such as consuming more than intended.
C. It shows a strong fear of gaining weight, which is typical in anorexia nervosa. However, it is more a sign of extreme concern about body image rather than a specific cognitive distortion pattern. Cognitive distortions often involve faulty logic or irrational beliefs, and this statement is more about an emotional response to weight gain.
D. Cutting food into small pieces can be a behavioral characteristic or ritual for someone with anorexia nervosa, but it does not necessarily reflect a cognitive distortion on its own. It might be a way to control portions or prolong the eating process, but it is not a direct example of distorted thinking.

A. This refers to irregular bleeding between menstrual periods. While anorexia nervosa can lead to amenorrhea (the absence of menstruation) due to hormonal imbalances from severe weight loss and malnutrition, metrorrhagia is not a typical finding associated with anorexia nervosa.
B. This is a condition characterized by elevated levels of potassium in the blood. It is not a common finding in anorexia nervosa. Instead, clients with anorexia nervosa are more likely to have electrolyte imbalances such as hypokalemia (low potassium levels), especially if they engage in behaviors like vomiting or excessive use of laxatives.
C. This is a common finding in clients with anorexia nervosa. Constipation occurs due to inadequate intake of food and fluids, which results in decreased bowel motility. Malnutrition and dehydration from restricted intake can also contribute to this problem.
D. This refers to an abnormally fast heart rate. While tachycardia can occur in various conditions, in the context of anorexia nervosa, clients may actually exhibit bradycardia (slow heart rate) rather than tachycardia. The low body weight and malnutrition associated with anorexia can lead to a slowed heart rate as part of the body's response to starvation and decreased metabolic activity.