The nurse on the behavioral health unit negotiates a behavior modification contract with an adolescent client with anorexia nervosa. The nurse determines further teaching is necessary when the client makes which statement? 1. "Exercise is not allowed until I reach my target weight." 2. "The faster I gain weight, the faster I will return to school." 3. "I will eat at each meal time because it’s my only option." 4. "I know someone will watch me during eating and after I eat."

2. "The faster I gain weight, the faster I will return to school."

Explanation:

Anorexia nervosa is an eating disorder in which the person dangerously restricts their food intake. They develop a body image issue and feel that they are overweight even when they can have a perfectly normal weight. They starve themselves which eventually harms the body in the long run.

A person recovering from anorexia nervosa should gain weight slowly. If they suddenly start to consume a lot of food, the body will be put under lot of stress. It is already recovering from starvation and the organs have become weak due to it. If suddenly too much food is consumed, it will have to work extra hard to digest and assimilate it. This can put lot of pressure and shock on heart, liver, stomach etc. Thus, it is recommended not to gain more than 2 lbs or 1kg in a week.

Hence, "The faster I gain weight, the faster I will return to school" statement by client is incorrect and they require further teaching.

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