A nurse in a mental health clinic is assessing a client who was recently diagnosed with anorexia nervosa. Which of the following findings should the nurse identify as an indication of laxative misuse?

A. Polyuria is not a direct indication of laxative misuse. While clients with anorexia nervosa may experience fluid and electrolyte imbalances, increased urination is more commonly associated with conditions such as hyperglycemia or diuretic use rather than laxative abuse. B. Positive Trousseau’s sign is correct because it indicates hypocalcemia, which can result from chronic laxative misuse. Excessive laxative use leads to significant loss of electrolytes, especially calcium and potassium, through the gastrointestinal tract. Hypocalcemia increases neuromuscular excitability, which is demonstrated by Trousseau’s sign (carpal spasm when a blood pressure cuff is inflated). This finding is a key indicator of electrolyte imbalance secondary to purging behaviors. C. Hypoglycemia may occur in clients with anorexia nervosa due to inadequate caloric intake, but it is not specifically indicative of laxative misuse. It reflects general malnutrition rather than a specific purging method. D. Jaundice of the sclera is not associated with laxative misuse. It is more commonly related to liver dysfunction, hemolysis, or biliary obstruction and does not indicate electrolyte loss from purging behaviors.