A nurse is assessing a client who has bulimia nervosa. Which of the following findings should the nurse expect?

Choice A reason: Lanugo is a fine, downy hair that develops on the body as a compensatory mechanism in clients with anorexia nervosa due to severe malnutrition and low body fat. It is not typically associated with bulimia nervosa, since bulimia involves recurrent binge eating followed by compensatory behaviors such as vomiting or laxative use, but does not usually result in the same degree of starvation seen in anorexia. Choice B reason: Dental caries are expected in bulimia nervosa because repeated self-induced vomiting exposes teeth to gastric acid. This acid erodes enamel, leading to tooth decay, sensitivity, and caries. This is a hallmark physical finding in bulimia and directly reflects the purging behavior characteristic of the disorder. Choice C reason: Cold extremities are more commonly associated with anorexia nervosa due to severe malnutrition, hypothermia, and poor circulation from low body fat. Clients with bulimia nervosa may have normal weight or even be overweight, so cold extremities are not a typical finding. Choice D reason: Amenorrhea is more characteristic of anorexia nervosa due to extreme caloric restriction and low body fat, which disrupts hormonal regulation of the menstrual cycle. While menstrual irregularities can occur in bulimia nervosa, amenorrhea is not a defining or expected finding.