A nurse is assisting in the care of an adolescent in a pediatric clinic. For each data collection finding, click to specify if the finding is consistent with anorexia nervosa or bulimia nervosa. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

Rationale: • BMI: The adolescent’s BMI is 16.1 (4th percentile), reflecting significant underweight status. Low BMI is a hallmark criterion for anorexia nervosa, indicating chronic energy deficiency and severe restriction. In bulimia nervosa, BMI is often normal or slightly below normal, so this finding is more consistent with anorexia nervosa. • Caloric intake: The adolescent reports consuming only one meal per day and limiting intake to around 500 calories, which represents severe caloric restriction. Chronic dietary restriction is central to anorexia nervosa. While individuals with bulimia nervosa may also restrict calories, it is typically interspersed with binge-eating episodes. • Report about exercise: Excessive exercise is a compensatory behavior for weight control observed in both disorders. In anorexia nervosa, exercise reinforces caloric deficit; in bulimia nervosa, it is often used after binge episodes. The adolescent’s reports of frequent and secretive exercise indicate risk behaviors present in both conditions. • Obsessive-compulsive behaviors: Obsessive tendencies, such as reorganizing clothing and pantry items, are common in both disorders. In anorexia nervosa, these behaviors often center on control over food and body image. In bulimia nervosa, compulsive behaviors may focus on binge-purge cycles and weight control. The adolescent’s rigid patterns of organization reflect this trait.