A nurse is assisting with planning care for a 17-year-old client who may have anorexia nervosa (AN). Which of the following should the nurse recognize as a common reproductive health concern for this client?

A. Amenorrhea. Anorexia nervosa is associated with severe weight loss and malnutrition, leading to hormonal imbalances that disrupt the menstrual cycle. Decreased estrogen levels result in amenorrhea, which is a hallmark symptom of the disorder and a significant reproductive health concern. B. Increased fertility. Anorexia nervosa typically leads to hormonal imbalances, including decreased levels of gonadotropins and estrogen, which suppress ovulation and reduce fertility rather than increasing it. C. Early onset of puberty. Malnutrition and low body fat delay puberty rather than accelerating it. Adolescents with anorexia nervosa may experience delayed menarche and stunted growth due to inadequate nutrition. D. Pelvic inflammatory disease (PID). PID is usually caused by sexually transmitted infections and is not directly associated with anorexia nervosa. The primary reproductive concern in anorexia is hormonal disruption leading to menstrual irregularities.