A nurse is caring for a client in an emergency department (ED). Exhibits The nurse has reviewed the Nurses’ Notes, Vital Signs, Laboratory Results, and Diagnostic Results from Day 2. Which of the following assessment findings indicates the client is progressing as expected?

A. Vital signs: The client’s heart rate remains elevated (110–118/min) and orthostatic hypotension persists (BP 116/80 sitting, 88/68 standing), indicating ongoing dehydration and malnutrition. These findings suggest worsening fluid and electrolyte imbalance, not improvement. B. Client statement: The client’s verbalization, “I want to stop and get better,” reflects acknowledgment of the disorder and readiness for behavioral change, a critical first step in recovery from bulimia nervosa. This statement shows therapeutic progress in the mental health aspect of treatment, demonstrating insight and motivation for recovery. In clients with eating disorders, early progress is typically seen in attitude and cooperation rather than rapid physical recovery. C. ECG: The ECG continues to show sinus tachycardia with premature ventricular contractions (PVCs), consistent with hypokalemia and cardiac irritability. No improvement in cardiac stability is evident. D. Electrolytes: Laboratory results show worsening hypokalemia (K⁺ 2.9 mEq/L) and hyponatremia (Na⁺ 130 mEq/L). These indicate increasing severity of electrolyte imbalance, a potentially life-threatening complication.