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

Choice A reason: Russell’s sign, calluses on the knuckles from self-induced vomiting, is a hallmark of bulimia nervosa. Repeated purging causes skin abrasions, making this a common physical finding, so this is the correct expected observation. Choice B reason: Hyperkalemia is not typical in bulimia; hypokalemia is more common due to vomiting or laxative abuse. Electrolyte imbalances occur, but high potassium is unrelated, making this incorrect for bulimia findings. Choice C reason: Lanugo, fine body hair, is associated with anorexia nervosa, not bulimia. Bulimia patients often maintain normal weight, lacking severe starvation signs, making this incorrect for the expected findings. Choice D reason: Sunken parotid glands are not a bulimia feature; enlarged parotids occur due to frequent vomiting. Sunken glands are unrelated, making this incorrect compared to Russell’s sign as a bulimia indicator.