A nurse is caring for a female client who has bulimia nervosa and reports frequent self-induced vomiting. Which of the following findings should the nurse expect?

Choice A reason: Hyperkalemia is not typical in bulimia nervosa. Frequent vomiting causes electrolyte loss, particularly potassium, leading to hypokalemia due to hydrogen ion exchange in the kidneys. Hyperkalemia is more associated with renal failure or other conditions, not bulimia’s vomiting-induced losses. Choice B reason: Dental decay is expected in bulimia nervosa due to frequent self-induced vomiting, which exposes teeth to gastric acid, eroding enamel. This acid exposure, often high in hydrogen ions, demineralizes teeth, causing cavities and sensitivity, a hallmark physical consequence of bulimia’s purging behavior. Choice C reason: Amenorrhea is more associated with anorexia nervosa, where severe weight loss disrupts hormonal balance, halting menstruation. Bulimia patients often maintain normal weight, so menstrual cycles are typically preserved, making amenorrhea an unlikely finding in this condition. Choice D reason: Lower than normal body weight is characteristic of anorexia nervosa, not bulimia nervosa, where patients often maintain normal or slightly above-normal weight due to binge-purge cycles. Weight fluctuations occur, but significant underweight status is not typical, unlike in anorexia.