A nurse is observing a group therapy session. Which of the following client statements should the nurse identify as an indication of bulimia nervosa?

Choice A rationale This statement, "I feel a sense of power by restricting my food intake," is more characteristic of anorexia nervosa, where control over food and weight is central to the disorder and provides a significant sense of accomplishment and mastery for the individual, reinforcing the restrictive behaviors. Choice B rationale While laxative misuse can occur in bulimia nervosa as a compensatory behavior, the statement "I only use the laxatives when I am feeling constipated" suggests a more typical, physiologically-driven use rather than the compulsive and excessive use for weight control seen in bulimia nervosa. Choice C rationale A common feature of bulimia nervosa is the secrecy surrounding bingeing and purging behaviors due to shame and guilt. Individuals often go to great lengths to hide their behaviors from family and friends for extended periods, making this statement highly indicative of the disorder's covert nature. Choice D rationale While there might be temporary emotional relief or a distorted sense of control during binge-purge episodes, describing an "emotional high" is not a universally characteristic or primary emotional experience in bulimia nervosa. More commonly, feelings of distress, shame, and guilt follow these episodes.