Which is the most therapeutic response by the nurse when a patient with anorexia nervosa expresses fear of gaining weight?

Choice A rationale Telling a patient that their fear is irrational and not based on reality is dismissive and non-therapeutic. While the fear of weight gain in anorexia nervosa is disproportionate to the patient’s actual physical state, the feeling is very real to the individual. Dismissing their concerns shuts down communication and damages the therapeutic relationship. The nurse should acknowledge the patient's feelings without necessarily agreeing with their distorted perception, allowing for further exploration of the underlying psychological distress. Choice B rationale Stating that it is not about weight and telling the patient to just follow the diet plan ignores the profound psychological component of anorexia nervosa. For the patient, the disorder is deeply rooted in issues of control and body image. Simply focusing on the diet plan without addressing the emotional distress associated with eating makes the patient feel unheard. It reduces a complex psychiatric condition to a matter of simple compliance, which is rarely effective in long-term recovery. Choice C rationale Threatening the patient with hospitalization is a coercive tactic that increases anxiety and erodes trust. Patients with anorexia nervosa often struggle with autonomy and control, and using threats can lead to increased resistance and power struggles. While medical stabilization is sometimes necessary, it should be presented as a clinical necessity for safety rather than a punishment for not eating. This approach fails to provide the emotional support needed to help the patient manage their intense fears. Choice D rationale Asking the patient to tell the nurse more about their fear is a therapeutic, open-ended technique that encourages the expression of feelings. This approach validates the patient's experience and helps the nurse understand the specific triggers and thoughts associated with the fear of weight gain. By facilitating communication, the nurse can help the patient identify coping strategies and work through the cognitive distortions. This builds a supportive environment that is essential for the long-term treatment of eating disorders.