Which nursing interventions should be included in the care plan for a client with anorexia nervosa? Select all that apply.

Choice A rationale Daily weight monitoring is a standard intervention for clients with anorexia nervosa to track nutritional progress and physical stability. This process must be highly structured to minimize the client's anxiety and prevent manipulation of the weight results. Using the same scale and time ensures consistency. The nurse observes for behaviors like hiding weights in clothing or water loading before the weigh-in, as these are common manifestations of the intense fear of weight gain. Choice B rationale Cognitive-behavioral therapy is the primary psychological intervention for anorexia. It focuses on identifying and restructuring distorted thoughts regarding body image, self-worth, and food consumption. By challenging the irrational belief that thinness equates to value, the client learns to develop healthier coping mechanisms. This therapy helps the client recognize the physical dangers of starvation while addressing the underlying emotional triggers that lead to restrictive eating behaviors and excessive exercise seen in this population. Choice C rationale Maintaining a strict schedule for meals and snacks provides the necessary structure to reduce anxiety around eating. Consistency helps the body regain a normal metabolic rhythm and prevents the client from negotiating or skipping meals. A predictable environment decreases the power struggle between the client and the nursing staff. This intervention supports the primary goal of nutritional rehabilitation, ensuring the client receives the caloric intake required to reverse the life-threatening effects of severe malnutrition. Choice D rationale Rewarding weight gain with food-related objectives is counterproductive and contraindicated in the treatment of eating disorders. Using food as a reward or punishment reinforces the client's unhealthy obsession and emotional attachment to eating. Behavioral modification should instead focus on non-food rewards, such as increased social privileges or activities. The goal is to separate emotional value from nutritional intake, helping the client view food as fuel for the body rather than a tool for control.