A nurse teaches a group of other nurses about the safety issues associated with bulimia. Which statement by a learner indicates an adequate understanding of the most significant safety risk associated with bulimia?

The vomiting when purging may lead to dehydration and hypotension.

The presence of callouses on a client's fingers means they self-induce vomiting.

The vomiting may cause breakdown of the tooth enamel.

Use of laxatives may cause diarrhea and skin breakdown.