A patient tells the nurse that he is planning to hire a private detective to follow his wife, who he believes is having an extramarital affair. The patient looks behind the door to be sure no one is eavesdropping and asks the nurse what she did with his medical record after he left. The patient's behaviors are most consistent with a diagnosis of:

Correct Answer: C

Rationale: Rationale: The correct diagnosis is paranoid personality disorder (C). This is supported by the patient's suspiciousness and mistrust, as shown by planning to hire a detective and checking for eavesdroppers. These behaviors align with the core features of paranoid personality disorder, such as pervasive distrust and suspicion of others. Incorrect choices: A: Antisocial personality disorder is characterized by disregard for others' rights and lack of empathy, not by suspicion or mistrust. B: Schizoid personality disorder entails social withdrawal and emotional coldness, not suspiciousness. D: Obsessive-compulsive personality disorder involves perfectionism and control, not paranoia or mistrust.

Correct Answer: B

Rationale: The correct answer is B: To help the patient eliminate purging behaviors and develop healthy eating habits. This goal is important because it addresses the core issues of bulimia nervosa, which are unhealthy purging behaviors and distorted eating patterns. By helping the patient stop purging and establish healthy eating habits, the nurse can promote long-term recovery and overall well-being. Choice A is incorrect because promoting weight loss through strict dietary control can exacerbate the patient's unhealthy relationship with food and body image. Choice C is incorrect as encouraging excessive exercise can contribute to a cycle of compulsive behaviors and worsen the patient's physical and mental health. Choice D is incorrect because focusing solely on body image issues neglects the underlying psychological factors contributing to bulimia nervosa.

Correct Answer: B

Rationale: The correct answer is B because restoring nutritional balance through safe weight gain is a realistic and appropriate goal for a nurse working with a patient with anorexia nervosa. This goal focuses on the patient's physical health and addresses the underlying issue of malnutrition. Rapid weight gain (A) may be dangerous and unsustainable. Accepting body image without intervention (C) ignores the severity of the disorder. Maintaining a healthy weight without professional assistance (D) is unlikely for someone with anorexia nervosa who requires specialized care.

Correct Answer: C

Rationale: The correct answer is C: Body image disturbance and self-imposed starvation. This is a priority because it directly addresses the core issues of anorexia nervosa and poses immediate risks to the patient's health. Body image disturbance contributes to the patient's self-imposed starvation, which can lead to severe malnutrition and other serious complications. Addressing this issue is crucial for the patient's well-being. A: Weight loss of 2 pounds over the past week is concerning but may not be an immediate priority compared to addressing the underlying psychological issues. B: Denial of the need for nutrition rehabilitation is important to address but may not pose an immediate threat to the patient's health compared to self-imposed starvation. D: Refusal to participate in social activities may be a consequence of anorexia nervosa but does not directly address the urgent need to address body image disturbance and self-imposed starvation.

Correct Answer: D

Rationale: The correct answer is D: Fear of making a mistake. This is because individuals with obsessive-compulsive personality disorder often have an intense fear of making errors or mistakes. This fear can lead to indecisiveness and procrastination when faced with decision-making tasks. The client's behavior of being nearly immobilized during times requiring decision-making is characteristic of this fear of making a mistake. Incorrect choices: A: A need to make others uncomfortable - This is not related to the fear of making a mistake commonly seen in individuals with obsessive-compulsive personality disorder. B: Needing to be the center of attention - This is not a typical characteristic of individuals with obsessive-compulsive personality disorder. C: Wanting someone else to be responsible - This is not directly related to the fear of making a mistake, which is a core feature of the disorder.