A physical therapist recently convicted of multiple counts of Medicare fraud is brought to the emergency department after taking an overdose of sedatives. He tells the nurse, 'Sure I overbilled. Why not? Everybody takes advantage of the government. They have too many rules. No one can abide by all of them.' These statements can be assessed as showing:

Correct Answer: C

Rationale: The correct answer is C: lack of guilt feelings. The physical therapist's statements reveal a lack of remorse or guilt for committing Medicare fraud, indicating a disregard for ethical standards and a lack of moral responsibility. This behavior is indicative of a lack of guilt feelings, as the individual shows no remorse for their actions. Summary of other choices: A: Glibness and charm typically involve smooth talking and being persuasive, which is not demonstrated in the scenario. B: Superficial remorse implies a shallow or insincere apology, but the individual does not express any form of remorse in this situation. D: Excessive suspiciousness refers to being overly mistrustful or paranoid, which is not evident in the physical therapist's statements.

Correct Answer: D

Rationale: The correct answer is D. In narcissistic personality disorder, individuals exhibit grandiosity, self-importance, and a sense of entitlement. This is a key feature of the disorder where individuals have an inflated sense of their own importance and require excessive admiration. This behavior is often accompanied by a lack of empathy and exploitation of others. Choice A (charm, drama, seductiveness, and admiration seeking) is more characteristic of histrionic personality disorder. Choice B (preoccupation with minute details and perfectionism) is more characteristic of obsessive-compulsive personality disorder. Choice C (difficulty being alone, indecisiveness, and submissiveness) does not align with the typical presentation of narcissistic personality disorder.

Correct Answer: A

Rationale: The correct answer is A because encouraging the patient to eat small, frequent meals without pressure promotes a balanced approach to eating. This intervention helps to establish a regular eating pattern and prevents episodes of binge-eating. It also respects the patient's autonomy and can help build trust between the patient and healthcare provider. Choice B is incorrect because forcing the patient to eat larger meals can lead to increased anxiety and resistance, worsening the eating disorder. Choice C is incorrect as allowing the patient to skip meals can perpetuate unhealthy behaviors and reinforce the cycle of restriction and bingeing. Choice D is incorrect because neglecting the patient's eating habits can overlook a crucial aspect of their overall well-being and exacerbate the eating disorder.

Correct Answer: B

Rationale: The correct answer is B because purging in bulimia nervosa is a maladaptive behavior with severe health consequences. The nurse should educate the patient about the long-term harmful effects of purging, such as electrolyte imbalances, dental issues, and organ damage. Encouraging the patient to continue purging (A) reinforces the harmful behavior. Agreeing with the patient (C) or suggesting purging as an effective weight management method (D) further perpetuates the unhealthy behavior and fails to address the underlying issues. Overall, educating the patient about the risks of purging is essential in promoting recovery and better health outcomes.

Correct Answer: B

Rationale: The correct answer is B because providing a structured meal plan and monitoring nutritional intake is crucial in the care of a patient with anorexia nervosa to ensure they receive adequate nutrition. By following a structured plan, the patient can gradually restore a healthy relationship with food and gain weight safely. Encouraging the patient to eat freely (choice C) can lead to further disordered eating behaviors. Encouraging food restriction and weight control (choice A) can worsen the patient's condition. Encouraging daily exercise (choice D) may exacerbate the patient's excessive focus on weight and body image. In summary, choice B is the best option as it focuses on promoting healthy eating habits and addressing the nutritional needs of the patient with anorexia nervosa.