An 18-year-old referred to the mental health center often cooks gourmet meals but eats only tiny portions. The patient wears layers of loose clothing saying, 'I like the style.' The patient's weight dropped from 130 to 95 pounds. She has amenorrhea. Which diagnosis is most likely?

Correct Answer: B

Rationale: The correct answer is B: Anorexia nervosa. The patient displays key symptoms such as severe restriction of food intake leading to significantly low body weight, fear of gaining weight, distorted body image, and amenorrhea. These criteria align with the diagnosis of anorexia nervosa according to the DSM-5. Choices A, C, and D do not fully capture the severity and specific characteristics exhibited by the patient. Choice A lacks the criteria for anorexia nervosa, while choices C and D do not match the symptoms described in the scenario.

Correct Answer: C

Rationale: The correct answer is C: Reports of serum electrolytes. This is crucial as patients with anorexia nervosa are at risk of refeeding syndrome, characterized by electrolyte imbalances. Monitoring serum electrolytes helps detect potential complications such as hypophosphatemia, which can lead to cardiac and respiratory failure. A: Pupillary reaction to light is important but not as critical as monitoring electrolytes in this context. B: Temperature measurements are important for general assessment, but electrolyte monitoring takes precedence in refeeding complications. D: Complaints of sleep disturbances are relevant but do not directly assess the risk of refeeding syndrome.

Correct Answer: D

Rationale: The correct answer is D because according to Mahler's theory, during the rapprochement phase, the child learns to balance independence and dependence. If Janet did not receive critical 'emotional refueling' during this phase, she may struggle with abandonment fears and internalized rage. This can lead to difficulties in forming stable relationships and intense fear of being abandoned. Choices A and B are not directly related to the consequences of deficient emotional refueling in Mahler's theory. Choice C, while related to trust issues, does not specifically address the internalized rage and fears of abandonment resulting from the deficiency during the rapprochement phase.

Correct Answer: A

Rationale: The correct answer is A: To decrease anxiety and develop trust. This is the primary focus for nursing care for Danny because his symptoms of anxiety, paranoia, and refusal to eat are indicative of his distress and lack of trust in his environment. By decreasing his anxiety and building trust, the nurse can establish a therapeutic relationship with Danny, which is essential for effective treatment and care. Setting limits on his behavior (B) may escalate his anxiety and worsen his symptoms. Ensuring group therapy attendance (C) may not be effective if Danny is not in a mental state to participate. Attending to hygiene needs (D) is important but secondary to addressing his underlying anxiety and trust issues.

Correct Answer: A

Rationale: Answer A is correct as beneficence refers to the duty to act for the benefit and well-being of others. This principle emphasizes promoting the good of individuals and ensuring their welfare. It aligns with the ethical responsibility to actively do good and provide positive outcomes. Answer B (duty to avoid harm) is related to nonmaleficence, not beneficence. Answer C (duty to respect autonomy) pertains to autonomy, not beneficence. Answer D (duty to distribute resources equally) is related to distributive justice, not beneficence.