What should the nurse focus on when planning care for a patient with anorexia nervosa?

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.

Correct Answer: D

Rationale: The correct answer is D: manipulative. The patient's behavior demonstrates manipulation by attempting to create discord and control the relationships between the nurses. The patient uses different tactics to manipulate each nurse's emotions and perceptions for personal gain. Seductive (choice A) implies enticing or charming behavior, which is not evident in the scenario. Detached (choice B) suggests a lack of emotional connection, which is not the focus here. Guilt producing (choice C) involves inducing guilt, which the patient is not directly doing in this situation. Manipulative (choice D) best captures the patient's intent to influence others through deceptive and controlling tactics.

Correct Answer: A

Rationale: The correct answer is A: delirium. Delirium is an acute change in mental status characterized by fluctuating levels of consciousness, inattention, disorganized thinking, and altered perception. In this case, the patient's clouded and clear sensorium, agitation, and recent onset of symptoms are indicative of delirium. Choice B: dementia, is incorrect because dementia is a chronic, progressive decline in cognitive function that does not typically present with acute changes in mental status. Choice C: sundown syndrome, is incorrect as it refers to a pattern of worsening confusion or agitation in the late afternoon or evening, not necessarily characterized by acute onset and fluctuating levels of consciousness. Choice D: early-onset Alzheimer disease, is incorrect because Alzheimer's disease is a specific type of dementia that does not typically present with the acute and fluctuating symptoms described in the scenario.

Correct Answer: D

Rationale: The correct answer is D: acetylcholinesterase inhibitors. Patients with Alzheimer's disease often benefit from this type of medication to help improve cognitive function. The family would need information on this to understand the treatment plan. Antimetabolites (A), benzodiazepines (B), and immunosuppressants (C) are not typically used in the treatment of Alzheimer's disease and would not be relevant for the family to know about in this context.

Correct Answer: D

Rationale: The correct initial nursing diagnosis is D: Imbalanced nutrition: less than body requirements related to self-starvation. The patient's presentation of yellow skin, cold extremities, bradycardia, low weight, and refusal to eat indicate severe malnutrition due to self-starvation. The key indicators are the physical signs of malnutrition and the patient's statement about not eating until they lose enough weight. Options A and B do not address the primary issue of malnutrition and self-starvation. Option C focuses on coping skills, which is not the priority in this case. Therefore, option D is the best initial nursing diagnosis to address the patient's life-threatening condition of malnutrition.