While the nurse at the personality disorders clinic is interviewing a patient, the patient constantly scans the environment and frequently interrupts to ask what the nurse means by certain words or phrases. The nurse notes that the patient is very sensitive to the nurse's nonverbal behavior. His responses are often argumentative, sarcastic, and hostile. He suggests that he is being hospitalized 'so they can exploit me.' The patient's behaviors are most consistent with the clinical picture of:

Correct Answer: A

Rationale: The correct answer is A: paranoid personality disorder. The patient's behaviors align with the diagnostic criteria for paranoid personality disorder, characterized by suspicion, distrust, sensitivity to criticism, and interpreting benign interactions as threatening. The patient's constant scanning of the environment, interrupting to clarify meanings, being sensitive to nonverbal cues, and displaying argumentative and hostile responses are all indicative of paranoid traits. Additionally, the belief that hospitalization is for exploitation is consistent with paranoid beliefs. Choices B, C, and D can be ruled out: B: Histrionic personality disorder is characterized by attention-seeking behavior, emotional instability, and dramatic expression. The patient's behaviors are not suggestive of seeking attention or being overly dramatic. C: Avoidant personality disorder is marked by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. The patient's behaviors are more indicative of suspiciousness rather than avoidance. D: Narcissistic personality disorder involves grandiosity, need for admiration, and lack of

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.

Correct Answer: B

Rationale: The correct answer is B: Impaired social interaction related to unfamiliar environment as evidenced by isolation and not talking with peers. This is the most appropriate nursing diagnosis for the client because it accurately reflects the client's behavior of isolation and lack of communication with peers, which are indicative of impaired social interaction. Rationale: 1. Impaired social interaction is a key characteristic of schizoid personality disorder, as individuals with this disorder tend to be socially isolated and have difficulty forming relationships. 2. The client's behavior of not speaking to peers and sitting through meetings without interaction supports the diagnosis of impaired social interaction. 3. The description of the client by her mother as shy and having few friends further supports the diagnosis of impaired social interaction. Summary: A: Anxiety related to a new environment is incorrect because the client's behavior is more indicative of impaired social interaction rather than anxiety. C: Ineffective coping related to new environment is incorrect as there is no evidence to suggest that the client is using maladaptive coping