Sustenance is something, especially food, that sustains life or health, so nourishment is the essential element.Water and grains (choices b and c) are components of nourishment, but other things can be taken in as well. A menu (choice d) may present a list of foods, but it is not essential to sustenance.
An infirmary is a place that takes care of the infirm, sick, or injured.Without patients, there is no infirmary. Surgery (choice a) may not be required for patients. A disease (choice b) is not necessary because the infirmary may only see patients with injuries. A receptionist (choice d) would be helpful but not essential.
A purchase is an acquisition of something. A purchase may be made by trade (choice a) or with money (choice b), so those are not essential elements. A bank (choice c) may or may not be involved in a purchase.
A dimension is a measure of spatial content. A compass (choice a) and ruler (choice b) may help determine the dimension, but other instruments may also be used, so these are not the essential element here. An inch (choice c) is only one way to determine a dimension.