A 10-year-old boy is brought by his mother to the PMHNP for evaluation of a sudden onset of obsessions, compulsions, and tics. During the history and exam, the PMHNP learns that the child recently had strep throat. What is the most likely diagnosis?
Tourette's syndrome
Pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infection (PANDAS)
Obsessive-compulsive disorder
Neurodevelopmental disorder
The Correct Answer is B
Choice A reason: Tourette’s syndrome is characterized by chronic motor and vocal tics beginning before age 18, but sudden onset following infection is atypical.
Choice B reason: PANDAS is marked by a sudden onset of OCD-like symptoms and/or tics following a streptococcal infection, which matches this patient’s history and symptom presentation.
Choice C reason: While OCD could be considered, the sudden onset after strep infection is more indicative of PANDAS rather than primary OCD.
Choice D reason: Neurodevelopmental disorders are chronic and present earlier in development, not as sudden post-infectious changes, making this diagnosis less likely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Avoidant personality disorder is characterized by social inhibition and fear of rejection. While the student is rigid, the primary issue is perfectionism and control, not avoidance of social interactions.
Choice B reason: Narcissistic personality disorder involves grandiosity, need for admiration, and lack of empathy. The student’s behaviors reflect rigidity and perfectionism rather than entitlement or excessive self-focus.
Choice C reason: Borderline personality disorder involves instability in relationships, mood, and self-image, along with impulsivity. The student’s behaviors do not demonstrate these traits.
Choice D reason: OCPD is characterized by perfectionism, rigidity, and an excessive focus on order and control. The student’s insistence on perfect sequential completion and inability to compromise aligns with OCPD traits.
Correct Answer is D
Explanation
Choice A reason: Type 1 diabetes is an autoimmune condition associated with increased risk of celiac disease, warranting evaluation.
Choice B reason: Down syndrome is a genetic condition associated with higher prevalence of celiac disease, indicating evaluation is appropriate.
Choice C reason: Having a first-degree relative with celiac disease significantly increases risk, making further assessment necessary.
Choice D reason: Obesity alone is not a recognized risk factor for celiac disease and does not indicate the need for routine screening unless other symptoms are present.
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