A 13-year-old girl begins to have episodes of temper outbursts that are out of proportion to the situation. Which of the following is a possible diagnosis?
Bipolar disorder
Disruptive mood dysregulation disorder
Schizophrenia
Brief psychotic disorder
The Correct Answer is B
Choice A reason: Bipolar disorder involves mood swings between mania and depression, but frequent temper outbursts that are persistent and disproportionate are more characteristic of disruptive mood dysregulation disorder than classic bipolar episodes.
Choice B reason: Disruptive mood dysregulation disorder is defined by severe, recurrent temper outbursts that are inconsistent with developmental level, occurring frequently over time. This diagnosis accounts for chronic irritability and is appropriate for this patient’s presentation.
Choice C reason: Schizophrenia involves psychotic symptoms such as delusions and hallucinations and does not typically present with recurrent temper outbursts alone.
Choice D reason: Brief psychotic disorder involves sudden onset of psychotic symptoms that last less than one month, which does not align with chronic temper outbursts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Low-dose aspirin is used for preeclampsia prevention during pregnancy, not for acute postpartum hypertension with severe symptoms.
Choice B reason: Magnesium sulfate is the treatment of choice for preventing seizures in postpartum preeclampsia or eclampsia and managing severe symptoms such as headaches, blurred vision, and upper abdominal pain.
Choice C reason: Lorazepam is an anxiolytic and anticonvulsant but is not first-line therapy for preeclampsia or eclampsia.
Choice D reason: Lactated Ringer's solution is a supportive fluid but does not address the underlying risk of seizures or severe hypertension.
Correct Answer is D
Explanation
Choice A reason: The Observer-Rated Scale for Mania is designed for nonclinicians and caregivers to rate observed manic behaviors rather than being a structured, clinician-administered assessment. It is less suitable for precise clinical assessment by a PMHNP.
Choice B reason: The Altman Self-Rating Mania Scale is a self-report tool that requires patient participation. In this scenario, the patient refuses to complete self-rated assessments, making this tool ineffective.
Choice C reason: The Self-Report Manic Inventory is also a self-report measure, requiring patient cooperation to provide accurate symptom reporting. Refusal by the patient prevents its use.
Choice D reason: The Young Mania Rating Scale (YMRS) is a clinician-administered tool widely used to assess the severity of manic symptoms. It combines direct clinician observation with patient input during the clinical interview. It evaluates mood, motor activity, speech, irritability, grandiosity, sleep, and insight, making it ideal for situations where the patient is unwilling to complete self-report measures.
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