A 15-year-old boy is brought by his father to the psychiatric mental health nurse practitioner (PMHNP) for evaluation of what he considers unusual behavior. The boy's father states that for the past 2 months, his son claims he can communicate with "aliens from another planet." During this same time, he has been withdrawn from friends and activities, and he has been less talkative at home, making it difficult to communicate with him. What is the most likely diagnosis?
Schizophrenia
Brief psychotic disorder
Schizoaffective disorder
Schizophreniform disorder
The Correct Answer is D
Choice A reason: Schizophrenia requires symptoms to persist for at least six months, including at least one month of active-phase symptoms such as delusions, hallucinations, or disorganized speech. Since the boy’s symptoms have lasted only two months, this diagnosis is premature.
Choice B reason: Brief psychotic disorder involves sudden onset of psychotic symptoms lasting more than one day but less than one month, followed by full recovery. The boy’s symptoms have persisted for two months, which exceeds the duration criteria for this diagnosis.
Choice C reason: Schizoaffective disorder includes symptoms of schizophrenia along with prominent mood episodes (either depressive or manic). There is no mention of mood symptoms in this case, making schizoaffective disorder unlikely.
Choice D reason: Schizophreniform disorder is diagnosed when symptoms of schizophrenia are present for more than one month but less than six months. The boy’s delusions, social withdrawal, and communication difficulties over two months fit this timeframe, making this the most appropriate diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: A QTc interval of 100–200 milliseconds is abnormally short and not typically associated with torsades de pointes. While short QT syndrome is a separate arrhythmogenic condition, torsades is linked to prolonged QTc intervals.
Choice B reason: A QTc interval of 300–400 milliseconds is within the normal range for most adults. This range does not pose a significant risk for torsades de pointes unless accompanied by other risk factors or medications.
Choice C reason: A QTc interval of 500–700 milliseconds is markedly prolonged and significantly increases the risk for torsades de pointes, a potentially life-threatening polymorphic ventricular tachycardia. Ziprasidone is known to prolong the QT interval, and monitoring is essential to prevent arrhythmias.
Choice D reason: A QTc interval of 260–460 milliseconds includes both low-normal and upper-normal values. While the upper end may warrant caution, especially in patients on QT-prolonging drugs, it does not represent the highest risk range for torsades.
Correct Answer is A
Explanation
Choice A reason: A diagnosis of obstructive sleep apnea (OSA) is confirmed when polysomnography reveals at least 5 episodes of apnea or hypopnea per hour of sleep in the presence of symptoms such as snoring, gasping, or daytime sleepiness. This threshold is consistent with clinical guidelines and reflects mild OSA.
Choice B reason: While 15 or more episodes per hour indicate moderate to severe OSA, the minimum diagnostic threshold is 5 events per hour with associated symptoms. Therefore, this choice is overly restrictive and not the best initial diagnostic criterion.
Choice C reason: Polysomnography is the gold standard for diagnosing OSA. Clinical symptoms alone are insufficient for a definitive diagnosis, especially when treatment decisions depend on severity classification.
Choice D reason: Resolution of apneas/hypopneas with CPAP confirms treatment efficacy but does not establish the initial diagnosis. This finding is relevant after diagnosis and during titration studies, not for confirming OSA.
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