A 16-year-old girl of South Asian descent presents to the PMHNP accompanied by her father. He reports that since the death of her mother 3 months ago, his daughter has been having episodes of strange behavior. He describes these episodes as beginning with a stomach ache and dizziness. Then she behaves as though her dead mother has taken control of her body. After a few minutes, she is back to herself again. Afterward, the patient states she cannot remember anything about these episodes. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?
Amok
Khayal
Possession syndrome
Ataque de nervios
The Correct Answer is C
Choice A reason: Amok is a culture-bound syndrome mostly reported in Southeast Asia characterized by sudden episodes of aggressive or homicidal behavior, usually followed by amnesia. This does not match the described symptoms of dissociation and possession.
Choice B reason: Khayal is a culture-bound syndrome from South Asia involving panic-like symptoms with palpitations, dizziness, and fear of death, often related to wind sensations. While it shares somatic features, it does not involve the sense of a deceased person controlling the body.
Choice C reason: This choice is correct because possession syndrome involves episodes where an individual believes a spirit or supernatural entity has taken control of their body, often accompanied by dissociative amnesia. The patient’s behavior, post-episode memory loss, and cultural context fit this syndrome.
Choice D reason: Ataque de nervios is commonly reported in Latin American populations and includes intense emotional outbursts such as crying, trembling, and shouting, which are culturally specific and do not align with the presentation described here.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The Observer-Rated Scale for Mania is used by clinicians to assess manic symptoms but is less practical for initial self-reported screening in outpatient settings.
Choice B reason: The Mood Disorders Questionnaire (MDQ) is a self-report screening tool designed to identify symptoms of bipolar disorder, including periods of elevated mood and increased energy, making it appropriate for this patient’s history.
Choice C reason: The PHQ-9 assesses depressive symptoms but does not screen for hypomanic or manic episodes.
Choice D reason: The Young Mania Rating Scale (YMRS) is used for rating current manic severity but is not a screening tool for past hypomanic or manic episodes.
Correct Answer is D
Explanation
Choice A reason: While liver function tests are sometimes monitored, lithium is primarily excreted renally, making creatinine more critical than liver function tests for baseline evaluation.
Choice B reason: Liver function tests alone are insufficient; kidney function must be assessed because lithium can cause nephrotoxicity.
Choice C reason: A complete blood count is not required prior to initiating lithium; the focus is on renal and thyroid function and pregnancy status.
Choice D reason: Baseline thyroid function is essential because lithium can affect thyroid activity. Creatinine assesses renal function since lithium is renally excreted. A pregnancy test is important due to potential teratogenic effects during pregnancy.
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