A 22-year-old man reports that he hears someone knocking on his door at night, but every time he answers the door, no one is there. He thinks he hears his neighbors outside talking, even when he knows they are not home. He says he knows it’s his “imagination," but he feels “compelled” to answer the door, “no matter what time of day,” even if he is sleeping. He says he has had similar episodes “in the past,” but this has been going on for at least 6 months, and it has become problematic. What is the most appropriate diagnosis?
Obsessive-compulsive disorder (OCD)
Schizophrenia
Social anxiety disorder
Delusional disorder
The Correct Answer is A
Choice A reason: This is correct. The patient demonstrates both obsessions and compulsions. Obsessions are intrusive, unwanted thoughts or images, such as hearing knocking or voices that are not real. Compulsions are repetitive behaviors performed to reduce distress or prevent a feared outcome, demonstrated by the patient feeling compelled to check the door repeatedly. The symptoms have persisted for over six months and cause significant impairment, meeting diagnostic criteria for OCD.
Choice B reason: Schizophrenia involves persistent psychotic symptoms, such as hallucinations, delusions, disorganized speech, or negative symptoms, typically accompanied by functional decline. This patient recognizes the hallucinations as his imagination, which is inconsistent with schizophrenia.
Choice C reason: Social anxiety disorder is characterized by fear or anxiety in social situations due to concern about being judged or embarrassed. The patient's behaviors are not motivated by social evaluation and thus do not align with social anxiety disorder.
Choice D reason: Delusional disorder involves fixed, false beliefs that are not amenable to reason. The patient acknowledges that the experiences are imagined, which does not meet criteria for delusional disorder.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Class I heart failure is defined as patients who experience no limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea, which fits the description of this patient.
Choice B reason: Class II involves slight limitation of physical activity; the patient is comfortable at rest but ordinary activity results in symptoms. This patient is asymptomatic with ordinary activity, so Class II is less appropriate.
Choice C reason: Class III involves marked limitation of physical activity; patients are comfortable at rest but less than ordinary activity causes symptoms. The patient is not experiencing this degree of limitation.
Choice D reason: Class IV involves inability to carry on any physical activity without discomfort; symptoms may be present at rest. The patient does not have this level of functional limitation.
Correct Answer is C
Explanation
Choice A reason: Avoiding sick contacts is important for infection prevention, but low platelet count primarily increases bleeding risk, not infection risk.
Choice B reason: Aspirin inhibits platelet function and is contraindicated in severe thrombocytopenia, making this statement unsafe.
Choice C reason: This is correct. Patients with very low platelet counts are at high risk of bleeding; avoiding activities that could cause trauma reduces the risk of serious hemorrhage.
Choice D reason: While rest is beneficial, stopping work and sleeping excessively does not address the primary danger of thrombocytopenia, which is bleeding risk.
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