A 24-year-old man presents to the PMHNP with complaints of worsening mental health symptoms after an extended period of isolation during COVID-19 quarantine. He now reports inability to go grocery shopping, use public transportation, or leave home on most days, due to fear of being unable to obtain help if he experiences an "anxiety attack." Which of the following most accurately describes his condition?
Social anxiety disorder
Generalized anxiety disorder
Agoraphobia
Panic disorder
The Correct Answer is C
Choice A reason: Social anxiety disorder primarily involves fear of social situations in which one might be judged, rather than fear of being unable to obtain help in public settings.
Choice B reason: Generalized anxiety disorder is characterized by excessive worry about various life events, not situational avoidance due to fear of panic or being trapped.
Choice C reason: Agoraphobia involves fear and avoidance of situations where escape might be difficult or help unavailable in the event of panic-like symptoms. The patient’s avoidance of public spaces aligns directly with this disorder.
Choice D reason: Panic disorder involves recurrent panic attacks, which may occur without situational triggers. While panic is relevant, the defining feature here is avoidance behavior consistent with agoraphobia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Alprazolam is a short-acting benzodiazepine that carries high risk for dependence. Using it as monotherapy without long-term management is not recommended.
Choice B reason: This is the correct answer. SSRIs are first-line long-term treatment for generalized anxiety disorder, and low-dose benzodiazepines such as clonazepam can be used short-term for rapid symptom relief during initiation of SSRIs. This approach balances immediate relief with safe long-term management.
Choice C reason: While starting an SSRI alone is reasonable, it may not provide immediate symptom relief, which the patient is requesting. Short-term adjunctive therapy is often needed initially.
Choice D reason: Psychotherapy alone is effective but does not meet the patient’s request for rapid symptom control. Combining therapy with pharmacologic treatment is more appropriate in this scenario.
Correct Answer is C
Explanation
Choice A reason: Permanent deformity is not required for diagnosis; while severe picking may cause scarring, the diagnostic criterion focuses on observable skin lesions.
Choice B reason: Infections can occur secondary to skin-picking but are not necessary to fulfill diagnostic criteria.
Choice C reason: Skin lesions resulting from recurrent and compulsive picking are the core diagnostic feature of excoriation disorder. The behavior must result in noticeable tissue damage.
Choice D reason: Seeking medical attention is not a requirement for diagnosis; many individuals with excoriation disorder do not present for care despite the lesions.
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