A 25-year-old female client presents to the PMHNP for a psychiatric evaluation. She reports having moods that are "all over the place," but the moods never meet the level of full-blown mania or a major depressive episode. She says people call her "moody" and "unreliable." Which of the following conditions does she most likely meet diagnostic criteria for?
Schizoaffective disorder
Bipolar II disorder
Bipolar I disorder
Cyclothymic disorder
The Correct Answer is D
Choice A reason: Schizoaffective disorder involves a combination of mood symptoms (mania or depression) and psychotic symptoms, such as hallucinations or delusions, which are not described in this patient.
Choice B reason: Bipolar II disorder is characterized by hypomanic episodes and major depressive episodes. This patient does not report full depressive episodes, so criteria for Bipolar II are not met.
Choice C reason: Bipolar I disorder requires at least one manic episode, which the patient has not experienced. Therefore, Bipolar I is not appropriate.
Choice D reason: Cyclothymic disorder is characterized by chronic fluctuating mood disturbances, including periods of hypomanic symptoms and depressive symptoms that do not meet full criteria for hypomania or major depression. This matches the patient’s description of mood swings and chronic "moody" behavior.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Anorexia nervosa is characterized primarily by restrictive eating and significantly low body weight, which may not result in the dental erosion described here.
Choice B reason: Binge eating disorder involves recurrent episodes of excessive food intake without compensatory behaviors such as purging. Dental erosion is uncommon in this disorder.
Choice C reason: Atypical eating disorder can present with mixed features, but the classical sign of enamel erosion suggests repeated vomiting, pointing toward bulimia rather than atypical presentations.
Choice D reason: Bulimia nervosa is characterized by recurrent binge-eating episodes followed by compensatory behaviors such as self-induced vomiting, which often leads to enamel erosion and dental decay, especially of the anterior teeth. This aligns with the dentist’s observations.
Correct Answer is C
Explanation
Choice A reason: Lack of social engagement is common in autism spectrum disorder and is not specific to Rett syndrome.
Choice B reason: Lack of imaginative play is also a feature of autism but is not uniquely associated with Rett syndrome.
Choice C reason: Deceleration of head growth (microcephaly) around 6 months of age is a hallmark of Rett syndrome, distinguishing it from autism, and, combined with motor regression and stereotypic hand movements, strongly supports this diagnosis.
Choice D reason: Lack of eye contact can occur in both autism spectrum disorder and Rett syndrome, so it is not a differentiating factor.
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