A 28-year-old woman presents to the PMHNP for an evaluation of "crying spells" associated with her recent move to the area. She moved across the country approximately 2 months ago to accept a new job. She states that she cries every day after getting home from work. She is confused by this reaction, because this was a "happy" move for her. She misses her family and friends, but she does not regret the move in any way. What is the most likely diagnosis?
Acute stress disorder
Adjustment disorder
Conversion disorder
Posttraumatic stress disorder (PTSD)
The Correct Answer is B
Choice A reason: Acute stress disorder occurs within the first month after a traumatic event, and this scenario involves emotional response to a life transition rather than trauma.
Choice B reason: Adjustment disorder is characterized by emotional or behavioral symptoms in response to identifiable stressors, such as relocation or life changes, occurring within three months of the stressor. The timing and context of her symptoms fit this diagnosis.
Choice C reason: Conversion disorder involves neurological symptoms without a medical cause and is unrelated to crying spells in response to stressors.
Choice D reason: PTSD requires exposure to a traumatic event involving threat to life or safety, which is not present in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Waiting to perform a genetic test until after multiple medication failures unnecessarily delays personalized care and may contribute to patient anxiety.
Choice B reason: Offering a genetic test respects the patient’s interest in pharmacogenomics, supports shared decision-making, and can guide individualized treatment to minimize side effects and improve outcomes.
Choice C reason: Knowing family medication history is helpful but does not directly address the patient’s request for genetic testing or guide immediate personalized care.
Choice D reason: Initiating treatment based on family history before obtaining test results may compromise the principle of individualized care and ignores the patient’s expressed interest in genetic testing.
Correct Answer is B
Explanation
Choice A reason: Severe dehydration can cause dizziness and weakness, but the presence of confusion, nausea, and her history of diabetes raises concern for metabolic complications rather than isolated fluid loss.
Choice B reason: Diabetic ketoacidosis is characterized by hyperglycemia, ketonemia, metabolic acidosis, and dehydration. The patient’s symptoms of dizziness, nausea, confusion, and weakness are consistent with this potentially life-threatening complication of type 1 diabetes, which may be exacerbated by eating disorder behaviors such as vomiting or insulin manipulation.
Choice C reason: Acute renal failure typically presents with oliguria, fluid retention, and electrolyte disturbances. While kidney injury may develop as a complication, it does not directly explain the acute symptom cluster observed here.
Choice D reason: Myocardial toxicity may present with arrhythmias or heart failure symptoms but is less likely in the context of acute metabolic and neurological symptoms in a diabetic adolescent.
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