A 29-year-old single woman presents to the PMHNP for evaluation of a chief complaint of fatigue. She states she has been feeling "tired" and "empty" for the past 4 years. She sleeps up to 11 hours a day and is still tired. She has trouble concentrating and has difficulty making decisions. She has gained 10 pounds over the past 2 years due to overeating and little physical activity. She reports no suicidal ideation or manic symptoms, and no delusions or hallucinations. What is the most likely diagnosis?
Major depressive disorder
Generalized anxiety disorder
Persistent depressive disorder (Dysthymia)
Cyclothymic disorder
The Correct Answer is C
Choice A reason: Major depressive disorder typically involves discrete episodes lasting at least 2 weeks with more acute severity. This patient’s 4-year chronic course suggests a different diagnosis.
Choice B reason: Generalized anxiety disorder is characterized by excessive worry rather than chronic low mood, fatigue, and anhedonia.
Choice C reason: Persistent depressive disorder (dysthymia) involves chronic depressive symptoms lasting at least 2 years in adults. The patient’s long-term low mood, fatigue, hypersomnia, poor concentration, and weight changes are consistent with dysthymia.
Choice D reason: Cyclothymic disorder involves fluctuating hypomanic and depressive symptoms; this patient has no hypomanic features.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Borderline personality disorder is characterized by instability in relationships, self-image, and affect, but early chronic irritability in childhood is not a strong predictor of this disorder.
Choice B reason: Schizophrenia usually presents in late adolescence or early adulthood with psychotic symptoms; chronic irritability alone is not predictive of schizophrenia.
Choice C reason: Bipolar I disorder involves episodic mania and depression. Chronic irritability without distinct manic episodes is less predictive of developing bipolar disorder.
Choice D reason: Persistent irritability and frequent temper outbursts in childhood, particularly when chronic and severe, are most predictive of developing unipolar depressive disorders in adulthood, reflecting an enduring affective dysregulation pattern.
Correct Answer is A
Explanation
Choice A reason: Biofeedback provides real-time feedback of physiological signals (heart rate, muscle tension, etc.) to help patients gain voluntary control over bodily functions, which can help manage ADHD symptoms without medication.
Choice B reason: Stimulating the olfactory system is unrelated to biofeedback.
Choice C reason: Manipulating energy points refers to alternative medicine approaches, not biofeedback.
Choice D reason: Blood circulation and lymph flow are unrelated to the mechanism of biofeedback.
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