A 29-year-old woman is dependent on her husband for many needs that require social interaction. She depends on him to pump her gas and to make all phone calls. She holds a job that requires little to no interaction with others. She is highly sensitive to criticism and fears embarrassment or rejection. She is submissive to the demands of her mother, which causes interpersonal conflict within her marriage. What is her most likely diagnosis?
Avoidant personality disorder and dependent personality disorder
Borderline personality disorder
Social anxiety disorder
Agoraphobia
The Correct Answer is A
Choice A reason: The client exhibits traits of both avoidant and dependent personality disorders. Avoidant personality disorder is marked by social inhibition, feelings of inadequacy, and hypersensitivity to criticism. Dependent personality disorder involves excessive reliance on others for decision-making and daily tasks. Her avoidance of social interaction, fear of rejection, and dependence on her husband and mother support this dual diagnosis.
Choice B reason: Borderline personality disorder involves emotional instability, impulsivity, and intense interpersonal relationships. The client does not display mood lability, self-harm, or unstable relationships typical of borderline personality disorder.
Choice C reason: Social anxiety disorder involves intense fear of social situations due to concerns about being judged or embarrassed. While the client has social avoidance, her pervasive dependence and submissiveness suggest a personality disorder rather than an anxiety disorder alone.
Choice D reason: Agoraphobia is the fear of being in situations where escape might be difficult or help unavailable. It typically involves avoidance of public places, not reliance on others for social tasks or submissiveness in relationships.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This statement is open-ended, collaborative, and empathetic. It invites the client to share concerns while positioning the PMHNP as a supportive partner. It fosters trust and sets the tone for a therapeutic alliance.
Choice B reason: This question is direct but may feel clinical or impersonal. It focuses on problems rather than the client’s experience or goals, which may hinder rapport-building.
Choice C reason: While commonly used, this question can be vague and may not encourage deeper reflection or engagement. It lacks the collaborative tone of choice A.
Choice D reason: This question is goal-oriented and useful for structuring the session, but it may be premature for a first meeting. It assumes the client has clear expectations, which may not be the case.
Correct Answer is C
Explanation
Choice A reason: This response incorrectly implies that lack of efficacy from St. John's Wort precludes SSRI use. The concern is not efficacy overlap but the risk of serotonin syndrome due to additive serotonergic effects.
Choice B reason: This is incorrect and dangerous. St. John's Wort and SSRIs both increase serotonin levels, and their combination can lead to serotonin syndrome. They do not complement each other and should not be used together.
Choice C reason: This is the correct response. St. John's Wort has serotonergic properties and can interact with SSRIs, increasing the risk of serotonin syndrome. The combination is contraindicated due to the potential for life-threatening adverse effects.
Choice D reason: This response delays appropriate treatment and overlooks the safety concern. Continuing St. John's Wort while initiating an SSRI is unsafe and not recommended.
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