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 B
Explanation
Choice A reason: While melatonin is generally considered safe for short-term use, it has clinically significant interactions with several medications, including immunosuppressants. It can stimulate immune function, which may counteract the effects of immunosuppressive therapy. Therefore, this response is overly dismissive and potentially unsafe.
Choice B reason: Melatonin can interfere with immunosuppressive therapy by enhancing immune activity, which is counterproductive in conditions like rheumatoid arthritis where immunosuppression is often necessary. This makes it contraindicated or at least a cautionary supplement in such contexts. The PMHNP should recognize this and advise accordingly.
Choice C reason: While deferring to the primary care provider may seem prudent, the PMHNP is qualified to assess drug interactions and should take responsibility for evaluating the safety of melatonin in this context. This response lacks clinical assertiveness.
Choice D reason: Suggesting a benzodiazepine as a replacement for melatonin without assessing the client’s full psychiatric and medical profile is inappropriate. Benzodiazepines carry risks of dependence and sedation and are not a direct substitute for melatonin in most cases.
Correct Answer is D
Explanation
Choice A reason: This question assesses paranoid ideation and is more relevant to psychotic symptoms rather than personality traits.
Choice B reason: This question targets anhedonia, a core symptom of depression, and is part of the mood assessment rather than personality.
Choice C reason: This question evaluates depersonalization and derealization, which are dissociative symptoms, not personality-related.
Choice D reason: This question directly addresses enduring patterns of thoughts, moods, and behaviors that affect interpersonal functioning, which is central to personality disorders. It is designed to elicit information about maladaptive personality traits.
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