A 47-year-old man only travels by train despite the necessity of frequently traveling long distances for his job. This causes significant difficulty, since the train trips are much longer than the plane rides and he misses important meetings. He has tried flying on several occasions, only to have a panic attack each time, even when the flight was smooth with no turbulence. Which of the following is the correct diagnosis?
Panic disorder
Specific phobia, situational type
Acute stress disorder
Social anxiety disorder
The Correct Answer is B
Choice A reason: Panic disorder involves recurrent, unexpected panic attacks that are not consistently triggered by a specific situation, whereas this patient’s panic occurs reliably in response to flying.
Choice B reason: This is correct. The patient exhibits situationally bound panic in response to flying, consistent with a specific phobia, situational type, causing avoidance and functional impairment.
Choice C reason: Acute stress disorder occurs within 4 weeks of a traumatic event and is time-limited, which does not match the chronic pattern seen here.
Choice D reason: Social anxiety disorder is characterized by fear of social scrutiny; the patient’s panic is specific to flying and not social situations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Asking about punishment may not provide insight into the underlying cause and could promote negative feelings in the child.
Choice B reason: Family history can provide context, but it does not address potential environmental or psychological triggers for new-onset enuresis.
Choice C reason: While some bedwetting can be normal, onset after a period of being toilet trained (secondary enuresis) warrants evaluation for stressors, medical conditions, or psychological factors.
Choice D reason: This is correct. Secondary enuresis often results from stressors or major life changes, such as the arrival of a new sibling. Asking this question helps identify psychosocial triggers.
Correct Answer is D
Explanation
Choice A reason: Anorexia nervosa involves restriction of caloric intake and often leads to significantly low body weight. This patient’s BMI is in the overweight range, making anorexia less likely.
Choice B reason: Binge eating disorder involves recurrent episodes of excessive food consumption without compensatory behaviors. While it may affect BMI, it typically does not cause enamel erosion.
Choice C reason: Atypical eating disorder is a broad category used when individuals exhibit some symptoms of eating disorders but do not meet full criteria. The pattern of enamel erosion strongly suggests purging behavior, indicating a more specific diagnosis.
Choice D reason: This is correct. Bulimia nervosa involves recurrent binge eating episodes followed by compensatory behaviors such as self-induced vomiting. Repeated vomiting exposes teeth to gastric acid, causing enamel erosion and dental decay, which aligns with the dentist’s findings.
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