A 49-year-old man with a known history of alcohol dependence and schizophrenia is brought to the psychiatric hospital because of frank delusions and visual hallucinations. Which of the following should be a diagnostic possibility for inclusion in the differential diagnosis?
Borderline personality disorder
Steroid-induced psychosis
Brief psychotic disorder
Substance/medication-induced psychotic disorder
The Correct Answer is D
Choice A reason: Borderline personality disorder may involve transient psychotic symptoms under stress, but it does not typically present with sustained delusions and visual hallucinations. It is not a primary differential diagnosis in this context.
Choice B reason: Steroid-induced psychosis is a valid diagnosis but requires a history of corticosteroid use. There is no mention of steroid exposure in this case, making it less likely.
Choice C reason: Brief psychotic disorder involves sudden onset of psychotic symptoms lasting less than one month, often triggered by stress. Given the patient’s chronic psychiatric and substance use history, this diagnosis is less appropriate.
Choice D reason: Substance/medication-induced psychotic disorder is highly relevant in this case. Alcohol dependence can lead to psychotic symptoms, especially during withdrawal or intoxication. This diagnosis accounts for both substance use and the presence of hallucinations and delusions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Beneficence refers to the ethical obligation to act in ways that promote the well-being of others. It emphasizes doing good and preventing harm but does not specifically address loyalty or truthfulness.
Choice B reason: Justice is the principle of fairness and equality in care delivery. It ensures that all patients are treated impartially but does not encompass loyalty or faithfulness.
Choice C reason: Respect involves honoring the dignity, autonomy, and rights of individuals. While it is a core ethical value, it does not specifically refer to being loyal or faithful.
Choice D reason: Fidelity is the ethical principle that emphasizes faithfulness, loyalty, and keeping promises. In nursing, it means being true to the commitments made to patients, maintaining trust, and upholding confidentiality. It directly reflects the concept of being true and loyal.
Correct Answer is A
Explanation
Choice A reason: These questions align with validated alcohol screening tools such as the AUDIT and NIAAA guidelines. They quantify drinking patterns and help identify risky behaviors, making them appropriate for the SBIRT framework.
Choice B reason: While these questions may provide insight into drinking habits, they are not part of standardized screening tools and lack the specificity needed for clinical assessment under SBIRT.
Choice C reason: These questions are more appropriate for assessing readiness to change or dependence severity but are not primary screening questions in SBIRT.
Choice D reason: These questions explore social consequences and polysubstance use but are not standard initial screening items in SBIRT. They may be useful in follow-up assessments.
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