A 9-year-old girl witnessed the violent murder of a close family member. She now says she is blind. However, she flinches when objects are quickly moved toward her face. There is no neurologic evidence of blindness. What is the most likely diagnosis?
Factitious disorder
Illness anxiety disorder
Conversion disorder
Somatic symptom disorder
The Correct Answer is C
Choice A reason: Factitious disorder involves intentionally producing or feigning symptoms to assume the sick role, usually for attention. This child is not deliberately faking blindness; it is a subconscious response to trauma.
Choice B reason: Illness anxiety disorder involves excessive worry about having or acquiring a serious illness without significant somatic symptoms. The child’s symptoms are not due to health anxiety.
Choice C reason: This is the correct answer. Conversion disorder involves neurologic symptoms, such as blindness, paralysis, or seizures, without a medical explanation, often triggered by psychological stress. The flinching reflex indicates intact vision despite reported blindness, consistent with conversion disorder.
Choice D reason: Somatic symptom disorder involves distressing somatic symptoms that cause significant impairment but are not intentionally produced. While similar, the acute onset of functional blindness after trauma fits conversion disorder rather than somatic symptom disorder.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Threatening the patient with negative outcomes is not therapeutic and may increase avoidance behaviors, making it an inappropriate response.
Choice B reason: Pressuring the patient to undergo EMDR can heighten anxiety and reduce engagement in therapy. It does not validate the patient’s concerns.
Choice C reason: This response normalizes the patient’s symptoms, educates about the function of avoidance in maintaining PTSD, and encourages engagement in therapy without coercion. It is patient-centered and evidence-based.
Choice D reason: Minimizing the patient’s emotional experience is not helpful and may be perceived as dismissive. EMDR requires acknowledging the patient’s distress while managing exposure gradually.
Correct Answer is A
Explanation
Choice A reason: Delayed puberty with features such as lack of secondary sexual characteristics, short stature, and physical anomalies such as extra neck folds may indicate Turner syndrome. Estrogen therapy is essential to induce the development of secondary sexual characteristics and support bone health.
Choice B reason: Testosterone is indicated for male hypogonadism or delayed puberty in boys. It is not appropriate for a female patient with delayed puberty.
Choice C reason: Doing nothing delays sexual development, potentially affects bone health, and does not address underlying endocrine issues. This is not appropriate management.
Choice D reason: Synthetic thyroid addresses hypothyroidism, but this patient presents with delayed puberty and physical features consistent with Turner syndrome rather than thyroid deficiency. Thyroid therapy alone will not initiate puberty.
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