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: HPV vaccination is recommended for girls and women, but the optimal age for routine vaccination is 11-12 years, not the entire 9-26 age range.
Choice B reason: Similarly, vaccination is recommended for boys and men, with routine administration starting at 11-12 years.
Choice C reason: Routine HPV vaccination is recommended for both girls and boys at ages 11-12 to maximize immune response before potential exposure to HPV, making this the correct age group.
Choice D reason: The vaccine can be given up to age 26, but the recommendation is specifically for children ages 11-12 for routine immunization.
Correct Answer is D
Explanation
Choice A reason: Carbamazepine is primarily an anticonvulsant and mood stabilizer. It is not indicated for acute situational anxiety related to preoperative stress.
Choice B reason: Clonidine can reduce sympathetic symptoms but is not first-line for acute anxiety. Its use for situational preoperative anxiety is limited.
Choice C reason: Fluoxetine is an SSRI used for long-term management of anxiety or depressive disorders. It is not effective for acute anxiety in a short-term preoperative context due to delayed onset of therapeutic effects.
Choice D reason: This is correct. Lorazepam is a short-acting benzodiazepine effective for acute situational anxiety. It can be safely used in a controlled hospital setting to alleviate preoperative anxiety and has a rapid onset of action.
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