A dentist refers a 21-year-old woman with a BMI of 26 to the PMHNP after he discovers significant enamel erosion and decay of her front teeth. What diagnosis does the dentist suspect?
Anorexia nervosa
Binge eating disorder
Atypical eating disorder
Bulimia nervosa
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: SWS is indeed a rare neurocutaneous disorder affecting both the skin and nervous system, often presenting with facial port-wine stains and neurological symptoms.
Choice B reason: Seizures, hemiparesis, and intellectual disability are well-documented features of SWS, consistent with the patient’s presentation.
Choice C reason: Management of SWS can include anti-seizure medications for seizures, treatment of glaucoma, and occasionally low-dose aspirin to reduce risk of vascular complications; these are accurate clinical features.
Choice D reason: The prognosis for SWS varies widely; many patients survive into adulthood with appropriate management. An average lifespan of 30 years is not accurate, making this statement not a true clinical feature of SWS.
Correct Answer is C
Explanation
Choice A reason: Dose-dependent hyperhidrosis is a known adverse effect of SSRIs, including paroxetine. This symptom often occurs when the medication dose is increased, reflecting the serotonergic stimulation of the hypothalamic thermoregulatory centers. Therefore, this statement is correct.
Choice B reason: SSRIs may be less effective in women over 50 due to age-related hormonal changes, particularly reduced estrogen, which can affect serotonergic pathways and the pharmacodynamics of antidepressants. This statement aligns with clinical observations and is correct.
Choice C reason: There is no strong evidence that switching from paroxetine to escitalopram reliably reduces hyperhidrosis. While individual tolerability may differ, recommending a switch solely to mitigate dose-dependent hyperhidrosis is not considered a standard or evidence-based approach. This statement is incorrect in the context of the scenario.
Choice D reason: Reducing the dose of paroxetine to the previous effective level and using short-term adjunctive strategies for acute anxiety is an appropriate management plan. Additionally, evaluating hormone levels can provide insight into menopausal or endocrine contributions to symptoms. This approach is evidence-based and correct.
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