A nurse is discussing the three clusters of personality disorders.
Which of the following personality disorders is part of cluster C?

Choice A rationale

Lanugo, a fine, downy hair growth on the body, is more commonly associated with anorexia nervosa, particularly in severe cases, as a physiological response to malnutrition and hypothermia, where the body attempts to conserve heat. It is not typically a characteristic finding in bulimia nervosa, where significant weight loss and malnourishment are not always present to the same extent due to compensatory behaviors that may prevent extreme weight deficits.

Choice B rationale

Hyperkalemia, an elevated potassium level, is not a typical finding in bulimia nervosa. Instead, hypokalemia, a low potassium level, is a common and serious electrolyte imbalance in bulimia, resulting from frequent vomiting, diuretic abuse, or laxative misuse, which lead to significant loss of electrolytes from the body. Normal serum potassium levels typically range from 3.5 to 5.0 mEq/L.

Choice C rationale

Sunken parotid glands are not a characteristic finding in bulimia nervosa. On the contrary, chronic and recurrent vomiting, a hallmark of bulimia, often leads to hypertrophy (enlargement) of the parotid glands, giving the cheeks a swollen appearance. This enlargement is due to inflammation and compensatory growth in response to repeated stimulation and irritation from gastric acid exposure.

Choice D rationale

Russell's sign refers to calluses or abrasions on the dorsal aspect of the hand, particularly over the knuckles, caused by repeated trauma from inducing vomiting using fingers or other objects. This physical manifestation is a strong indicator of self-induced vomiting and is a classic clinical finding in individuals with bulimia nervosa, providing objective evidence of the compensatory behaviors central to the disorder.

Choice A rationale

Somatic symptom disorder involves experiencing physical symptoms without a clear medical cause, leading to significant distress or functional impairment. The primary focus is on the physical symptoms themselves, rather than a pervasive fear of acquiring a disease, differentiating it from the client's described extreme fear. This disorder often includes excessive thoughts, feelings, or behaviors related to the somatic symptoms.

Choice B rationale

Illness anxiety disorder is characterized by a preoccupation with having or acquiring a serious illness, despite the absence of significant somatic symptoms. Individuals exhibit high levels of anxiety about health and frequently engage in excessive health-related behaviors like repeated body checking, which aligns precisely with the client's described manifestations. This anxiety persists even after medical reassurance.

Choice C rationale

Functional neurological symptom disorder, also known as conversion disorder, involves neurological symptoms like paralysis or blindness that are inconsistent with known neurological conditions. The distress manifests as a loss of function rather than a fear of acquiring disease or repetitive body checking behaviors. The symptoms are not intentionally produced and are thought to be related to psychological factors.

Choice D rationale

Factitious disorder is characterized by the falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception. The motivation for these behaviors is to assume the sick role, not an actual fear of having or acquiring a disease, nor is it merely repeated body checking due to anxiety. This disorder involves intentional deception.