A patient states, "I feel detached from myself and weird all the time. It is as though I am looking at life through a cloudy window. Everything seems unreal. It really messes up things at work and school." This scenario is most suggestive of which health problem?

Dissociative amnesia.

Depersonalization disorder.

Acute stress disorder.

Disinhibited social engagement disorder.

Answer and Explanation

The Correct Answer is B

Choice A reason: Dissociative amnesia involves memory loss for specific events, linked to hippocampal dysfunction and stress-induced cortisol elevation. The patient’s persistent detachment and unreality feelings do not indicate memory loss but rather altered temporoparietal neural activity, making amnesia an incorrect diagnosis for the described symptoms.

Choice B reason: Depersonalization disorder involves persistent feelings of detachment and unreality, driven by disrupted temporoparietal cortex activity and altered serotonin signaling. The patient’s description of feeling detached and life seeming unreal aligns with this condition, reflecting neurochemical imbalances affecting perception and emotional integration.

Choice C reason: Acute stress disorder involves trauma-related symptoms like hyperarousal or dissociation within a month of trauma, driven by amygdala hyperactivity. The patient’s chronic detachment suggests a persistent condition, not time-limited, making depersonalization disorder more likely than acute stress disorder’s transient neural dysregulation.

Choice D reason: Disinhibited social engagement disorder, seen in children post-trauma, involves inappropriate social familiarity, linked to amygdala-prefrontal dysregulation. The patient’s symptoms of detachment and unreality are unrelated to social behavior, making this diagnosis inappropriate, as it does not involve temporoparietal perceptual distortions.

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Correct Answer is C

Explanation

Choice A reason: Strenuous outdoor activities increase dehydration risk with lithium, which has a narrow therapeutic index and affects renal sodium handling. No changes are unsafe, as dehydration elevates lithium levels, risking toxicity via neuronal and renal sodium-potassium ATPase disruption.

Choice B reason: Sunscreen is unrelated to lithium’s mechanism, which stabilizes mood via sodium channel modulation and inositol depletion. Lithium does not cause photosensitivity, and this advice does not address the critical risk of dehydration impacting renal lithium clearance.

Choice C reason: Lithium’s renal excretion depends on hydration, as it disrupts sodium-potassium ATPase, risking toxicity with dehydration. Increased fluid intake during heavy perspiration prevents elevated lithium levels, protecting neuronal and renal function, making this the most appropriate response.

Choice D reason: Reducing fluid intake increases lithium toxicity risk by decreasing renal clearance. Lithium’s effect on sodium-potassium ATPase heightens neuronal and renal sensitivity to dehydration, potentially causing toxic levels, making this advice dangerous and inappropriate for safe lithium use.

Correct Answer is ["100"]

Explanation

Step 1: Identify the total volume and infusion time.
Total volume = 1,000 mL
Infusion time = 10 hours
Result at step 1 = 1,000 mL ÷ 10 hours

Step 2: Calculate the infusion rate in mL/hr.
1,000 mL ÷ 10 hours = 100 mL/hr
Result at step 2 = 100 mL/hr

Step 3: Round to the nearest whole number.
100 mL/hr is already a whole number.
Result at step 3 = 100 mL/hr

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A patient states, "I feel detached from myself and weird all the time. It is as though I am looking at life through a cloudy window. Everything seems unreal. It really messes up things at work and school." This scenario is most suggestive of which health problem?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client asks a nurse about the need to alter any activities because of taking lithium. Which response would be most appropriate?

Correct Answer is C

Explanation

A nurse is preparing to administer dextrose 5% in water (D5W) 1,000 mL IV to infuse over 10 hours. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round to the nearest whole number.)

Correct Answer is ["100"]

Explanation

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