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.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: Anger involves resentment or frustration, driven by amygdala hyperactivity and norepinephrine surges. The husband’s calm acknowledgment of death reflects acceptance, not anger, indicating resolved emotional processing, not ongoing neural distress.

Choice B reason: Depression involves sadness and despair, with low serotonin and amygdala-driven grief. The husband’s statement reflects peace and acceptance, not depressive symptoms, indicating he has moved beyond this stage to neural emotional stability.

Choice C reason: Bargaining involves seeking to delay death, driven by amygdala-anxiety and cortisol release. The husband’s statement accepts the inevitability of death, reflecting prefrontal cortex-mediated resolution, not ongoing neural attempts to negotiate or delay.

Choice D reason: Acceptance, per Kubler-Ross, involves acknowledging death calmly, as shown by the husband’s statement. This reflects balanced amygdala-prefrontal cortex processing, with serotonin-mediated emotional stability, indicating resolution of grief and acceptance of the inevitable.

A. Aripiprazole (Abilify). B. Risperidone (Risperdal). C. Diphenhydramine (Benadryl). D. Propranolol (Inderal).

Correct Answer is C

Explanation

Choice A reason: Aripiprazole, an antipsychotic, may cause dystonic reactions via partial dopamine agonism. It is not used to treat dystonia, as it could worsen extrapyramidal symptoms by altering basal ganglia dopamine signaling, making it inappropriate for acute dystonic reaction management.

Choice B reason: Risperidone, an antipsychotic, can cause dystonic reactions due to dopamine D2 receptor blockade in the basal ganglia. Administering it would exacerbate extrapyramidal symptoms, not relieve them, making it unsuitable for treating acute dystonic reactions.

Choice C reason: Diphenhydramine, an antihistamine with anticholinergic properties, relieves dystonic reactions by counteracting dopamine blockade-induced basal ganglia dysfunction. It restores cholinergic-dopaminergic balance, reducing muscle spasms and rigidity, making it the standard treatment for antipsychotic-induced acute dystonic reactions.

Choice D reason: Propranolol, a beta-blocker, treats tremors or hypertension but not dystonic reactions, which stem from dopamine-cholinergic imbalance in the basal ganglia. It lacks anticholinergic effects needed to reverse dystonia, making it ineffective for this antipsychotic-related side effect.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

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 nurse is conducting a visit to a client who is receiving palliative care at home for dying. The client’s husband tells the nurse, "I know she needs to be with God. That is the best place for her now." The client is experiencing which stage of Kubler-Ross’ stages of grieving?

Correct Answer is D

Explanation

A hospitalized client diagnosed with schizophrenia is receiving antipsychotic medications. While assessing the client, a nurse identifies signs and symptoms of a dystonic reaction. Which medication would the nurse expect to administer?

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.)

A patient diagnosed with major depressive disorder began taking citalopram (Celexa) 4 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be to:

Which scenario best demonstrates an example of eustress?

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

Which health care worker should be referred to critical incident stress debriefing?

A nurse is preparing to administer acetaminophen 320 mg PO every four hours as needed for pain. The amount available from the pharmacy is acetaminophen liquid 160 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest whole number.)

The experience of trauma causes neurochemical changes in the brain that play a role in encoding fear memories that are implicated in Post Traumatic Stress Disorder. The nurse identifies the involvement of which neurotransmitters?

Which patient meets the criteria for hospice services?