A teacher is concerned that a 7-year-old girl does not talk in class. She only talks when she is alone or with specific close friends. This scenario is most consistent with which psychiatric condition?
Rett syndrome
Selective mutism
Autism
Rumination disorder
The Correct Answer is B
Choice A reason: Rett syndrome is a genetic disorder primarily affecting females, with developmental regression, hand stereotypies, and loss of purposeful hand skills, not selective speaking behavior.
Choice B reason: Selective mutism is an anxiety disorder characterized by consistent failure to speak in specific social situations (such as school) despite speaking in other settings. It typically presents in children around age 5–7 and is associated with social anxiety.
Choice C reason: Autism spectrum disorder involves social communication deficits, restricted interests, and repetitive behaviors. While mutism may occur, the key feature here is situation-specific silence rather than global social communication deficits.
Choice D reason: Rumination disorder involves repeated regurgitation of food and is unrelated to selective speech behavior.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: SAM-e (S-adenosylmethionine) can increase the risk of bleeding by enhancing anticoagulant effects when combined with warfarin. Patients on warfarin must avoid SAM-e due to the potential for potentiating anticoagulation and increasing the risk of hemorrhage.
Choice B reason: Omega-3 fatty acids may have mild antiplatelet effects but generally do not significantly interact with warfarin at typical dietary doses. Clinicians monitor coagulation parameters but do not universally require discontinuation.
Choice C reason: Melatonin is primarily used for sleep regulation and has minimal effect on warfarin metabolism. It does not pose a significant bleeding risk.
Choice D reason: Tryptophan is a precursor to serotonin and primarily affects mood and sleep. It has no clinically significant effect on warfarin or coagulation.
Correct Answer is C
Explanation
Choice A reason: Lack of social engagement is common in autism spectrum disorder and is not specific for Rett syndrome.
Choice B reason: Lack of imaginative play is also a feature of autism spectrum disorder, making it nonspecific for Rett syndrome.
Choice C reason: This is the correct answer. A hallmark of Rett syndrome is deceleration of head growth beginning around 6 months of age. This feature, in combination with severe psychomotor impairment and stereotypic hand movements, helps differentiate Rett syndrome from autism.
Choice D reason: Lack of eye contact is common in autism spectrum disorder and is not a distinguishing feature of Rett syndrome.
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