An 8-year-old boy begins to exhibit chronic, severe, persistent irritability associated with frequent temper outbursts. Which of the following disorders is he most likely to develop in adulthood?
Borderline personality disorder
Schizophrenia
Bipolar I disorder
Unipolar depressive disorder
The Correct Answer is D
Choice A reason: Borderline personality disorder is characterized by instability in interpersonal relationships, self-image, and affect, typically emerging in adolescence or early adulthood. While emotional dysregulation is present, chronic irritability in childhood is not a strong predictor of developing borderline personality disorder.
Choice B reason: Schizophrenia involves psychosis, delusions, and hallucinations, typically emerging in late adolescence or early adulthood. Chronic irritability and temper outbursts in childhood are not predictive of schizophrenia.
Choice C reason: Bipolar I disorder is characterized by episodes of mania and depression. While irritability can appear in pediatric bipolar disorder, research shows that chronic, severe irritability with frequent temper outbursts without distinct manic episodes predicts unipolar depressive disorders rather than bipolar disorder.
Choice D reason: This is the correct answer. Chronic, severe irritability in childhood, especially when associated with temper outbursts, is strongly associated with the later development of unipolar depressive disorder in adulthood. It reflects persistent negative mood and emotional dysregulation rather than episodic mania.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Amok is a sudden outburst of aggressive behavior followed by amnesia, often seen in Southeast Asian males. This patient’s presentation does not include aggression and is not male-specific, making Amok less likely.
Choice B reason: Khayal attacks involve panic-like symptoms with palpitations, dizziness, and anxiety, common in Southeast Asian cultures. While some overlap exists, the episodic possession-like behavior is more indicative of possession syndrome.
Choice C reason: Possession syndrome involves episodes where the individual acts as though another entity has taken control, often with amnesia for the event. This aligns with the patient’s experience following her mother’s death. Cultural beliefs may shape the expression of stress and grief.
Choice D reason: Ataque de nervios is a cultural syndrome characterized by emotional outbursts, crying, trembling, or aggression, mainly described in Latin American populations. The patient’s presentation does not match this syndrome.
Correct Answer is C
Explanation
Choice A reason: SSRIs are not indicated for cluster headaches. These medications are primarily used to treat depression and anxiety and have minimal effect on the pathophysiology of cluster headaches.
Choice B reason: Diazepam, a benzodiazepine, may help with anxiety or insomnia but is not effective in aborting or preventing cluster headaches.
Choice C reason: This is the correct answer. Cluster headaches are severe, unilateral, stabbing headaches often associated with autonomic symptoms like tearing and nasal congestion. Sumatriptan, a selective serotonin 5-HT1B/1D receptor agonist, is the treatment of choice for acute attacks due to its rapid onset and ability to alleviate pain.
Choice D reason: Naproxen, an NSAID, may be effective for tension-type headaches or migraine prophylaxis but is ineffective for acute cluster headache attacks due to the extreme severity and rapid onset of pain.
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