During a psychiatric evaluation, the PMHNP conducts a psychiatric review of systems (ROS) in which she reviews common psychiatric symptoms that may not have been elicited in the history of present illness (HPI). Which of the following questions is most likely designed to elicit a response for the system "personality"?
Do you ever feel that people are following you or trying to hurt you in some way?
Have you lost interest or pleasure in things you used to enjoy?
Do you ever feel as if people or places familiar to you are unreal, or that you are so detached from your body that you are standing outside your body watching yourself?
Can you identify patterns, such as thoughts, moods, and actions, that have caused you significant problems with your friends or family at work or in another setting?
The Correct Answer is D
Choice A reason: This question assesses paranoid ideation and is more relevant to psychotic symptoms rather than personality traits.
Choice B reason: This question targets anhedonia, a core symptom of depression, and is part of the mood assessment rather than personality.
Choice C reason: This question evaluates depersonalization and derealization, which are dissociative symptoms, not personality-related.
Choice D reason: This question directly addresses enduring patterns of thoughts, moods, and behaviors that affect interpersonal functioning, which is central to personality disorders. It is designed to elicit information about maladaptive personality traits.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Carbamazepine is associated with significant teratogenic risks, including neural tube defects and craniofacial abnormalities. It is contraindicated in pregnancy due to its potential to cause congenital malformations, especially during the first trimester.
Choice B reason: Lurasidone has limited data on teratogenicity but is generally considered safer than mood stabilizers like carbamazepine. It is often used cautiously in pregnancy when benefits outweigh risks.
Choice C reason: Lamotrigine is considered one of the safer mood stabilizers during pregnancy. It has not been strongly associated with major congenital malformations and is often preferred for bipolar maintenance in pregnant patients.
Choice D reason: Quetiapine is an atypical antipsychotic with a relatively low teratogenic risk profile. It is frequently used in pregnancy for mood stabilization due to its favorable safety data.
Correct Answer is A
Explanation
Choice A reason: The client exhibits traits of both avoidant and dependent personality disorders. Avoidant personality disorder is marked by social inhibition, feelings of inadequacy, and hypersensitivity to criticism. Dependent personality disorder involves excessive reliance on others for decision-making and daily tasks. Her avoidance of social interaction, fear of rejection, and dependence on her husband and mother support this dual diagnosis.
Choice B reason: Borderline personality disorder involves emotional instability, impulsivity, and intense interpersonal relationships. The client does not display mood lability, self-harm, or unstable relationships typical of borderline personality disorder.
Choice C reason: Social anxiety disorder involves intense fear of social situations due to concerns about being judged or embarrassed. While the client has social avoidance, her pervasive dependence and submissiveness suggest a personality disorder rather than an anxiety disorder alone.
Choice D reason: Agoraphobia is the fear of being in situations where escape might be difficult or help unavailable. It typically involves avoidance of public places, not reliance on others for social tasks or submissiveness in relationships.
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