During a telehealth session, a 32-year-old single woman reports being home during the quarantine for a period of 4 months with no outside contact. She says she knows several people who died from COVID-19, and although she never became ill, she has become extremely nervous about leaving her house. She tried leaving her house once during the Phase 1 reopening, but she says it felt like "an elephant" was sitting on her chest and went back home. She is terrified to use public transportation or go to any stores and stand in line, in case she has another episode of chest pain and "cannot escape." She is too terrified to go out again but misses seeing her friends and family. Which diagnosis is most correct?
Specific phobia, situational type
Adjustment disorder
Posttraumatic stress disorder
Agoraphobia
The Correct Answer is D
Choice A reason: Specific phobia involves intense fear of a particular object or situation, but the patient’s fear is generalized to multiple everyday situations, not one isolated trigger.
Choice B reason: Adjustment disorder involves emotional or behavioral symptoms in response to a stressor but does not typically include intense avoidance of multiple situations with panic-like symptoms.
Choice C reason: PTSD involves re-experiencing trauma, avoidance, hyperarousal, and negative mood, usually linked to a traumatic event. While COVID-19 exposure may be stressful, her symptoms are primarily avoidance-based rather than trauma re-experiencing.
Choice D reason: Agoraphobia is characterized by anxiety or panic in situations where escape is difficult or help may be unavailable, such as public transportation, stores, or being outside the home. The patient’s avoidance of leaving her house and fear of “not being able to escape” aligns closely with agoraphobia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Historically, testing focused on the birth cohort of 1945–1965 because of higher prevalence, but updated guidelines now recommend universal screening for all adults.
Choice B reason: This is incorrect because age alone should not exclude HCV testing. Older adults may still have undiagnosed HCV, and screening can identify infections for treatment.
Choice C reason: This is correct. Current recommendations advise that all adults aged 18 and older should receive at least one lifetime HCV screening, regardless of risk factors, to ensure early diagnosis and treatment.
Choice D reason: Testing on a case-by-case basis may have been applied before universal screening guidelines but is no longer the primary recommendation.
Correct Answer is B
Explanation
Choice A reason: Panic disorder involves recurrent, unexpected panic attacks and persistent concern about having additional attacks. In this case, the patient’s panic attacks are triggered specifically by flying, not occurring unexpectedly in multiple situations. Therefore, the attacks are situationally bound rather than generalized or spontaneous.
Choice B reason: Specific phobia, situational type, is characterized by intense fear or anxiety triggered by a specific object or situation, such as flying, that leads to avoidance behavior. The patient’s avoidance of air travel and repeated panic attacks during flights are consistent with this diagnosis.
Choice C reason: Acute stress disorder occurs after exposure to a traumatic event and involves intrusive memories, dissociation, or hyperarousal. The patient’s symptoms are not related to a recent trauma and are specifically associated with air travel, making this diagnosis less appropriate.
Choice D reason: Social anxiety disorder involves fear or anxiety about social situations in which the person may be judged or scrutinized. The patient’s anxiety is related to flying, not social evaluation, so this diagnosis does not fit the clinical picture.
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