DAVIS ADVANTAGE: Personality Disorders, Neurocognitive Disorders, Psychosomatic Disorders, Eating Disorders

Jane has been diagnosed with bulimia nervosa. Which symptoms would you expect Jane to present with? Select all that apply. Intense fear of gaining weight or becoming fat. Induces vomiting and takes laxatives to avoid gaining weight. Body shape and weight influence self-evaluation. Recurrent episodes of binge eating in a short period of time with loss of control. Feels disgusted and guilty after binging episode. Question 4 of 5

Body shape and weight influence self-evaluation. Recurrent episodes of binge eating in a short period of time with loss of control. Feels disgusted and guilty after binging episode.

A nurse working in an inpatient psychiatric setting is most likely to encounter which of the following personality disorders? Select all that apply. Dependent Borderline Histrionic Avoidant Antisocial

Borderline Histrionic Antisocial

Monica presents to her primary care provider for the third time with a complaint of, "I'm still having difficulty swallowing." The provider has run all tests and there is not a pathophysiological change that can explain what is happening. The doctor is worried that Monica is faking. What disorder best fits? Somatic symptom disorder Factitious disorder Illness anxiety disorder Conversion disorder

Conversion Disorder

Jill presents to the provider with the complaint of urinary retention. The provider can't find a pathophysiological change to explain what is going on with Jill.What disorder does Jill have?

Conversion disorder is a loss of or change in body function that cannot be explained by any known medical disorder or pathophysiological mechanism, and the person believes there is a serious medical condition.

Samir reports feelings of distorted sense of time and emotional numbing, saying, "I feel like I am an outside observer to myself."What term describes what is going on with Samir?

Depersonalization-derealization disorder causes the person to have feelings of unreality, detachment, and of being outside of one's body. There is a disturbance in perception of oneself as well as the external environment. Depersonalization causes the person to feel detached or like an outside observer from one's body.

Shawn states that he has been feeling like he is in a "dreamlike state," like things around him "just don't seem real."What best describes the problem Shawn has?

Depersonalization-derealization disorder causes the person to have feelings of unreality, detachment, and of being outside of one's body. There is a disturbance in perception of oneself as well as the external environment. Derealization specifically describes an alteration in the perception of the external environment and surroundings. People experiencing derealization state that things around them don't seem real, or they will feel like they are in a dreamlike state. Sometimes, they will complain of feeling foggy and lifeless or of having visual distortions.

Rose was recently attacked after work one night. She states that she can't remember anything about that night or what her attackers looked like.What term best describes Rose's symptoms?

Dissociative amnesia happens when there is extreme distress or trauma and is usually a temporary condition. There are several types of amnesia: localized amnesia is the inability to recall anything associated with the trauma, selective amnesia is the ability to only recall certain aspects of the trauma, and generalized amnesia is when the person can't remember who they are or anything about themselves.

Which of the following symptoms would indicate that a patient has binge-eating disorder? Select all that apply. Fear of gaining weight or getting fat. Eating alone because of embarrassment about the amount of food. Recurrent episodes of binge-eating where the person has no control. Eating very quickly and until uncomfortably full. Compensatory mechanisms are used to prevent weight gain.

Eating alone because of embarrassment about the amount of food. Recurrent episodes of binge-eating where the person has no control. Eating very quickly and until uncomfortably full.

To handle the demands of the caregiver role, family caregivers of patients with neurocognitive disorders need: Education and support from the nurse working with the patient. Respite care from the patient for at least 2 weeks at a time several times a year. All family members to participate in the care of the patient equally. To place the patient in a nursing home so that appropriate care can be provided.

Education and support from the nurse working with the patient.

Which of the following are etiological theories of Alzheimer's dementia? Select all that apply. Excess glutamate Plaques and tangles Decreased production of acetylcholine Head trauma Genetic predisposition

Excess glutamate Plaques and tangles Decreased production of acetylcholine Head trauma Genetic predisposition

Carol brings her 3-year-old son in to see the provider with complaints of weight loss, vomiting, and diarrhea. The provider has run medical tests and has not been able to find any pathophysiological changes to cause the problems. The provider wants to order blood work for the boy to test for any substances or medications in his system. What diagnosis is most appropriate here? Factitious disorder imposed on another Somatic symptom disorder Factitious disorder imposed on self Conversion disorder

Factitious disorder imposed on another

Gary has been faking a chronic illness to get special accommodations at work.What condition does Gary have?

Factitious disorder is the purposeful faking of symptoms to get care and concern from other people. These people are so skilled at pretending to have symptoms that they are often admitted to the hospital. Factitious disorder can also be imposed on another individual, such as a child.

Patients with dependent personality disorder exhibit which of the following symptoms?

Fear of separation; passive; Lack self confidence

Which of the following physical symptoms would you expect to see with bulimia nervosa? Select all that apply. Hyperthermia Gastric tears Electrolyte imbalance Peripheral edema Dehydration

Gastric tears Electrolyte imbalance Dehydration

During group Debbie takes over to talk about her problems regarding the boyfriend who just broke up with her and then begins to flirt with the men in the session and asks them about how pretty she looks today. Which diagnosis is most consistent with Debbie's presentation of symptoms? Narcissistic Histrionic Antisocial Borderline

Histrionic

Which physical symptoms would you expect to see in your patient diagnosed with anorexia nervosa? Select all that apply. Hypotension Amenorrhea Tooth erosion Lanugo Bradycardia

Hypotension Amenorrhea Lanugo Bradycardia

The primary treatment goal for patients with delirium is to: Manage problematic behaviors utilizing nonpharmacological interventions. Maintain interventions to manage disruptive patient behaviors. Discontinue all medication to rule out polypharmacy. Identify and resolve the underlying pathophysiological process.

Identify and resolve the underlying pathophysiological process.

A patient presents to the primary care provider with vague physical complaints and excessive thoughts about being diagnosed with a serious illness. Which diagnosis best fits the description of the patient's symptoms? Conversion disorder Illness anxiety disorder Somatic symptom disorder Factitious disorder

Illness anxiety disorder

Libbey presents to her provider because she is concerned that her recent sunburn has caused skin cancer. She has been to the provider multiple times in the past for similar concerns about her health.What disorder does Libbey have?Make the connection.

Illness anxiety disorder is associated with preoccupation or fear of having a serious medical condition. There are usually no somatic symptoms or they are mild, or they have a preoccupation with getting an illness that runs in the family. There are also high levels of anxiety about health and the person engages in excessive health related behaviors.

Which of the following are symptoms of dissociative amnesia? Select all that apply. Recurrent gaps in daily memory, personal information, and/or traumatic events. Inability to recall personal information associated with a traumatic event. Feeling detached or an outside observer from one's body. Not caused by a substance or medical condition. Significant distress and impairment in functioning.

Inability to recall personal information associated with a traumatic event. Not caused by a substance or medical condition. Significant distress and impairment in functioning.

The nurse is assessing a patient who presents as very organized, disciplined, and efficient, but is also inflexible and perfectionistic. Which diagnosis best fits the description of this patient? Dependent Avoidant Narcissistic Obsessive-compulsive

Obsessive-Compulsive Disorder

Carrie goes to her OB/GYN because she believes she is pregnant. Her period has stopped, her belly is swollen, she has gained weight, and she has nausea and vomiting. However, the provider determines that Carrie is not pregnant.What symptom is Carrie experiencing?

Pseudocyesis, or false pregnancy, is a conversion symptom and may actually represent a strong desire to be pregnant.

Neurocognitive disorder due to Lewy body dementia has which of the following symptoms? Select all that apply. Rapid progression Decreased acetylcholinesterase Hallucinations Delusions Cardiovascular issues

Rapid progression Decreased acetylcholinesterase Hallucinations Delusions

A patient is in the recovery room after an emergency surgery. The nurse is assessing the patient and observes a flat affect, some bizarre behaviors with odd beliefs, suspiciousness, and tangential speech. What diagnosis would be most appropriate for this patient? Paranoid Schizoid Schizotypal Antisocial

Schizotypal

Harry was recently in a car accident where his car was totaled. He tells the nurse that he remembers knowing he was about to be in an accident and feeling a sense of panic but that he doesn't recall the accident itself. The next thing he knew, he was in an ambulance heading to the hospital. What best describes what is going on with Harry? Generalized amnesia Localized amnesia Selective amnesia Dissociative fugue

Selective amnesia

Fred presents to the office for the third time with continued leg pain. Several tests were ordered and nothing can confirm any medical reasons for the pain.What disorder does Fred have?

Somatic symptom disorder is characterized by physical symptoms that may be vague to exaggerated and cause significant distress to the person experiencing them. The person spends an excessive amount of time trying to determine the cause of the symptoms and they firmly believe that the symptoms are medical in nature. When no medical reason can be found, the person still does not believe that the cause could be related to stress or psychosocial factors.

Julie brings her 8-year-old daughter, Olivia, in to see the provider. Olivia has been feeling generally unwell for the last few months. The provider has run multiple tests and has not found anything medically wrong with Olivia. The provider asks Julie how things have been at home and she admits that she had been fighting a lot with her girlfriend over bills before Olivia got sick. However, since Olivia has been unwell, they have been too worried about her to fight.

Sometimes, when a family is having difficulty resolving conflicts, a child's illness can create a shift in focus from the unresolved conflicts to the child. This refocusing provides a break from the instability posed by issues that the family cannot confront openly, and the child, in turn, receives positive reinforcement for being sick, which is somatization. This becomes reinforced as a way to shift the focus away from family issues and fighting.

The family has noticed that their grandmother is having a hard time remembering names and difficulties answering questions. Based on this presentation, in which stage of dementia would you place this patient? Stage 3: Mild cognitive decline Stage 4: Moderate cognitive decline Stage 2: Very mild changes Stage 1: No apparent symptoms

Stage 3: Mild Cognitive Decline

During the treatment of dissociative identity disorder (DID), Samantha recalls her past trauma in detail and re-experiences the event that caused the illness.What is this process called?

The main goal of therapy for DID is to return the patient to an optimal level of functioning through integration or collaboration of the personalities. Psychotherapy with the patient with DID is directed toward uncovering and gaining insight into the underlying psychological conflicts. The therapist who engages in psychotherapy with this client must be skilled in various approaches, including insight-oriented psychotherapy, cognitive therapy, and especially trauma-informed and post-traumatic stress disorder (PTSD) treatment approaches. Patients are assisted in recalling past traumas in detail to mentally re-experience, or remember with feeling, the trauma that caused the illness.

paranoid personality disorder

The person with paranoid personality disorder expects (without sufficient basis) exploitation, harm, and deception from others, has unjustified doubts about the loyalty and trustworthiness of friends, and reads hidden meaning into benign remarks or events. This person persistently holds grudges, is reluctant to confide, perceives attacks on their character or reputation (not apparent to others) and quickly reacts with anger or a counterattack, and has recurrent, unjustified suspicions.

Which of the following are neurobiological changes that the nurse would observe in someone who has binge-eating disorder? Select all that apply. Decreased secretion of cholecystokinin. Delayed gastric emptying. Alterations in serotonin and norepinephrine. Increased levels of endogenous opioids. Enlarged stomach capacity.

Which of the following are neurobiological changes that the nurse would observe in someone who has binge-eating disorder? Select all that apply. Decreased secretion of cholecystokinin. Delayed gastric emptying. Enlarged stomach capacity.

Schizoid personality disorder is manifested by

lack of desire for or enjoyment from close relationships, almost always chooses solitary activities, takes pleasure in few, if any, activities, and is indifferent to praise or criticism. The person also shows little interest for sexual contact, lacks close friends or confidants, and shows emotional coldness, detachment with flattened affect.