Correct Answer: C

Rationale: Anorexia nervosa can lead to electrolyte imbalances, including hyponatremia (low serum sodium level), due to inadequate intake of sodium and fluid restriction. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can also contribute to hyponatremia by causing the syndrome of inappropriate antidiuretic hormone secretion (SIADH), which leads to water retention and dilutional hyponatremia. However, it is not as life-threatening as hypokalemia. This is a common and potentially life-threatening complication in individuals with anorexia nervosa who are undergoing treatment. It can lead to cardiac arrhythmias. Anorexia nervosa typically does not lead to hyperkalemia (high serum potassium level), as potassium is usually lost through purging behaviors or inadequate intake. Antidepressants also do not commonly cause hyperkalemia as a side effect.

Correct Answer: D

Rationale: Anger typically involves feelings of frustration, resentment, or hostility towards others or the situation. While anger can be a reaction to receiving a terminal diagnosis, it is not reflective of refusing to accept the diagnosis itself. Anxiety involves feelings of worry, fear, or unease about future events or uncertainties. While anxiety can accompany a terminal diagnosis, it does not manifest as outright refusal or disbelief in the diagnosis itself. Withdrawal refers to a retreat or disengagement from social interactions or activities. It can be a coping mechanism in response to stress or difficult emotions. However, withdrawal does not specifically relate to refusing to accept a diagnosis like terminal cancer. Denial is a defense mechanism where individuals refuse to acknowledge or accept a painful or distressing reality. In this case, despite objective medical evidence (biopsy results and MRI findings), the client persists in believing that the diagnosis of terminal cancer is incorrect. This refusal to accept the reality of the situation is characteristic of denial.

Correct Answer: C,D

Rationale: C. Hypochondriasis can strain interpersonal relationships due to excessive preoccupation with health concerns, frequent doctor visits, and seeking reassurance from others. D. Hypochondriasis often follows a chronic course with periods of intense anxiety about health alternating with periods of relative calm. Despite reassurances and negative medical tests, individuals with hypochondriasis may continue to worry about their health. A. Hypochondriasis typically develops in adulthood rather than childhood. It involves persistent anxiety about health and the interpretation of normal bodily sensations as signs of serious illness. Childhood is less commonly associated with the onset of hypochondriasis. B. While stress can exacerbate symptoms of hypochondriasis, it is not typically diagnosed immediately following a specific stressor. The disorder often develops gradually over time due to a combination of factors, including anxiety, personality traits, and past experiences with illness. E. There is no consistent evidence suggesting that exposure to serious illness in childhood predisposes individuals to hypochondriasis. The disorder is more associated with individual psychological factors, cognitive biases, and anxiety sensitivity rather than childhood illness exposure.

Correct Answer: A,B,D,E

Rationale: A. Severely restricted food intake can lead to imbalances in electrolytes such as potassium, sodium, and chloride. These imbalances can disrupt normal heart rhythm (arrhythmias) and other vital functions, potentially leading to cardiac arrest, which is a common cause of death in individuals with anorexia nervosa. B. Individuals with anorexia nervosa are at increased risk of suicidal thoughts and behaviors. This risk may be due to the severe psychological distress associated with the disorder, as well as the physical complications that can feel overwhelming. Suicide can unfortunately be a tragic consequence in some cases. D. Dehydration is a significant risk in individuals with anorexia nervosa, especially when combined with electrolyte imbalances. Dehydration can lead to organ failure, particularly kidney failure, which can be life-threatening if not promptly treated. E. Severe muscle wasting can occur in individuals with anorexia nervosa, particularly in later stages of the disorder. Loss of muscle mass contributes to overall physical weakness and compromises essential bodily functions, potentially leading to organ failure and death. C. Anorexia nervosa itself does not directly cause diabetes. However, individuals with severe anorexia may develop metabolic disturbances, including insulin resistance, due to malnutrition. This can lead to abnormal blood sugar levels, but diabetes as a direct cause of death in anorexia is less common compared to other complications.

Correct Answer: D

Rationale: Dissociative amnesia is characterized by significant memory loss that cannot be explained by ordinary forgetfulness. If a client experiences sudden travel and cannot remember how they arrived at a distant location, it could indicate dissociative amnesia. Hospitalization is not absolutely necessary. Dissociative disorders are primarily treated with psychotherapy rather than medication adjustments. However, if medication adjustments are necessary for co-occurring conditions or to manage symptoms like anxiety or depression, hospitalization is not necessary. Monitoring of identities is typically done on an outpatient basis, unless there are additional complications or risks identified by a healthcare professional. Dissociative disorders, particularly post-traumatic stress disorder (PTS
D) and acute stress disorder, can involve the reliving of traumatic events through flashbacks, nightmares, or intrusive memories. Hospitalization may be required if the client experiences severe distress, is at risk of self-harm or harm to others during flashbacks.