A soldier returns to the United States from active duty in a combat zone in Afghanistan. The soldier is diagnosed with posttraumatic stress disorder (PTSD). The nurse's highest priority is to screen this soldier for:

Correct Answer: C

Rationale: In this scenario, the nurse's highest priority is to screen the soldier for depression (Option C) because individuals with posttraumatic stress disorder (PTSD) often experience co-occurring depression. It is crucial to screen for depression as it is a common comorbidity with PTSD and can significantly impact the individual's overall well-being and quality of life. Bipolar disorder (Option A) and schizophrenia (Option B) are serious mental health conditions, but they are not typically the primary focus when a soldier returns from a combat zone with symptoms of PTSD. While PTSD and these disorders can coexist, depression is more commonly associated with PTSD in this context. Dementia (Option D) is a neurocognitive disorder characterized by a decline in memory and other cognitive abilities. It is not typically a primary concern when a soldier returns from combat with PTSD. Screening for dementia would not be the highest priority in this situation compared to screening for depression given the known links between PTSD and depression. Educationally, understanding the common comorbidities of PTSD is essential for healthcare providers working with individuals who have experienced trauma. Recognizing the signs and symptoms of associated conditions allows for timely intervention and holistic care to address the individual's mental health needs comprehensively.

Correct Answer: A

Rationale: In the context of psychobiologic disorders, dissociative fugue is characterized by sudden, unexpected travel away from home, accompanied by amnesia regarding one's identity and past life. Option A, "I cannot recall why I'm living in this town," best supports dissociative fugue as it reflects the key feature of dissociative amnesia regarding personal information or past experiences. This statement aligns with the disconnection from one's identity and surroundings typical of dissociative fugue. Option B, "I feel as if I'm living in a fuzzy dream state," does not specifically address the amnesia and disorientation associated with dissociative fugue. Option C, "I feel like different parts of my body are at war," suggests dissociative identity disorder rather than dissociative fugue. Option D, "I feel very anxious and worried about my problems," indicates generalized anxiety rather than the characteristic amnesia and dislocation seen in dissociative fugue. Educationally, understanding the nuances of different psychobiologic disorders is crucial for accurate assessment and diagnosis in clinical practice. By recognizing the specific assessment findings that align with each disorder, healthcare professionals can provide appropriate interventions and support for individuals experiencing these conditions.

Correct Answer: C

Rationale: Acute stress disorder, depersonalization disorder, and posttraumatic stress disorder can involve dissociative elements, such as numbing, feeling unreal, and being amnesic for traumatic events. All three disorders are also responses to acute stress or trauma, which has occurred here. The distracters are disorders not evident in this patient's presentation. Generalized anxiety disorder involves extensive worrying that is disproportionate to the stressors or foci of the worrying. Reactive attachment disorder and disinhibited social engagement disorder are problems of childhood.

Correct Answer: B

Rationale: Patients with illness anxiety disorder (hypochondriasis) tend to be more anxious about their concerns and display more obsessive attention to detail, whereas the patient with conversion (functional neurological) disorder often exhibits less concern with the symptom they are presenting than would be expected. Neither disorder involves voluntary control of the symptoms. Results of diagnostic testing for both would be negative (i.e., no physiological basis would be found for the symptoms). Secondary gains can occur in both disorders but are not necessary to either.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer because it promotes patient independence and autonomy in managing their condition. By explaining the arrangement of the food on the tray to the patient, the nurse empowers the individual to feed themselves, fostering self-reliance and potentially aiding in the therapeutic process of overcoming the conversion disorder. Option A is incorrect because while social support is valuable, it may not address the underlying issue of promoting patient self-care and independence. Option C is incorrect as it places the burden solely on the patient without providing any guidance or support. Option D is incorrect as it neglects the immediate needs of the patient in favor of others, which goes against the principle of patient-centered care. Educationally, this question highlights the importance of understanding and promoting patient autonomy in managing psychobiologic disorders. Nurses play a crucial role in empowering patients to take control of their care, and in this case, facilitating the patient's ability to feed themselves can be a significant step in their recovery journey.