A soldier served in combat zones in Iraq during 2010 and was deployed to Afghanistan in 2013. When is it most important for the nurse to screen for signs and symptoms of posttraumatic stress disorder (PTSD)?

Correct Answer: D

Rationale: In the context of psychobiologic disorders like PTSD, the correct answer is D) Screening should be on-going. PTSD symptoms may not immediately manifest upon return from a combat zone; they can develop over time and may vary in intensity. Ongoing screening allows for early detection and intervention, leading to better outcomes for the individual. Option A) Immediately upon return to the U.S. is incorrect because PTSD symptoms may not be immediately apparent and could develop or worsen over time. Option B) Before departing Afghanistan to return to the U.S. is incorrect as PTSD symptoms may not fully manifest until the individual has left the combat zone and is in a different environment. Option C) One year after returning from Afghanistan is incorrect because symptoms of PTSD can present at any time post-deployment, not just after a specific duration. Educationally, it is important to emphasize the need for ongoing screening and monitoring for PTSD in individuals with a history of military deployment, as early detection and intervention can significantly improve outcomes and quality of life for those affected by this serious disorder. Regular screening also helps to reduce stigma around mental health issues and encourages open communication about emotional well-being.

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: In the context of psychobiologic disorders, it is essential for healthcare providers to be able to differentiate between symptoms of conversion disorder and illness anxiety disorder to provide appropriate care. The correct answer, option B ("Patient's style of presentation"), is crucial in this regard because the way a patient presents their symptoms can offer valuable insights into the underlying disorder. In conversion disorder, symptoms are often inconsistent with known neurological patterns and may not follow a typical physiological pathway. Patients may exhibit dramatic, variable, or contradictory symptoms that do not align with known medical conditions. On the other hand, in illness anxiety disorder (hypochondriasis), individuals are excessively worried about having a serious illness despite reassurance from medical professionals. Their focus is on the fear of having a medical condition rather than the manifestation of physical symptoms. Option A ("Voluntary control of symptoms") is incorrect because both conversion disorder and illness anxiety disorder involve symptoms that are not under conscious control, although the underlying mechanisms differ. Option C ("Results of diagnostic testing") is also incorrect as both disorders can present with normal diagnostic test results, making it unreliable in distinguishing between the two. Option D ("The role of secondary gains") is not directly related to distinguishing between conversion disorder and illness anxiety disorder. While secondary gains may play a role in both disorders, it is not a primary factor in differentiation. Educationally, understanding the nuances between these disorders is crucial for healthcare providers to offer appropriate treatment and support to patients. By recognizing the distinct clinical presentations and symptom patterns, providers can tailor interventions that address the specific needs of individuals with conversion disorder or illness anxiety disorder effectively.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Separation anxiety. Separation anxiety is a common psychobiologic disorder in which individuals, typically children, experience excessive distress when separated from the people they are attached to, such as parents or caregivers. Ria's crying and tension when her father drops her off at school are classic symptoms of separation anxiety. Option A) Depression is not the correct answer because Ria's symptoms are more related to a specific situation (being separated from her father) rather than a pervasive feeling of sadness and hopelessness that characterizes depression. Option B) Phobia is also not the correct answer as phobias are characterized by an irrational fear of specific objects or situations, whereas Ria's distress is specifically related to separation from her father. Option C) Schizophrenia is an incorrect answer as it is a severe mental disorder characterized by distortions in thinking, perception, emotions, and behavior. Ria's symptoms do not align with the characteristic symptoms of schizophrenia. In an educational context, understanding psychobiologic disorders like separation anxiety is crucial for healthcare professionals, especially nurses, who may encounter patients experiencing these conditions. Recognizing the symptoms and understanding the underlying causes of these disorders can help in providing appropriate care and support to individuals affected by them.

Correct Answer: B

Rationale: The correct answer is B) Somatoform disorder. This term refers to bodily symptoms that occur without any underlying physical disease to explain them. In somatoform disorders, the symptoms are real to the individual experiencing them but are not able to be attributed to a specific medical condition upon evaluation. This is a key characteristic that distinguishes somatoform disorders from other psychological or physical conditions. Option A) Depressive disorder involves primarily emotional symptoms such as persistent sadness, loss of interest in activities, and changes in appetite or sleep patterns. While depression can manifest with physical symptoms, they are typically related to the emotional state of the individual. Option C) Hallucination refers to sensory perceptions that are not based on external stimuli, such as hearing voices or seeing things that are not present. While hallucinations can be part of certain psychiatric disorders, they are not the defining feature of bodily symptoms without a physical basis. Option D) Dissociative disorder involves disruptions in memory, identity, consciousness, or perception of the environment. While dissociative disorders can sometimes present with physical symptoms, they are not the same as somatoform disorders where physical symptoms are the primary focus without a clear physical explanation. In an educational context, understanding psychobiologic disorders like somatoform disorders is crucial for healthcare providers to appropriately assess and treat patients who present with unexplained physical symptoms. By recognizing the psychological factors contributing to these symptoms, healthcare professionals can provide holistic care and refer patients for appropriate mental health support when needed.