Correct Answer: C

Rationale: Dysthymia is a type of persistent depressive disorder characterized by a depressed mood that lasts for at least two years. It typically involves emotional and behavioral symptoms rather than physical symptoms without clinical findings. Body dysmorphic disorder involves a preoccupation with perceived defects or flaws in physical appearance that are not observable or appear slight to others. While it involves body image concerns, it does not manifest as physical symptoms in the absence of objective findings. Somatoform disorders are characterized by physical symptoms that suggest a medical condition but cannot be fully explained by a general medical condition, another mental disorder, or substance use. Individuals with somatoform disorders often experience distress or impairment due to these symptoms despite medical reassurance that no physical cause can be found. Major depressive disorder primarily involves mood disturbances such as sadness, loss of interest or pleasure, and changes in appetite or sleep. While physical symptoms like fatigue and changes in weight can occur, they are not typically reported persistently without objective clinical findings as seen in somatoform disorders.

Correct Answer: C

Rationale: Dysthymia is a type of persistent depressive disorder characterized by a depressed mood that lasts for at least two years. It typically involves emotional and behavioral symptoms rather than physical symptoms without clinical findings. Body dysmorphic disorder involves a preoccupation with perceived defects or flaws in physical appearance that are not observable or appear slight to others. While it involves body image concerns, it does not manifest as physical symptoms in the absence of objective findings. Somatoform disorders are characterized by physical symptoms that suggest a medical condition but cannot be fully explained by a general medical condition, another mental disorder, or substance use. Individuals with somatoform disorders often experience distress or impairment due to these symptoms despite medical reassurance that no physical cause can be found. Major depressive disorder primarily involves mood disturbances such as sadness, loss of interest or pleasure, and changes in appetite or sleep. While physical symptoms like fatigue and changes in weight can occur, they are not typically reported persistently without objective clinical findings as seen in somatoform disorders.

Correct Answer: D

Rationale: Major depressive disorder is characterized by persistent feelings of sadness and loss of interest or pleasure in activities. It does not involve manic or hypomanic episodes, which are essential for diagnosing bipolar disorder. Dysthymic disorder involves chronic, low-grade depression that lasts for at least two years. It does not typically present with episodes of mania or hypomania. Personality disorders involve enduring patterns of behavior, cognition, and inner experience that deviate markedly from the expectations of the individual's culture. While some personality disorders can present with mood instability, the description of severe and sudden mood swings from mania to depression is not characteristic of personality disorders in general. Bipolar disorder is characterized by episodes of mania or hypomania (elevated, expansive, or irritable mood, increased energy, racing thoughts) alternating with episodes of depression (sadness, loss of interest, low energy). The mood swings can be severe, and the transition between mood states can occur suddenly.

Correct Answer: C

Rationale: CNS stimulants are not typically used in the treatment of bulimia. They may increase anxiety and have abuse potential, which could exacerbate symptoms. While some anxiolytics may be prescribed for comorbid anxiety disorders often seen with bulimia nervosa, they are not the primary treatment for bulimia itself. Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), are commonly used in the treatment of bulimia nervosa. SSRIs such as fluoxetine (Prozac), sertraline (Zoloft), and others are FDA-approved for the treatment of bulimia nervosa due to their effectiveness in reducing binge eating episodes and helping to control the symptoms associated with the disorder.

Correct Answer: A

Rationale: This response acknowledges the client's feelings of helplessness, which can validate her experience and promote further discussion about her emotions and challenges related to her eating disorder. It shows empathy and encourages the client to explore her feelings. While this question is open-ended and invites the client to explore the underlying reasons for her behavior, it might inadvertently suggest that the client should have insights or control over her behavior that she may not currently possess. It could potentially make the client feel blamed or misunderstood if she cannot provide a clear answer. This response is directive and judgmental, which can lead to the client feeling criticized or defensive. It does not acknowledge the complexity of the client's experience and may not be effective in building rapport or promoting trust between the nurse and client. This response acknowledges the client's self-awareness and validates her recognition of the problem, which can be empowering and supportive. However, it does not directly address her expressed feelings of helplessness, making it less therapeutic in this context.