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: 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.

Correct Answer: A,C,D,F

Rationale: A. Irritability is a common symptom of depression in adolescents. They may become easily annoyed, frustrated, or angered, often over minor issues. B. Euphoria, which refers to an exaggerated feeling of happiness or excitement, is not typically associated with depression. Instead, it may indicate a different mood disorder, such as bipolar disorder. C. Adolescents with depression often experience decreased energy levels or fatigue. They may feel physically drained and lack motivation to engage in usual activities. D. Social withdrawal and isolation from peers is a significant behavioral indicator of depression. Adolescents may avoid social activities, stop participating in hobbies, or spend more time alone. E. Grandiosity refers to an exaggerated sense of one's importance, abilities, or achievements. This symptom is more characteristic of certain mood disorders like bipolar disorder or narcissistic personality disorder rather than depression. F. Feelings of loneliness and social isolation are common in adolescents with depression. They may feel disconnected from others, even if they are physically present in social settings.

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: 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.