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,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

Rationale: A. Denial is a common initial reaction where individuals refuse to accept the reality of their illness. They may minimize symptoms, avoid medical advice, or believe that the diagnosis is incorrect. Denial can serve as a defense mechanism to protect individuals from the shock and emotional distress of a diagnosis. B. Anger is another stage where individuals may experience frustration, resentment, or hostility towards themselves, others, or the situation. They might feel angry about their diagnosis, the impact it has on their life, or towards healthcare providers and caregivers. C. Grief is a natural response to loss and can be experienced when individuals face the changes, limitations, or potential outcomes associated with their illness. Grief involves feelings of sadness, despair, and mourning for the life they had before the illness, as well as for potential losses in the future. However, it is not a typical stage of the illness experience. D. Dependency refers to a stage where individuals may rely on others for physical, emotional, or practical support due to the challenges posed by their illness. This stage can involve seeking assistance with daily activities, relying on healthcare providers for treatment, or leaning on family and friends for emotional support. However, it is not a typical stage of the illness experience.

Correct Answer: B

Rationale: This option is not the first priority because while addressing anorexia nervosa is important, safety concerns related to the suicide attempt and potential substance abuse take precedence. Making a weight gain contract requires the client's cooperation and readiness, which may not be feasible immediately upon admission. This is the most appropriate initial action. One-to-one observation ensures constant monitoring of the client's safety and prevents further harm, such as another suicide attempt or self-harm. Given the client's history of depression and recent suicide attempt, ensuring their safety is paramount. While assessing the severity of depression is crucial, it is secondary to ensuring immediate safety in this context. The client's safety must be established first through continuous observation and intervention. While important to understand the substances involved in the suicide attempt, this action is secondary to ensuring ongoing safety through direct observation.
Toxicology results can guide subsequent treatment decisions but are not as urgent as immediate safety measures.

Correct Answer: D

Rationale: While positive communication between teachers and teenagers can contribute to academic success and emotional support, it is not typically listed as a primary factor directly related to depression in adolescence. Issues related to academics and school performance may indirectly affect depression, but direct communication with teachers is less likely to be a significant factor compared to other options. Effective communication between parents and teenagers plays a crucial role in adolescent development. Supportive and open communication can help adolescents feel understood, validated, and supported, which can have a protective effect against depression. Conversely, poor communication or conflict within the family environment can contribute to feelings of isolation, distress, and ultimately depression. Academic stress, performance pressure, and difficulties in school can significantly impact an adolescent's mental health. High expectations, bullying, academic failure, or feeling overwhelmed by schoolwork can contribute to feelings of inadequacy, low selfesteem, and depression in adolescents. Peer relationships are critically important during adolescence. Positive peer relationships can provide emotional support, a sense of belonging, and opportunities for socialization and development of social skills. On the other hand, negative peer relationships, such as bullying, social exclusion, or conflicts with peers, can contribute to feelings of loneliness, rejection, and depression.