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.

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: 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: 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: B

Rationale: Aspirin is not appropriate for treating serotonin syndrome. Monitoring the client's symptoms is important, but this action does not address the potential seriousness of the symptoms described. This is the correct priority action. Serotonin syndrome can be life-threatening if not promptly recognized and treated. The physician needs to be notified immediately so that appropriate actions can be taken to manage the client's symptoms and potentially adjust the medication regimen. Delaying notification could lead to worsening of symptoms and potential complications. Given the potential seriousness of serotonin syndrome, waiting until it's convenient is not appropriate. While headache, palpitations, and stiffness could potentially be side effects of antidepressant medication, the combination of these symptoms raises concern for serotonin syndrome, which requires immediate medical attention rather than reassurance alone.