NCLEX : Identifying Neural Conditions
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Example Question #1094 : Nclex
You are the nurse in a psychiatrist's office taking care of a patient who presents with three years of pulling at her hair in a compulsive manner. The patient states that she has a strong urge to pull her hair out, especially in times of stress, and that removing hairs helps to relieve tension. She is bald on two-thirds of her scalp, and feels very distressed and socially impaired. Which of the following best describes this patient's illness?
Social phobia
Trichotillomania
Agoraphobia
Arachnophobia
Walking-corpse syndrome
Trichotillomania
The correct answer is "trichotillomania." This is the correct answer, as this term describes the obsessive-compulsive condition in which patients have an uncontrollable urge to remove their hair, which causes baldness, and social/emotional distress and impairment. Patients typically pull hair from the scalp, eyebrows, lashes, and extremities. Treatment includes a variable combination of psychotherapy and/or medications.
On the other hand, the other choices are incorrect. Walking-corpse syndrome is a psychiatric condition in which a patient thinks that they are dead, while in reality, they are indeed alive. Arachnophobia is a fear of spiders. Agoraphobia is a fear of being in public places. Last, social phobia is a fear of social situations.
Example Question #31 : Identifying Neural Conditions
A patient with a past medical history of hypertension comes into the emergency room reporting the sudden onset of the "worst headache of their life". They feel nauseous with blurry vision and generally appear unwell. What is the most likely diagnosis based on this history?
Subarachnoid hemorrhage
Herpes simplex virus
Subdural hemoatoma
Epidural hematoma
Subarachnoid hemorrhage
The "worst headache of my life" or "thunderclap headache" is characteristic of subarachnoid hemorrhage. This is bleeding in the brain and must be treated urgently. It is usually caused by the rupture of a berry aneurysm within the blood supply to the brain. Hypertension is a major risk factor.
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