Mental Health Northern Kentucky University Proctored Exam 5
A 16-year-old girl is brought to the PMHNP by her mother for evaluation. The mother thinks her daughter is "crazy" because she wants a nose job. The girl says she looks "hideous” with her big nose, and she will get plastic surgery as soon as she can afford it. Upon examination, the girl denies excessive preoccupation with her appearance, such as repetitive behaviors or mental acts. She says she does not compare her nose to other people's, nor does she make attempts to hide her nose. She says she is not "crazy" and that plastic surgery is common. The mother is upset because her daughter is "too beautiful" to need surgery. Which diagnosis would be most appropriate?
Explanation & Rationale
Choice A reason: Body dysmorphic disorder involves excessive preoccupation and repetitive behaviors regarding perceived defects, which this patient does not exhibit. Choice B reason: Delusional disorder, somatic type, involves fixed false beliefs about bodily defects, which are not present here. Choice C reason: Correct. The patient’s concern is typical adolescent interest in appearance and does not impair function or cause distress beyond normal expectations. Choice D reason: Narcissistic personality disorder involves grandiosity, need for admiration, and lack of empathy, which is not indicated in this scenario.
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