A healthy adolescent client with no history of substance abuse presents to the mental health clinic. This client tells the nurse that she has experienced several episodes where she feels like she is watching a movie of herself where she is floating above and watching herself as an outside observer. She asks the nurse what is wrong with her. Which statement made by the nurse is most appropriate?

Question

Quizplus · Accepted Answer

1.This is incorrect. Derealization disorder describes an alteration of perception of the external environment. Objects in the environment are perceived as altered in size and shape. Other people in the environment may seem automated or mechanical. Not only is the nurse giving the client false information, but she is also practicing outside the scope of nursing by offering a client a diagnosis.
2.This is correct. Depersonalization disorder is characterized by a temporary change in the quality of self-awareness. The client may have feelings of unreality and may experience changes in body image, feelings of detachment from the environment, or a sense of observing oneself from outside the body. The nurse is correct to refer her to a psychiatrist who can make a diagnosis.
3.This is incorrect. Even though schizophrenics may have out-of-body experiences, this is not enough information to confirm a diagnosis. It is outside of the scope of nursing to diagnose clients.
4.This is incorrect. Hormonal changes in adolescent females are not responsible for the client having out-of-body experiences.

A Healthy Adolescent Client with No History of Substance Abuse