Which of the following clients or patients is exhibiting the signs of primary insomnia?
A) Jason, who has delusions of persecution and drinks copious quantities of energy drinks to remain vigilant
B) Mr. Kwan, whose debts and business problems have caused him great stress in recent months.
C) Mrs. Fleming, who has frequent awakenings since becoming depressed
D) Amber, a methamphetamine user who sometimes goes several nights without sleep.
Ans: B
Primary insomnia is caused by emotional discomfort such as chronic stress. It is not caused by the direct physiologic effects of a substance or a general medical condition. Secondary insomnia is the inability to initiate or maintain sleep or nonrestorative sleep due to a psychiatric disorder such as depression, schizophrenia, or substance abuse.
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