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Psychiatric – Chp 9 – Flashcards 90 terms

Tiffany Hanchett

90 terms

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Psychiatric – Chp 9 – Flashcards

question

A psychiatric client informs the nurse that he is feeling better and does not want to take his antidepressive medication. This client is exhibiting which of the following when making this decision? a) Veracity b) Beneficence c) Justice d) Autonomy

answer

d) Autonomy

question

Which of the following rights could the psychiatric client lose when admitted to a locked, inpatient psychiatric treatment facility? a) Right to schedule his or her own time b) Right to safety from harm c) Right to communicate with an attorney d) Right to send and receive mail without censorship

answer

a) Right to schedule his or her own time

question

While conducting an interview with a 14-year-old mental health client, he tells you that he has a plan to kill students at his school because they will not stop picking on him. He says, "I have everything I need all set up, including a gun." What would be your responsibility after hearing this statement? a) To break his confidentiality by telling your friends about your client's plan and getting advice b) To maintain the client's confidentiality and not share the information with anyone c) To break the client's confidentiality because he has threatened the lives of other people d) To maintain the client's confidentiality, but try to convince him that it is the wrong thing to do

answer

c) To break the client's confidentiality because he has threatened the lives of other people

question

The Tarasoff decision involves an exception to the client's right to confidentiality as being ... a) A duty to warn b) Placement of the client in the least restrictive environment c) Mandated outpatient treatment (MOT) d) An appointment of a legal guardian

answer

a) A duty to warn

question

A client 22 years of age with schizophrenia is refusing his antipsychotic medication. He states, "I don't like the dopey way it makes me feel. I feel like I'm walking underwater when I take it." The nurse explains to him, "Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better." This conversation reflects a conflict between which two types of ethical principles? a) Paternalism and veracity b) Autonomy and justice c) Justice and nonmaleficence d) Autonomy and beneficence

answer

d) Autonomy and beneficence

question

When it is discovered that a nurse did not act reasonably when providing care that is compatible with the standard of nursing care, the remaining factor that would confirm that the nurse acted negligently is whether ... a) The client's actions played a part in the nurse's reaction b) The client's injury was serious c) The nurse was responsible for client injury d) The injury results in permanent disability

answer

c) The nurse was responsible for client injury

question

A psychiatric nursing class is discussing current trends in mental health care. A student voices the opinion that there should be equitable access to mental health care and resources for those who live in rural areas, for those without health insurance, and for those with very little income. The student nurse's opinion most closely reflects which ethical principle? a) Nonmaleficence b) Veracity c) Justice d) Paternalism

answer

c) Justice

question

A client has just been explained the reason that he must undergo an MRI. When the nurse asks the client if he understands the explanation, he correctly describes what has been said to him. The client is said to be what? a) Logical b) Congruent c) Competent d) Autonomous

answer

c) Competent

question

Dr. Smith, a psychotherapist, hears her client state, "I have had it with this marriage. I'm telling you, and not that I ever would do it, but I feel like hiring a hit man to kill the woman!" Dr. Smith ... a) must warn the client's wife, based on the Tarasoff rule. b) must keep this confidential because the client made a disclaimer that he would never do it. c) may be anxious, but since the client did not say he would kill his wife, must hold the client's statements in confidence. d) is bound to hold all psychotherapeutic content under strict confidence.

answer

a) must warn the client's wife, based on the Tarasoff rule.

question

What is provided in the Code of Ethics for Nurses of the American Nurses Association (ANA)? a) A guideline for nurses regarding ethical conduct b) Definitions of ethical principles and how they relate to nursing practice c) A description of case studies featuring ethical dilemmas d) Information about what to do when confronted with an ethical dilemma

answer

a) A guideline for nurses regarding ethical conduct

question

The depressed client is deciding which type of treatment would be beneficial for him. The nurse would document that the client is utilizing which of the following ethical principles in this situation? a) Veracity b) Autonomy c) Justice d) Beneficence

answer

b) Autonomy

question

A new nursing student correctly identifies which of the following as most essential for guiding psychiatric-mental health nursing actions? a) Federal laws b) Code of Ethics for Nurses c) Personal beliefs d) State laws

answer

b) Code of Ethics for Nurses

question

The nurse understands the importance of protecting clients' rights of self-determinism. Self-determination is similar to which of the following ethical principles? a) Beneficence b) Autonomy c) Veracity d) Justice

answer

b) Autonomy

question

A client was admitted for electroconvulsive therapy (ECT). The physician performing the procedure failed to obtain informed consent before the ECT was administered. The physician could be charged with which of the following? a) Battery b) Beneficence c) Assault d) Fidelity

answer

a) Battery

question

Which of the following occurs when there is a situation in which ethical principles conflict or when there is not one clear course of action in a given situation? a) Ethical dilemma b) Negligence c) Malpractice d) Breach of duty

answer

a) Ethical dilemma

question

A nurse working on the psychiatric unit receives a telephone call from the employer of one of the clients on the unit. The employer asks to be sent a copy of Mr. Murray's latest laboratory work and psychological testing results so Mr. Murray's medical records in employee health can be kept up-to-date. Based on the nurse's knowledge about issues surrounding breach of confidentiality, which response would be the most appropriate? a) "I am unable to acknowledge whether or not a Mr. Murray is a client on this unit." b) "Sure, give me your address, and I will see that the information is sent to you." c) "I'll have to get the client's signed consent before we can send that information to you." d) "I'm sorry; we're not allowed to give out that information about our client."

answer

a) "I am unable to acknowledge whether or not a Mr. Murray is a client on this unit."

question

One way that nurses can protect themselves against liability from malpractice is to do which of the following? a) Avoid documenting incriminating information. b) Know the statutory and professional standards. c) Request legal consultation from the employer. d) Carry individual malpractice insurance.

answer

b) Know the statutory and professional standards.

question

Which ethical principle focuses on the duty to do no harm? a) Justice b) Autonomy c) Beneficence d) Nonmaleficence

answer

d) Nonmaleficence

question

A nurse tells a client that she will bring him his pain medicine in 5 minutes after she checks on another client. The nurse returns in 5 minutes and administers the medication as planned. The nurse is practicing which of the following principles by returning as promised? a) Fidelity b) Autonomy c) Paternalism d) Nonmaleficence

answer

a) Fidelity

question

Which of the following occurs when staff members physically control the client and move him or her to a seclusion room? a) Human restraint b) Battery c) Mechanical restraint d) Abuse

answer

a) Human restraint

question

As a result of the increasing severity of her delusions and consequent unsafe behavior, a client has been admitted to a psychiatric facility and judged incompetent to make decisions. Who will now make decisions for the client? a) A hospital-appointed interdisciplinary committee b) A guardian appointed by the court c) The client's primary nurse d) The client's psychiatrist

answer

b) A guardian appointed by the court

question

A nurse is caring for a client in the healthcare facility. The client doesn't show signs of suicidal ideation or pose harm to others. The client wishes to leave the facility and go home. What is the most appropriate response of the nurse? a) "You could leave. I would inform the health care provider." b) "You could sign a written request for discharge." c) "You inform the healthcare provider and leave the facility." d) "The healthcare provider should assess you again before allowing your request."

answer

b) "You could sign a written request for discharge."

question

The nurse explains the benefits of seclusion to the caregivers of a client who is mentally ill. Which statements indicate the need for additional teaching? Select all that apply. a) Seclusion helps in protecting other people from the client." b) "Seclusion helps in protecting the privacy of the client." c) "Seclusion helps in reducing the number of stimuli." d) "Seclusion helps in avoiding use of psychotropic drugs." e) "Seclusion helps the client to be more active."

answer

d) "Seclusion helps in avoiding use of psychotropic drugs." e) "Seclusion helps the client to be more active."

question

Which ethical principle is at risk when the client presents an imminent threat of danger to himself or others? a) Justice b) Autonomy c) Beneficence d) Nonmaleficence

answer

d) Nonmaleficence

question

A nurse is caring for a client who is hospitalized for a mental disorder. The nurse is legally obligated to breach the client's confidentiality if the client states which of the following? a) "I get really 'turned on' by your appearance." b) "That doctor I had today really made me angry." c) "When I get out of here, I'm going to kill my neighbor." d) "I think that the federal government is spying on me."

answer

c) "When I get out of here, I'm going to kill my neighbor."

question

The goal of seclusion is to a) Promote thoughtful reflection regarding behavior b) Punish the client for bad behavior c) Give the client the opportunity to gain self-control d) Allow the nurse to monitor for side effects of medications

answer

c) Give the client the opportunity to gain self-control

question

The nurse is acting in accordance with the American Nurses Association principles when she does what? Select all that apply a) Notifies the physician when a prescribed medication is not managing the client's anxiety effectively b) Makes sure to take the client to the recreation room as promised c) Gets the client extra dessert when she reports that it is her birthday d) Shares with the client that discharge is not likely to occur this week e) Encourages the client to choose when she will call her family

answer

a) Notifies the physician when a prescribed medication is not managing the client's anxiety effectively b) Makes sure to take the client to the recreation room as promised d) Shares with the client that discharge is not likely to occur this week e) Encourages the client to choose when she will call her family

question

A new nursing student is studying ethics in nursing and informs a client who wants to stop medication about its benefits and how the client will continue to feel better only if use of the drug continues. Which of the following concepts is the nursing student using? a) Autonomy b) Justice c) Beneficence d) Veracity

answer

c) Beneficence

question

The inappropriate use of restraints or seclusion is considered ... a) Assault b) Causation c) Battery d) False imprisonment

answer

d) False imprisonment

question

The nurse has used wrist and ankle restraints for a client who was extremely aggressive. What assessments should the nurse perform on a regular basis after restraining the client? Select all that apply. a) Peripheral circulation b) Skin condition c) Side effects of medication d) Emotional well-being e) Memory

answer

a) Peripheral circulation b) Skin condition c) Side effects of medication d) Emotional well-being

question

An adolescent client has refused to wash or change his clothes for several days. He smells and looks filthy. Three male staff members approach him to escort him to the shower. The client resists and becomes combative when staff members insist. They place the client in seclusion and restraints and tell him that they will release him when he is calm and willing to shower. The client's rights have been ... a) Not violated, because a degree of cleanliness is important b) Violated, primarily because he shouldn't be forced to shower c) Not violated, because his combative behavior warranted seclusion and restraint to protect others d) Violated, primarily because of the inappropriate use of restraints

answer

d) Violated, primarily because of the inappropriate use of restraints

question

The nurse is caring for a client who has been physically restrained for aggressive behavior. The nurse tells the client's caregiver to remove the restraints temporarily from the limbs after every hour. What is the most appropriate reason for this? a) Removing the restraints will increase client activity. b) Removing the restraints would reduce the aggression in the client. c) Removing the restraints will facilitate blood supply. d) Removing the restraints will increase client comfort

answer

c) Removing the restraints will facilitate blood supply.

question

The psychiatric nurse is particularly concerned about securing informed consent for an invasive procedure from a ... a) 60-year-old female visiting from England who experienced a panic attack b) 45-year-old Asian male who is diagnosed with antisocial personality disorder c) 25-year-old Caucasian male who has just completed alcohol withdrawal therapy d) 21-year-old African American female with a history of both physical and sexual abuse

answer

b) 45-year-old Asian male who is diagnosed with antisocial personality disorder

question

A nurse is explaining about assisted outpatient treatment to a client who is getting discharged from the hospital. What advise should the nurse give the client regarding the assisted outpatient treatment? Select all that apply. a) The client must take prescribed medications as per the dosing schedule. b) The client can decide whether to join the assisted outpatient treatment program. c) The client must attend specific group therapy programs. d) The clients must attend community healthcare lectures on the disorder. e) The client must attend the follow ups as per the schedule.

answer

a) The client must take prescribed medications as per the dosing schedule. c) The client must attend specific group therapy programs. e) The client must attend the follow ups as per the schedule.

question

A nurse is explaining the distinction between confidentiality and privacy. Which of the following would the nurse include as reflecting privacy? a) Knowledge of treatment costs and benefits b) Part of personal life not governed by society's laws c) Ethical duty for nondisclosure d) Involvement of two individuals

answer

b) Part of personal life not governed by society's laws

question

A physician who fails to obtain informed consent before performing a procedure is subject to liability for which of the following? a) False imprisonment b) Medical battery c) Battery d) Assault

answer

b) Medical battery

question

A client with a psychiatric illness has become extremely aggressive and the nurse decides that the client needs to be restrained. Which action would be considered human restraint? a) The nurse sedates the client with morphine. b) The nurse asks the client to calm down. c) The nurse ties the client's wrist using wrist restraints. d) The nurse and a group of paramedics hold the client.

answer

d) The nurse and a group of paramedics hold the client.

question

While performing the admission assessment of a new client, the nurse observed that the client brought a bottle of over-the-counter pain medication to the hospital. The nurse failed to document this or remove the medication from the room. Subsequently, the client experienced a serious adverse drug reaction as a result of the interaction between this drug and one of the drugs that she was prescribed in the hospital. This nurse may be guilty of what? a) Incompetence b) Malpractice c) Assault d) Failure of duty to warn

answer

b) Malpractice

question

Which client behavior would prompt the nurse manager to discuss the duty to warn with staff members? a) Suicidal ideation. b) Extremely aggressive. c) Unwilling to take medications. d) Danger to others.

answer

d) Danger to others.

question

A client receives a court order for commitment. Which of the following best exemplifies the concept of "least restrictive environment?" a) Involuntary commitment to an outpatient community mental health center b) Medication administration for sedation so the client cannot get out of bed c) Placing the client in a locked padded room in response to threats of self-harm d) Allowing the client to make the decision about whether treatment is necessary

answer

a) Involuntary commitment to an outpatient community mental health center

question

A client with bipolar disorder has been following the prescribed medication regimen. The client indicates to the nurse a desire to stop the medication now that he is feeling better. The nurse tells him that most likely he will have to remain on the medication for life to keep the condition under control. The nurse is practicing which of the following principles? a) Justice b) Autonomy c) Veracity d) Fidelity

answer

c) Veracity

question

Which client would the nurse determine to be the most likely candidate for involuntary commitment? a) The client who is screaming in the street disturbing neighbors b) The client who refuses to participate in the planned therapy c) The client with a mental disorder who is homeless d) The client who refuses to take the prescribed medication

answer

a) The client who is screaming in the street disturbing neighbors

question

The nurse is assessing whether a room is fit for seclusion of clients. What are the requirements of a seclusion room? Select all that apply. a) The room should have facility for direct visual monitoring. b) The room should have pens or pencils. c) The room should not have locked doors. d) The room should not have any sharp objects. e) The room should have a bed that is bolted to the floor.

answer

a) The room should have facility for direct visual monitoring. d) The room should not have any sharp objects. e) The room should have a bed that is bolted to the floor.

question

The nurse is teaching the caregivers of the client regarding the seclusion of the client. What statements about the intervention, immediately after seclusion, are correct? Select all that apply. a) "The client will be assessed by the nurse every 1 to 2 hours." b) "The client will be removed from seclusion in one day." c) "The client will be kept under observation for 12 hours after seclusion." d) "The health-care provider will review the seclusion order every 4 hours." e) "The client will be assessed by a specialized independent practitioner within the hour."

answer

a) "The client will be assessed by the nurse every 1 to 2 hours." d) "The health-care provider will review the seclusion order every 4 hours." e) "The client will be assessed by a specialized independent practitioner within the hour."

question

An agitated client has been put in restraints against his will because of inadequate staffing. The nurse determines this as which form of malpractice? a) False imprisonment b) Assault c) Battery d) Defamation

answer

a) False imprisonment

question

From a legal standpoint, clients hospitalized as voluntary admissions differ from other types of admissions which of the following ways? a) They can leave the hospital whenever they want. b) They are not considered a danger to themselves or others. c) They are considered competent. d) They cannot refuse treatment.

answer

c) They are considered competent.

question

All but which of the following states have abolished the insanity defense? a) Iowa b) Idaho c) Utah d) Montana

answer

a) Iowa

question

Which of the following ethical principles becomes an issue in mental health when a segment of a population does not have access to health care? a) Justice b) Fidelity c) Veracity d) Nonmaleficence

answer

a) Justice

question

Which of the following mental health clients meets criteria to be involuntarily committed? a) A client diagnosed with borderline personality disorder who is threatening to cut himself b) A client diagnosed with mania who is pacing the hallways c) A client diagnosed with schizophrenia who is singing in his room d) A client diagnosed with anxiety disorder who is fidgeting

answer

a) A client diagnosed with borderline personality disorder who is threatening to cut himself

question

Which court decision or act states that psychotherapists have a duty to exercise reasonable care in protecting the foreseeable victims of their clients' violent actions? a) The Mental Health Systems Act of 1980 b) The Patient Self-Determination Act c) Public Law 99-319, The Protection and Advocacy for Mentally Ill Individuals Act of 1986 d) Tarasoff v. Regents of the University of California

answer

d) Tarasoff v. Regents of the University of California

question

A client in a psychiatric facility has ideations about killing his wife. This client requests to be discharged from the facility. Which represents the most appropriate action? The healthcare provider should: a) Allow the client to go home. b) Not accept the client's request. c) Ask the caregivers of the client for consent. d) File for a civil commitment to detain.

answer

d) File for a civil commitment to detain.

question

Which ethical principle is at risk when the client presents an imminent threat of danger to himself or others? a) Nonmaleficence b) Autonomy c) Justice d) Beneficence

answer

a) Nonmaleficence

question

A nursing student is initiating a relationship with an assigned client. After meeting and spending approximately 20 minutes talking with the client, the student makes arrangements to visit again after lunch. After lunch, fellow classmates invite the student to go to the gym with them and a group of clients to play volleyball. The student starts to go with them but then remembers the promise to meet with the client. The student decides to forgo volleyball and talk with her client. The student's decision reflects which ethical principle? a) Fidelity b) Beneficence c) Autonomy d) Veracity

answer

a) Fidelity

question

The insanity defense is used in approximately how many criminal cases? a) 1% b) 10% c) 50% d) 20%

answer

a) 1%

question

A client's plan of care includes revoking privileges for inappropriate behavior, based on a contract between the client and the nurse who wrote the plan. Another nurse decides to ignore this, because the client promises that she will adhere to the contract in the future. The second nurse's behavior may have violated which ethical principle? a) Beneficence b) Fidelity c) Autonomy d) Veracity

answer

b) Fidelity

question

A client comes to the emergency department (ED) with severe depression and suicidal ideation. Staff members determine that the client does not have adequate insurance to cover inpatient psychiatric services at their facility, so they discharge the client with some prescriptions for medication. Which of the following principles is being ignored by discharging this client? a) Veracity b) Justice c) Autonomy d) None of the above

answer

b) Justice

question

A nurse is teaching about assisted outpatient treatment to the caregivers of the client in the psychiatric facility. What are the benefits of this treatment program? Select all that apply. a) The client would respond better to psychotropic drugs. b) The client's risk of self-harm would be reduced. c) The client would adapt better to the society. d) The client would be protected from criminal victimization of others. e) The client would require shorter inpatient stays.

answer

b) The client's risk of self-harm would be reduced. d) The client would be protected from criminal victimization of others. e) The client would require shorter inpatient stays.

question

A client diagnosed with schizophrenia insists on stopping her medication because it causes her to gain weight. The client is exercising which ethical principle? a) Beneficence b) Justice c) Veracity d) Autonomy

answer

d) Autonomy

question

A client asks if her medication has any possible negative side effects. The nurse considers the client highly suggestible, believes the medication will benefit the client, and, since the client has no history of cardiovascular disease, does not tell her of the potential for cardiac dysrhythmias. The nurse's actions involve a conflict between which two ethical principles? a) Veracity and beneficence b) Veracity and paternalism c) Veracity and justice d) Veracity and fidelity

answer

b) Veracity and paternalism

question

Providing milieu therapy is an example of use of which ethical principle? a) Beneficence b) Fidelity c) Veracity d) Autonomy

answer

a) Beneficence

question

What findings would lead the nurse to conclude that the client needs a conservator? Select all that apply. a) The client is not taking medications on time. b) The client cannot provide food, clothing and shelter for self. c) The client is extremely aggressive. d) The client has schizophrenia. e) The client is unable to act in one's best interest.

answer

b) The client cannot provide food, clothing and shelter for self. e) The client is unable to act in one's best interest.

question

Which ethical principle focuses on the duty to do no harm? a) Autonomy b) Justice c) Beneficence d) Nonmaleficence

answer

d) Nonmaleficence

question

Principles that serve as codes of conduct about right and wrong behaviors to guide actions are known as what? a) Veracity b) Beneficence c) Ethics d) Fidelity

answer

c) Ethics

question

Short-term use of restraints is permitted only in which of the following situations? a) The client wants to leave the hospital but there is no order to do so. b) The client is noncompliant with his treatment. c) The client is agitated and talkative. d) The client is imminently aggressive and a danger to himself or others.

answer

d) The client is imminently aggressive and a danger to himself or others.

question

A client who was deemed to be at high risk for suicide was ordered visual checks every 15 minutes. Nurse K. had been performing these checks since the beginning of her shift but neglected to pass off this responsibility to a colleague before leaving the unit for her scheduled break. As a result, the client made a suicide attempt while Nurse K. was off the unit. Which ethical principle has Nurse K. most clearly violated? a) Fidelity b) Autonomy c) Veracity d) Beneficence

answer

a) Fidelity

question

The nurse is speaking to a client with severe mania who has been physically restrained. The nurse is explaining the instructions for removing the restraints. What instructions given by the nurse is appropriate? Select all that apply. a) "You should be willing to do the task I have given you." b) "You should not verbally threaten anybody." c) "You should be able to control yourself." d) "You should take medications prescribed by your doctor." e) "You should speak out your problems calmly."

answer

b) "You should not verbally threaten anybody." c) "You should be able to control yourself." e) "You should speak out your problems calmly."

question

Malpractice must be proven by four elements. All of the following must be proven except ... a) Injury b) Causation c) Intent d) Duty

answer

c) Intent

question

The nurse recognizes that the difference between a voluntary and an involuntary commitment is that ... a) The voluntarily committed client usually has good insight into his or her mental health problem b) An involuntarily committed client may refuse treatment c) The voluntarily committed client is usually less aggressive d) An involuntarily committed client may not initiate their own discharge

answer

d) An involuntarily committed client may not initiate their own discharge

question

The nurse is explaining the responsibilities to a client's legal guardian. Which statements by the nurse are correct? Select all that apply. a) "You, not the client, should sign legal documents." b) "You are supposed to monitor the client all the time." c) "You are supposed to write checks for the client." d) "You have to make healthcare decisions for the client." e) "You have to make the client stay with you."

answer

a) "You, not the client, should sign legal documents." c) "You are supposed to write checks for the client." d) "You have to make healthcare decisions for the client."

question

A client who has bipolar disorder stops taking her medication because she says she likes how she feels in a manic state. What is a client's right to make decisions for oneself known as? a) Veracity b) Autonomy c) Paternalism d) Justice

answer

b) Autonomy

question

Malpractice is proven when certain criteria have been met. Which of the following lists includes the correct criteria? a) Duty of care, professional performance, injury related to the nurse's action, and action foreseeably could have caused the injury b) Duty of care, professional performance, injury related to the nurse's action, failure to document injury, and proven injury c) Professional performance, injury related to the nurse's action, action foreseeably could have caused the injury, and proven injury d) Duty of care, professional performance, injury related to the nurse's action, action foreseeably could have caused the injury, and proven injury

answer

d) Duty of care, professional performance, injury related to the nurse's action, action foreseeably could have caused the injury, and proven injury

question

Which of the following practices places a nurse at risk for being charged with malpractice? a) Always treating clients with compassion and respect b) Always attempting to provide the most economically sensitive client care c) Constantly working to improve communication skills d) Documenting all reasons for any deviation from the applicable standard of care

answer

b) Always attempting to provide the most economically sensitive client care

question

The nurse is teaching the client about the importance of being compliant with his medication regimen. The client does not believe that it is important. The nurse is communicating which ethical principle? a) Justice b) Beneficence c) Veracity d) Paternalism

answer

b) Beneficence

question

Ensuring that the client has informed consent before agreeing to a treatment regimen displays which of the following ethical principles? a) Nonmaleficence b) Fidelity c) Autonomy d) Justice

answer

c) Autonomy

question

For a plaintiff to receive monetary damages by suing a professional nurse for malpractice, he or she must prove all except which of the following elements of nursing negligence? a) The nurse's performance fell below the standard of care. b) The act in which the nurse engaged resulted in physical injury to the client. c) The nurse professional had a duty of due care toward the plaintiff. d) The plaintiff consumer must prove his or her injuries.

answer

b) The act in which the nurse engaged resulted in physical injury to the client.

question

A hospital client has attributed his long-standing struggle with depression to the fact that he was sexually abused by his father as a child and early adolescent. The client has admitted to the nurse that he intends to seek out his father and "do some justice." What is the nurse's primary responsibility in response to the patient's threat? a) Report the patient's threat to the appropriate authorities. b) Inform the patient that threats of violence will not be tolerated in the health care facility. c) Document that the patient is experiencing delusions. d) Note the statement mentally but maintain silence to protect the patient's confidentiality.

answer

a) Report the patient's threat to the appropriate authorities.

question

Which of the following clients most likely has the legal right to refuse treatment? a) Terrance, a 20-year-old man who has been admitted to the hospital for the treatment of depression after a suicide attempt b) Mrs. Crane, who committed an assault while she was experiencing delusions c) Mr. Modesto, who voluntarily entered a substance abuse treatment facility to address his addiction to alcohol d) Mrs. Lepke, a homeless woman with schizophrenia who was admitted to the hospital with dehydration after refusing to eat for several days

answer

c) Mr. Modesto, who voluntarily entered a substance abuse treatment facility to address his addiction to alcohol

question

A psychiatric-mental health client has an advance care directive on his medical record. A clinician provides treatment that disregards the client's directive. The clinician would be liable for which of the following? a) Battery b) Assault c) False imprisonment d) Medical battery

answer

d) Medical battery

question

Susan, age 22 years, has voluntarily sought treatment for an eating disorder at a residential facility in an isolated rural location. Despite a promising start, she has been involved in recent conflicts with staff members and insists that she wants to leave the facility. Staff members have refused to facilitate her transportation from the facility and have stated that they will not return her money and identification that were held when she was admitted. Staff at the treatment facility may be guilty of false imprisonment because of what fact? a) Susan is legally competent. b) The facility is in an inaccessible location. c) Susan's diagnosis is not psychiatric in etiology. d) Susan's diagnosis is not terminal.

answer

a) Susan is legally competent.

question

Ali has been admitted to the hospital involuntarily for the treatment of depression. Which of the following criteria provides legal justification for Ali's involuntary admission? a) Ali's family is unable to manage his care. b) Ali poses a threat to himself. c) Ali's primary care provider is a psychiatrist. d) Ali's treatment will require pharmacologic interventions.

answer

b) Ali poses a threat to himself.

question

When it is discovered that a nurse did not act reasonably when providing care that is compatible with the standard of nursing care, the remaining factor that would confirm that the nurse acted negligently is whether ... a) The injury results in permanent disability b) The nurse was responsible for client injury c) The client's injury was serious d) The client's actions played a part in the nurse's reaction

answer

b) The nurse was responsible for client injury

question

A client who was admitted to the facility voluntarily has requested to be discharged and allowed to return home. The health care provider files for a civil commitment to hold the client in the hospital. What is the most likely reason to file this action? a) The client has suicidal ideation. b) The client needs medications to be administered on time. c) The client requires psychotherapy. d) The client needs to be monitored regularly for vital signs.

answer

a) The client has suicidal ideation.

question

A mental health nurse is caring for a client with an anxiety and substance use disorder. The family is requesting to see the client's records. The nurse understands that this would be a violation of which law? a) American Nurses' Association (ANA) b) Joint Commission on Accreditation of Healthcare Organizations (JCAHO) c) Health Insurance Portability and Accountability Act (HIPAA) d) Occupational Safety and Health Administration (OSHA)

answer

c) Health Insurance Portability and Accountability Act (HIPAA)

question

The client who is involuntarily committed to an impatient psychiatric unit loses which of the following rights? a) Right to freedom b) Right to refuse treatment c) Right to sign legal documents d) The client loses no rights

answer

a) Right to freedom

question

A client has a prescription for Haloperidol, 5mg orally two times a day, as ordered by the physician. The client is suspicious and refuses to take to medication. The nurse says, "If you don't take this pill, I'll get an order to give you an injection." The nurse's statement is an example of a) assualt b) battery c) malpractice d) unintentional tort

answer

a) assualt

question

A hospitalized client is delusional, yelling, "The world is coming to an end.We must all run to safety!" When the other clients complain that this client is loud and annoying, the nurse decides to put the client in seclusion. The client has mad no threatening gestures or statement to anyone. The nurse's action is an example of a) assault b) false imprisonment c) malpractice d) negligence

answer

b) false imprisonment

question

Which of the following would indicate a duty to warn a third party? a) A client with delusions states, "I'm going to get them before they get me." b) A hostile client says, "I hate all police." c) A client says he plans to blow up the federal government d) A client states, "If I can't have my girlfriend back, then no one can have her."

answer

d) A client states, "If I can't have my girlfriend back, then no one can have her."

question

The nurse gives the client quetiapine (Seroquel) in error when olanzapine (Zyprexa) was ordered. The client has no ill effects from the quetiapine. In addition to making a medication error, the nurse has committed which of the following? a) malpractice b) negligence c) tort (unintentional) d) none of the above

answer

d) none of the above

question

Which of the following elements are essential in a clinician's duty to warn? (select all that apply) a) client makes threatening statements b) history of violence c) potential victim(s) are identifiable d) potential victim is easy to locate e) threat is not a delusion f) threat of harm is serious

answer

a) client makes threatening statements c) potential victim(s) are identifiable f) threat of harm is serious

question

Which of the following elements are necessary to prove liability in a malpractice lawsuit? (select all that apply) a) client is injured b) failure to conform to standards of care c) injury caused by breach of duty d) injuries must be visible and verified e) recognized relationship between client and nurse

answer

a) client is injured b) failure to conform to standards of care c) injury caused by breach of duty e) recognized relationship between client and nurse

STUDY

Abnormal Psychology Female Sexual Interest Arousal Disorder Human Sexual Response Cycle Hypoactive Sexual Desire Psychology Sexology

Next abnormal psychology – Flashcards 72 terms

Brad Bledsoe

72 terms

Preview

Next abnormal psychology – Flashcards

question

A paraphilia:

answer

is a response to a socially inappropriate object or situation

question

If someone had a sexual dysfunction, we know that this person would NOT be having difficulty in which of the following phases of the sexual response cycle?

answer

resolution

question

In a person who has an unusually long resolution phase of the sexual response cycle, which of the following is MOST likely?

answer

The person did not have an orgasm

question

Hypoactive sexual desire may include all of the following EXCEPT:

answer

finding sexual activity repulsive.

question

To be classified as having hypoactive sexual desire, one would have a reduced interest in sex and have little sexual activity, lasting:

answer

six months.

question

Female sexual interest/arousal disorder differs from male hypoactive sexual desire disorder MOST notably in that it:

answer

the sexual response cycle

question

Some individuals experience a normal interest in sex but choose, as a matter of lifestyle, not to engage in sexual relations. Such people would be diagnosed with:

answer

no sexual dysfunction

question

A sexual dysfunction differs from a paraphilia in that it:

answer

involves some difficulty with the sexual response cycle

question

Which of the following drugs, used at low levels, may raise the sex drive?

answer

alcohol

question

A young woman who formerly had a fairly high sex drive, and who reports no new medical problems, nonetheless experiences an unexpected drop in sex drive. What would be an important question to ask her, before recommending some sort of psychotherapy?

answer

Have you recently started taking birth control pills

question

In males, the penis becomes erect during which phase of the sexual response cycle?

answer

excitement

question

Women with sexual arousal disorder have difficulty with:

answer

maintaining proper lubrication

question

What were once referred to as frigidity and impotence are dysfunctions that occur during the ______ phase of sexual arousal.

answer

excitement

question

Which of the following is NOT a symptom of female sexual interest arousal disorder?

answer

vaginal contractions that prevent penetration

question

A recent study showed that the majority of women in sexually healthy, positive marriages report that ________ is the MOST satisfying component of sexual activity with their partner

answer

foreplay

question

A normal healthy man experiences:

answer

erections during REM sleep.

question

Which of the following occupations is MOST similar to what Masters and Johnson identified as the spectator role in sexual behavior?

answer

judge

question

Which of the following is a sociocultural cause for male erectile disorder?

answer

loss of a job

question

Based on the likely sociocultural factors related to erectile disorders, the BEST advice you could give to an aging couple would be to:

answer

Provide more intense and lengthy penile stimulation

question

Which of the following is MOST descriptive of an orgasm?

answer

muscle contraction

question

According to DSM-5, the cut-off point for diagnosing early ejaculation is within _____ of initiating sexual activity.

answer

a minute

question

Compared to erectile disorder, early ejaculation is:

answer

common among men of all ages

question

In the United States, over the past several decades, the typical duration of sexual intercourse has

answer

increased, as has the distress of those suffering from early ejaculation

question

From a psychological perspective, early ejaculation is usually the result of:

answer

sexual inexperience.

question

According to DSM-5, all of the excitement disorders have in common the diagnostic requirement that the difficulty:

answer

causes significant distress or impairment

question

Attitudes about women's sexuality are more liberal now, yet the rates of female orgasmic disorders have remained the same. This trend:

answer

argues against a purely sociocultural cause of female orgasmic disorder

question

Research shows that parents who want to decrease the likelihood that their young daughters will experience orgasmic disorder as adults should:

answer

be affectionate with each other

question

Having a supportive and healthy relationship with one's mother is associated with ______ in women.

answer

positive orgasm outcomes

question

During the young adult years (18-24), which of the following is LEAST common among women?

answer

not having had heterosexual contact

question

During ______, about 90 percent of males masturbate one or two times a week and most have at least two sex partners.

answer

adolescence

question

People experiencing dyspareunia:

answer

experience pain during sex

question

A woman's dyspareunia is MOST likely caused by:

answer

some physical condition

question

Symptoms of vaginismus always include

answer

involuntary contraction of vaginal muscles

question

What problem did early behavioral therapists focus on when treating sexual dysfunction?

answer

fear

question

Which of the following would a qualified sex therapist be LEAST likely to say to a client?

answer

Focus on your performance as if you were a spectator

question

Sensate focus‖ refers to the technique in which:

answer

the sexual relationship is rebuilt, concentrating on pleasure.

question

Which of the following does NOT belong with the others?

answer

sexual aversion

question

Which of the following is the MOST accurate conclusion regarding the use of Viagra and related drugs to treat erectile disorders?

answer

The drugs work about 75 percent of the time and are often given without first assessing what is causing the problem. (True Answer )Correct

question

In treating erectile disorder, the ―tease‖ technique involves: three or more episodes of intercourse each night for a month.

answer

stimulating the penis, but stimulation is stopped once erection occurs

question

How does Viagra work?

answer

It increases blood flow into the penis

question

Theoretically, why do SSRIs help treat early ejaculation? Men who ejaculate early often become depressed. Incorrect SSRIs reduce serotonin levels, thus increasing arousal.

answer

SSRIs reduce arousal and orgasm and help men delay ejaculation.

question

A client receives directed masturbation training and self-exploration instruction as part of the client's sex therapy. MOST likely, the client is a:

answer

woman being treated for orgasmic disorder

question

If someone experiencing female orgasmic disorder asks you what is the MOST effective treatment, you should say

answer

Learn to masturbate

question

A woman who, following directions, is inserting graduated cylinders into her vagina at home is probably being treated for:

answer

vaginismus

question

All of the following are examples of current trends in sex therapy EXCEPT:

answer

treating only those who do not have other serious psychological problems.

question

Most sex therapists are uneasy about recent reliance on drug treatments for sexual dysfunctions because:

answer

the integrated approach to therapy might be ignored

question

Which of the following disorders is NOT listed in DSM-5, but might be in future DSMs, following additional study?

answer

hypersexuality

question

DSM-5 recommends a diagnosis of paraphilia only when associated behaviors, fantasies, or urges last at least:

answer

six months.

question

According to DSM-5, someone who initiates sexual contact with children is:

answer

experiencing a paraphilia, regardless of how troubled the individual may be.

question

Of the following men, which would MOST likely be treated with masturbatory satiation?

answer

a fetish.

question

Which of the following does NOT belong with the others?

answer

orgasmic reorientation

question

Cross-dressing‖ is another term for

answer

transvestic disorder.

question

Why are people who go to strip clubs not generally considered to be voyeurs?

answer

The performers are consenting to being seen by the audience.

question

During which period does pedophilia typically develop?

answer

adolescence

question

It's all right to have sex with children as long as they agree.‖ This is an example of the ______ often experienced by pedophiles.

answer

distorted thinking

question

Recent studies of pedophiliacs show that:

answer

most have at least one other psychological disorder.

question

In the classic type of pedophilic disorder, those MOST at risk are:

answer

prepubescent.

question

Clients identify the situations that trigger pedophilic fantasies and then learn to avoid the situations or cope with them more effectively. The treatment approach being used is:

answer

relapse prevention.

question

The technique of having a client with pedophilia identify situations in which he performs inappropriate behavior and teaching more appropriate coping strategies is called:

answer

relapse-prevention training

question

Arnold cannot enjoy sexual intercourse unless he is tied up by his partner and beaten. His behavior is typical of:

answer

sexual masochism.

question

Autoerotic asphyxia is a fatal side effect of:

answer

a masochistic practice

question

What is the PRIMARY source of sexual excitement for sexual sadists?

answer

the victim's suffering

question

One who is experiencing gender dysphoria:

answer

is unhappy with his or her biological gender.

question

What is the MOST common outcome of gender dysphoria in childhood?

answer

It disappears by adolescence or adulthood

question

Which of the following pairs are MOST analogous (comparable)?

answer

female-to-male gender dysphoria and male-to-female gender dysphoria: androphilic type

question

What do androphilia and autogynephilia have in common?

answer

Those diagnosed are genetically male

question

When people with gender identity disorder take hormones, it is in an attempt to:

answer

facilitate their living as the other gender.

question

Who is MOST likely to receive phalloplasty?

answer

someone experiencing gender identity

question

Which is not a treatment for pedophilia?

answer

...

question

A person may be diagnosed with _____when they experience equal or greater sexual arousal from a prepubescent or early pubescent children than from a physically mature person

answer

pedophillic disorder

question

Which type of cognitive-behavioral treatment has been used to treat pedophilia?

answer

relapse prevention traning

question

Modern sex therapy:

answer

short term and instructive

STUDY

Female Sexual Interest Arousal Disorder Hypoactive Sexual Desire Sexology

Human Sexuality Chapter 17 Sexual Disorders and Sexy Therapy – Flashcards 28 terms

Lisa Currey

28 terms

Preview

Human Sexuality Chapter 17 Sexual Disorders and Sexy Therapy – Flashcards

question

Sexual disorder (dysfunction)

answer

A problem with sexual response that causes a person mental distress

question

Lifelong sexual disorder

answer

A sexual disorder that has been present ever since the person began sexual functioning

question

Acquired sexual disorder

answer

A sexual disorder that develops after a period of normal functioning

question

Hypoactive sexual desire (HSD)

answer

A sexual disorder in which there is a lack of interest in sexual activity; also termed inhibited sexual desire or low sexual desire

question

Discrepancy of sexual deisre

answer

A sexual disorder in which the partners have considerable different levels of sexual desire

question

Sexual aversion disorder

answer

A disorder in which the person feels an actual aversion or repulsion toward sex

question

Female sexual arousal disorder (FSAD)

answer

A sexual disorder in which there is a lack of response to sexual stimulation

question

Erectile disorder

answer

The inability to have or maintain an erection

question

Lifelong erectile diorder

answer

Cases of erectile disorder in which the man has never had an erection sufficient to have intercourse

question

Acquired erectile disorder

answer

Cases of erectile disorder in which the man at one time was able to have satisfactory erections bu can no longer do so

question

Premature ejaculation (PE)

answer

A sexual disorder in which the man ejaculates too soon and thinks he cannot control when he ejaculates

question

Male orgasmic disorder

answer

A sexual disorder in which the man cannot have an orgasm, even though he is highly aroused and has had a great deal of sexual stimulation

question

Female orgasmic disorder

answer

A sexual disorder in which the woman is unable to have an orgasm

question

Situational orgasmic disorder

answer

A case of orgasmic disorder in which the woman is able to have an orgasm in some situations (e.g., while masturbating) but not in others (e.g., while having sexual intercourse)

question

Dyspareunia

answer

Painful intercourse

question

Vaginismus

answer

A sexual disorder in which there is a spastic contraction of the muscles surrounding the entrance to the vagina, in some cases so severe that intercourse is impossible

question

Organic factors of sexual disorders

answer

Physical factors, such as disease or injury, that cause sexual disorders

question

Prior learning

answer

Things that people have learned earlier-for example, in childhood-that now affect their sexual response

question

Immediate causes

answer

Various factors that occur in the act of lovemaking that inhibit sexual response

question

Cognitive interference

answer

Negative thoughts that distract a person from focusing on the erotic experience

question

Spectatoring

answer

Masters and Johnson's term for acting as an observer or judge of one's own sexual performance; thought to contribute to sexual disorders

question

Behavior therapy

answer

A system of therapy based on learning theory, in which the focus is on the problem behavior and how it can be modified or changed

question

Sensate focus exercise

answer

A part of the sex therapy developed by Masters and Johnson in which one partner caresses the other, the other communicates what is pleasurable, and there are no performance demands

question

Cognitive-behavioral therapy

answer

A form of therapy that combines behavior therapy and restructuring of negative thought patterns

question

Kegel exercises

answer

A part of sex therapy for women with orgasmic disorder, in which the woman exercises the muscles surrounding the vagina; also called pubococcygeal or PC muscle exercises

question

Bibliotherapy

answer

The use of a self-help book to treat a disorder

question

Viagra

answer

A drug used in the treatment of erectile disorder; sildenafil

question

Penile prosthesis

answer

A surgical treatment for erectile dysfunction, in which inflatable tubes are inserted into the penis

STUDY

Abnormal Psychology Driving Under The Influence Female Sexual Interest Arousal Disorder Mental Status Examination Poor Academic Performance Psychiatry Psychology Rem Sleep Behavior Disorder

Psychiatry NBME’s – Flashcards 41 terms

Dennis Jennings

41 terms

Preview

Psychiatry NBME’s – Flashcards

question

1) a 55 year old woman is brought to the emergency department by her parents because of strange behavior for 3 months. She insist that her father and next door neighbor want to steal money from her. She also said that there were fumes that her neighbors were blowing under her door causing headaches and skin tone changes. She has called the radio station for the same. Other than this she has no problems and insist that she is normal. Mental status shows no incoherence, loose associations, hallucinations. She is oriented to time, place, person. 1) Schizophreniform 2) Paranoid. 3) shizo 4) MDD 5) Delusional

answer

Delusional!

question

2) A 47 year old man comes to the physician because of 4 weeks of depression, lack of energy, poor concentration, daytime sleepiness. He started a program for weight loss 6 weeks ago, consisitng of diet and exercise, and had a 5.9(13kg) weight loss.He has HTn and was switched to water pill from propranolol. no h/o psych illness. He is 180cm tall and now weights 97kg. Bim is 30. Bp 1135/90. Mental status shows depressed mood and poor concentration. What is the diagnosis? 1) adjustement disorder with depressed moon 2) Dysthymic 3) MDD 4) mood disorder to to medical condition 5) substance induced

answer

5) Substance-induced mood disorder - Propranolol can cause depression

question

3) A 67 year old with parkinson is bought by his wife. She said, "he has become increasingly withdrawn and tearful during the past 3 weeks. He has had poor energy and decreased sleep for 2 months." Current medications is Cari-levadopa and pramipexole. He has had a 6.kg weight loss in 3 months. He is 5ft 3 inches tall and now weights 90lbs. Resting tremor and hand bradykinesia have increased since last visit. On examination he has flat affect and downcast gaze, speech is slow and soft. When asked about the crying spells he said, "Who wouldn't be sad with the damn disease I got?" He doesn't want to go anywhere because he doesn't want people to see him with his tremor. Most likely diagnosis 1) Adjustement with depressed moos 2) Normal reaction to medical condition 3) MDD 4) Dysthymic 5) D/t carbi-levadopa

answer

3) MDD

question

4) a 13 year old girl is brought by her mother because she has not started menstruation yet. The patient has MDD which was treated with fluoxetine for 8months. Not sexually active and physical examination is normal. Sexual development is at tanner stage 2. Mental status shows mild depression and anxiety. What do you do next? 1) Discuss normal pubertal development 2) reassessment by her psychiatrist 3) Prolactin measurement 4) discontinue fluoxetine 5) begin benzo

answer

1) Discuss normal pubertal development

question

8) a 47yo woman is admitted to the hospital because of a 12 hr history of tremors and confusion. she has a history of alcoholism and last consumed alcohol 24 hours ago. she has no other history of serious illness. she does not smoke cigarettes or use illicit drugs. on admission, she is agitated, diaphoretic, orientnted to person but not to time or place. vitamin B1 , folic acid, and three doses of diazepam are administered intravenously. 35 min later, respiratory compromise develops. patient is intubated, mechanical ventilation is started . 2 hr later, she remains agitated. she is pulling at her peripheral intravenous and urethral catheters and picking at her blankets. pulse 140/min, bp160/100, neurologic exam show tremor of upper and lower extremities and hyperreflexia bilaterally. next step pharmacotherapy? 1) add flumazenil 2) add haloperidol 3) add phenytoin 4) Additional diazepam 5) Add B1 (thiamine)

answer

4) This is refractory DT's -> give more BDZ's

question

1. 47 yo woman with schizophrenia. Treated with haloperidol for 15 yrs and well controlled. PE is normal. MSE shows neutral mood and blunted affect. No auditory or visual hallucinations. Mentions that she is worried about tardive dyskinesia and she wants to decrease her risk for this condition. Most appropriate measure? A) Decrease dosage of haloperidol B) Swith from haloperidol to aripriazole C) Switch from haloperidol to carbamazepine D) Add citalopram E) Add lorazepam F) Maintain current regimen

answer

question

67 yo male comes in complaining of 2 mont history of fatigue and decreased libido. Used to sleep 8 hr every night, but now sleeps 10 hours at night and naps during day. 10lbs weight loss during this period. Has Type 2DM, HTN, degenerative arthritis of knee, back hips; HLD. On metformin, ibuprofen, simvastatin, sildenafil, lisinopril, HCTZ. 5'10", weight 230lbs. BMI 33. HR 74, BP 130/82. Pedal pulses decreased. HEberden nodes over DIP joints. Sensation to pinprick decreased over feet. MSE shows constricted affect. Says losing interest in life because multile meds are so hard to manage. No suicidal ideation. Glucose 155; Cholesterol 162 (HDL 46, LDL 90), TG 128. What is most appropriate next step? A) add bupropion B) add insulin C) add venlaxafine D) discontinue lisinopril E) discontinue simvastatin

answer

question

47 yo man comes to ED 1 hour after hit his head on glass door he thought was open. Fell to ground fo a few seconds and said he felt faint. Parents assist him to chair. No loss of consciousness and recalls the whole sequence of events. Dx with schizophrenia at 17 and institutionalized until 19. Lived at home with parents since then. Only medication is olanzapine. HR 80, BP 120/70 while supine; HR 90, BP 105/75 while standing. PE shows 2cm circular ecchymosis on left side of forehead. Neuro exam shows fine tremor and occasional protrustions of the tongue. AOx3. CT of head will show what? A) accumulation of fluid in subdural space in left temporoparietal area B) bilateral calcification of nuclei basales C) contustions of frontal lobes D) symmetric enlargement of ventricles E) tumor in pituitary gland

answer

question

3.5 year old boy been wetting bed 2x per week since being toilet trained at age of 2. Says their 2 daughters were toilet trained at 2 years old and haven't wet bed since. Tried all available treatments including bedwetting alarm and waking child up at midnight to have him use bathroom. They believe child is wetting the bed just to make them angry. Which is most appropriate intervention? A) Reassurance that this is normal behavior B) Play therapy C) Family therapy D) Imipramine E) Sulfamethoxazole

answer

A! He is less than 5 years old - still normal

question

A 32-year-old woman with schizoaffective disorder is brought to the emergency department because of a 7day history of progressive lethargy, loss of appetite, nausea, and leg swelling; she has had jaundice since this morning. Five weeks ago, she was hospitalized for treatment of her psychiatric symptoms. Treatment with three medications was started during hospitalization, but she does not remember their names. She has no history of liver disease or other serious illness. She appears drowsy. Her pulse is 72/min, and blood pressure is 105/70 mm Hg. There is scleral icterus. Abdominal examination shows tenderness in the right upper quadrant. Neurologic examination shows a fine bilateral hand tremor. Mental status examination shows no evidence of hallucinations or delusions. She is oriented to person, place, and year but not to the day of the week or month. Serum studies show: Bilirubin, total 5 mg/dL Alkaline phosphatase 160 U/L AST 240 U/L ALT 210 U/L Which of the following medications is most likely responsible for these findings? A) Clozapine B) Haloperidol C) Lithium carbonate D) Trazodone E) Valproic acid

answer

E! Valproate - recall that it can cause fatal hepatotoxicity

question

A 37-year-old man is brought to the emergency department by police after he was found wandering on the street. The officers say that the patient was screaming and talking to himself. He is unkempt and agitated, and he is wearing winter clothes on a hot summer day. Neurologic examination shows no focal findings. During the examination, he says that he is not going to take any medicine, and the "television told me about the murders." Which of the following is the most likely additional finding in this patient? A) Cerebral edema on CT scan of the head B) Enlarged lateral and third ventricles on CT scan of the head C) Increased serum dopamine concentration D) Increased serum and urine copper concentrations E) Temporal spikes on EEG

answer

B! Ventriculomegaly is often seen in schizophrenia

question

One month after undergoing liver transplantation, a 47yearold woman is admitted to the hospital for treatment of organ rejection. Twentyfour hours after intravenous methylprednisolone therapy is begun, she begins to have visual hallucinations that her organ donor has entered her hospital room naked and is drawing symbols on her skin with an eyebrow pencil. Current medications include tacrolimus, mycophenolate mofetil, omeprazole, trimethoprimsulfamethoxazole, acyclovir, and nystatin. The patient has no history of psychiatric illness. She is awake and alert. Physical examination shows a wellhealing surgical incision over the abdomen. On mental status examination, she says she is worried about her visual hallucinations. She is oriented to person, place, and time. Which of the following is the most likely explanation for this patient's psychiatric symptoms? A) Adjustment disorder with anxious mood B) Corticosteroidinduced psychotic disorder C) Delirium D) Malingering E) Schizophrenia

answer

B! 24 hours after getting IV methylprednisolone

question

A 27-year-old man is brought to the emergency department 30 minutes after his brother found him agitated, tremulous, and complaining of a headache. He had eaten a peanut butter sandwich 12 hours before his symptoms began. He has a 10 year history of severe major depressive disorder. During this period, he has attempted suicide three times despite treatment with both selective serotonin reuptake inhibitors and tricyclic antidepressants. Eight days ago, he went to a new physician because of increasing despondency. This physician immediately discontinued the fluoxetine and substituted tranylcypromine to start 1 week later. He also instructed the patient to start a monoamine oxidase inhibitor diet immediately. Current medications also include diphenhydramine as needed for seasonal allergies. He has no history of hypertension, diabetes mellitus, or migraine. On arrival, he is agitated. His temperature is 40.6°C (105°F), pulse is 130/min, respirations are 26/min, and blood pressure is 180/120 mm Hg. Physical examination shows diaphoresis and tremor of the upper extremities. Deep tendon reflexes are 3+ bilaterally; there are no pathologic reflexes. On mental status examination, he is complaining of occipital headache. He is oriented to person but not to place or time. Which of the following is the most likely cause of these findings? A) Acute anxiety attack B) Acute fluoxetine withdrawal C) Drugdrug interaction D) Ingestion of peanut butter E) Use of diphenhydramine

answer

C! Started tranylcypromine (an MAOI) 1 week after discontinuing an SSRI. According to First aid, you should allow at least 2 weeks of no overlap between the 2 to prevent serotonin syndrome

question

An 87-year-old man is admitted to the hospital because of dehydration and emaciation. He appears catatonic and is unresponsive to questions. One month ago, he began withdrawing from relatives and talking constantly about death. He gradually stopped eating and drinking and has had a 9kg (20lb) weight loss during this time. He has a 35year history of major depressive disorder and has attempted suicide twice. He has no chronic medical conditions and currently takes no medications. He appears cachectic and is staring into space. He does not respond to verbal stimuli. He is 168 cm (5 ft 6 in) tall and weighs 50 kg (110 lb); BMI is 18 kg/m . Examination shows temporal wasting. Which of the following is the most appropriate next step in management? A) Biofeedback B) Desipramine therapy only C) Fluoxetine therapy only D) Desipramine and risperidone therapy E) Fluoxetine and risperidone therapy F) Electroconvulsive therapy

answer

F! He has catatonia likely 2/2 MDD ECT is the most effective therapy for MDD, especially with psychotic features, acute mania, and catatonia!

question

A 37-year-old male police officer comes to the physician at the request of his superiors 1 week after he witnessed a terrorist bombing during which several civilians and three fellow police officers were killed. He sustained only minor injuries and assisted in rescuing survivors and gathering body parts. Since the bombing, he has felt emotionally numb and has been unable to enjoy activities he used to find pleasurable. He has continued to work but has requested assignments far removed from the site of the attack. He describes his sleep as fitful. Two years ago, he sustained a bullet wound to the right calf, which left him with a slight limp. He has no other history of medical or psychiatric illness. He says he used to drink one to two beers nightly but has been drinking two to three beers nightly for the past week. Physical examination confirms the previous gunshot injury to the calf and shows no other abnormalities. On mental status examination, he is irritable and says he is not depressed. He tells the physician, "They made me come. I'm not interested in talking with anyone. I just want to spend time with my buddies and be left alone." Which of the following is the most appropriate initial step in management? A) Encourage the patient to discuss the trauma in detail B) Provide information about the range of reactions to trauma C) Recommend group therapy with other trauma survivors D) Recommend a 1month medical leave of absence from active duty E) Recommend a physician led trauma debriefing series F) Recommend a 12step program G) Begin clonazepam therapy H) Begin fluoxetine therapy

answer

question

A 27-year-old woman is brought to the emergency department 2 hours after cutting her arms superficially with a razor blade. On arrival, she appears calm and is holding a stuffed animal. She says that she cut herself because she wanted to "feel something" and is unsure if she will be able to stop herself from doing this again. She says that she sleeps 8 hours each night and has a good appetite. From the ages of 10 to 15 years, she was physically and sexually abused by her stepfather and mother on several occasions. She has never had a longterm relationship and has been fired from several jobs because of difficulty getting along with her supervisors. Her pulse is 80/min, respirations are 16/min, and blood pressure is 120/60 mm Hg. Physical examination shows lacerations over both forearms. Neurologic examination shows no abnormalities. On mental status examination, she denies depressed mood or suicidal ideation but is convinced that she is worthless and deserves to die. Which of the following is the most likely diagnosis? A) Borderline personality disorder B) Conversion disorder C) Dissociative identity disorder D) Hypochondriasis E) Major depressive disorder F) Malingering G) Posttraumatic stress disorder

answer

A! Borderline personality disorder - cutting herself to feel something is a very characteristic sign

question

A 13-year-old girl is brought to the physician by her father for a wellchild examination. He is concerned about her weight and eating habits. He says that she is always "on the go" and never sits down for a full meal. She will often just grab a piece of fruit when she is on her way to an activity. She will eat a full meal when the family has dinner together every Sunday. She has talked about wanting to become a vegetarian because of her concern for animals. She has had the same group of friends since elementary school. She is the captain of her soccer team and practices 4 days weekly. She is active in an afterschool drama program 3 days weekly and is the lead in this season's play. She maintains a B grade average. Her father says that she talks on the telephone "constantly" and is animated and cheerful most of the time. When she is in her bedroom, she prefers to keep the door closed and stops talking if she is on the telephone and her father walks into the room. She has a disorganized bedroom and often falls fast asleep on a bed covered with piles of clothes. Menarche has not occurred. She appears thin and muscular. She is at the 50th percentile for height and 35th percentile for weight, which is unchanged from last year. Vital signs are within normal limits. Breast and pubic hair development are Tanner stage 2. Physical examination shows no abnormalities. When interviewed alone, she is animated. She shrugs and rolls her eyes when asked about her diet and weight. She thinks she is fine and does not understand why her father is so upset. Which of the following is the most appropriate next step? A) Reassure the father that this is normal development B) Recommend individual psychotherapy C) Recommend nutritional counseling D) Recommend that the father keep a log of what his daughter eats E) Schedule weekly examination and weighing

answer

A! She has an unchanged weight from the previous year and seems healthy "thin and muscular"

question

A 22-year-old woman is brought to the emergency department because of a 4hour history of violent, agitated behavior. Her college roommates are concerned that she may have used illicit drugs. She has no known history of similar behavior or serious illness. She takes no medications. Her temperature is 38°C (100.4°F), pulse is 120/min, respirations are 20/min, and blood pressure is 140/90 mm Hg. On mental status examination, her speech is loud and rapid in rate and rhythm. She describes her mood as "wild"; her affect is reactive but primarily exuberant and irritable. Her thought process is tangential. She reports no hallucinations. During the examination, she tries to leave the emergency department, pushing a security guard aside and throwing a clipboard on the floor. Intoxication with which of the following substances is the most likely cause of this patient's symptoms? A) Cannabis B) Ecstasy (3,4methylenedioxymethamphetamine) C) Heroin D) LSD E) Methamphetamine

answer

E! Methamphetamine - she has evidence of psychomotor agitation

question

A 47-year-old man with Down syndrome is brought to the physician because of increasing forgetfulness and irritability over the past 10 months. He has been awakening at 3 am to get dressed for the day and now gets lost when he takes his daily walk. He appears disheveled. Examination shows decreased memory and a normal mood and affect. During the interview, he attempts to leave the office, saying "take me home." A) Amygdaloid nucleus B) Caudate nucleus C) Medial geniculate nucleus D) Nucleus basalis of Meynert E) Red nucleus F) Substantia nigra G) Subthalamic nucleus

answer

D! Early onset AD from Down Syndrome

question

A 37-year-old man is brought to the physician because of a change in personality over the past 4 months. He has become sexually disinhibited, tactless, impulsive, and easily irritated. His father had similar symptoms at the age of 42 years. Examination shows involuntary movements of the tongue. He has a sudden coarse involuntary jerking movement of the upper extremity that he attempts to hide by pretending to straighten his hair. A) Amygdaloid nucleus B) Caudate nucleus C) Medial geniculate nucleus D) Nucleus basalis of Meynert E) Red nucleus F) Substantia nigra G) Subthalamic nucleus

answer

B! Huntington disease

question

A 24yo man is brought to the emergency department from a psychiatric hospital because of a decreasing level of consciousness over the past 3 days. He has become progressively less responsive and has remained in bed for the past 12 hours without speaking or following commands. He has a history of schizophrenia with multiple psychiatric hospitalizations and is currently being treated with haloperidol and benztropine. His temperature is 39.4°C (103°F), pulse is 120/min, respirations are 28/min, and blood pressure is 180/100 mm Hg. He withdraws weakly to noxious stimuli. His eyes are open, but he does not fix or follow visual stimuli or gaze around the room. He is mute and does not follow commands. Examination shows marked rigidity of the neck and all extremities. Laboratory studies show: Leukocyte count 18,000/mm3 Segmented neutrophils 80% Lymphocytes 20% Serum creatine kinase 12,000 U/L Cerebrospinal fluid: Erythrocyte count 2/mm3 Leukocyte count 1/mm3 Protein 28 mg/dL Glucose 78 mg/dL A CT scan of the head shows no abnormalities. Which of the following is the most likely underlying cause? A) Catatonia B) Conversion reaction C) Dissociative fugue D) Drug reaction E) Infection F) Malingering G) Toxin

answer

D! Drug reaction (likely NMS from haloperidol)

question

A 3-year-old girl is brought to the emergency department 1 hour after injuring her right arm. This is her third visit to the emergency department in 6 months. The parents say that she fell. The child is too upset to say how she injured herself. Her parents note that she is overly aggressive in day care, where she is not responding to instructions, and has hit other children. During her previous visit for a wrist injury, an xray of the wrist showed normal findings. On examination, the child appears fearful of the examiner, provides limited responses, and is restless and easily distracted. An x-ray of the right humerus shows a closed fracture. Which of the following is the most appropriate next step in management? A) Admit to hospital B) Cognitive behavior therapy C) Contact child protective services D) CT scan of the head E) Family counseling F) Followup outpatient appointment in 2 weeks G) Neuropsychological testing H) Psychiatric assessment

answer

C! Contact CPS for child abuse

question

A 57-year-old woman comes to the physician because of difficulty sleeping, tearfulness, and restlessness since her daughter was diagnosed with metastatic breast cancer 3 days ago. She reports that when she goes to bed at night, she is unable to fall asleep for several hours and lays in bed worrying about her daughter's situation. The patient underwent a mastectomy for breast cancer 7 years ago. She takes acetaminophen/butalbital for occasional migraines. Her vital signs are within normal limits. Physical examination shows no abnormalities. On mental status examination, she is tearful and tense but calms during the conversation. There is no evidence of suicidal ideation. Which of the following is the most appropriate next step in management? A) Biofeedback B) Carbamazepine therapy C) Clonazepam therapy D) Clonidine therapy E) Imipramine therapy F) Olanzapine therapy G) Pentobarbital therapy H) Sertraline therapy

answer

C! Tricky question - she likely has adjustment d/o

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An 8-year-old boy is brought to the physician because of a 1year history of increasingly frequent episodes of eye blinking and facial grimacing during the past 6 months that now occur several times daily. He also frequently makes grunting and throat clearing noises. His teacher often sends him out of the room for being disruptive. He says that he will repeatedly shrug one of his shoulders and attempt to hide this behavior by smoothing his hair. He is embarrassed by these behaviors and can suppress them with effort, but they often return when he is distracted and are exacerbated by stress. The behaviors do not occur during sleep. He has no history of serious illness and takes no medications. During the examination, he has several episodes of rapid, forceful eye blinking and throat clearing. Physical examination shows no other abnormalities. Mental status examination shows a mildly anxious mood and affect. Which of the following is the most appropriate pharmacotherapy? A) Dextroamphetamine B) Hydroxyzine C) Imipramine D) Lithium carbonate E) Methylphenidate F) Risperidone

answer

F! Risperidone for Tourette's (first line is alpha2 agonists like clonidine, guanfacine)

question

A 47-year-old man has had tension and hand tremors for 1 month. He has been treated for bipolar disorder with lithium carbonate for 6 months. He has a 2year history of alcohol abuse on weekends. His temperature is 36.7°C (98°F), pulse is 90/min, respirations are 16/min, and blood pressure is 140/86 mm Hg. Examination shows mild tremors of the fingers and hands. Serum lithium carbonate concentration is 1 mEq/L (therapeutic range=0.6-1.2). Serum electrolyte concentrations and thyroid function tests are within normal limits. A) Bupropion B) Chlorpromazine C) Fluoxetine D) Haloperidol E) Imipramine F) Lorazepam G) Perphenazine H) Propranolol

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H - Essential tremor

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An 82-year-old man with dementia, Alzheimer type, is brought to the physician because of a 4day history of visual hallucinations and irritability. He has a 2month history of insomnia. He has osteoarthritis, hypertension, and hypothyroidism. His medications are rivastigmine, ibuprofen, atenolol, levothyroxine, and amitriptyline. His blood pressure is 128/88 mm Hg. Physical examination shows no abnormalities. On mental status examination, he recalls zero of three objects after 5 minutes. During the examination, he points his finger and sternly says, "You need to stop doing that right this minute." When asked whom he is addressing, he says, "that tiny little man shouting over in the corner." Results of a complete blood count, measurement of serum glucose concentration, and kidney and liver function tests are within the reference ranges. Urinalysis shows no abnormalities. Discontinuation of which of the following of this patient's medications is most appropriate at this time? A) Amitriptyline B) Atenolol C) Ibuprofen D) Levothyroxine E) Rivastigmine

answer

A! Amitriptyline

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A previously healthy 27-year-old man is brought to the emergency department by his girlfriend because of a 6week history of daily episodes of hearing a voice telling him that he is Christ. He is convinced that he has the power to heal the sick and requests that he be admitted into the wards to help the patients. During the past 4 weeks, he has had a 10kg (22lb) weight loss. He has not slept more than 2 hours nightly for 2 weeks. When he is awake at night, he watches television or calls strangers on the telephone. He does not drink alcohol or use illicit drugs. He is 173cm(5ft8in)tall and weighs80kg(176lb); BMIis27kg/m . His temperature is 37°C (98.6°F), pulse is 110/min, and blood pressure is 160/90 mm Hg. Physical examination shows no other abnormalities. On mental status examination, he appears restless and agitated. He flirts with female staff members and tries to convince people of his powers. He has pressured speech and talks incessantly. There is no evidence of visual hallucinations. Recall is difficult to assess because he cannot concentrate. Longterm memory is intact. He is oriented to person, place, and time. Which of the following is the most likely diagnosis? A) Bipolar disorder B) Cyclothymic disorder C) Major depressive disorder with psychotic features D) Schizoaffective disorder E) Schizophrenia

answer

A! Bipolar disorder

question

A 28-year-old man is brought to the emergency department because of flulike symptoms and cough productive of clear sputum for 24 hours. He has been hospitalized eight times over the past 5 years because of bizarre delusions and hallucinations during which a voice tells him what to do. He has a 9year history of type 1 diabetes mellitus. In addition to insulin, he is receiving clozapine therapy (400 mg daily) for his psychotic condition. During mental status examination, he is hallucinating and says that he is being pursued by special agents of the government. Leukocyte count is 2750/mm3, and serum glucose concentration is 140 mg/dL. Urinalysis is within normal limits. Which of the following is the most appropriate next step in management? A) Add lithium carbonate therapy B) Add penicillin therapy C) Decrease the dose of clozapine D) Discontinue clozapine therapy E) Increase the dose of clozapine

answer

D! Discontinue clozapine therapy - tricky does not meet clear indications for discontinuation based on ANC recommendations

question

An unconscious 7-year-old boy is brought to the emergency department by his parents. The family emigrated from rural Southeast Asia 4 years ago. An interpreter is used because the parents do not speak English. They say, "Our child has been possessed by a spirit since birth who speaks through his mouth with spit and blood and then takes his powers away." He has had these spells all of his life. He does not attend school. They recently sacrificed a piglet as an offering to the spirit, but there has been no change in the child's condition. The parents seem devoted. He awakens during the physical examination and smiles vacantly at his parents. He appears confused and speaks in monosyllables. No other abnormalities are noted. Which of the following is the most appropriate next step in diagnosis? A) Contact child protective services B) Psychoeducational assessment C) Family therapy D) Throat culture E) X-ray of the chest F)ECG G)EEG

answer

G! EEG - confused after regaining consciousness - likely post-ictal state

question

57-year-old man comes to the physician with his wife because of a 1-month history of bizarre behavior at night. His wife says that most nights he falls asleep at approximately 11 pm and begins kicking and groaning in the bed shortly after 12:30 am. Seven times during this period, he has jumped out of the bed and run back and forth across the room, punching the air. She tries to wake him during these episodes because she is afraid that he might hurt her or himself. She reports that when she succeeds, he seems alert but tells her that he was being attacked and needed to defend himself or escape. The patient tells the physician that he does not recall the behavior his wife is describing but remembers having a recurrent dream in which he is in danger and cannot breathe. Vital signs are within normal limits. Physical examination shows no abnormalities. On mental status examination, he has a pleasant and full range of affect. His thought process is rational and goal directed. He says that based on his wife's description of his behavior at night, he is afraid that he might hurt her. Results of laboratory studies are within the reference range. Which of the following is the most likely diagnosis? A) Central sleep apnea B) Nocturnal panic disorder C) Nocturnal paroxysmal dystonia D) REM sleep behavior disorder E) Restless legs syndrome F) Sleep-related complex partial seizure disorder G) Sleep terror disorder

answer

D! REM sleep behavior disorder

question

Over the past 7 years, a 25-year-old graduate student has had increasingly severe palpitations, tremulousness, nausea, sweating, and inability to concentrate while taking examinations. He is worried because he recently failed an examination despite being thoroughly prepared. Examination shows normal findings. Which of the following is the most appropriate next step in diagnosis? A) Ambulatory ECG monitoring B) 24-Hour urine collection for 5-hydroxyindoleacetic acid C) 24-Hour urine collection for measurement of catecholamine and metanephrine concentrations D) Measurement of serum thyroxine (T 4) and thyroid-stimulating hormone concentrations E) Psychiatric evaluation

answer

E! Psych eval

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A 27-year-old woman, gravida 1, para 1, comes to the physician with her husband because of progressive irritability and anxiety since the birth of her child 3 weeks ago. Pregnancy was complicated by premature labor that was managed with bed rest. Delivery occurred at term with no complications. Examination of her newborn at birth showed no abnormalities. The patient reports that he feeds well and appears healthy, but she has constant worries about his health and her own health. She adds that she has had a decreased appetite and difficulty sleeping. Her husband notes that she has been increasingly withdrawn from family and friends and that she has reported thoughts of suicide. The patient has no history of serious illness or major depressive disorder. Her only medication is a multivitamin. She appears tired. Physical examination shows no abnormalities. On mental status examination, she has an irritable mood and depressed affect. She is oriented to person, place, and time. Which of the following is the most likely diagnosis? A) Adjustment disorder B) Bipolar disorder C) Generalized anxiety disorder D) Major depressive disorder E) Post-traumatic stress disorder

answer

D! She meets criteria for MDD

question

An 8-year-old girl is brought to the physician by her mother because of frequent stomachaches over the past 3 months. She has a 1-year history of difficulty falling asleep and poor concentration. She has always been a good student and excels in extracurricular activities. Her parents divorced 6 months ago. Physical examination shows no abnormalities. Mental status examination shows an anxious affect and coherent thought process. She says that she is worried about her classes and about her performance in the school band and on the soccer team. Which of the following is the most likely diagnosis? A) Generalized anxiety disorder B) Obsessive-compulsive disorder C) Panic disorder D) Post-traumatic stress disorder E) Separation anxiety disorder

answer

A! She worries about multiple domains

question

A 32-year-old Bosnian man is brought to the emergency department by police 30 minutes after they found him sitting in a cemetery and muttering to himself. The police officers report that the patient appeared lost in thought and did not respond to their questions; he then passively accompanied them to the hospital. Identification in the patient's wallet indicates that he is a construction worker. The physician calls the patient's employer and learns that he was part of a crew working on a bridge that morning when a crane collapsed, causing multiple injuries to people working in trailers on the ground. A hospital interpreter says that the patient had been an ambulance driver in a military war zone 10 years ago. The patient sits quietly and stares ahead; he appears unaffected by the bustling activity in the emergency department. His pulse is 72/min, and respirations are 14/min. Physical examination shows no abnormalities. Mental status examination shows a reserved demeanor. He speaks in monotone and responds to questions with vague, noncommittal answers. He says he is not depressed or anxious. Which of the following is the most likely diagnosis? A) Adjustment disorder B) Catatonia C) Dissociative disorder D) Generalized anxiety disorder E) Schizotypal personality disorder

answer

Dissociative disorder!

question

A 23-year-old man is brought to the emergency department because of progressive paranoia and agitation for 48 hours. His roommate reports that the patient has not been sleeping or eating during this period but had been staying up all night studying for examinations for the past 4 days. He adds that last night the patient crouched below their apartment window peering out and insisting that every passing car was occupied by FBI agents. The patient has no history of psychosis. He states that he has been under stress from his new position as a software engineer. Physical examination shows 4-mm pupils, dry mouth, and mild tremulousness. On mental status examination, he is agitated, and his speech is rapid with increased volume. There is evidence of paranoid delusions about persecution by the police. Which of the following is the most likely diagnosis? A) Bipolar disorder B) Delusional disorder C) Generalized anxiety disorder D) Schizophrenia E) Substance-induced psychotic disorder

answer

While he has been staying up and has rapid speech, he lacks a lot of the grandiosity, elevations in mood, etc... for acute mania. It also hasn't been going on long enough. Doesn't meet criteria for any of the others so E) substance-induced is most likely

question

A 72-year-old woman comes to the physician because of a 3-month history of fatigue and difficulty sleeping. She has had a 5.4-kg (12-1b) weight loss during this period because of decreased appetite. Her husband died 18 months ago. She has a 15-year history of hypertension treated with verapamil and a 3-month history of insomnia treated with zolpidem. Laboratory studies 1 week ago showed no abnormalities. She is 170 cm (5 ft 7 in) tall and weighs 60 kg (133 lb); BMI is 21 kg/m 2. Her pulse is 74/min, and blood pressure is 131/84 mm Hg. Physical examination shows no abnormalities. Mental status examination shows an irritable and tearful mood. She expresses hopelessness about the future. Which of the following is the most likely finding in this patient? A) Decreased hemoglobin concentration B) Decreased serum vitamin B (thiamine) concentration C) Increased percentage of bands on complete blood count D) Increased serum cortisol concentration E) Increased serum prolactin concentration

answer

D! She meets criteria for MDD - high cortisol has been implicated in development of depressive d/o per First aid

question

A 30-year-old woman has had frontal headaches, stomach upset, and poor appetite for 4 weeks; she has had a 2-kg (5-1b) weight loss during this period. She has pain in the left upper quadrant of the abdomen 1 to 3 hours after eating dinner. Over-the-counter antacids have been ineffective. She blames herself for not taking better care of her body. The headaches occur at night and awaken her. She feels fatigued in the morning and has difficulty getting up and going to work. Over the past month, her supervisor has complained about her recent errors, which she attributes to difficulty concentrating. She says that she is so tired when she comes home that she has stopped going out with her friends and just goes to sleep. Which of the following is the most likely diagnosis? A) Adjustment disorder with depressed mood B) Borderline personality disorder C) Dysthymic disorder D) Major depressive disorder E) Somatization disorder F) Ulcerative colitis

answer

D! MDD Sleep - fatigued in the morning/awakened by headache Interest- not going out with friends anymore -> anhedonia likely Guilt - blames herself for not taking better care of her body E - fatigue C - poor concentration A - weight loss P - probable S - wasn't asked >= 2 weeks Likely has depressed mood but she meets so many other criteria I think we can infer here

question

A 52-year-old woman comes to the physician for a routine follow-up examination. She has received inpatient psychiatric treatment several times since the age of 25 years for auditory hallucinations and the belief that her thoughts and movements were being controlled by a local television station; her last admission to the hospital was 10 years ago. Treatment with haloperidol for the past 20 years has decreased the occurrence of symptoms. She attempted suicide at the ages of 30 and 38 years. She lives in a supervised residence and does not work. During the examination, she repeatedly smacks her lips and slightly protrudes her tongue. When the physician asks if she is chewing gum, she laughs and opens her mouth to show she is not. She can hold her mouth and tongue still when asked but begins lip smacking when the physician resumes the examination. Which of the following is the most appropriate next step in pharmacotherapy? A) Continue haloperidol and add alprazolam B) Continue haloperidol and add propranolol C) Discontinue haloperidol D) Discontinue haloperidol and begin chlorpromazine E) Discontinue haloperidol and begin risperidone

answer

E! Discontinue haloperidol and begin risperidone

question

An 8-month-old male infant who was adopted recently is brought to the physician because of poor weight gain. He was born at term and weighed 2410 g (5 lb 5 oz). He was formula fed at birth and has consistently been below the 3rd percentile for weight. Currently, his diet consists of 16 ounces of iron-fortified cow milk formula, juice, cereal, prepared fruit, and pureed green vegetables. There is no history of vomiting. He has one formed stool daily. He is alert and appears well. He currently weighs 7002 g (15 lb 7 oz). On examination, he says "mama" and "bye-bye" while waving. He sits unsupported. He is wary of strangers. There are narrow palpebral fissures, epicanthal folds, a thin upper lip with a "fish mouth" appearance of the oral cavity, and an indistinct nasal philtrum. His ears are normally set, the nasal bridge is flattened, and the tongue is not enlarged. There is a single palmar crease on the left hand. Cardiopulmonary examination shows no abnormalities. There is no hepatosplenomegaly, and no masses are palpated. There is no peripheral edema. Which of the following is the most likely diagnosis? A) Celiac disease B) Down syndrome C) Fetal alcohol syndrome D) Psychosocial deprivation E) Silver-Russell syndrome

answer

Most likely fetal alcohol syndrome!

question

A 23-year-old man comes to the physician because of anxiety since beginning a second part-time job as a courier for a photographer 6 weeks ago. He reports a fear of heights and of riding in elevators. He takes stairs and escalators whenever possible, which prevents him from completing his deliveries on time. He has not had panic attacks. He has no history of serious illness and takes no medications. His temperature is 36.8°C (98.2°F), pulse is 80/min, respirations are 18/min, and blood pressure is 118/73 mm Hg. Physical examination shows no abnormalities. On mental status examination, he has an anxious mood and full range of affect. He reports no symptoms of depression or suicidal ideation. Which of the following is the most appropriate next step in management? A) Cognitive behavioral therapy B) Interpersonal therapy C) a-Adrenergic agonist therapy D) I3-Adrenergic blocker therapy E) Selective serotonin reuptake inhibitor therapy

answer

Very important question! CBT is the tx of choice for specific phobia!!! SSRI's are nice distractors

question

A 27-year-old woman comes to the physician for an examination prior to starting a new job. She has a 10-year history of binge-eating and self-induced vomiting. She takes no medications. She does not drink alcohol or use illicit drugs. She is 178 cm (5 ft 10 in) tall and weighs 72 kg (160 lb); BMI is 23 kg/m 2. Her temperature is 37°C (98.6°F), pulse is 70/min, respirations are 10/min, and blood pressure is 120/70 mm Hg. Physical examination shows yellow dental enamel and abdominal striae. Serum studies are most likely to show which of the following abnormalities? A) Decreased bicarbonate concentration B) Increased amylase activity C) Increased magnesium concentration D) Increased potassium concentration E) Increased sodium concentration

answer

STUDY

Abnormal Psychology Female Sexual Interest Arousal Disorder Hypoactive Sexual Desire Disorder Junior High School Obsessive Compulsive Personality Disorder

Abnormal Psych Exam 5 – Flashcards 169 terms

Steven Colyer

169 terms

Preview

Abnormal Psych Exam 5 – Flashcards

question

The finding that temperament may play a role in the etiology of personality disorders suggests that

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d. a susceptibility to the development of a personality disorder may be inherited.

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The histrionic seeks ________, while the narcissist needs ________.

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a. attention; admiration

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The drug that can create a state most like psychosis is

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b. LSD.

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Which statement about Project MATCH is accurate?

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a. It showed that matching a client's personality to a form of treatment makes no difference.

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Problematic drinking behavior commonly develops during

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c. crisis periods in a marriage or other intimate personal relationship.

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Which of the following is NOT a misconception about alcohol?

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b. Alcohol can interfere with sleep.

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Sharon says, "I would love to be in an intimate relationship. My life is terribly boring and lonely. But I am extremely shy and I would fall apart if any man criticized me in the slightest." This description best matches the symptoms of ________ personality disorder.

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c. avoidant

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The research on the association between borderline personality disorder and childhood sexual abuse

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b. are problematic - the abuse most likely is occurring with other factors that might be more important.

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Like many individuals with personality disorders, individuals with histrionic personality disorder are rarely able to maintain relationships over time. Why?

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d. Their need for attention and manipulation is likely to drive others away.

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Which of the following people is most likely to be dependent on barbiturates?

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d. Middle-aged and older persons who cannot get to sleep without them

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Persons at high risk for developing alcohol-related problems tend to be more ________ than those at low risk.

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a. impulsive

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Which of the following personality disorders is most likely to be mistaken for schizophrenia?

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d. Schizotypal

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Greg has been diagnosed with schizoid personality disorder. Knowing this, which of the following jobs would he be most likely to enjoy?

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a. Night-time security guard who works alone

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The five factor model

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a. is a model of normal personality that includes an expanded description of the five basic personality dimensions.

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The behavioral patterns of individuals with personality disorders

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c. are thought to be relatively consistent over time, with little adaptation to new kinds of experiences.

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Stu has no friends except his brother. He would desperately love to date women but is certain no woman would be interested in him. He tried a dating service but was convinced that the secretary was trying to get rid of him because he was such a poor candidate. The most likely diagnosis for Stu is

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a. avoidant personality disorder.

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Observed changes in drinking patterns suggest that in the future

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b. the ratio of male to female problem drinkers will decrease.

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Early criminal behavior is most characteristic of

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a. antisocial personality disorder.

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Involvement in an abusive relationship (as the one who is abused) would be most expected of the individual with ________ personality disorder.

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c. dependent

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In contrast to other treatment programs, Alcoholics Anonymous

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a. offers both group and one-on-one support.

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Which of the following is most typical of the interpersonal attitudes and behaviors of someone with borderline personality disorder?

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a. Vacillation between overidealization and bitter disappointment

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Randy has been dependent on alcohol for at least ten years. Drinking has ruined his marriage, his occupational standing, and his health. If a friend told Randy that he needed to enter treatment, and Randy responded the way most alcohol dependent people do, he would probably say

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d. "Who do you think you are attacking me? You are the one with the problem."

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Concerning the causes of alcoholism,

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a. there are probably several different patterns of causes associated with several different types of alcohol dependence.

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Which of the following best explains why women tend to not "hold their booze" as well as men?

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b. Women metabolize alcohol less quickly than men.

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The central problem of schizoid personality disorder is

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d. an inability to form attachments to other people.

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Amphetamine psychosis resembles

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b. Oddness or eccentricity

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The main difference between borderline personality disorder and antisocial personality disorder is that

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c. both exploit others but the person with borderline personality disorder does it due to an angry reaction to disappointments and the person with antisocial personality disorder does it for gain and without guilt.

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According to the DSM-IV-TR, which of the following must be true for a personality disorder diagnosis?

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d. The person's behavior problems must cause them distress or impairment.

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Which basic personality traits from the five-factor model seem most important in the development of dependent personality disorder?

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a. High neuroticism and high agreeableness

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Transient psychotic symptoms are seen in which of the following personality disorders?

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d. Paranoid and schizotypal

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Which statement about crack cocaine use is accurate?

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b. Chronic users develop sexual dysfunctions and a disinterest in sex.

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Self-mutilation, such as is seen in borderline personality disorder, is

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c. done to reduce anxiety and depression.

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Which type of child is most likely to show the personality traits of a psychopath as an adult?

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a. One who has fearlessness, low anxiety and high callousness

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Why might opiate antagonists be used in the treatment of alcoholism?

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b. To minimize cravings

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Drug abuse and dependence are most common in what age group and in what type of community?

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b. Adolescence and young adulthood; economically depressed communities

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Tom tells you that he can make his roommate take out the trash by simply thinking about his roommate doing it. He agrees with you that this could sometimes just be a coincidence, but he seems to truly believe he can sometimes get people to do things just by thinking about it. You find him understandable when he talks, but sometimes hard to follow. His clothes are messy and don't match. Tom tells you not to tell anyone about his power, because he knows that other people don't like him because they are jealous and they would hurt him if they could. The best diagnosis for Tom is

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c. schizotypal personality disorder.

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Impulsivity and extreme instability in interpersonal relationships, self-image, and mood best characterize

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d. borderline personality disorder.

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Which of the following statements is NOT true of treating personality disorders?

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d. People with both an Axis I and an Axis II diagnosis are easier to treat than people with just an Axis II disorder because they have more distress.

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Which type of treatment for alcoholism has been found to be most effective?

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d. All were about equal

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Which of the following is NOT part of the clinical picture in antisocial personality and psychopathy?

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a. Careful planning of future activities that will help their families.

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The presence of psychopathy

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a. is the single best predictor of future violence and crime recidivism.

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Which basic personality traits from the five factor model seem most important in the development of paranoid personality disorder?

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c. Antagonism and neuroticism

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Individuals who seem odd and eccentric to others may have personality disorders from

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a. Cluster A.

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Which of the following is both a stimulant and a hallucinogen?

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c. Ecstasy

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Unlike psychoactive substance abuse, psychoactive substance dependence usually involves

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a. physiological symptoms such as tolerance and withdrawal.

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Lori is vain and self-centered. When she goes out, it is not at all uncommon for her to do things that ensure she is the center of attention. Her close friends describe her as a "drama queen." Assuming that her behavior is sufficient to warrant an Axis II diagnosis, which of the following personality disorders is she most likely to be diagnosed with?

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c. Histrionic

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Which of the following is most typical of the interpersonal attitudes and behaviors of someone with borderline personality disorder?

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a. Vacillation between overidealization and bitter disappointment

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Which of the following statements is true about alcohol use?

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c. Alcoholism increases the risk of suicide.

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The individual with ________ personality disorder is likely to be described as rigid and cold.

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c. obsessive-compulsive

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What is the main difference between Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Personality Disorder (OCPD)?

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c. People with OCPD don't have true obsessions or compulsions like people with OCD have.

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The fear of abandonment is seen in both borderline and dependent personality disorder. A key difference is their reaction to it:

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b. The person with borderline personality disorder gets angry and the person with dependent personality disorder becomes submissive.

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"I am a person who has an affliction-I cannot drink like social drinkers. Spiritual change may help me in recovering from my addiction, but I will be an alcoholic for life." The person who said this would feel most comfortable in ________.

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b. Alcoholics Anonymous

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Which of the following statements about alcohol problems is accurate?

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b. The average life span of an alcoholic is twelve years shorter than the average citizen.

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Which basic personality traits from the five factor model seem most important in the development of schizoid personality disorder?

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b. High introversion and low openness to feelings

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Observed changes in drinking patterns suggest that in the future

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b. the ratio of male to female problem drinkers will decrease.

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Which of the following has legitimate medical uses, but is associated with both physiological and psychological dependence and lethal overdoses?

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b. Barbiturates

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Which of the following is a factor that complicates determining the causes of personality disorders?

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a. The high likelihood that an individual with one personality disorder may also have another

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Endorphins

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b. are opium-like substances produced by the body.

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Which of the following is most likely to be used to produce sleep?

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a. Barbiturates

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What core belief might explain the behavior of the individual with dependent personality disorder?

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a. "I am helpless."

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Alcohol's effects on ________ explain its ability to impair judgment.

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c. glutamate

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Like many individuals with personality disorders, individuals with histrionic personality disorder are rarely able to maintain relationships over time. Why?

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d. Their need for attention and manipulation is likely to drive others away.

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Glenna believed that Sam loved her and that she could not live without him. When he told her he did not want to see her again, she became violently angry and manipulated him into staying with her by threatening suicide. Which of the following personality disorder does Glenna's behavior suggest she might have?

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d. Borderline

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Visual, attentional, and memory deficits comparable to those seen in schizophrenia have been documented in ________ personality disorder.

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c. schizotypal

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Both a lack of parental indulgence and parental overindulgence have been proposed as explanations for ________ personality disorder.

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d. narcissistic

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The "clusters" of personality disorders found in the DSM-IV-TR are grouped based on

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c. symptom or feature similarities.

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Hattie has a dependent personality disorder. This means that she

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c. has acute discomfort when she is alone.

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Sam shows little emotion and is loner. He has no social relationships, other than his family, and he seems to experience little pleasure, if any. What personality disorder might Sam have?

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b. Schizoid

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Which of the following is NOT a Cluster B personality disorder?

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a. Depressive

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In research studies, in addition to failing to learn to avoid punishment, psychopaths

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c. did not show normal fear potential startle responses.

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People find Adam difficult to be around. His behavior is unpredictable and erratic but most often is annoying to others. He doesn't seem to learn from his bad experiences, instead he keeps repeating the same mistakes over and over. His family says Adam has been like this since at least junior high school. Adam most likely has

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d. a personality disorder.

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Antisocial personality disorder differs from the other Cluster B disorders in that

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b. a need for approval or attention is not displayed.

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Which of the following best accounts for why women are more likely to be diagnosed with histrionic personality disorder than men?

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b. The symptoms tend to be maladaptive exaggerations of traits normally seen in women.

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Harold is perfectionistic and extremely concerned with maintaining a set routine. He probably suffers from ________ personality disorder.

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b. obsessive-compulsive

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Transient psychotic symptoms are seen in which of the following personality disorders?

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d. Paranoid and schizotypal

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The best current research shows that children of parents with antisocial personality disorder who were adopted into other families

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c. developed antisocial personality disorder at higher rates only if their adoptive family had problems, such as marital conflict.

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Unlike disorders like depression and PTSD,

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a. personality disorders develop gradually.

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The behavioral patterns of individuals with personality disorders

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c. are thought to be relatively consistent over time, with little adaptation to new kinds of experiences.

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The first stage in the treatment of any form of substance dependence is

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b. treating physical withdrawal symptoms.

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The reciprocal influence model is best described as a ________ explanation for teen drinking.

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cognitive

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Which of the following is a common personality characteristic of those who later abuse alcohol?

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c. strong need for praise and admiration

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Rosa comes to you for treatment of her alcohol abuse. You suspect that she might have some other Axis I disorder as well. Why is it important for you to evaluate her Axis I status?

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d. The co-occurrence of another mental disorder has a very significant effect on treatment outcome.

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Which of the following countries has the highest per capita rate of alcohol consumption?

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b. France

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Korsakoff's psychosis is now known as

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d. alcohol amnestic disorder.

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Aversive conditioning for alcoholics

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d. involves pairing alcohol with something unpleasant like electric shock.

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Alcoholic psychosis may occur due to

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a. low thiamine levels.

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An involuntary reoccurrence of perceptual distortions can occur weeks or months after taking a particular drug. The phenomenon is called ________; the drug is called ________.

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b. a flashback; LSD

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Controlled drinking - teaching alcoholics to drink in moderation -

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b. seems to work for some people with less severe alcoholism.

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A moderating variable is

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b. something that influences the connection between two other variables.

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Which parenting skill or parental behavior is most associated with adolescent substance use?

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d. Lack of monitoring the adolescent's activities

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The individual with which of the following Axis I diagnoses is most likely to also abuse alcohol?

answer

b. Depression

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Tina has been using cocaine for many months. She decides to stop. She can expect

answer

d. to have depression, fatigue, disturbed sleep, and increased dreaming.

question

Opium and heroin

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a. were originally used by physicians as pain relievers.

question

Dialectical behavior therapy is

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a. a promising, problem-focused treatment for borderline personality disorder.

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Luisa is a lively and emotional graduate student. She dresses provocatively and behaves in a very seductive manner with her male professors. She has had a long string of short-lived, stormy romances. Luisa is most likely to have a diagnosis of

answer

a. histrionic personality disorder.

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A cognitive explanation for schizoid personality disorder proposes that the individual with this disorder believes that

answer

a. he is basically alone.

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Histrionic personality disorder is most likely to be diagnosed in people who

answer

c. are attention-seeking and overly emotional.

question

While the individual with ________ personality disorder appears cool and aloof, the individual with ________ personality disorder is best described as odd.

answer

b. schizoid; schizotypal

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Some people always think that everyone is looking at them and talking about them, wishing to be like them. This self-focused view of the world would be expected in someone with ________ personality disorder.

answer

c. narcissistic

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Heavy drinking during pregnancy, especially the early part, often causes

answer

c. aggressiveness and withdrawal in the child.

question

Your text describes two commonly recognized psychotic reactions to alcohol. They are

answer

c. what used to be called "delirium tremens" and "Korsakoff's psychosis."

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Alcoholic blackouts

answer

c. can occur with just moderate drinking.

question

Which of the following is the most significant barrier to getting an alcoholic into treatment?

answer

c. Overcoming denial

question

"Crack" is a form of

answer

b. cocaine.

question

The main reason addicts gave for using heroin was

answer

a. pleasure.

question

In what type of treatment are clients taught to recognize situations that are likely to trigger drinking?

answer

c. Relapse Prevention Treatment

question

Judd has been drinking heavily for a number of years. When he is not drinking, he experiences profuse sweating and shakes. This indicates that Judd

answer

b. has withdrawal symptoms when he abstains from alcohol.

question

Which of the following is most typical of the interpersonal attitudes and behaviors of someone with histrionic personality disorder?

answer

d. repeated manipulation of others to gain attention

question

An employee evaluation: "He takes what he wants rather than earns it. He hates routine and boredom more than anything else. Thrill-seeking and impulsive actions have gotten him fired from this job. It will get him fired at many others." What kind of disorder does the employee illustrate?

answer

b. Psychopathy

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There is a general agreement among researchers that personality

answer

b. can be characterized by five basic trait dimensions.

question

The individual with avoidant personality disorder behaves most similarly to someone with ________ personality disorder.

answer

c. schizoid

question

Which basic personality traits from the five factor model seem most important in the development of schizoid personality disorder?

answer

b. High introversion and low openness to feelings

question

The borderline personality differs from histrionic disorder in that

answer

d. the central role of sexuality is not present.

question

Individuals with personality disorders

answer

c. are unable to live up to societal expectations.

question

The individual with avoidant personality disorder is unlikely to develop lasting relationships as a result of his or her

answer

b. fear of rejection.

question

Unlike psychoactive substance abuse, psychoactive substance dependence usually involves

answer

a. physiological symptoms such as tolerance and withdrawal.

question

The drug that can create a state most like psychosis is

answer

b. LSD.

question

Brendan has been using marijuana daily for more than six years. If he stops using the drug, we may expect

answer

a. withdrawal-like symptoms such as nervousness and changes in sleeping and eating.

question

The reciprocal influence model of alcohol use suggests that

answer

a. expectancies of social benefit can influence adolescents to begin or to continue drinking.

question

Cirrhosis of the liver

answer

c. is caused by overworking the liver trying to assimilate large amounts of alcohol.

question

Which of the following best explains why women tend to not "hold their booze" as well as men?

answer

b. Women metabolize alcohol less quickly than men.

question

The best description of the biological component of personality disorders is

answer

c. personality traits are inherited that predispose a person to developing a personality disorder.

question

Because they are regarded as being different from standard psychiatric syndromes, the personality disorders are

answer

c. coded on Axis II.

question

The individual with ________ personality disorder is likely to be described as rigid and cold.

answer

c. obsessive-compulsive

question

Emily calls her husband every day at work to ask him what she should make for dinner. She spends her days at her mother's, because Emily worries that something will go wrong in her own home that she won't be able to handle. Even though she paints and draws well, Emily has never tried to take a class or use her talent, because she says she knows she really isn't good enough. Emily's most likely diagnosis is

answer

b. dependent personality disorder.

question

Donna has borderline personality disorder. She is in therapy, but progress is slow. One problem is that some days she thinks her therapist is the most wonderful person in the world. On other days, she thinks he is worthless and untrustworthy. This type of thinking is called

answer

b. splitting.

question

Barbituate withdrawal

answer

b. is more dangerous and long-lasting than most drugs.

question

Unlike psychoactive substance abuse, psychoactive substance dependence usually involves

answer

a. physiological symptoms such as tolerance and withdrawal.

question

Endorphins

answer

b. are opium-like substances produced by the body.

question

A moderating variable is

answer

b. something that influences the connection between two other variables.

question

Passing out from a high blood level of alcohol

answer

a. may actually be a safety device

question

Antisocial personality disorder differs from psychopathy in the antisocial personality disorder is accurate?

answer

c. The personality disorder most often associated with alcohol abuse is antisocial personality disorder.

question

What "border" did the term "borderline" in borderline personality refer to?

answer

d. The behavior exhibited by people with borderline personality disorder lie on continuum between neurotic and psychotic disorders.

question

The tension-reduction model of alcoholism

answer

a. does not explain why some excessive drinkers are able to maintain control over their drinking while others are not

question

Sam shows little emotion and is a loner. He has no social relationships, other than his family, and he seems to experience little pleasure, if any. What personality disorder might Sam have?

answer

b. schizoid

question

Which of the following is a consequence of organic impairment resulting from long-term substance use, as opposed to being a consequence of drug toxicity?

answer

a. alcohol amnestic disorder

question

The reciprocal influence model suggests that

answer

b. it may be possible to interrupt the cycle by changing expectancies about drinking

question

Carl has psychopathy. You would expect him to

answer

b. be very interested in rewards and to continue his behavior quickly if rewards don't come as often as they did.

question

An example of a moderating influence would be

answer

a. the effect of time on outcome expectancy about alcohol

question

Personality disorders were once known as

answer

a. character disorders

question

Which of the following men has an alcohol-risk personality?

answer

c. sean, who is impulsive, risk-taking, and poor at planning

question

Which of the following statements is NOT true of treating personality disorders?

answer

d. People with both an Axis I and an Axis II diagnosis are easier to treat than people with just an Axis II disorder because they have more distress

question

In contrast to schizoid individuals, those with avoidant personality disorder

answer

c. are extremely upset by their lack of social relationships

question

Misdiagnosis are common when looking at potential personality disorders because

answer

b. may of the personality disorders share common features

question

Which statement about personality disorders is accurate?

answer

a. the category is broad and encompasses behavioral problems that vary widely in form and severity

question

About half the individuals with borderline personality disorder also qualify for a diagnosis of ______ as some time.

answer

c. a mood disorder

question

Which of the following is a factor that complicates determining the causes of personality disorders?

answer

a. The high likelihood that an individual with one personality disorder may also have another

question

Which of the following is true about the connection between psychopathy and antisocial personality disorder?

answer

b. many people who have antisocial personality disorder do not have psychopathy

question

Impaired memory and concentration, sluggishness, lack of motor coordination, and brain damage are side effect associated with excessive use of

answer

c. sedatives

question

Hope believes that she is the "star" of her graduate class and that the other students dislike her because they are jealous of her superior intelligence. She believes that she is entitled to be exempted from an important exam because of her outstanding performance in class. Hope probably suffers from

answer

b. Narcissistic personality disorder

question

Why does it make sense to view addiction as a mental disorder?

answer

a. The symptoms reflect behaviors that involve the pathological need for a substance.

question

Children of mothers who use crack

answer

c. are at risk for being mistreated by their mothers

question

______ personality disorder is much more common in men than women and involves the exploitation of others without remorse.

answer

a. antisocial

question

Antisocial personality disorder differs from psychopathy in that antisocial personality disorder

answer

c. focuses more on observable behaviors

question

Which basic personality traits from the five-factor model seem most important in the development of obsessive compulsive personality disorder?

answer

a. high conscientiousness and low compliance

question

Which statement about alcohol abuse disorders and other psychological disorders is accurate?

answer

c. The personality disorder most often associated with alcohol abuse is antisocial personality disorder

question

Schizophrenic disorders seem to be most strongly linked genetically to

answer

b schizotypal

question

Alcohol withdrawal delirium

answer

c. typically lasts from three to six days

question

Bill is an alcoholic. His wife, Marge, has a lot of ready excuses she uses to explain to his boss, their friends, and their children to explain his frequent absences. This is an example of

answer

b. why treatment needs to include identifying factors that may encourage drinking

question

In 2005, which of the following accounted for 11 percent of all drug-related emergency room admissions?

answer

d. heroin

question

Which statement about crack cocaine use is accurate?

answer

b. chronic users develop sexual dysfunctions and disinterest in sex

question

At a young age, children are not able to understand that the world that others experience is different from their own. Children also tend to overestimate their own abilities. A failure to outgrow these youthful characteristics might explain the development of _______ personality disorder.

answer

d. narcissistic

question

Avoidant personality disorder is extremely similar to and hard to distinguish from

answer

a. generalized social phobia

question

Which of the following is a diagnosis found in the DSM-IV-TR?

answer

d. Substance-Dependence Disorder

question

Keith constantly complains life is just "what you do while you're waiting to die" with a mood constantly that of a "sad sack." He says his job at the factory is lousy, but it is the best he can do (although he has a college degree in business). He doesn't' see the point in trying to change anything because he doesn't believe things will ever get better. What is Keith's most likely diagnosis?

answer

b. depressive personality disorder

question

John has a great need for oder and perfectionism. He can't leave the house until every hair is in place, and he has been known to iron the same shirt over and over to ensure that he is wrinkle-free. What personality disorder does John's behavior suggest?

answer

c. Obsessive-compulsive disorder

question

Binge drinking in college

answer

c. can lead to may alcohol-related health and life problems.

question

Helena has avoidant personality disorder. She is likely to

answer

d. be hypersensitive to any sign of criticism or rejection

question

Who is most likely to develop antisocial personality disorder?

answer

d. A child with conduct disorder and A or B

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