8003 FINAL items + lecture Flashcards by Alexander Nachlis

A diagnosis of Schizophrenia is associated with a reduction in life expectancy by as much as 20 percent. What is the number one cause of premature death among individuals diagnosed with schizophrenia?
a. Cardiovascular disease
b. Suicide
c. Type II Diabetes Mellitus
d. Human Immunodeficiency Virus (HIV/AIDS)

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Several studies have shown that over the 5 to 10-year period after the first psychiatric hospitalization for schizophrenia, only about 10 to 20 percent of patients can be described as having a good outcome. Which of the following indicates a positive prognostic factor in the treatment of schizophrenia?
a. Positive symptoms
b. Negative symptoms
c. Childhood or adolescent onset
d. Insidious onset

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Serotonin is widely recognized as a modulator of neural activity and its receptors are broadly targeted in a variety of psychiatric drugs. In what area of the neuron is the biogenic amine serotonin synthesized?
a. Dendrite
b. Soma
c. Node of Ranvier
d. Axon terminal

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Studies have shown that pubertal development was significantly related to structural maturation of all six regions of the brain in both sexes. Which of the following statements is most accurate regarding teenage brain development?

a. THC can retard developing portions of the brain including impairing the ability of the prefrontal cortex to fully develop.
b. The prefrontal cortex appears to shrink prior to puberty.
c. Sedentary lifestyle and high screen time during age of 13-18 years old has shown a 5% loss of grey matter.
d. There is a loss of synapse formation during puberty.

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Eric Erikson believed that people move through a series of several psychosocial stages throughout the lifespan. According to Erikson’s psychosocial stages theory, what stage would a 13-year-old be entering?
a. Initiative vs. Guilt

b. Intimacy vs. Isolation

c. Identity vs. Role Confusion
d. Industry vs. Inferiority

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Which of the following medications requires routine blood level monitoring?

a. Nortriptyline (Pamelor)

b. Sertraline (Zoloft)

c. Venlafaxine (Effexor)

d. Bupropion XL (Wellbutrin XL)

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Which of the following most accurately describes clinical aspects of bipolar disorder?
a. Bipolar disorder is a chronic illness and will require consistent medication management throughout the lifetime to prevent relapse of symptoms
b. Bipolar illness is not a chronic illness and can go into remission after one year of medication management where patients can stop all medications
c. Bipolar illness presents with manic episodes, but no more than 5 manic episodes in a lifetime
d. Bipolar illness presents with depressive episodes, but no more than 5 depressive episodes in a lifetime

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Which of the following most accurately describes the prognosis for Bipolar II as compared to Bipolar I?

a. Bipolar II is a less chronic course of illness compared to bipolar I

b. Bipolar II has an increased risk for suicide compared to bipolar I

c. Bipolar II has longer periods of time between depressive episodes compared to bipolar I

d. Bipolar II patients spend the majority of time in hypomanic episodes

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Which of the following is the most effective treatment for people with mood disorders?

a. Physical Activity

b. Psychotherapy Alone

c. Pharmacotherapy Alone

d. Psychotherapy & Pharmacotherapy

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Which of the following is the best indicator when assessing for risk of suicide?
a. Family support structure
b. Being unemployed
c. Past suicide attempt
d. Currently on psychiatric medication

Past suicide attempt is the correct answer. Past suicide attempts are the best indicator for risk (Tyson, 2023).

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Which of the following is the most accurate assessment scale to predict risk of suicide?
a. beck anxiety inventory (BAI)
b. the Adult ADHD Self-Report Scale (ASRS)
c. mood disorder questionnaire (MDQ)
d. The Columbia – Suicide Severity Rating Scale (C-SSRS)

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Which of the following most accurately describes a static factor in evaluating Dissociative Identity Disorder (DID)?

a. past history of trauma
b. difficulty getting along with others
c. experiencing memory loss
d. switching between personalities

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It is well known that somatic symptom disorder presents more often in females. What other feature is most accurate in the prevalence of somatic symptom disorder (SSD)?

a. SSD has not been shown to be impacted by a person’s cultural background
b. SSD is inversely related to social position and occurs most often with persons with little education and low incomes
c. There is no difference in SSD’s prevalence across different countries
d. SSD consists of four subtypes

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Which most accurately describes the prevalence of separation anxiety in the US population?
a. separation anxiety is most prevalent in adults age 21-30 years old
b. separation anxiety is most prevalent in adolescents age 13-16 years old.
c. separation anxiety is most prevalent in adults age 30-40 years old.
d. separation anxiety is most prevalent in children younger than age 12 years old.

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Which of the following is the most accurate in the development and course of selective mutism?
a. selective mutism is more prevalent in males
b. selective mutism usually develops before 5 years of age
c. selective mutism is never found with comorbid anxiety disorders
d. selective mutism usually develops after 10 years of age

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How many types of personality disorders are currently listed in the DSM 5?
a. 3
b. 10
c. 5
d. 2

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Which of the following most accurately describes cluster B antisocial personality disorder?
a. often unstable personal relationships, impulsive behavior, chronic emptiness, chronic fears of abandonment, reckless behavior and suicidality, Attention seeking behavior, and splitting.
b. often strives to be the center of attention, attention seeking in socially inappropriate situations, provocative interactions, theatrical expressions, false sense of intimacy, and very superficial
c. strong sense of entitlement, extremely negative reactions to criticism, elevated sense of self-importance, have difficulty showing empathy or remorse, preoccupation with grandiosity or success.
d. general disregard and violation of rights of others, high prevalence in the prison population, deceptive, focus on personal gain, disregard for the law, and little or no remorse.

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Which of the following diseases is clinically similar to Alzheimer disease, but presents with hallucinations, parkinsonian features, capgras syndrome, and extrapyramidal signs?
a. frontotemporal dementia
b. huntington disease
c. lewy body disease
d. binswanger disease

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There are two separate classifications for the diagnosis of cognitive impairments; mild and severe. Which of the following most accurately describes how to select the correct classification when diagnosing?
a. slight decline in decision-making alone is classified as major
b. slight decline in 1 daily function is considered major
c. Delirium is classified as mild cognitive impairment
d. determined by the degree to which the condition affects their level of independence.

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What is considered the most complex organ in the entire human body?
a. Heart
b. Kidney
c. Brain
d. Liver

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Which lobe of the brain is primarily responsible for motor skills, higher cognition and expressive language?
a. Frontal Lobe
b. Parietal Lobe
c. Temporal Lobe
d. Occipital Lobe

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Which region of the brain is considered the “thermostat of the body”?i
a. Hypothalamus
b. Thalamus
c. Cerebellum
d. Basal Ganglia

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Which system of the brain is responsible for emotional responses?
a. Sensory
b. Somatosensory
c. Motor
d. Limbic

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In what part of the neuron is Serotonin synthesized? a. Axon Terminal b. Soma c. Dendrite d. Nucleus

What is the precursor amino acid for Serotonin? a. Histamine b. Tryptophan c. Acetylcholine d. Glutamate

Which of the following is considered a Peptide Neurotransmitter? a. Substance Y b. Neuropeptide P c. Corticotropin-Releasing Factor d. GABA

What changes are noted in the teenage brain in the 2002 landmark study conducted by Giedd, et. al? a. Prefrontal cortex appears to grow right before puberty b. There is a 2nd wave of synapse formation noted around ages 11-12 c. Between 13-18 years of age, the teenage brain loses approximately 1% gray matter d. All of the above

Regarding the female versus the male brain during development over the teenage years, which one of the following statements is true? a. The female brain is 10% larger than the male brain b. Male brains mature earlier than female brains c. The basal ganglia is larger in teenage females than in teenage males d. The basal ganglia is smaller in teenage females than in teenage males

Regarding the neurogenetics of Schizophrenia, if a patient has a first degree relative with Schizophrenia, what is their chance of developing the disease? a. 1% b. 5% c. 10% d. 25%

Select the statement that is FALSE: Pruning is the process of removing and decreasing brain structures such as axons, synapses, and neurons from the number present at birth. Pruning causes deactivation of certain brain structures once they have performed their designated functions such as production of neurotrophic and growth factors In utero fetal brains have more neurons than will be needed once adulthood is reached There are approximately twice as many synapses present at birth in the cerebral cortex than early and mid-life.

Which rooting reflex is present at birth according to Boland and Verduin (2022)? The glabellar reflex (Myerson’s Sign) The palmomental reflex The Babinski reflex The Huntington's reflex

Warning signs of school violence include: Social withdrawal Uncontrolled anger Drug and alcohol use All of the above

Bradykinesia is An inability to initiate movements Quick and repetitive movements Clonic movements of the arms and legs Slow, flapping movements of the arms

Language comprehension is processed at three levels. These are: Phonologic, cortical and Wernicke processing centers Lexical, Broca and vestibular processing centers Phonologic, lexical and semantic processing centers Cochlear, semantic and Wernicke’s processes centers

Where is serotonin found in the body? The majority of serotonin is found in the spinal cord but can also be found in platelets, mast cells and enterochromaffin cells. Less than 2% is found in the body and more than 80% is found in the gut. Because serotonin cannot cross the Blood Brain Barrier (BBB) it gets trapped in this space. It is synthesized by the amino acid tyrosine and taken up to the brain using active transport.

According to Jean Piaget the stages of cognitive development, in order, are: Formal operations, concrete operations, preoperational thought, then formal thought Preoperational thought, sensorimotor, concrete operations, then formal operations. Sensorimotor, concrete operations, formal operations, then preoperational thought. Sensorimotor, preoperational thought, concrete operations, then formal operations.

Mary Ainsworth was a developmental psychologist from Canada that describes the three main insecure attachment types as insecure-avoidant, insecure-ambivalent and: Insecure-disorganized Insecure-organized Insecure-detachment Insecure-indecisive

Which statement is FALSE about the history of the DSM? According to Halter, Rolin-Kenny, and Grund (2013) the 1840 US Census was the first attempt to capture data on mental illness. Epilepsy was once considered a psychiatric disorder. The International Statistical Classification of Disease (ICD) was developed and suggested to be updated annually Military and Veterans Affairs created their own version of classifying mental disorders to include anxiety and stress reactions. This was known as The Medical 203.

The Model of Mental Health as Maturity defines mental health as: Most people would be included in normality while a smaller portion would be considered abnormal; people fall somewhere on the continuum. The human brain takes a lifetime to develop and leads to mental health as opposed to other organs that are healthier earlier in life. The analgram of positive emotions that bind us all together. Emotional intelligence is the defining piece to this model and is a subjective experience.

nconsistency among a person’s beliefs, knowledge, and behavior is known as what theory? A. Social learning theory B. Attribution theory C. Avoidance theory D. Cognitive dissonance

The focus on how a person perceives the causes of behavior is known as what theory? A. Avoidance theory B. Cognitive dissonance C. Attribution theory D. Social learning theory

Which part of the brain is responsible for learning? A. Occipital lobe B. Medulla and pons C. Hippocampus and cerebellum D. Frontal lobe

Broca and Wernicke have identified areas of the brain involved in what? A. Habituation and sensitization B. Speech and language C. Aggression and competition D. Circadian rhythm and sleep

Symptoms of cannabis withdrawal have been what? A. Restless leg syndrome, disruptive mood, binge eating disorder. B. Increased appetite, sleep disturbance, agitation C. Nightmares, imagining being stoned, cravings. D. Sleep-related hypoventilation, excoriation, disinhibited social engagement disorder.

Who was responsible for first proposing mental illness is a disease of the brain? A. Erik Kraepelin B. Hippocrates C. John Bowlby D. Jean Piaget

What is the component of one’s personality that is responsible for dealing with reality according to Sigmund Freud? A. Conscious B. Superego C. ID D. Ego

The act of taking out feelings/impulses etc. on those that won’t result in a true threat is what? A. Repression B. Denial C. Displacement D. Reaction Formation

Erikson believed that people move through a series of how many psychosocial changes throughout their lifespan? A. Four B. Twelve C. Ten D. Eight

Treating someone who you dislike as someone you really like to hide your true feelings is an example of what? A. Displacement B. Reaction Formation C. Denial D. Repression

What age group is Dominique-R designed for? Ages 6-11 Ages 4-6 Ages 12-17 Ages 2-3

Prolactin levels can sometimes be elevated in antipsychotic and mood stabilizing medications. Which medication is Prolactin commonly elevated in? Lithium Carbamazepine Risperdal Nortriptyline

An overdose of these medications can be lethal. Tricyclics FGA SGA Benzodiazepines

Who first proposed Mental illness a disease of the brain? Eric Kraeplin Hippocrates Evelyn Hooker Jean Piaget

Who was a British psychoanalyst and originated attachment theory? Eric Kraeplin Hippocrates Evelyn Hooker John Boldy

What is not a role of culture? Note the individuals cultural reference group Assess the degree of involvement with identified cultural group If immigrant, pay particular attention to the pre-immigration experience Where the Patient was last weekend

What is an example of lifetime prevelance? Number of persons who have disorder at a specified point Number of persons who have disorder at some time during their life which is measured as specific point in time Number of persons being treated for a disorder obtained by counting those in a defined geographic area Number of person who have disorder at a specified period

What part of Freud’s system provides guidelines for making judgments and emerges at around 5 years? A. Ego B. ID Unconscious D. Superego

What genetic term is an inherited characteristic? A. Genome B. Proband C. Traito D. Allele

What is the peak ages that men develop Schizophrenia? 5-10 25-35 10-25 35-45

What mental health disorder is most associated with disruption of the biological rhythms? a. Anxiety b. Depression c. Anorexia d. Dementia

When dopamine levels are elevated classic symptoms of what disorder are seen? a. ADHD b. Bipolar Disorder c. Schizophrenia d. Obsessive Compulsive Disorder

Where is serotonin synthesized? a. Axon hillock b. Soma c. Dendrite d. Axon terminal

Prenatal exposure to all below prescribed medications can results in abnormalities in the newborn EXCEPT: a. Minocycline b. Warfarin c. Valproate d. Clindamycin

The Rorschach Test is one of the common assessment instruments used by clinicians. What does the Rorschach test? a. Intelligence b. Memory c. Personality d. Cognition

Defense mechanism is a tactic used to safeguard the mind against feelings and thoughts that are too difficult for the conscious mind to deal with. George Vaillant used a classification system to catalog the four types: Narcissistic Defenses, Immature Defenses, Neurotic Defenses and Mature Defense. Which one of these four defense systems is most likely when an individual shows signs of altruism? a. Narcissistic Defense b. Immature Defense c. Neurotic Defense d. Mature Defense

Examples of medical conditions that more commonly present with neuropsychiatric symptoms that must be ruled out before moving forward with a mental health disorder diagnosis include all the following except: a. Vitamin B12 deficiency b. Systemic Lupus Erythematous c. Primary Sjogren’s Syndrome d. Hypothyroidism

Mental health issues that present with audiovisual hallucinations or paranoid delusions, like schizophrenia, signify a dysregulation or chemical imbalance in which system? a. Somatosensory System b. Limbic System c. Motor System d. Sensory System

A child completes all his assignments on time every day for one week as asked. The consequence of this behavior is letting the child skip chores at home for 2 days. Taking into consideration The Law of Effect in Operant Learning. Which is taking place in the above example? a. Positive Reinforcement b. Negative Reinforcement c. Positive Punishment d. Negative Punishment

Lucy had her first schizophrenic episode during her freshman year in college. She was not diagnosed with schizophrenia until 1 year after her first episode. Her treating doctor understands this to be an important time in the disease progression because the most effective time to prevent brain tissue loss as well as other effects of schizophrenia are in: a. The first two years after the first psychotic break. b. The first year after a confirmed diagnosis. c. The first year after the first psychotic break. d. The first two years after a confirmed diagnosis.

To meet criteria in DSM-5 for major Depressive Disorder, 5 or more symptoms MUST be present in the same 2 week period. At least 1 of the criteria must include which of the following? A. Insomnia or hypersomnia nearly everyday B. Fatigue or loss of energy C. Loss of interest or pleasure D. Psychomotor agitation or retardation

SY is a 9 year old male who presents for an initial interview. He is accompanied by his mother, who provides some background information. Her main concerns include, falling asleep at school, excessive mood swings, anger outbursts, inappropriate laughter, especially during instruction at school, difficulty concentrating and difficulty sleeping. After obtaining background information, which assessment would be lease likely to be administ3ered at this time? A. K-SADS B. CAPA C. CIPS D. PHQ-9

Pathologically, the definition of mental disorder or disability does Not meet criteria if which of the following are NOT present? A. Clinically significant occupational distress B. Anhedonia C. Fatigue D. Incongruent mood

Prior to DSM-5 criteria, Bluelers 4 A’s helped delineate symptmos of schizophrenia. Which of the following is NOT one of the 4 A’s? A. Association B. Affective C. Ambivalence D. Aggression

What is the number one cause of premature death in Schizophrenia? A. Heart Attack B. Suicide C. Accidental drug overdose D. Infection

In treatment of mood disorders, it is recommended to use the following : A. ECT only B. Medication alone C. Psychotherapy only D. Medication and psychotherapy together

Which class of medications used to treat major depressive disorder causes significant increased need to monitor dietary intake due to medical contraindications? A. SSRI’s B. MAOI’s C. Tricyclic Antidepressants D. Mood stabilizers

Which of the antipsychotics are most beneficial in treating anger/rage? A. Risperdal B. Fluoxetine C. Lurasidone D. Latuda

Which of the following would NOT be considered part of Bipolar Manic episode? A. Spending increased amounts of money they do not have B. Increased/hypersexuality C. Anhedonia D. God-like complelx

When someone is in a full-blown manic episode, which of the following is the most important consideration? A. Start medications right away B. Give individual referral for therapy C. Make sure the patient is safe from harm D. Wait for a 2nd episode to start treatment.

SA, a 21-year-old male reports hearing voices that others can't hear, and he often believes that people are conspiring against him. A neuroimaging scan reveals abnormalities in the Brain. Which component of the Brain is unlikely to be affected in SA case and is not relevant to the symptoms of schizophrenia? A) Third ventricle & Lateral ventricle B) Prefrontal cortex & Thalamus C) Adrenal cortex & medulla D) Hippocampus &Amygdala

The following statement describes one of the Neurotic defense mechanisms “The management of unacceptable impulses by permitting expression of the impulse in antithetical form” (Boland et al., 2022). Which one is correct? A) Repression B) Reaction formation C) Inhibition D) Displacement

Select the correct order of the 4 Cognitive Development Stages created by Jean Piaget, who had significant interactions with children in both educational and clinical contexts, as mentioned in (Boland et al., 2022). A) Sensorimotor, preoperational thought, concrete operations, and formal operations. B) Preoperational thought, Sensorimotor, concrete operations, and formal operations. C) Somatosensory, concrete operations, preoperational thought, and formal operations. D) Sensorimotor, preoperational thought, formal operations, and concrete operations.

When you ask a child, “Who is guiltier, the person who breaks one dish on purpose or the person who breaks ten dishes by accident?” the child’s answer will be the person who breaks more dishes is guilty. According to Stages of Intellectual Development Nominated by Piaget (Boland et al., 2022), which stage is mentioned above? A) Formal operations B) Sensorimotor C) Preoperational thought D) Concrete operations

This learning theory is centered on homeostasis. What is the name of this theory? A) Hull drive reduction theory B) Kandel habituation & sensitization C) Pavlov classic conditioning D) Skinner operant conditioning

Fifteen new disorders were added to the DSM 5. Which of the following are included within the fifteen disorders? A) Central Sleep Apnea and Sleep-Related Hypoventilation. B) Bipolar disorder unspecified C) Cocaine withdrawal D) Insomnia Disorder

Which of the following statements are true regarding the limbic system's involvement in neuro-pathologic studies of schizophrenia and Eugen Bleuler's four A's? (Boland et al., 2022). A) Loss of association, social awkwardness, altruism, and flat affect. B) Affect, associations, ambivalence, and autism. C) Mixed feelings, appropriate affect, decreased eye contact, and psychomotor agitation. D) Euthymic, loss of association, ambivalence, and flat affect.

All the following statements are correct except one concerning schizophreniform disorder. Which statement is false? A) Schizophreniform disorder symptoms are short-term and lasting at least 1 month but less than 6 months. B) Schizophreniform disorder is an acute psychotic disorder with a rapid onset and lacks a long prodromal phase. C) If the duration of the symptoms in schizophreniform disorder exceeds 1 year, then schizoaffective should be considered. D) Schizophreniform disorder is unlikely to report a progressive decline in social and occupational functioning.

One of the mature defense mechanisms is where the person has a “gratification of an impulse whose aim is changed from socially objectable one to socially valued one.” Which one of the following is correct? A) Altruism B) Anticipation C) Humor D) Sublimation

Which one of the following is the primary characteristic of Cyclothymia. Cyclothymia is one of the mood disorders? A) Prolonged periods of severe mania B) Recurrent episodes of full-blown major depression C) Frequent mood swings between hypomania and mild depression D) Complete absence of mood disturbances

Who emphasized how children think and acquire knowledge? a. Sigmoid Freud b. Mary Ainsworth c. Piaget d. John Bolbie

Attachment theory created between 1979-1990. The theory studied infant attachment and separation, Attachment developers gradually resulting in infants wanting to be with a preferred person, who it perceives as the person who is wiser, stronger and the person who reduces his/her anxiety or distress (Boland, Verdiun, & Ruiz, 2022, p. 1011). Who is the creator of the attachment theory? a. Sigmoid Freud b. John Bolwlby c. Piaget d. Gerber

Pick the statement that is True. a. Suicide is the third leading cause of death among adolescents worldwide (Centers for diease control and Prevention, 2023). b.Drug overdose is the leading cause of death among adolescents. c.Covid is the leading cause of death worldwide among young adults. d.All of the above

When evaluating a patient with psychotic symptoms. You should evaluate for other causes of those symptoms. What other diseases processes can mimic psychotic symptoms? a.Neurosyphilis, AID, and Epilepsy b.Dm, HTN, and CHF c.Dementia d.Traumatic brain injury (TBI), substance use, and elevated ammonia levels. Answer A- Neurosyphilis, AID, and Epilepsy

True or False. A mental disorder is a syndrome characterized by clinically significant disturbances in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental process underlying mental functioning? a.True b.False

Patients with untreated schizophrenia often exhibit violent behavior. What are risk factors for that increase patient risk of violence? a. Persecutory delusions b. Hx of violence c. Neurological deficits d. All of the above

The symptoms of schizophrenia can be divided into 3 categories, positive symptoms, negative symptoms, and cognitive symptoms. Positive symptoms are considered abnormal behaviors. Negative symptoms are the absence of normal behavior, and cognitive symptoms are impairments in normal cognitive function. Hallucination, delusions, bizarre behavior, and positive formal thought disorder. Are examples of which category of symptoms related to schizophrenia (Boland, Verdiun, & Ruiz, 2022). a.Cognitive symptoms b.Negative symptoms c.Positive symptoms d.None of the above e.All of the above

Catatonic type of schizophrenia involves marked disturbance in motor function, this disturbance may involve stupor, negativism, rigidity, excitement, or posturing (Boland, Verdiun, & Ruiz, 2022). True or false a.True c.False

.In patients diagnosed with bipolar disorder with manic episodes, what percentage of patients have delusions? a. 100 b. 75 c. 50 d. 25

What is the minimum duration of treatment is acute phase of schizophrenia? (Boland, Verdiun, & Ruiz, 2022, p. 351) a. 4-8 weeks b. 3-9 weeks c. 12-24 weeks d. No specific time frames

Where is serotonin made? Axon terminal Schwann cell Cell body Axon Hillock

Abe struggles with depression and has a PMH of chronic pain, type 2 diabetes, and migraines, he takes fluoxetine 40 mg daily, trazodone 150mg daily, tryptophan supplement, a multivitamin, and l-theanine 400mg daily and occasionally 50mg sumatriptan and 50mg tramadol. After Thanksgiving day, Abe starts to feel very restless and anxious. Abe states, “I feel like I can’t stop moving”. What is most likely starting to happen to Abe? Serotonin syndrome Hyperglycemia, concerns for DKA (Diabetic Ketoacidosis) or HHS (hyperosmolar hyperglycemic state). He has been misdiagnosed and actually as ADHD. He is beginning to have a panic attack.

You are concerned about Pick’s disease in our patient. What are the initial symptoms you should be assessing for? Personality and behavioral changes Recurrent visual hallucinations Memory loss Loss of language comprehension

According to Erickson’s development theory, Which stage would a person be most likely to begin to struggle with gender dysphoria? Identity vs role confusion Intimacy vs isolation Autonomy vs shame and doubt Industry vs inferiority

According to Erikson, why would someone in the above stage of development most likely start to struggle with gender dysphoria? People are more concerned about how they appear to others and wanting to fit in. People continue to be focused on fantasies and childhood roles. People have a stable identity. People develop a virtue of fidelity.

Which of the following symptoms are pediatric patients most likely to complain of with depression? social withdrawal, isolation Loss of motivation Loss of interest in hobbies Eating too much or too little

In schizophrenia, which is the most commonly occurring substance being abused? nicotine methamphetamine cocaine LSD

You work in an outpatient clinic and are establishing care for a 13-year-old girl who was discharged 2 weeks ago from an inpatient facility for an overdose attempt with SI. Since the patient has been home, she has been complaining of insomnia due to, “not being tired”. Which medication should you heed caution about prescribing? Amitriptyline doxepin trazodone Hydroxyzine (Atarax)

You are working in the emergency department, and you have a patient who comes in with mental status changes, xerosis, headache, and visual changes. The patient takes no medications besides Accutane and endorses a diet of animal products, including dairy and liver. Which lab value will you check? Vitamin A Vitamin D Blood glucose TSH

You are treating an established patient with bipolar 2 disorder with depression who is currently on aripiprazole. The patient is complaining of ongoing irritability, anger, aggression and rage. Which medication would you consider changing the patient to? Risperdal (risperidone) Buproprion (Wellbutrin) Lithium Valproate (Depakene)

You are taking care of a patient with a history of depression who has tried various antidepressants with adequate dosing and time on each medication and also had a negative experience with an antipsychotic and is refusing to try another antipsychotic. You are considering starting the patient on Phenelzine (Nardil). What is the most critical information you can give the patient about this medication? Diet must remain free of fermented, aged foods, including: alcohol, cheese, and cured meats. Must be taken with food, at least 350 calories Should be taken at night to assist with sleep. Serum levels should be monitored monthly.

A male client has been taking his antipsychotic medication routinely and now has developed gynecomastia and also noticed some discharge. What labs would be elevated? A. AST/ALP B. Prolactin C. White blood count D. Fasting plasma glucose concentration

A female client just had routine labs from her PCP. Her PCP noticed that her BUN 50, creatinine 2 and TSH 1.5 elevated from her baseline labs 6 months ago. Her PCP reviews her medication list: Atorvastatin 20mg po daily, Metformin 500mg po BID, Lisinopril 10 mg po daily, Zoloft 50mg po at bedtime and Lithium 600mg po BID. Her last visit with her PMHNP was 1 month ago. The PCP refers her to see her PMHNP. What medication would cause these labs to increase? A. Atorvastatin B. Metformin C. Lisinopril D. Lithium

A client presents to the office for follow up Mental Health visit with complaint of difficulty standing, walking and aphasia. What lobe of the brain is responsible for her symptoms? A. Parietal B. Temporal C. Frontal D. Occipital

Which medication can cause Qt interval prolongation and should have a baseline EKG? A. Geodon B. Risperdal C. Clozapine D, Quetiapine

What neurotransmitter is synthesized in the axon terminal? A. Dopamine B. Serotonin C. GABA D. Acetylcholine

Mom brings in her 11-year-old son to be evaluated for behavioral issues at school. Teachers reports inability to focus and sit during lessons causing distracting behaviors for the rest of the class. What neuropsychiatric exam would be initiated? A. K-SADS B. CAPA C. MDQ D. PHQ-9

What part of the brain is associated with an emotional response causing positive symptoms such as hallucinations, agitation, and delusions? A. Cerebellum B. Hypothalamus C. Cerebral cortex D. Limbic system

17 -year old client presents to clinic for initial mental health evaluation. His mother is present at visit. Mother states his behavior has changed in the last month. She reports he has been hearing voices when no one else is in the room. What would the NP diagnosis? A. Schizophreniform B. Schizoaffective C. Bipolar D. Schizophrenia

This mental disorder is more prevalent in women with a later onset. It is defined with bipolar type with major depressive or manic episodes. A. Bipolar 1 B. Schizophreniform C. Schizoaffective disorder D. Schizophrenia

Bleuler was well-known for 4 A’s of Schizophrenia? A. Autonomy, Affective, Appropriate, Autoimmune B. Ambivalence, Alogia, Anhedonia, Avolition). C. Affective, Alogia, Anhedonia, Autonomy D. Association, Affective, Ambivalence, Autism

10 y/o Ashton presents to your office with his mother. While processing behavioral issues, Ashton states, “I’m sorry mom, I see how much it worries you when I don’t come home from my friends house on time.” Ashton is in what period of Piaget’s cognitive development? a) Concrete Operational b) Formal operational c) Pre-operational d) None of the above

In John Bowlby’s Attachment Theory, which of the below statement/s are true a) Infants become more attached to caregivers that reduce anxiety and stress b) Time spent with the infant is more important than activities enjoyed together c) Attachment is developed at first sight d) A and B

Suzie has her phone taken away for 24 hours because she came home 1 hour after curfew. By what method is Suzie learning? a) Classical conditioning b) Operant conditioning c) Behavioral conditioning d) None of the above

A good example of Cognitive Dissonance is? a) Leslie smokes even though she knows it causes cancer b) John was asked to file papers at his clerical job c) Jill Johnson PMHNP prescribed Lithium for mood swings d) B & C

Mike displays a hatred for homosexual men because deep inside he is attracted to men. What type of defense mechanism is Mike displaying? a) Distortion b) Repression c) Displacement d) Reaction Formation

Which one of the characteristics below is NOT one of Bleuler’s 4 As? a) Attentiveness: ability to follow tasks b) Associations: looseness of thoughts c) Affect disturbances d) Autism: social awkwardness e) Ambivalence: emotionally neutral

Antipsychotics are an effective treatment of various types of Schizophrenia. What mechanism of action do they perform? a) Selective serotonin reuptake inhibitor b) Prevents dopamine build-up in the brain c) Serotonin-norepinephrine reuptake inhibitor d) Both A & C

Which side effects below are positive side effects for schizophrenia? A) Volitional impairment B) Anhedonia C) Audio/visual hallucinations D) Alogia

What is the hallmark sign of mania/manic episode? A) Pressured speech B) Elevated, expansive, irritable mood C) Impaired judgement D) All the above

When choosing an anticonvulsant to treat Acute Bipolar Depression, as a PMHNP, you know the best choice is? A) Levetiracetam B) Lithium C) Lamotrigine D) All are effective anticonvulsant agents for Acute Bipolar Depression

Damage to what lobe would cause difficulties recognizing objects? Frontal Occipital Parietal Temporal

Degeneration of neurons in what area of the brain are associated with Parkinson’s disease? Medulla Pons Red nucleus Substantia Nigra

What neurotransmitter is most closely related to anxiety? Dopamine GABA Glutamate Serotonin

Repression is an example of what defense mechanism? -Immature -Mature -Narcissistic -Neurotic

What laboratory test may be helpful to explain symptoms of depression? -ammonia -Prolactin -renal function -TSH

Which of the following is an example of a semi structured assessment tool that does NOT require specific training? CAPA CAS DIS K-SADS

What symptom of schizophrenia is most likely to be associated with a good prognosis? -avolition -young onset -catatonia -hallucinations

Who would be the most at risk to attempt and complete a suicide a major depressive episode in the United States? -a 10-year-old male -a 16-year-old female -a 25-year-old male -a 45-year-old female

What medication should be avoided in patients in an alcohol detox program? -Celexa -Nardil -Paxil -Wellbutrin

What antipsychotic is most closely related to elevated prolactin levels that could lead to lactation or gynecomastia? Clozapine Ziprasidone quetiapine risperidone

According to the American Psychiatric Association, which of the following is typically a symptom of schizophrenia? Select All: a) Delusions b) Increased energy c) Hallucinations d) Disorganized thinking

a c d

Which of the following factors is considered a risk factor for schizophrenia according to the APA? a) Alcohol addiction b) Obesity c) Consuming a high-fat diet d) Having a family history of the disorder

Which organization publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)? a) World Health Organization b) National Institute of Mental Health c) American Psychological Association d) American Psychiatric Association

What is the primary purpose of the DSM-5 according to the APA? a) To provide psychotherapy techniques b) To classify and diagnose mental disorders c) To outline treatment modalities for all known diseases d) To guide research in psychology

Which of the following statements is true regarding the distinction between Schizophrenia and Schizophreniform Disorder? a) Schizophreniform Disorder involves more severe symptoms than Schizophrenia. b) Schizophrenia has a shorter duration of symptoms than Schizophreniform Disorder. c) The primary distinction between the two is the duration of symptoms. d) Schizophreniform Disorder always transitions into Schizophrenia.

According to DSM-5 criteria, which of the following is required for a diagnosis of Schizophreniform Disorder? Select All: a) Hallucinations b) Major depressive episode c) Delusions d) Disorganized speech

a c d

Which of the following mood episodes can be present in Schizoaffective Disorder? a) Depressive b) Manic c) Hypomanic d) All of the above

Which factor differentiates Schizophrenia from Schizoaffective Disorder? a) The presence of hallucinations b) The severity of delusions c) The presence of a major mood episode d) The presence of disorganized speech

The gap between two neurons where communication occurs is known as: a) Neurotransmitter b) Vesicle c) Synapse d) Receptor

Which of the following structures of a neuron receives incoming signals from other neurons? a) Axon b) Dendrites c) Myelin sheath d) Synaptic vesicles

Which of the following is an example of a “positive symptom” of schizophrenia? A.) Absence of affect B.) Absence of attention C.) Delusions D.) Social inattentiveness

Which disorder is defined as a psychotic condition that involves the sudden onset of psychotic symptoms which lasts 1 day or more but less than 1 month with full remission and the individual returns to the premorbid level of functioning? A.) Delusional disorder B.) Brief psychotic disorder C.) Bipolar I Disorder D.) Bipolar II Disorder

What is considered a “hallmark” of mania? A.) Poor concentration B.) Grandiose thoughts C.) Distractibility D.) Pressured speech

Sarah has Bipolar I disorder for which she takes Lithium carbonate. Which of the following lithium levels indicate that Sarah is within a therapeutic range? A.) 1.6 mEq/L B.) 0.4 mEq/L C.) 0.8 mEq/L D.) 1.8 mEq/L

Which statement made by a patient would distinguish dysthymia from major depressive disorder? A.) “I have always been depressed.” B.) “I have a hard time sleeping.” C.) “I feel hopeless.” D.) “I have no energy and just feel depressed.”

Nate is an adolescent with autism spectrum disorder who has been exhibiting severe irritability despite behavioral therapy. Which of the following medications is considered the first line of medication treatment for children and adolescents with autism spectrum disorder who exhibit severe irritability and may be a good option for Nate? A.) Haloperidol B.) Risperidone C.) Ziprasidone D.) Quetiapine

Which antipsychotic is considered the most effective for treatment the of schizophrenia, particularly in patients who have been unresponsive to other treatments but is a challenging drug to administer due to its risk of both severe side effects? A.) Cariprazine B.) Aripiprazole C.) Olanzapine D.) Clozapine

8.) What is the single leading cause of premature death among people with schizophrenia? A) Drug Overdose B) Suicide C.) Heart disease D.) Stroke

A patient is prescribed a second-generation antipsychotic. All the following should be monitored except: A.) BMI B.) Fasting blood glucose C.) Lipid profile D.) Liver enzymes

What is the first choice of agents for pharmacologic treatment of ADHD? A.) CNS stimulants B.) Antipsychotics C.) SSRIs D.) Benzodiazepines

Delusions occur in what percentage of manic bipolar disorder patients? 50% 75% 60% 80%

Which of the following are types of short-term psychotherapies? A. Interpersonal B. Cognitive C. Behavioral D. All of the above

DSM-5 classifies the severity levels of intellectual disability into what four categories? Mild , average, above average, profound Low, minor, major, critical Mild, moderate, severe, profound Minor, moderate, major, critical

Symptoms of schizophrenia are divided into what three groupings? Positive, negative, cognitive Mild, moderate, severe Minor, major, critical None of the above

Nondeclarative memory includes which of the following? Skills and habits Priming Nonassociative learning All of the above

What term was coined in 1975 by Edward Obsbone Wilson, an American biologist, whose book emphasized the role of evolution in shaping behavior? Ethology Sociobiology Phenology Ecology

There are four major stages that lead to the capacity for adult thought. What is the third stage of this capacity? Formal operations Preoperational thought Sensorimotor Concrete Operations

Memory consists of various subtypes, however, amnesia affects only one kind of memory. What memory does amnesia affect? Declarative memory Cognitive memory Nondeclarative memory None of the above

The human brain contains approximately 85 billion glial cells. Of these types of glial cells, which one is the most common? Microglia Dendrites Oligodendrocytes Astrocytes

Body muscle movements are controlled by what neurons? Upper motor neurons Basal ganglia Lower motor neurons Cerebellum

What is the best treatment option for mood disorders? a. Medications b. Psychotherapy c. Socialization d. Medications in combination with psychotherapy

When is Electroconvulsive Therapy (ECT) contraindicated for a patient with a mood disorder? a. The patients illness is severe, the patient is suicidal and was just started on a Selective Serotonin reuptake inhibitor (SSRI) 3 days ago. b. The patient is pregnant. c. The patient has a brain tumor. d. The patient has had medication trials which have been unsuccessful.

Lithium is processed by the kidneys and has a narrow therapeutic range. Due to risk of toxicity, what maintenance range should Lithium be kept? a. 0.5-1.3 mEq/L b. 1.2-2.6 mEq/L c. 0.6-1.2 mEq/L d. 0.8-1.5 mEq/L

During childhood, when it comes to psychological disorders, which is more common in girls than boys? a. ADHD b. Autism c. Tourette syndrome d. Anorexia Nervosa

There is a theory in psychology that suggests that cannabis can have a detrimental effect on the brain of a teenager, this is due to the brain sometimes not being fully developed until what age? a. 30 b. 6 c. 25 d. 10

What do most antipsychotic mediations do to help with symptoms of schizophrenia? a. Block dopamine build up in the brain b. Increase the amount of dopamine found in the brain c. Increase Serotonin found in the brain d. Decrease gamma-aminobutyric acid (GABA) found in the gut.

Who originated work in the Attachment Theory? a. Freud b. John Bowlby c. Carl Rogers d. Jean Piaget

Which of these Assessment Instruments is used to test cognition? a. Rorschach Test b. Mini Mental Status Exam c. Wechsler Memory Test d. Minnesota Multiphasic Personality Inventory (MMPI)

According to Freud, the ego functions in the _____? a. Conscious, pre-conscious and the unconscious mind b. The conscious mind only c. The unconscious mind only d. The superego

When it comes to the prevalence and incidence of depression, which of the following is true? a. Depression is found in more men than women. b. The mean onset for major depression disorder (MDD) is age 40. c. Depression is found more in those who have higher economic status than those with lower economic status. d. Caucasian Americans have a higher incidence of depression than African Americans and Asian Americans.

What is described as the foundational paradigm from which all biology arises and it’s also described as any change in the genetic makeup of a population? a. Reproduction b. Evolution c. Biology d. Competition

Culture shapes how psychiatric symptoms are expressed. What should be a component of every complete psychiatric assessment? a. Cultural assessment b. Food aversions c. Social media d. Temperament

Manic patients are excited, talkative, sometimes amusing, and frequently hyperactive. Which type of speech is considered a hallmark of mania? a. Manic speech b. Hyperactive speech c. Depressed speech d. Pressured speech

Selective serotonin reuptake inhibitors (SSRI’s) are believed to exert their therapeutic effects through serotonin reuptake inhibition. All of these are SSRI’s except a. Celexa b. Venlafaxine c. Prozac d. Paxil

The most common clinical mistake leading to an unsuccessful trial of antidepressant is the use of too low a dosage for too short a time. How many weeks should an antidepressant be raised at a maximum level and maintained at that level before a drug trial is considered unsuccessful? a. 4 to 5 weeks b. 10 days c. 2 or 3 weeks d. 8 to 10 weeks.

In contrast to major depressive disorder, Which disorder has a roughly equal prevalence among men and women? a. Depression b. Manic episodes c. Bipolar 1 disorder d. Bipolar 2 disorder

This hormone is a posterior hormone involved in osmoregulation, it also has been used experimentally in autistic children to increase socialization, what is it called? a. Melatonin b. Prolactin c. Oxytocin d. Insulin

What is the name one of the boundaries of the limbic system, which is a critically important gate through which internal and external stimuli are generated? a. Septum b. Basal forebrain c. Amygdala d. Orbito-frontal complex

Part of the basal ganglia, the caudate nucleus acts as a gatekeeper to allow the motor system to perform acts that are goal directed. When the caudate nucleus fails to perform, all of these may happen except? a. Tourette’s b. OCD c. Bradykinesia d. All the above

Substance use is related to a variety of behaviors. Adolescents with inadequate social skills may use a substance as a modality to join a peer group. Which substance with an abrupt cessation used heavily by adolescents can result in insomnia, irritability, restlessness, drug craving and depressed mood followed by anxiety? a. Marijuana b. Alcohol c. Cocaine d. LSD

What parts of the brain make up the limbic system? a. hypocampus and amygdala b. cerebellum and thalmus c. hypothalmus d. cerebral cortex

The limbic system is responsible for what symptoms in schizophrenia? a. alogia b social inattentiveness c. affective flattening d. auditory hallucinations

New disorders identified in the DSM5 included: a. hoarding b cannibus withdrawal c. central sleep apnea d. all of the above

A patient presents with major depressive disorder and his predominate symptom is rage. Which medication would be best for treating this patient? a. Prozac b.Wellbutrin c. Risperdal d. Celexa

The difference in prognosis/severity of Bipolar 1 and Bipolar II is: a. type 1 is more severe because it has more manic episodes and requires a lifetime of medications b. type 2 because it has shorter periods of time between episodes c. type 1 because it starts with depression d. type 2 because there is an increased risk of suicide

Differential diagnosis for mania include: a. AIDS/HIV, substance abuse, hyperthyrodism b. hypothyroidism, measles, alcohol withdrawal c.coxsakies virus, rheumatic fever, hypotension d. AIDS/HIV, rubella, hepatitis C

Serotonin originates in the a. axon terminal b. cerebral cortex c. pituitary gland d. tyrosine vessel

The 4 A’s of Schizophrenia identified by Blueler include: association, affective disturbances, autism, and ambivalance. The patient exhibiting inappropriate social cues is displaying: a. association b. autism c. ambivalence d.affective disturbances

Attachment theory was originated by John Bowlby in early 1900 and he defined attachment as: a. change in behavior resulting from repeated practice b. emotional tone between children and their caregivers c. the ability of a parent to care for a child d. the theory of a child becoming attached to a material object

When therapists present drugs and psychotherapy as complementary to a client they are practicing which theory: a. attribution theory b. attachment theory c. learning theory d.operant conditioning theory

The hypothalamus is the part of the limbic system located in the cerebrum. As a driver of the autonomic system, the hypothalamus helps to regulate all of the following EXCEPT: a. Appetite b. Body temperature c. Libido d. Maintain balance

Sexual Maturity Rating (SMR) or Tanner Stages classifies the physical development of primary and secondary sex characteristics in children, adolescents, and adults. As a PMHNP, you are conducting a physical exam of a girl. The following results are which SMR or Tanner stage? The Female examined identified enlargement of the breast and areola but no separation in contour. The pubic hair is coarser, darker, curlier, and sparsely spread over the junctions of pubes. a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4 e. Stage 5

Neuroimaging measures brain structures, areas of function, and chemistry. All of the following are examples of neuroimaging EXCEPT: a. Computer Tomography (CT) b. Electroencephalogram (EEG) c. Magnetic Resonance Imaging (MRI) d. Positron Computer Tomography (PET) e. Single Photon Emission Tomography (SPECT)

What neuropsychological assessment instrument would a Psychiatric Mental Health Nurse Practitioner (PMHNP) utilize to evaluate an adult patient’s memory, including immediate recall and delayed retention? a. Mini Mental Status Exam b. Minnesota Multiphasic Personality Inventory (MMPI) c. Rorschach Test d. Wechsler Adult Intelligence Scale (WAIS) e. Weschler Memory Scale

Epidemiologic surveys have identified up to two-thirds of intellectually disabled children and adults have coexisting psychopathy. This is an example of _____________ prevalence. a. Lifetime prevalence b. Period prevalence c. Point prevalence d. Treated prevalence

Julie is an 18-year Freshman at UC who presents to the clinic for her first evaluation. Julie indicates she is struggling with sexual attraction towards another female classmate. She is concerned there is something wrong with her for not being attracted to males. As a PMHNP, you know Julie should be in which stage of Erik Erikson’s psychosocial development. a. Autonomy vs. shame and doubt b. Generativity vs. stagnation c. Intimacy vs. isolation d. Identity vs. role confusion e. Trust vs. mistrust

PMHNPs frequently utilize the Therapeutic Nurse-Client Relationship Theory or Intrapersonal Theory. This theory implements the orientation, working, and termination phases. Which nursing theorist is credited with developing the therapeutic nurse-client relationship theory? a. Madeline Leininger b. Dorothy Orem c. Hildegard Peplau d. Jean Watson

Joseph is a 22-year-old with a history of schizophrenia and was admitted to the inpatient psychiatric mental health unit. In reviewing Joseph’s medical history and assessment, including information from his parents, the PMHPNP identifies which of the following is a negative symptom. a. Hearing voices from the radio telling him to sell all his clothes. b. Threaten the mailperson when they deliver mail to the house. c. Absent from school and work for over two weeks. d. Speaking incoherent sentences.

In assuring a patient has been correctly diagnosed with schizophrenia disorder, the PHMNP recognizes which of the following as a DSM-5 requirement? a. Auditory hallucinations and grandiose delusions must be present consecutively for at least six months. b. The patient is keenly aware of the severity and nature of other symptoms. c. Poor hygiene and grooming. d. Hallucinogen intoxication detected on a urine drug screen.

Jane, a 15-year-old girl, has been diagnosed with major depressive disorder and started on fluoxetine (Prozac) 10 mg daily. The PHMNP can effectively monitor for therapeutic effectiveness by implementing which of the following? a. Urine drug screening to evaluate for compliance in taking the medication daily. b. Daily weights to ensure appetite is good. c. Hamilton Depression Rating Scale (HDRS) d. Sleep study

What is the primary reason that many clinicians avoid prescribing Monoamine Oxidase Inhibitors (MAOIs) to their patients suffering from depression? a. Those who take MAOIs would need to follow strict dietary guidelines that are difficult to adhere to and noncompliance may result in hypertensive crisis b. The waiting period for efficacy is too long for many patients c. They are not an effective group of medications to treat depression d. They lower the seizure threshold

Which of the following patients would Wellbutrin be an appropriate choice for? a. A patient suffering from depression with a history of an eating disorder b. A patient suffering from depression with a history of a seizure disorder c. A patient with anxiety who is trying to attempt their chronic daily alcohol use d. A patient in a depressive episode and a concurrent diagnosis of ADHD

Lithium is known as the gold standard for the treatment of Bipolar Disorder. What is the caveat when it comes to Lithium related to suicidality? a. Lithium toxicity is associated with suicidality b. Though Lithium is deadly in overdose it can also diminish suicidal ideation in patients who are therapeutic c. It’s narrow therapeutic index makes it difficult too monitor and therefore is not worth the risk d. Lithium therapy masks the risks for suicidality in the patient assessment

Substance use disorders (SUD) are very common in patients with Schizophrenia. What explanation could explain the association? a. Those who are considered biologically vulnerable and encounter an external stressor such as the use of a substance may be more prone to the development of a mental health disorder such as schizophrenia b. Substances are used to mask the symptoms of schizophrenia and/or side effects of their treatment regimen c. SUD and schizophrenia are similar when it comes to the process of disorder development in an individual d. All of the above

Why is bipolar disorder commonly a missed diagnosis? a. There are no labs that help clinicians with diagnosis b. The patients offer suffer with treatment resistant, chronic depression for several years before ever having their first manic episode c. Substance use is typically the main focus of treatment d. There are limited screening tools available for the diagnosis of mood disorders

What is the risk that a clinician should be aware of when starting a patient on an antidepressant or using ECT? a. The possibility of the patient experiencing their first manic episode b. Excessive weight gain c. The patient becoming violent or threatening d. The patient experiencing a traumatic experience during ECT

Which of the following is not more specific to children when it comes to the signs and symptoms of Bipolar Disorder? a. Their symptoms are similar to ADHD and they are sometimes misdiagnosed b. They often have somatic complaints such as a stomach ache or headache that is not improved with typical treatment c. The cycles are slower and more drawn out than adults suffering from Bipolar Disorder d. They often appear more irritable than adults when functioning in a manic episode

Extrapyramidal side effects (EPS) are a risk with the initiation of certain antipsychotics. They should be treated with anticholinergic and/or the offending medication should be discontinued. If treatment is not initiated in a timely manner, what can the patient then suffer from chronically that may be irreversible? a. Tardive Dyskinesia b. Sedation c. Hypotension d. Gynecomastia and lactation due to elevated prolactin levels

The child’s brain undergoes pruning or the loss of grey matter. Which of the following is false concerning the pruning process? a. Around 5% of grey matter is lost between the ages of 13-18 b. It is just as important as growth when it comes to brain development c. Adolescents consolidate learning by pruning away some synapses while simultaneously strengthening other connections d. Cannabis use may be harmful to the development of the brain during this sensitive time period

Social defeat such as bullying or a failure to connect with peers socially in adolescence can have what impact on the developing brain? a. Deficits in language and communication b. Deficits in long term memory c. Slowed puberty and physical development d. Cognitive deficits including a decrease in function of working memory due to dopamine’s role in the medial prefrontal cortex

Which of the following is a pictorial diagnostic instrument used for 6-11 year olds? A. Children’s Interview for Psychiatric Syndromes B. Diagnostic Interview Schedule (DIS) C. Dominic-R D. The Child Assessment Schedule (CAS)

The NP knows that monitoring patients for gynecomastia is most important with administration of which antipsychotic medication? A. Aripiprazole B. Clozapine C. Quetiapine D. Risperidone

With administration of which medication is it most important to obtain a baseline EKG? A. Aripiprazole (Abilify) B. Lurasidone (Latuda) C. Sertraline (Zoloft) D. Ziprasidone (Geodon)

Schizophrenia is thought to be primarily related to dysregulation of which neurotransmitter? A. Acetylcholine B. Dopamine C. Norepinephrine D. Serotonin

Antipsychotic drugs work primarily on which receptor? A. 5HT2A B. H1 C. M3 D. D2

What is the number one cause of premature death in people with schizophrenia? A. Cardiovascular disease B. Homocide C. Lung Cancer D. Suicide

Which of the following is indicative of poor long-term prognosis in schizophrenia? A. Married B. Support system C. Positive symptoms D. Young onset

In which of the following patients would electroconvulsive therapy (ECT) be contraindicated? A. 18-year-old with treatment resistant depression B. 25-year-old pregnant patient C. 50-year-old with suicidal ideation D. 65-year-old with a brain tumor

Which medication has the added benefit of eliminating suicidal ideation? A. Elavil B. Gabapentin C. Lithium D. Paroxetine

When prescribing Lamotrigine (Lamictal) it is important that the clinician does which of the following? A. Educate the patient on possible side effects such as priapism B. Monitor liver function C. Obtain baseline EKG D. Titrate slowly to minimize the risk for rash development.

A 29-year-old patient presents to the emergency department with complaints of A 29-year-old female presents to the emergency department with complaints of abdominal pain, nausea, vomiting, and bloody stools. Despite an extensive evaluation, no underlying cause for her symptoms can be identified and her lab work is within normal limits. The patient gets frustrated, insisting there is something physically wrong with her. Which of the following best describes her condition? Jealous delusion Persecutory delusion Somatic delusion Grandiose delusion

A 22-year-old male presents to the emergency department accompanied by police who were called because the patient was shouting at imaginary figures, displaying bizarre behavior, and appearing disoriented. The patient has acute onset delusions, believing he has special powers to communicate with aliens and is on a mission to save the world. He continues to exhibit disorganized speech and aggressive behavior. Which of the following can the PMHNP diagnose during the initial encounter? Schizoaffective disorder Schizophrenia Brief psychotic disorder Schizophreniform disorder

Which of the following best describes the essential feature of Bipolar I Disorder? At least one manic episode lasting for at least one week Alternating episodes of major depression and hypomania A pattern of depressive symptoms lasting for at least two years Frequent mood swings between extreme highs and lows

A patient is unable to acknowledge that his mental illness is perpetuated by his substance use disorder and is insisting that his mother's genes are to blame. Which defense mechanism is employed? Neurotic Immature Mature Narcissistic

Which type of bipolar disorder is characterized by recurrent major depressive episodes alternating with hypomanic episodes, but never reaching full-blown manic episodes? Bipolar I Disorder Bipolar II Disorder Cyclothymic Disorder Rapid-Cycling Bipolar Disorder

Which type of delusion involves the belief that one has extraordinary powers, abilities, or importance? Jealous delusion Persecutory delusion Somatic delusion Grandiose delusion

What disorder is characterized by the presence of both mood disorder episodes (e.g., major depressive or manic episodes) and psychotic symptoms (delusions or hallucinations)? Schizophrenia Schizophreniform Disorder Bipolar I Disorder Schizoaffective Disorder

Which of the following is a common symptom of catatonia, commonly associated with schizophrenia? Rapid, excessive speech Frequent mood shifts Immobility and muteness Excessive worrying

What is the leading cause of premature death in people with schizophrenia? Diabetes mellitus Substance use disorder Cardiovascular disease Suicide

When evaluating a new 44-year-old patient complaining of fatigue, irritability, dry skin, and poor sleep quality for a mood disorder, which of the following diagnostic tests should be ordered to aid in formulating a diagnosis? Thyroid-stimulating hormone (TSH) EKG Urine pregnancy test Hemoglobin A1c

Which of the brain functions served by the limbic system is NOT one of Eugen Bleuler’s well-known four A’s of schizophrenia : A) Autism B)Associations C) Affect D) Attention

Recently, amino acids have been recognized as neurotransmitters. Which are the two major ones when considering neurobiology causes of schizophrenia? A) Endocannabinoids and Neurotrophic factors B) Nucleotides and Sigma receptors C) GABA and Glutamate D) Eucsanoids and Substance P

Harry Harlow’s work in Ethological studies with monkeys demonstrated the emotions and behavioral effects of isolating monkeys from birth. Which theory of psychopathology was his work most applicable to? A) Social Learning Theory B) Cognitive Learning Theory C) Operant Conditioning D) Attachment Theory

The Drive Reduction Theory is described as a state of tension arousal caused by biological or physiological needs. All motivation arises as a result of biological needs. Which behaviorist(s) developed this theory? (Cherry, 2023) A) Broca and Wernicke B) Eric Kandel C) Clark Hull D) Mary Ainsworth

The Rorschach Test is a common assessment instrument to evaluate: A) Intelligence B) Memory C) Personality D) Cognitive screening

Patients treated for bipolar disorder with either carbamazepine or valproate should have which laboratory test drawn q 6-12 months to monitor for toxicity. A) CBC w/diff B) Fasting blood glucose C) renal functions D) LFT’s

With schizophrenia hallucinations can be a presenting symptom. Of the 5 senses which are the most common hallucinations? A) Tactile B) olfactory C) visual D) auditory

Symptoms of schizophrenia can be divided into three groups, positive, negative, and cognitive symptoms. Which one of these is not a positive symptom? A) anhedonia B) delusions C) pressured speech D) auditory hallucinations

What is the gold standard treatment of antidepressants for major depressive disorder? A) MAOI B)Tricyclic antidepressnats C) SNRI D) SSRI

Bipolar disorder can be caused by a variety of factors including biological, genetic, and environmental. Children with one bipolar parent have what percentage of increased risk for developing the disorder compared to the general population? A) 50% B) 25% C) 90% D) 15%

What area of the brain is associated with executive functioning and continues to mature throughout the adolescent period? A. Hypothalamus B. Prefrontal Cortex C. Medulla Oblongata D. Corpus Callosum

The majority of serotonin is located in what body system? A. The Gastrointestinal System B. The Central Nervous System C. The Vascular System D. The Immune System

A common assessment instrument used to assess a person's cognitive abilities is the ______? A. Rorschach Test B. Wechsler Memory Test C. Mini Mental Status Exam D. Wechsler Adult Intelligence Test

Jean Piaget found 4 major stages of formation of thought through infancy through adolescence, with each being a prerequisite for the one that follows. The 4 major stages in the correct order of occurrence are: A. Nature (birth-2), Nurture (2-7yo), Attachment (7-11yo), Engagement (11yo – end of adolescence) B. Sensory operations (birth-2), Motor operations (2-7yo), formal operations (7-11yo), concrete operations (11yo - end of adolescence) C. Familial Attachment (birth-2), Social Engagement (2-7yo), Identity Development (7-11yo), Analytic Autonomy (11yo - end of adolescence) D. Sensorimotor (birth-2), preoperational (2-7yo), concrete operations (7-11yo), formal operations (11yo - end of adolescence)

A young woman of 21 comes into your office with new onset sensations of panic that overtake her and she reports as debilitating. She has a normal BMI and is a nonsmoker. She reports sleeping well at night and waking feeling rested. She reports ‘it feels like my heart is suddenly racing, I feeling slightly dizzy and very short of breath’. She would like to be assessed for an anxiety/panic disorder. In addition to gathering a history that includes past and present medical conditions, family history, baseline labs, and a physical exam prior to initiating treatment what would be the BEST next appropriate clinical assessment tool to utilize to further evaluate her symptoms? A. Pap smear B. Echocardiogram C. Sleep Apnea Assessment D. EEG

The most common preventable cause of mental retardation is ______. A. Meningitis B. Fetal Alcohol Syndrome C. Congenital Rubella D. Neonatal Encephalopathy

Increasing evidence indicates that this Hypothalamic Pituitary Thyroid axis hormone, ______, may be integrally involved in learning and memory and may also be associated with depression. A. Melatonin B. Prolactin C. Oxytocin D. Insulin

Medical conditions that can include psychotic features include which of the following? A. Thyroid disease B. Systemic Lupus Erythematosus C. Temporal Lobe Disease D. All of the above

_______ is the leading cause of premature death in patients with schizophrenia with the most crucial factor being a major depressive episode. Epidemiological studies indicate that up to _____% of schizophrenic patients may have a major depressive episode at some time in their lives. A. Suicide; 80% B. Substance abuse; 50% C. Suicide; 50% D. Substance abuse; 80%

When managing a patient on an antipsychotic medication it is important to monitor _______ levels because all antipsychotics result in an elevation of this hormone, which with long-term term elevations suppress gonadotropin-releasing releasing hormone. A. Testosterone B. Progesterone C. Estrogen D. Prolactin

Which brain structure accounts for 50% of total neurons ? A. Thalmus B. Hypothalmus C. Cerebellum D. Brain stem

Degeneration of neurotransmitter dopamine in the substantia nigra is related to which of the following neurodegenerative disorders? A. Parkinson’s disease B. MS C. Alzheimer’s disease D. Huntington disease

The region of the brain associated with human consciousness, higher thinking, ability for reasoning, and that makes a human being unique is which of the following? A. Limbic system B. Thalmus C. Hypothalmus D. Cerebral cortex

What type of neurotransmitter is serotonin ? A. Nucleotide B. Biogenic amines C. Amino acid D. Neuropeptide

An example of a cenesthetic hallucination is which of the following: A. A cutting sensation in the bone marrow B. Hearing two voices converse among themselves C. Seeing elephants on a residential street D. Feeling as if bugs are crawling on your skin

One of the two most widely used screening tools for depression are which of the following: A. Cornell Scale for Depression in Dementia (CSDD) B. Major Depression Inventory (MDI) C. Hamilton Depression Rating Scale (HDRS) D. Patient Health Questionnaire (PHQ)

Which of the following antidepressants is known to decrease seizure threshold? A. Elavil B. Celexa C. Nardil D. Wellbutrin

Abrupt up- titration and/or weaning of which of the following mood stabilizers carries a risk of developing Steven-Johnson’s syndrome? A. Lithium B. Tegretol C. Depakote D. Lamictal

9. What are normal serum lithium levels ? A. 0.6-1.2 mEq/L B. 0.3-0.6 mEq/L C. 1.0-4.0 mEq/L D. Lithium levels do not need to be monitored

Which of the following is an effective approach to treat patients with mood disorder? A. Electroconvulsive therapy B. Medications C. Psychotherapy D. Psychotherapy and medications

Choose the best response. An 8 y/o male patient presents to you with his parents. His parents discuss that his IQ was assessed at school and it was found to be very below average. A presentation of visual hallucinations, low IQ and other cognitive impairments can be classified as premorbid markers of: a). Schizoaffective disorder b). Early onset schizophrenia c). Childhood-onset schizophrenia d). Bipolar disorder

Andy is a 9 y/o M who has been experiencing challenges at school. His teacher reports that he has a difficult time displaying his emotions. He’s described by his teacher as having a flat personality, and that he’s been responding to external stimuli during class which is disruptive. Additionally he experiences communication challenges when interacting with other children and his teachers. His parents are concerned because there is a history of Autism Spectrum disorder in their family. What would you as the health care provider share with Andy’s parents about his possible diagnosis? a). Autism Spectrum disorder is usually diagnosed by 8 years of age. b). Children with Autism Spectrum disorder do not typically respond to external stimuli. c). Have you seen Andy respond to any “imaginary friends” at home? He might have schizophrenia but we need to complete a proper workup. d). Children with Autism Spectrum disorder usually have delayed language skills and a low IQ.

Research has shown that childhood trauma can disrupt the mesocortical dopamine system of the brain. How could this process effect the brain as the individual moves through adulthood? a). Cognitive impairment of the growing brain will improve as the child moves into adulthood. b). Executive functioning will improve as soon as the child is removed from the trauma. c). Spatial working memory of the trauma impacted child may be impacted by altered prefrontal cortex development early in life, which causes decreased executive function of the adult. d). Altered prefrontal cortex development will not carry on into adulthood; this part of the brain will regenerate itself with time. The individual will most likely sustain an average level of executive functioning skills as an adult.

Choose the best response. Our senses give us the opportunity to take-in external stimuli to form our short and long term memory. Certain memory links are not as robust as others. Once our senses detect a stimulus, our memory is then stored in the: a). Cerebral cortex b). Hippocampus, cerebral cortex and cerebellum c). Limbic system so our memory can be associated with emotion d). Thalamus and basal ganglia

Which learning theory best describes how individuals interpret their perceived internal and external influences, and how it’s applied to their daily life? a). Cognitive dissonance b). Attribution Theory c). Cognitive Learning Theory d). Piaget’s Developmental Cognitive Theory

For which medications is a baseline EKG absolutely required? a). quetiapine and Lithium b). Geodon and clozapine c). clozapine and Tegretol d). tricyclic medications

Choose the best response. Which is true regarding poor prognosis and childhood-onset schizophrenia? a). A child who has a less robust response to antipsychotics than seen in adults b). Insidious onset at a young age c). A higher level of premorbid function d). Chronicity and length of the first psychotic episodes have a short duration

Which is true of Schizoaffective disorder? a). Symptoms present as mood symptoms first only, followed by positive symptoms of schizophrenia b). Schizoaffective disorder is another category of schizophrenia c). Disordered mood symptoms and symptoms of schizophrenia must be present d). Catatonia must be ruled out prior to diagnosing Schizoaffective disorder

Which symptoms can be associated with the onset of a brief psychotic disorder? a). Catatonia, mood changes and waxy flexibility b). Impaired attention, emotional volatility and confusion c). Confusion, loose associations and labile mood d). Hallucinations, impaired attention span and emotional lability

Which best describes the presentation of a patient with delusional disorder? a). A disorganized, disheveled individual with grandiose delusions for less than 1 month. b). Baseline functionality is not impaired. The individual continues to work, and a notable suspicion has perpetuated for 3 weeks that their boss has it out for them for no reason. c). Catatonia, with grandiose delusions of being Jesus Christ, and auditory hallucinations have been present for less than 1 month. d). A 25 y/o immigrant worker who recently moved to the U.S. from Burma is experiencing a psychotic episode related extreme cultural shock after moving to the U.S. 14 days ago.

The Hamilton depression scale is used to rate the severity of depression in patients through an evaluation of multiple areas. All the areas below are evaluated on this scale except: a) Depressed mood b) Retardation c) Suicide d) Chronic diseases

Depression related cognitive dysfunction also known as pseudo-dementia includes which of the following symptoms? (Select all that apply) a) Forgetfulness b) Increased activity c) Inability to focus d) Cognitive delays

a,c,d

There is a prevalence of comorbid substance abuse in patients diagnosed with schizophrenia. Approximately 90% of patients exhibit dependence on which of the substances listed below? a) Alcohol b) Cocaine c) Cannabis d) Nicotine

Which of Bleuler’s 4 As of schizophrenia is linked to awkward social interactions? a) Autism b) Association (looseness of) c) Affective (disturbances – flat affect) d) Ambivalence

ECT is used in the treatment of depression but is considered an absolute contraindication in the presence of: a) Pregnancy b) Seizures c) Brain tumor d) Suicidal ideations

Who was the founder of psychiatric classifications? a) Eric Kraepelin b) Hippocrates c) Sigmund Freud d) B.F. Skinner

7. Medical conditions may sometimes present with neuropsychiatric symptoms. Which diagnosis of the endocrine system is known to present with neuropsychiatric symptoms? a) Diabetes Mellitus b) Hypothyroidism c) Polycystic Ovarian Syndrome d) Turner Syndrome

Identity vs role confusion, one of the 8 stages of Erikson’s theory of psychosocial development is seen in the age group of: a) 2 - 3 years b) 12 - 21 years c) 40 – 65 years d) >65 years

Match the following defense mechanisms with their respective presentations: a) Narcissistic defenses ≈ b) Immature defenses c) Neurotic defenses d) Mature defenses Distortion Acting out Repression Altruism

a-d b-c c-b d-a

When considering neurogenetics and schizophrenia, there is a 50% chance of developing the illness when there is a 1st degree relative diagnosed with the illness. (True or False) a) True b) False

.As it applies to neurogenetics, an individual with a first-degree relative with schizophrenia has what percentage of chance of having the disease A. 5% B. 10% C. 15% D. 20%

Eugene Bleuler is credited for coining the term schizophrenia and describing the four A's of schizophrenia. Select the correct answer that contains Bleur's four A's A Affect, Anger, Anxiety, Autism B Affect, association , ambivalence, autism C Aggression, agitation, affect, autism D Affect, Anger, Ambivalence, anxiety

There is a 25-year-old patient currently in your care who has difficulty forming relationships. She copes with past traumas by keeping thoughts out of her consciousness. What defense mechanism is she currently employing? A. Displacement B. Denial C. Repression D. Regression

Which second-generation anti-psychotic medication is known to cause increased prolactin levels and even gynecomastia? A. Clonzapine B. Risperidone C. Olanzapine D. Quetiapine

A 22-year-old college male presents to the hospital with his girlfriend. She reports that he has been unable to sleep over the last seven days; he has had racing thoughts, increased activity, and risky behavior, including speeding and riding his motorcycle without a helmet. Due to his behavior, he could not attend class and was sent home from work. He had never had any behavioral issues before the start of his senior year. This is the third time he has experienced this behavior this year in the past 12 months. Considering these manifestation. The patient may be suffering from an initial presentation of? A. Bipolar I B. Bipolar II C. Cyclothymic disorder D. Anxiety Disorder

Schizophrenia is considered to be a _________________ process disease. A. Behavioral B. Thought C. Emotional D. Aggressive

Identify the most common form of hallucinations seen in schizophrenic patients.? A. Tactile B. Auditory C. Visual D. olfactory

The symptoms of schizophrenia can be divided into which three groups? A. Positive symptoms, negative symptoms, neutral symptoms B. Positive symptoms, affective symptoms, affective symptoms C. Positive symptoms, negative symptoms, cognitive symptoms D. Positive symptoms, dysfunctional symptoms, negative symptoms

A Cyclothymic Disorder presents with? A. Episodes of mania and mild depression B. Episodes of hypomania and mild depression C Episodes of hypomania and major depression D Episodes of hypomania and anxiety

For an initial diagnosis of bipolar I, the duration of symptoms is as follows A. Manic episode 2wk+, Hypomania episode 3 days+, Major depressive episode 4wks +. B. Manic episode 1wk+, Hypomania episode 4days+, Major depressive episode 2wks + C. Manic episode 4wk+, Hypomania episode 7 days+, Major depressive episode 4wks + D. Manic episode 1wk+, Hypomania episode 4days+, No MDD episode

While Schizophrenia is noted to have universal prevalence around the world, what psychiatric diagnosis is mainly seen in western industrialized countries? a. Bipolar Disorder b. Anorexia Nervosa c. Panic Disorder d. Obsessive Compulsive Disorder

Multiple new disorders were added to the DSM-5. Which of the following is NOT an example of a new disorder? a. Cannabis Withdrawal b. Hoarding c. Central Sleep Apnea d. Pain Disorder

Severity and course specifiers are added to a DSM diagnosis when full criteria are met. If full criteria are not met, what is an example of a subcategory that can be considered? a. Other Specified b. Recurrent c. Mild d. Single episode

Violence is _____ among people with schizophrenia and more commonly associated with the first psychotic break. a. Common b. Declining c. Increasing d. Unusual

Diagnoses of Schizophrenia is very difficult in children and adolescents and all of the following differential diagnoses should be considered EXCEPT: a. Major Depressive Disorder b. Drug Induced Psychosis c. Developmental Immaturity d. ADHD

Mood Disorders are broadly described as a. A group of diagnoses that must include symptoms of anxiety and depression b. A group of clinical conditions characterized by a loss of sense of control. c. A definable change in emotional state that may or may not interfere with ability to function d. A class of serious mental illness that focus on how people relate to others

What are the 4 A’s of Schizophrenia according to Bleuler? a. Affective, Ambivalence, Association, Anxiety b. Association, Affective, Autism, Ambivalence c. Alteration, Affect, Ambivalence, Atypical d. Anger, Anxiety, Association, Anhedonia

What diagnosis on the schizophrenia spectrum is half as common as schizophrenia, lacks a long prodromal phase, and progresses to schizophrenia in 60-80% of patients? a. Schizoaffective Disorder b. Catatonic Schizophrenia c. Schizophreniform Disorder d. Paranoid Schizophrenia

Two major amino acid neurotransmitters that act as inhibitory and excitatory messengers include: a. Serotonin and Dopamine b. Norepinephrine and Dopamine c. GABA and Glutamate d. Serotonin and Glutamate

What is the process of achieving stability in the face of adverse environmental events and results from interactions between specific environmental challenges and particular genetic backgrounds? a. Homeostasis b. Euthymia c. Mental balance d. Allostasis

Medical conditions that can induce psychotic features include? a. Thyroid disease b. Systemic lupus erythematosus c. Temporal disease d. All of the above

Where is more than 80% of all serotonin in the body found? a. Brain b. Gastrointestinal system c. Liver d. Pancreas

The symptoms of schizophrenia can be divided into how many groupings? a. 1 b. 6 c. 12 d. 3

Which of the following are positive symptoms for schizophrenia? a. Hallucinations b. Delusions c. Bizarre social and sexual behavior d. All of the above

Which depression screening tools are the two most widely used and recognized? a. Hamilton Depression Rating Scale (HDRS) b. Geriatric Depression Scale (GDS) c. Beck Depression Inventory (BDI) d. Both A and C

Untreated extrapyramidal symptoms can lead to what permanent side effect? a. Hypersomnolence b. Tardive dyskinesia c. Postural hypotension d. Elevated prolactin levels

Which atypical antipsychotic medication is utilized as a last resort for pharmacological therapy in schizophrenia and schizoaffective disorder? a. Olanzapine b. Haloperidol c. Aripiprazole d. Clozapine

What is an absolute medical contraindication for electroconvulsive therapy (ECT)? a. Depression b. Suicidal ideations c. Brain tumor d. Pregnancy

What percentage of children risk developing bipolar disorder if one parent is diagnosed with the illness? a. 10-15% b. 1% c. 25% d. 18%

Which neurotransmitter type listed below is the most common cause of schizophrenia? a. Acetylcholine b. Dopamine c. Epinephrine d. Histamine e. Norepinephrine

At the workplace, there is a woman who does not get along with another co-worker who is very rude and dismissive. The woman decides to be excessively friendly towards the co-worker in order to hide how she truly feels. What type of defense mechanism is the woman displaying? a. Denial b. Displacement c. Reaction d. Regression e. Repression

What are the most common side effects for patients taking Risperidone (Risperdal)? a. Decreased appetite b. Diarrhea c. Enlarged breast d. Hair loss e. Weight loss

Which of the following lab test is very important to monitor when patient is taking Lithium? a. Complete Blood Count Test b. Electrolytes and Blood Sugar c. Kidney and Liver Function Tests d. Neuroendocrine Test

Which medical condition is contraindicated in patients taking Lithium? a. Chronic Kidney Disease b. Cushing’s Disease c. Rheumatoid Arthritis d. Osteoporosis

For patients who are on antipsychotic medications, the mental health provider must make sure to have a baseline of the following results except? a. EKG Test b. Height c. BUN/Creatinine d. Prolactin Levels e. Weight

All of the following medications listed below requires routine blood levels drawn except? a. Clozaril b. Depakene c. Lithium d. Trazadone

The DSM-5 is a manual used to serve and guide how mental health providers prescribe drugs. Which of the following diagnosis is not included in the DSM-5 manual? a. Cannabis Withdrawal b. Binge Eating Disorder c. Hoarding & OCD d. Sexual Aversion Disorder e. Social Communication Disorder

What part of the brain function is closely linked to positive symptoms (e.g., hallucinations, agitations, delusions) found in schizophrenia? a. Hippocampus b. Hypothalamus c. Limbic system d. Prefrontal cortex

What is the number one cause of premature death among people with schizophrenia? a. Cancer b. Homicide c. HIV/AIDS d. Suicide

Rapid cycling in Bipolar Disorder 1 is defined as: A. 4 or more depressive episodes in 1 year B. 2 or more depressive episodes in 12 months C. 4 or more manic episodes in 12 months D. 2 or more manic episodes in 1 year

What is considered a hallmark of a manic episode? A. Rapid and loud speech B. An elevated, expansive, or irritable mood. C. Rapid thoughts D. Easily distracted

How common are delusions in manic episodes? A. 75% B. 90% C. 30% D. 40%

What differentiates Bipolar I (BP I), Bipolar II (BP II), and cyclothymic disorders? A. Bipolar I: hypomania; BP II: mania; cyclothymic: less severe hypomania B. BP I: less severe hypomania; BP II: mania; cyclothymic disorder: hypomania C. BD I: hypomania; BD II: less severe hypomania; cyclothymic disorder: mania D. BD I: mania; BDII: hypomania; cyclothymic disorder: less severe hypomania

What should be included in the differential diagnosis of a person experiencing acute Mania? A. AIDS/HIV B. Hyperthyroidism C. Catatonic schizophrenia D. Phencyclidine or bronchodilator induced mania E. All of the Above

Which sensory organ most commonly experiences hallucinations in patients with schizophrenia? A. Gustatory B. Olfactory C. Auditory D. Visual E. Tactile

Patients experiencing schizophrenic episodes are usually oriented to: (pick 3) A. Person B. Place C. Time D. Event

a,b,c

Which 3 subgroups can the symptoms of schizophrenia be divided? A. Positive, negative, benign B. Benign, cognitive, negative C. Positive, negative, and cognitive D. Cognitive, positive, bizarre

During acute episodes which grouping is most disruptive to the patient’s life: A. Positive B. Negative C. Bizarre D. Cognitive

Which of the following should be noted in the diagnosis of schizophrenia according to the DSM V: A. At least 2 symptoms, functional impairment, symptoms present continuously for 12 months B. At least 4 symptoms, no functional impairment, symptoms present continuously for 6 months C. At least 4 symptoms, no functional impairment, symptoms presently continuous for 12 months D. At least 2 symptoms, functional impairment, symptoms present continuously for 6 months

A 21-year-old male comes to the clinic and discloses to you that he has anxiety so he smokes marijuana every night to help him wind down and sleep. As an advanced practice psychiatric mental health nurse, what do you know of how marijuana affects the brain in a young adult? a) Marijuana doesn’t affect the brain negatively in young adults because young adults have greater neuroplasticity. b) Marijuana use in young adults between 20-30 years old has shown to help preserve short term memory when they become elderly. c) Marijuana can halt the development of the prefrontal cortex in young adults under 25. d) Marijuana can help the development of the prefrontal cortex in young adults under 25.

The precursor to serotonin is: a) tyrosine b) aldehyde c) acetylcholine d) tryptophan

In Washington state, mothers can have paid family leave for up to 12 weeks to bond with her newborn baby. The importance for a mother to bond with her newborn is based on what theory? a) attribution theory b) attachment theory c) social learning theory d) reaction formation

The number of persons who have a disorder at some time during their life which is measured as specific point in time is referred to as: a) point prevalence b) period prevalence c) treated prevalence d) lifetime prevalence

When diagnosing based on the DSM 5, what is TRUE about the use of specifiers? a) specifiers are mutually exclusive and are only applied if the full criteria have been met b) specifiers are not mutually exclusive and only applied with when the full criteria have been met c) specifiers are mutually exclusive but can only be used with a subtypes d) specifiers are not mutually exclusive and only applied if full criteria has not been met

What are Bleuler’s “four A’s”? a) Association, Affective, Autism, Ambivalence b) Association, Auditory, Autism, Ambivalence c) Affective, Auditory, Atypical, Ambivalence d) Association, Affective, Auditory, Atypical

What factor is associated with a poor prognosis in schizophrenia? a) Negative symptoms b) Positive symptoms c) Married d) Family history of mood disorders

Before prescribing lithium to your patient with a diagnosis of bipolar I, what health history of the patient would cause you to NOT prescribe lithium to your patient? a) Hypertension b) Diabetes c) Hyperlipidemia d) Chronic kidney disease

9. What CORRECTLY describes the DIFFERENCE between bipolar type I and bipolar type II? a) Bipolar I is less severe but more chronic than bipolar II; bipolar I have episodes of hypomania and depression with more frequent cycling, whereas bipolar II have episodes of mania and depression. b) Bipolar I is more severe but less chronic than bipolar II; bipolar I have episodes of mania and depression whereas bipolar II have episodes of hypomania and depression with more frequent cycling. c) Bipolar I is less severe but more chronic than bipolar II; bipolar I have episodes of mania and depression with more frequent cycling, whereas bipolar II have episodes of hypomania and depression. d) Bipolar I is more severe and more chronic than bipolar II; bipolar I have episodes of hypomania and depression, whereas bipolar II have episodes of mania and depression with more frequent cycling.

What is TRUE regarding the use of antidepressants in treatment of bipolar disorders? a) Antidepressants are preferable to be used as a 1st line treatment due to their mild side effect profile. b) Antidepressants as monotherapy can trigger a hypomanic episode. c) Antidepressants should be used during a patient’s depressive episodes and then stopped if and when they start a hypomanic episode. d) Antidepressants should not be used as an adjunctive medication with mood stabilizers.

What psychiatric medication class has a black-box warning stating “suicidal ideation”? a. Antipsychotics b. Mood stabilizers c. Antidepressants d. Anxiolytics

What is the “The feeling experienced internally”? a. Affect b. Depression c. Sadness d. Mood

Which bipolar disorder has an increased risk in suicide and more hypomanic and major depressive episodes with shorter periods of 6me between episodes? a. Bipolar disorder b. Bipolar II c. Bipolar I&II d. Bipolar I

As the psychiatric provider you are called to assess a patient. When you enter the room the patients states you need to get back or the will melt you with their super powers. The patient is experiencing? a. Supernatural powers b. Hallucinations c. Delusions d. A higher calling

What is the normal therapeutic range for a patient on lithium for bipolar disorder? a. 0.3 to 1.9 mEq/L b. 0.6 to 1.2 mEq/L c. 0.8 to 3.0 mEq/L d. 2.0 to 3.5 mEq/L

Which defense mechanism has the individual/patient utilizing Distortion? a. Neurotic Defenses b. Immature Defenses c. Narcissistic Defenses d. Mature Defenses

Which theorist coined the structural model and came up with three closely related systems (ego, id, and super-ego)? a. Dorothea Orem b. Erik Erickson c. Anne Casey d. Sigmond Freud

According to the updated DSM-5 there were 15 new disorders added. Is Central Sleep Apnea one of these? a. True b. False

What is the single leading cause of death amongst patients diagnosed with schizophrenia? a. HIV/AID b. Suicide c. Drug Overdose d. Reckless operation of a motor vehicle

A patient comes into the clinic weeks after a MVA accident. The patient is exhibiting loss of motor skills, inability to process higher cognition questions, and has difficulty expressing language. What area of the brain was likely affected? a. Parietal Lobe b. Temporal Lobe c. Occipital Lobe d. Frontal Lobe

Challenges in identifying Pediatric Bipolar Disorder may be attributed to all of the following, except: Lack of specificity among screening tools Disagreement of classification of symptoms between clinicians and researchers The presence of comorbid psychiatric disorders There are no decision-support tools to facilitate the interpretation of symptoms

According to the DSM-5, one of the following symptoms should be present for a significant portion of time during a one-month period, except: Delusions Hallucinations disorganized speech blunt affect

Perceptual disturbances common amongst individuals with schizophrenia include: Tactile Visual Auditory Olfactory

The following therapies may be appropriately utilized to treat individuals with schizophrenia include the following except: eye movement desensitization and reprocessing therapy cognitive behavioral therapy dialectical behavioral therapy art therapy

An example of a screening tool for depression is: GAD 7 PANSS PHQ-9 CIWA

The DSM-5 is a classification of mental disorders that could be used in the following settings, except: Clinical Educational Research Sociological

Electroconvulsive Therapy is indicated for patients who have all of the following except: Treatment-resistant depression Suicidality Adjustment Disorders Bipolar Disorders

The diagnostic criteria for cyclothymia involves ruling out all of the following except: Substance-abuse medical conditions Personality disorders Family history of bipolar

The definition of affect when assessing mood disorders is: the external expression of mood a feeling experienced internally a false fixed belief The ability to understand the world around them

Characteristics of childhood schizophrenia include: Symptom Onset is generally rapidly occurring Symptom Onset is insidious Children are socially accepted Children have exceptional abilities and perform well in school

Jen is a 30-year-old F w h/o Bipolar II disorder diagnosed at age 25. She used to take Lithium when she was first diagnosed with bipolar but had a large amount of weight gain and was taken off it. She was prescribed Prozac then prescribed Ketamine infusions due to severe depressive symptoms but stopped the Ketamine after getting pregnant. During her pregnancy, she remained on Prozac and is still taking it. She did not resume Ketamine after the birth of her child. She is on Prozac 20mg daily for her bipolar disorder and does not take any additional medications or supplements. She confides to you that she feels that her friends are plotting against her and don’t like her anymore. She also admits that has been sleeping less at night, has more energy than before despite less sleep, feels hyper-focused at work, and feels a sense of restlessness. What symptoms is she describing? a. Mania b. Hypomania c. Depression d. Rapid cycling

Heavy Alcohol use during pregnancy is a significant cause of severe physical and mental congenital disabilities in children. Some of the CNS effects of fetal alcohol syndrome include? a. Delayed development b. Attention-Deficit/hyperactivity disorder (ADHD) c. Learning disabilities/Intellectual deficits d. all of the above

What is the definition Color anomia? a. A medical or psychological condition prevents a person from correctly associating colors with common objects. (Inability to recognize a color despite being able to match it.- Kaplan) b. A condition in which a person cannot name the color but can connect the color to its name. (The inability to name a color despite being able to point at it-Kaplan pg 927) c. a problem with the eyes’ ability to detect and distinguish colors, usually due to a genetic defect in the color-sensitive cells of the retina. d. Inability to recognize a persons face

Excitatory neurotransmitters include all of the following except? a. Glutamate b. Serotonin c. Acetylcholine d. Epinephrine

D.F. is a 19yr old M with a past hx of depression, presents to your ER with reports of hearing voices telling him that he is worthless and doesn’t deserve to live. He also endorses seeing shadows out of the corner of his eyes. He states he has not been sleeping well and gets less than 4 hrs of sleep a night. He states he has been having symptoms for 3 weeks. He also endorses worsening depression, suicidal ideation, he has a history of 2 suicide attempts by acetaminophen overdose. Most recent attempt was 3 months ago. He graduated from high school 1 year ago and does not work at this time. He lives with his mother in an apartment. He states he does not currently have any friends because he felt they were plotting against him. He admits to smoking marijuana in the past. Denies alcohol use or use of other illicit substances. Medications listed are Lamictal 100mg daily and Prozac 20mg daily. He reports he stopped taking his meds 3 weeks ago because he did not feel like it was helping. He denies taking any other medications. Objective findings: He appears unkempt, hair appears oily, wearing dirty wrinkled clothing and smells of body odor. He frequently blinks. He is alert and oriented x 4. He is cooperative, has a flat affect, normal speech, and poor insight. Physical exam is unremarkable. Labs are unremarkable, urine drug screen was negative. What is his most likely diagnosis? a. Major Depressive disorder b. Bipolar II disorder c. Schizoaffective disorder d. Delusional disorder

What is neural plasticity? a. the ability of a phenotype to express different genotypes b. the ability of the brain to detect or identify a stimulus based on a specific experience c. the ability of the brain to adapt and change over time by building new networks in response to intrinsic or extrinsic stimuli d. the foundation for learning

All of the following are medical conditions that can display neuropsychiatric symptoms except: a. Wernicke encephalopathy b. HIV c. Hypothyroidsm d. Apthous stomatitis

DM is a 42yr old Female, who is married with 2 children, works a full time job, feels burnt out and strained as a care giver and recently decided to go back to school to change careers. She identifies as being in a “Mid-life crisis”. What psychosocial stage would she be in according to Erik Erikson? a. Generativity vs. stagnation b. Intimacy vs. isolation c. Idustry vs inferiority d. Integrity vs. despair

HK is a 30 yr old male with a hx of Bipolar I. He is taking Prozac 20mg daily, Trazodone 50mg qhs and Risperdal 2mg daily. He comes to you today stating he has noticed his chest specifically his breast enlarging. What lab tests would you order for further evaluation? a. TSH b. CMP c. Lipid panel d. Prolactin level

What type of operant conditioning would addiction fall under? a. Primary reward conditioning b. Escape conditioning c. Avoidance conditioning d. Associating learning

In treating bipolar depression, which medication has the highest potential to develop a maculopapular rash that could resolve with no change in treatment, need discontinuation of the medication, or potentially progress to a life-threatening condition such as Steven Johnson Syndrome? A) Valproate B) Lamotrigine C) Lithium D) Lorazepam

All the following tests are recommended prior to starting a 65-year-old woman with pre-existing heart disease and no suspicion of myocarditis on Haldol except - A) ECG B) Potassium level C) ECHO D) Magnesium level

A 23-year-old female on oral contraceptives taking carbamazepine should be counseled on which of the following? ensure that a hormone-based birth control is used A non-hormonal form of birth control should be used N/A there is no interaction between oral contraceptive, pills, and carbamazepine There is an increased risk of blood clots with the combination of the two medications

A schizophrenic patient who recently relapsed and has a history of violence and aggressive behavior is most likely to be treated with - Quetiapine Aripiprazole Ziprasidone Clozapine

A patient who is experiencing their first psychotic break and has never been treated in the past is likely to be recommended to start on any of the following meds except - A) aripiprazole B) risperidone C) clozapine D) ziprasidone

Sally is being treated with Geodon for schizophrenia. What is important to educate her on in regards to taking this medication - A) take with > 500 calories of food B) sodium levels need to be monitored every three months C) Monitor for signs and symptoms of hypoglycemia due to increased risk D) proper form of ingestion, as it is only available in sublingual form

Judy just delivered a baby with no complications and would like to be restarted on her lithium for treatment of bipolar one disease. She was wondering if it would be OK for her to breast-feed her newborn. What is typically recommended - A) breast-feeding is recommended because concentrations of lithium are only 1 to 3% B) breast-feeding is not recommended because the serum concentration of lithium in the infant can be as high as 50% of the mother's serum concentration C) breast-feeding would be recommended because lithium is metabolized and excreted too quickly to have an effect on the infant D) breast-feeding is not recommended because lithium does not cross over into milk by passive diffusion

When treating bipolar disorder, all the following are associated with poor treatment outcomes, except - A) depressive states lasting more than four weeks at a time B) delusional symptoms C) substance or alcohol abuse D) rapid cycling

Which medication is the only medication that is FDA approved as a mood stabilizer for children 12 and over - A) olanzapine B) valproate C) Lamictal D) lithium

Chelsea is taking valproate and constantly complaining of nausea, vomiting, and indigestion with every dose increase. All the following are most likely to be recommended to alleviate adverse effects, except - A) stop taking medication and switch to one with less side effects B) take with food C) use lower initial doses, and slowly titrate dose as needed D) switch to divalproex sodium ER

P.J is a 20 year old male with a history of MDD who has been brought in by his family due to concerns of erratic behaviors. At first his mother and father thought that his antidepressants medication dose had finally been figured out due to his increase in energy and ability to socialize with people. However, over the past four days his family noticed that he has been spending the majority of his time in the garage working on his paintings throughout the day and night, refusing meals and barely sleeping. What medication would be most appropriate for management of his mood disorder? A. Lithium, Quetiapine B: Quetiapine, Phenelzine C: Lamotrigine, Elavil D: Citalopram, Lithium and Quetiapine

What lobe of the brain is responsible for processing somatosensory information? A. Occipital lobe B. Frontal lobe C. Temporal lobe D. Parietal lobe

What structure of the brain is considered the body’s thermostat and works to regulate thirst, hunger, and circadian rhythms? A. Thalamus B. Hypothalamus C. Basal Ganglia D. Limbic System

Which biogenic amine is synthesized in the axon terminal, with the precursor amino acid tryptophan that is associated with depression and anxiety? A. Acetylcholine B. Dopamine C. Norepinephrine D. Serotonin

What would be a reason to obtain an EEG in the psychiatric setting? A. Seizure activity B. Atypical age of onset for anorexia without a family history C. Unilateral hallucinations D. All of the above

EPS side effects such as dystonia, muscle soreness, numbness, tingling of the lips related to anti-psychotic medication is treated by which of the following? A. Benadryl B. Cogentin C. Switching to different antipsychotic medication D. All of the above

With regards to schizophreniform disorder, which is the following is NOT considered true? A. It typically has an acute onset B. Usually does not progress to Schizophrenia C. Few have only one episode D. Most common in adolescents

Which is not a scale used to assess the severity of symptoms in patients with schizophrenia or schizoaffective disorder? A. PANSS scale B. Hamilton Depression Scale C. Young Mania Scale D. AIMS scale

Physical manifestations that occur during depressive episodes include all of the following EXCEPT? A. Stooped posture B. Downward, averted gaze C. Increase in spontaneous movements D. Generalized psychomotor retardation

What is the only contraindication for ECT treatment A. Pregnancy B. Brain Tumor C. Elderly D. Hx of Seizure disorder

Bipolar II differs from Bipolar I in all ways listed below except: A. More chronic in nature B. Increased risk of suicide C. Shorter period of time between depression and manic episodes D. More severe symptoms

Which of the following definitions accurately matches the term "Genome"? A) An inherited characteristic B) One of the variant forms of a gene at a particular location on a chromosome C) The individual in a pedigree who causes the pedigree to come to the attention of the medical or research staff D) The complete DNA sequence containing all genetic information and supporting proteins, in the chromosome of an individual or species E) A statistical method that examines pedigree data to determine whether a trait cosegregates with a genetic marker

Which of the following statements accurately captures a distinction between Pavlovian and operant conditioning? A) In Pavlovian conditioning, behavior is voluntary and is based on the organism's choices, whereas in operant conditioning, behavior is elicited by antecedent stimuli. B) Operant conditioning is primarily concerned with understanding the relation of behavior to its payoff, while Pavlovian conditioning is not focused on consequences. C) In operant conditioning, behavior operates on the environment and is controlled by its consequences, while in Pavlovian conditioning, behavior is elicited by preceding stimuli. D) Operant conditioning experiments were pioneered by Pavlov, whereas Skinner was the main figure behind respondent conditioning. E) Both operant and Pavlovian conditioning are processes where behavior is always reinforced by positive outcomes.

Which of the following statements best reflects the concept of altruism? A) Altruism is a behavior in which an individual prioritizes their personal reproductive success over others. B) Altruism is defined as behavior that enhances the reproductive success of the initiator while decreasing that of the recipient. C) Altruism is behavior that reduces an individual's reproductive success but increases that of the recipient, and contradicts traditional Darwinian theory. D) Male–male competition and sexual dimorphism are primary examples of altruistic behaviors in nature. E) Altruistic behavior in animals always revolves around direct reproductive success, without any indirect benefits to the initiator.

According to the information provided, which of the following statements about the outline for cultural formulation in the DSM-5 is TRUE? A) The outline is solely focused on diagnosing mental illness within a cultural context. B) The cultural assessment is solely focused on understanding the individual's cultural identity. C) The outline aims to improve the application of diagnostic criteria in multicultural settings and understand cultural differences affecting the patient-clinician relationship. D) The cultural assessment only considers the cultural identity and explanations of the individual's illness. E) The cultural formulation dismisses the role of culture in psychiatric illness.

Based on Juanita's case study, which statement best captures the role of sociocultural factors in exacerbating her schizophrenia-related symptoms? Case Study: Juanita, a 28-year-old woman, was diagnosed with schizophrenia when she was 24. While medication helped manage some of her symptoms, societal reactions played a significant role in her mental health journey. Growing up in a close-knit community where mental health issues were stigmatized, she often felt isolated and misunderstood. Despite her family's efforts to be supportive, there were clear signs that they, too, were influenced by the prevailing cultural views. They sometimes inadvertently blamed her for not trying hard enough or suggested that her condition was a result of past wrongdoings. As Juanita's symptoms became more apparent to her community, she found herself increasingly ostracized, leading to severe bouts of depression and, on occasion, exacerbation of her schizophrenia symptoms. The few times she tried to reintegrate into her community or find employment, she faced discrimination and misunderstanding, which further discouraged her from seeking opportunities. This cycle continued until she moved to a more accepting environment where she could access better support and understanding. A) Juanita's symptoms worsened primarily because she was non-compliant with her medication. B) The cultural stigma and societal misunderstanding in Juanita's community led to her feeling isolated and exacerbated her symptoms. C) Juanita's condition deteriorated mainly because of her family's lack of understanding of schizophrenia. D) The primary factor affecting Juanita's mental health was her own reluctance to reintegrate into society.

Which of the following disorders was newly introduced as a distinct category in the DSM-5? A) Obsessive-Compulsive Disorder B) Schizophrenia C) Disruptive Mood Dysregulation Disorder D) Post-Traumatic Stress Disorder E) Bipolar I Disorder

Which of the following disorders requires the presence of at least one delusion that persists for a minimum of one month? A) Schizophrenia B) Schizophreniform disorder C) Schizoaffective disorder D) Delusional disorder

8. What best describes the cognitive symptoms of schizophrenia? A) They are easily observable behaviors that manifest early in the disease process. B) Cognitive symptoms are enhancements in memory and attention in individuals with schizophrenia. C) They may be subtle, especially in the early stages, but significantly contribute to the disability associated with the disease. D) Cognitive symptoms refer to the presence of hallucinations and delusions in the affected individual.

Which of the following best describes the categorization and characteristics of mood disorder symptoms? A) All mood disorders are classified under depressive disorders, which primarily present with mood, behavioral, and physical symptoms. B) Mood disorders can be either depressive or bipolar, with depressive symptoms divided into mood, behavioral, cognitive, and physical categories, while bipolar disorders are primarily characterized by periods of mania/hypomania. C) Persistent Depressive Disorder has the same severity of symptoms as Major Depressive Disorder but lasts for a shorter duration. D) Premenstrual dysphoric disorder is a constant state of mood lability and anxiety throughout the menstrual cycle.

Which statement best captures the characteristics of cyclothymic disorder? A) Cyclothymic disorder is characterized by alternating periods of full-blown mania and major depression that persist for at least one year. B) Individuals with cyclothymic disorder experience severe depressive episodes with occasional periods of hypomania lasting for several months. C) Cyclothymic disorder involves periods of hypomanic symptoms and mild depressive symptoms, interspersed with periods of normal mood, persisting for two or more years. D) Cyclothymic disorder is a short-term condition marked by constant hypomania without any depressive symptoms.

In the contributions to Psychiatry made by Attachment Theory, which dysfunctional attachment style does Mary Ainsworth consider the most concerning for a child’s future development? Insecure-ambivalent Insecure-avoidant Insecure-dependant Insecure-disorganized

When considering the two types of memory, declarative and nondeclarative, what is an example of declarative memory? Events Priming Simple Classical Conditioning Skills and Habits

Damage to which part of the brain is most likely to affect one’s verbal abilities such as lists of words or stories. (Boland, R., Verduin, M. L., Ruiz, P., Shah, P., & Sadock, B. J., 2022, 1032)? Left medial temporal region Right medial temporal region Medial temporal region or diencephalic structures in the left cerebral hemisphere Medial temporal region or diencephalic structures in the right cerebral hemisphere

All of the following are examples of a mature defense mechanism EXCEPT (Boland, R., Verduin, M. L., Ruiz, P., Shah, P., & Sadock, B. J., 2022, 1066-1067): Asceticism Introjection Sublimation Suppression

Which of the following statements accurately reflects the most common presentation of early-onset schizophrenia (Boland, R., Verduin, M. L., Ruiz, P., Shah, P., & Sadock, B. J., 2022, 207)? A child experiencing hallucinations likely has schizophrenia. Children and adults have similar deficits in memory, IQ, and perceptuomotor skill testing. The symptoms of early-onset schizophrenia are often more subtle than adult-onset, with only changes in behavior or affect as early clues. There is no significant difference in clinical course between early-onset schizophrenia and adult-onset schizophrenia.

Which of the following is a typical finding in a patient with schizophrenia (Boland, R., Verduin, M. L., Ruiz, P., Shah, P., & Sadock, B. J., 2022, 338-339)? Belief that an outside force is controlling their thoughts or behavior Not oriented to person, place, and/or time Olfactory Hallucinations Poor reliability

Which of the following statements about psychotic disorders is accurate? Hallucinations or delusions must be present to diagnose schizophrenia. Patients with delusional disorder do not experience hallucinations. Psychotic symptoms must be present for at least a 2-week period without mood symptoms to meet the criteria for schizoaffective disorder. Schizophreniform disorder rarely progresses into schizophrenia.

All of the following are possible differential diagnoses for a patient presenting with psychosis EXCEPT: Alzheimer disease Brain tumor Hypocalcemia or hypernatremia Mood disorder Steroid use

Comorbidities of Schizophrenia include an increased risk of all of the following EXCEPT: COPD Diabetes Mellitus Type II HIV Rheumatoid Arthritis Substance Use Disorders

All of the following are characteristics of antipsychotic medications EXCEPT: Antipsychotics with long-acting injectable forms are aripiprazole, olanzapine, paliperidone, risperidone, fluphenazine, and haloperidol. Aripiprazole, Brexiprazole, and Cariprazine are Partial Dopamine D2 Agnoists that are highly protein-bound and have relatively long half-lives for oral dosing, ranging from 75 hours to 5 days. Clozapine is a Dopamine D2 - Serotonin 2A Antagonist which is highly protein-bound and has a 12-hour half-life for oral administration. While it is one of the most effective antipsychotics, the risk for agranulocytosis (0.3%), seizures (5%), and rare myocarditis require weekly lab testing for the first 6 months of medication use and have caused this medication to be primarily indicated for use only after failure on two previous medications. Lurasidone and Ziprasidone are Dopamine D2 - Serotonin 2A Antagonists that are highly protein-bound and require that the oral medication be taken with a small meal. Some antipsychotic medications elevate prolactin levels, which can cause galactorrhea and menstrual irregularities.

Attachment theory analyzes the importance of the bond and need for closeness developed between infant and their caregiver for normal emotional and social development. What British psychoanalyst originated Attachment theory? -Jean Piaget -John Bowlby -Mary Ainsworth -Harry Harlow

B.F. Skinner identified the concept that learning occurs as a result of an action, utilizing the tools of reward and punishment for behavior modification. This is known as what learning theory? -Operant conditioning -Trial and error learning -Social learning theory - Classic conditioning

Considering the progressive concept/theory of evolution, selfless behavior that puts others’ needs before their own, is known as what? -Reproduction -Aggression -Altruism -Competition

Defense mechanisms are thought to act as a protector and safety for the mind. Of George Vaillant's classification system, which is thought to be the most primitive of the defense mechanisms? -Immature Defenses -Mature Defenses -Neurotic Defenses -Narcissistic Defenses

When working with the pediatric population, semi-structured diagnostic interviews are helpful assessment tools for diagnosing. Which semi-structured assessment advises training in the field of child psychiatry and allots for 1-1.5 hours to administer for children 6-18 years old? - K-SADS - Dominic -R -CAPA -DIS

With advances and ever-changing research in the field of psychiatry, the revised DSM-5 Manual identifies 15 new disorders. Name one of the new disorders added with the revision: -Major Depressive Disorder -Obsessive-Compulsive Personality Disorder -Dissociative Identity Disorder -Cannabis Withdrawal

Considering a medicinal approach, treating Schizoaffective Disorder has a range of pharmacologic options. What atypical antipsychotic affects blood cell count, requires you to do a registry, and is often used as an absolutely “last resort” for treatment? -Haloperidol -Clozapine -Fluoxetine -Lithium

Emerging research has found that some biological, genetic and psychosocial factors can increase the risk of developing depressive disorder. All of the following are examples of screening tools for mood disorders, specifically depression, except: -Beck Depression Inventory (BDI) -Patient Health Questionnaire (PHQ) -Pediatric Symptom Checklist - GAD-7

For the treatment of mood disorders, psychotherapy with medication has had a more positive significant impact for therapeutic response to treatment. Medication classes to consider when treating a Mood Affective Disorder can include antidepressants, antipsychotics, and mood stabilizers. This particular antidepressant requires a very strict diet regimen for food avoidance and can result in a hypertensive crisis if not followed appropriately: - Tricyclic Antidepressants -Selective Serotonin Reuptake Inhibitors (SSRI) - Monoamine Oxidase Inhibitors (MAOI) - Serotonin and Norepinephrine Reuptake Inhibitors (SNRI)

An individual with Bipolar Disorder can experience manic episodes, depressed episodes or mixed episodes. Manic symptoms may include all of the following except: -Grandiosity -Feelings of worthlessness -Highly prone to distractibility -Excessive participation in risky behavior

Based on diagnostic criteria, which of the following statements best differentiates schizophrenia from bipolar disorder? A. Schizophrenia is characterized primarily by mood episodes, including mania and depression B. Bipolar disorder is primarily characterized by hallucinations and delusions without any mood episodes C. Schizophrenia primarily involves symptoms like hallucinations, delusions, and disorganized thinking without always including mood episodes. D. Bipolar disorder and schizophrenia share the exact same diagnostic criteria and are indistinguishable

The hypothalamic-pituitary axis (HPA axis) is critical for various physiological processes. Which of the following is primarily regulated by the HPA axis? a. Digestion of food b. Muscle contraction c. Stress response d. Auditory perception

Individuals with schizophrenia often have comorbid conditions. Which of the following is a common comorbidity in patients with schizophrenia? a. Hypertension b. Substance use disorders c. Rheumatoid arthritis d. Migraine

During the maintenance phase of treatment for schizophrenia, what is the primary therapeutic goal? a. Rapid symptom reduction b. Prevention of psychotic relapse c. Initial diagnosis and assessment d. Detoxification from substances

Which of the following is a key diagnostic criterion for schizoaffective disorder? a. Absence of mood episodes during the active phase of the disorder b. Mood episodes that only coincide with the active phase symptoms c. Hallucinations or delusions for 2 weeks in the absence of a major mood episode d. A history of manic episodes without any psychotic symptoms

All the following are signs or symptoms of major depressive disorder (MDD) except a. Persistent feelings of sadness or hopelessness b. Loss of interest or pleasure in activities once enjoyed c. Increased energy and hyperactivity d. Sleep disturbances, including insomnia or hypersomnia

Which of the following statements best distinguishes between bipolar I disorder and bipolar II disorder? a. Both bipolar I and bipolar II involve manic episodes. b. Bipolar I is characterized by major depressive episodes only. c. Bipolar II involves hypomanic episodes but not full manic episodes. d. Bipolar II is characterized by manic episodes only.

Which of the following is a recommended first-line treatment for acute mania in bipolar I disorder according to standard treatment guidelines? a. Selective serotonin reuptake inhibitors (SSRIs) b. Benzodiazepine monotherapy c. Mood stabilizers such as lithium or valproate d. Atypical antipsychotics as adjunctive treatment only

Which of the following statements best describes cyclothymia? a. It is characterized by rapid cycling between full manic and major depressive episodes b. It involves mood disturbances that meet the criteria for major depressive episodes only c. It is a mood disorder involving periods of hypomanic symptoms and periods with depressive symptoms that do not meet the criteria for major depressive episodes d. It is a severe form of bipolar I disorder

For which of the following scenarios is ECT most commonly considered as a treatment option in bipolar disorder? a. For patients experiencing their first manic episode b. For those with bipolar disorder who are non-responsive to pharmacological treatments and strong suicidal tendency is present c. For all patients diagnosed with bipolar II disorder d. As a first-line treatment for mild depressive episodes in bipolar disorder

What are the diagnostic criteria for schizophrenia set by the DSM-5? a. An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with criterion for schizophrenia including the major depressive episode must include depressed mood b. Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness c. Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness d. The disturbance is not attributable to the effects of a substance or to another medical condition e. All the above.

What differentiates Bipolar 1 and Bipolar 2 disorder? a. Bipolar 1 has hypomania and less severe; Bipolar 2 has hypomania more severe b. Bipolar 1 has hypermania more severe, Bipolar 2 has hypomania less severe c. Bipolar 1 has hypermania and less severe, Bipolar 2 has hypomania and more severe

Identify the assessment tools used with schizoaffective disorder? a. PANSS b. Hamilton depression scale c. Yong mania scale d. All the above e. None of the above

Marijuana use greatly stunts the neurological development of patients even up to what age? a. 15 b. 19 c. 20 d. 25

What is the typical age of onset for individuals with schizophrenia? a. 10 to 25 years for men, 25 to 35 years for women b. 20-30 years for men, 25-40 years for women c. 30-40 years for men, 30-40 years for women d. 40-50 years for men, 30-50 years for women

What is the overall suicide incidence rate of individuals with schizophrenia? a. 5% b. 10% c. 25% d. 50%

Substance use disorder is a co-occurring comorbidity among individuals with schizophrenia. Which SUD is has a prevalence of 90% among this population? a. Alcohol use disorder b. Amphetamine use disorder c. Nicotine use disorder d. Sedative hypnotic use disorder.

Glutamate, glycine, asparate, homocysteine, GABA are associated with what type of neurotransmitter: a. Amino acids b. Biogenic amines c. Neuropeptides d. Nucleotides e. Gases

What neurotransmitters are associated with anxiety: a. Histamine and GABA b. Epinephrine and dopamine c. Serotonin and GABA d. GABA and glutamate

Two neurotransmitters that are the most closely associated with Schizophrenia are: a. Histamine and GABA b. Epinephrine and dopamine c. Dopamine and glutamate d. GABA and glutamate

The limbic system's neuropathology is linked to schizophrenia. Eugen Bleuler's four A's pertain to specific brain functions influenced by this system. Which of the following correctly lists Bleuler's four A's associated with schizophrenia? a. Affect, ambivalence, associations, and autism. b. Affect, anxiety, associations, and abolition. c. Affect, associations, autism, and avolition.

Beyond chemical methods, how else do neurons communicate? a. Monoamines b. Electrical c. Ion channel

A 36-month-old toddler is exhibiting a heightened sense of independence, often refusing help. Which of Erickson's developmental stages is this toddler likely experiencing? a. Trust vs. Mistrust b. Initiative vs. Guilt c. Autonomy vs. Shame

A 15-year-old is facing difficulties with executive functions. Which part of the brain oversees these tasks? a. Cerebellum b. Limbic system c. Prefrontal cortex

Jean Piaget theorized several stages of cognitive development for children. How many stages did he suggest? a. 6 b. 3 c. 4 d. 8

Parents are concerned about their 23-year-old displaying erratic behaviors and mentioning hearing voices. Which mental condition is this indicative of? a. Bipolar Disorder b. Anxiety c. Schizophrenia

When evaluating an individual with potential signs of a psychotic disorder, what's the initial step for a clinician? a. Develop a safety plan with the patient and family. b. Obtain a comprehensive family medical history. c. Promptly investigate any undiagnosed nonpsychiatric medical issues.

Patients diagnosed with schizophrenia are often susceptible to comorbid conditions like obesity and diabetes mellitus. Which other condition is frequently seen? a. Cancer b. Cardiovascular Disease c. Obstructive Sleep Apnea

A 29-year-old newly diagnosed with schizophrenia prefers treatment with either medication or psychotherapy as treatment. What should the clinician's recommendation be? a. Recommend antipsychotic medication and psychotherapy. b. Advocate for antipsychotic medication only. c. Suggest psychotherapy exclusively.

A 27-year-old patient with a recent schizophrenia diagnosis experienced side effects post-haloperidol administration. What might be a more suitable medication alternative? a. Fluphenazine b. Ziprasidone c. Benzodiazepine

Which of the following is a positive symptoms of schizophrenia? A. Tangential speech B. Affective flattening C. Alogia D. Apathy

Which type of mood disorder is defined by at least one hypomanic episode , one major depressive episode and no manic episodes? A. Bipolar 1 disorder B. Bipolar 2 disorder C. Rapid cycling bipolar disorder D. Major depressive disorder

Which of the following conditions are not associated with schizophrenia? A. Diabetes B. Hyperlipidemia C. Catatonia D. Neuropathy

Which drug toxicity presents with symptoms of slurred speech, confusion and lethargy? A. Mild lithium toxicity B. Severe lithium toxicity C. Clozapine toxicity D. valproate toxicity

The Nurse Practitioner prescribed Clozapine to a patient diagnosed with schizophrenia. After starting treatment, the patient calls the clinic to report the onset of new concerning symptoms. extrapyramidal symptom? A. Acute dystonia B. Akathisia C. Tardive dyskinesia D. Tachycardia

Which of the following drugs are contraindicated in patients taking Haloperidol? A. Ibuprofen B. Lithium C. Sertraline D. Benadryl

What are some adverse reactions reported in patients taking Valproate? A. Dizziness, diarrhea, blurred vision, hair loss, menstruation changes B. Dizziness, constipation, weight loss, lethargy C. Dizziness, ataxia, vomiting, and severe skin reactions D. Arrhythmia, EPS, Agranulocytosis, metabolic syndrome

The following are all stages of psychosocial development based on Erikson’s theory, except: A. Trust v. Mistrust B. Industry v. Inferiority C. Integrity v. Dishonesty D. Identity v. Confusion

What are the top two mood disorders associated with suicide risk? A. Psychotic disorder, bipolar disorder B. sleep disorder, dysthymic disorder C. Substance abuse disorder, bipolar disorder

Which of the following parts of the brain is involved with sensory function, attention and language? A. The parietal lobe B. The thalamus C. The Frontal lobe D. The occipital lobe

Which of Erikson’s psychosocial developmental stage takes place between the ages of 12 and 18 years? A. Identity v role confusion B. Intimacy v isolation C. Generativity v stagnation D. Integrity v Despair

Which part of the brain is responsible for regulation of breathing, blood pressure and heart rhythm? A. Medulla B. Cerebellum C. Occipital lobe D. Frontal lobe

Which one of the following is NOT a side effect of Nortriptyline: A. Hallucinations B. Lightheadedness C. cardiac arrhythmias D. Urinary retention

Which of the following is contraindicated to administer to patients currently taking Nortriptyline: A. Bromperidole B. Ibuprofen C. Acetaminophen D. Cyprofloxacine

Which of the followings is the maximum oral dose Aripiprazole in the management of schizophrenia? A. 900 mg per day B. 30 mg per day C. 800 mg per day

Which philosopher defines attachment theory? A. John bowlby B. Erik Erikson C. Sigmund Freud D. B.F. Skinner

What are the three agencies according to Freud’s theory? A. Id, ego, and superhero B. Id, ego, and superego C. Id, ego, the conscious mind, and the subconscious mind

What other conditions can sometimes mimic the symptoms of bipolar disorder? Choose all that apply A. Lupus B. Thyroid disease C. Diabetes D. Insomnia

a,b

Where is Dopamine synthesized, and which enzyme is associated with reduced production? A. Hypothalamus, Tyrosine Hydroxylase B. Pituitary Gland, Tyrosine hydroxilase C. Cerebellum, DAT D. Brain stem, DAT

What cause of death is most prevalent in patients suffering from bipolar disorder? A. Car accidents B. drug overdose C. suicide D. homicide

Two neurotransmitters that are the most closely associated with anxiety are: a. Epinephrine and Histamine b. Serotonin and dopamine c. GABA and glutamate d. GABA and serotonin

Executive function- cognitive processes that help make a person able to have organized and adaptive behavior is associated with which region of the brain? a. Hypothalamus b. Cerebral cortex c. Prefrontal cortex d. Basal ganglia

The best example of Cognitive Dissonance is: a. Setting goals but not achieving them b. Needing to see yourself in a positive light c. Belief that people act a certain way because of who they are d. Doing something that is inconsistent with your belief system

Match the theory or concept to its founder a. Sigmund Freud 1.first developmental theorist to recognize the importance of birth order. Coined the term “inferiority complex” b. Erik Erikson 2. founder of Ego Psychology, introduced the concepts of ego, id and superego. c. Alfred Adler 3. created two theories of anxiety, one based on repressed libido and the other called signal anxiety. d. Erich Fromm 4.Created a theory of psychological development across the lifespan. Coined the term “identity crisis”

A-2 and 3 B-4 C-1

The PMHNP knows that the prognosis of the patient with schizophrenia is likely good due to all the following factors EXCEPT this: a. They are married b. Good support system c. Onset in early childhood d. Accompanying mood symptoms

According to the DSM-5, the diagnostic criteria for schizophrenia must include at least one of these three symptoms that are present over a significant portion of time during a one-month period: a. Delusions, disorganized speech, and catatonic behavior b. Delusions, negative symptoms, and hallucinations c. Delusions, hallucinations, and disorganized speech d. Delusions, hallucinations and disorganized behavior

What is the most common predictor of non-adherence to treatment, higher relapse rates, and overall poorer course of illness in schizophrenic patients? a. Anosognosia b. Negative symptoms c. Aggressive behaviors d. Comorbid mood disorders

You are seeing a female 42-year-old patient in your FP clinic. She has a chief complaint of fatigue and describes other symptoms such as hypersomnia, anhedonia, forgetfulness, and weight loss due to lack of appetite. The PMHNP strongly suspects Major Depressive Disorder as a diagnosis. What assessment tool or diagnostic test is not necessary to definitively diagnose this patient with MDD. A. Thyroid function testing B. Hamilton Depression Scale C. Urine drug screen D. GAD score E. PHQ-9

You are seeing a 34-year-old patient in your clinic today and he complains of a sudden onset of enlarged breast tissue causing him severe distress. You reassure him that this is likely a side effect of which mood stabilizing medication? a. Lithium b. Risperidone (Risperdal) c. Carbamazepine (Tegretol) d. Lamotrigine (Lamictal) e. Spironolactone

You are evaluating a new patient that was recently diagnosed with Bipolar II disorder and when you are prescribing a mood stabilizing medication you consider Lithium. What medications might interact with Lithium? SELECT ALL THAT APPLY: a. Valproate b. Zestoric c. Propranolol d. Flagyl

b,d

What is the precursor amino acid to Serotonin? A. Tryptophan B. Tyrosine C. Phenylalanine D. Glutamate

Damage to what part of the brain would result in: Changes in sexual habits, socialization, personality, and increased risk-taking? A. Frontal Lobe B. Parietal Lobe C. Occipital Lobe D. Temporal Lobe

Based on Erkison’s belief that people move through a series of psychosocial stages throughout the lifespan; What stage would a 30 year old be in? A. Industry vs Inferiority B. Generative vs Stagnation C. Intimacy vs Isolation D. D Identity vs Role Confusion

Distortion is an example of what type of defense mechanism? A. Neurotic Defense B. Narcissistic Defense C. Mature Defense D. Immature Defense

When evaluating for Mental Health Disorder it is important to rule out medical conditions as the cause of presenting Neuropsychiatric symptoms. Which of the below is NOT a medical condition that could result in neuropsychiatric symptoms? A. Systemic Lupus Erythematosus, SLE B. Hypothyroidism C. Uremia D. Diabetes Mellitus 2

Which of the following is not one of the 15 New Disorders added to the DSM-5? A. Caffeine withdrawal B. Chemo Brain C. Premenstrual Dysphoric Disorder D. Central Sleep Apnea

What is the single leading cause of death among persons with schizophrenia? A. Complications of Diabetes B. Cardiovascular Disease C. Suicide D. Drug Abuse

The following are all negative symptoms of schizophrenia or schizoaffective disorder EXCEPT? A. Catatonia B. Amotivation C. Hallucinations D. Blunted Affect

Which of the following are true concerning effective treatment for Depression? (Mark all that are correct) A. Medication alone can improve symptoms by 70% B. Psychotherapy alone can improve symptoms by 70% C. It is recommended to use both medication & psychotherapy for the most effective treatment D. Phototherapy is considered a 1st line therapy

a,b,c

Bipolar I & II are both mood disorders that are life long and require treatment. Which of the statements below best describes this disorder to patients and family? A. Bipolar Disorder is a mood & thought disorder B. Bipolar Disorder is a disorder of Dysthymia with occasional episodes of mania C. Bipolar is a biochemical disorder that affects mood with no emotional basement or ceiling, allowing for extreme highs and lows. D. Bipolar is a personality disorder often confused with Cyclothymic disorder.

Schizophrenia is said to have an onset that typically occurs between what ages? a. 3 - 15 years b. 15 – 30 years c. 30 – 40 years d. 40 – 60 years

What is included in criterion A for schizophrenia that it shares with schizoaffective disorder? a. Onset is typically in the setting of substance use disorder exacerbation. b. Delusions, hallucinations, disorganized speech, negative symptoms c. Laboratory evidence of disease such as elevated WBCs, thyroid dysfunction, abnormal LFTs d. The two disorders do not share diagnostic criteria.

Schizophrenia differs from schizoaffective disorder in that: a. The two disorders do not differ; they are interchangeable terms used by clinician discretion b. Schizoaffective disorder includes a mood component, whereas schizophrenia typically lacks significant mania or a major depressive episodes c. Schizophrenia most often occurs in the setting of a medical disease d. Schizophrenia starts in middle adulthood whereas schizoaffective disorder starts in adolescence.

What are the four “A’s” of schizophrenia? a. Attitude, Abstract, Attention, Auditory hallucinations b. Association, Affect, Autism, Ambivalence c. Affiliation, Attention, Acuity, Abstract d. Attitude, Autism, Affiliation, Auditory hallucinations

In which disorder is the overall incidence of suicide the greatest? a. Cyclothymia b. Bipolar I Disorder c. Schizophreniform disorder d. Bipolar II Disorder

Measuring Liver Function Tests (LFTs) is particularly important with which psychiatric medication? a. Aripiprazole, invega b. Sertraline, fluoxetine c. Carbamazepine, valproate d. Lorazepam, clonazepam

For which of the following is ECT not typically used: a. For treatment resistant depression after 2+ unsuccessful medication trials b. When pregnancy and other medical conditions make medications unsafe c. As an emergent treatment for suicidality in the severely mentally ill d. As a starting therapy in new onset bipolar II disorder

What differentiates mania from hypomania? a. Hypomania is milder form of mania b. Mania occurs in the summertime and hypomania occurs during the winter c. Those with hypomania do not have elevated mood d. Mania includes increase productivity whereas hypomania does not

How is bipolar II disorder different from cyclothymia? a. Symptoms of hypomania and depression are present without fully meeting criteria for a manic, hypomanic, or depressive episode. b. Bipolar II and cyclothymia are interchangeable terms to characterize the same illness. c. Cyclothymia is a more severe form of bipolar II disorder d. Bipolar II presents at a later stage in life than cyclothymia

Why is a basic foundational knowledge of medical diseases important in psychiatry? a. Many medical illnesses, such as infections, will need to be treated by the PMHNP b. It is important to know if a disease might be the underlying cause of neuropsychiatric symptoms c. Psychiatry providers must be competent in all medical illness so they may educate patients in naturopathic management strategies d. If a patient has a medical illness, they cannot be treated by a PMHNP

Judith was thrilled to be chosen to participate in a university sponsored summer program for high school students interested in science for a career. Her mentor, a biology professor and researcher at the university was shocked when she shared that she wanted to be a pharmacist one day. “You would be putting antacids on the shelf. Is that what you really want to do?” Judith felt embarrassed yet struggled with the idea of being a scientific researcher like her mentor. What psychosocial stage best describes Judith’s behavior? Autonomy vs versus shame and doubt Identity vs role confusion Industry vs Inferiority Initiative vs guilt

According to Jean Piaget, which cognitive development stage is characterized by the ability to understand weights and measures and apply the concept of conservation and reversibility of matter? Formal operation Concrete operation Preoperational thought Deductive reasoning

Which theory is best demonstrated by the following scenario: Joey is crying when his mother hands him off to the daycare provider. He is suddenly soothed when his mother whips out his teddy bear and blanket. He then is guided quietly to a bunch of toy cars on the floor. Skinner’s operant learning - while Joey could learn that crying can bring him his teddy bear and blanket, Joey’s crying here is because he is being separated from his mother. Bowlby’s attachment theory - best explains why Joey is crying when he is being separated from his mother, his secure base. The teddy bear and blanket serves as a substitute secure base called a transitional object. With the help of a transitional object, Joey is able to leave his base of security to explore. Erikson’s theory of psychological development and crisis - autonomy versus shame and doubt is not demonstrated here. Freud’s structural theory of the mind - there’s no allusion to the operations of the id, ego, and superego in the scenario

Which neurotransmitters are derived from the amino acid tyrosine. Serotonin, norepinephrine, and epinephrine Dopamine, norepinephrine, and epinephrine Dopamine, histamine, acetylcholine Serotonin, dopamine, histamine

Which lobes of the brain do language functions reside in? Right frontal and right temporal lobes Right and Left temporal lobes Left frontal and left temporal lobes Left parietal and left temporal lobes

Which of the following is more characteristic of bipolar depression as opposed to unipolar depression: Age of onset 30, 40, 50s (associated more with unipolar depression) Insomnia vs. hypersomnia (associated more with unipolar depression) Retardation > agitation (associated more with bipolar depression) Sex ratio: more women than men (associated more with unipolar depression)

What type of medication can precipitate mania? Antidepressants Anticonvulsants Antipsychotics Lithium

Which of the following group of symptoms meet diagnostic criteria for schizophrenia if present for at least 6 months and causes functional impairment Repetitive pacing, paucity of speech, and negativism (Does not have any of the required symptoms for schizophrenia) Hallucinatory voices, disorganized behavior, and inappropriate affect. (Has hallucination, one of the required symptoms and two of the others - disorganized behavior and a negative symptom). (pg 341, Schizophrenia Spectrum and Other Psychotic Disorders - Boland & Verduin, 2023) Grandiose delusions, irritable mood, hyperactivity (Has delusions, one of the required but the other two are mood disorder symptoms) Absence of interest in peers, lack of facial expressions, repetitive motor movements. (Does not have any of the required symptoms for schizophrenia)

Janet is a 40 yo high school teacher with a history of treatment resistant depression. She is already currently taking the maximum daily dose of zoloft. Her BMI is 35 and she is also pre-diabetic. In considering an antidepressant adjunct, which antipsychotic could help her avoid further weight gain? Risperdal (Risperidone) Zyprexa (Olanzapine) Ziprasidone (Geodon) Aripiprazole (Abilify)

In uncomplicated depression, how long can an untreated episode of depression last when compared to treated depression? 13 to 19 months as opposed to 3 months 13 to 19 months as opposed to 6 months 6 to 13 months as opposed to 6 months 6 to 13 months as opposed to 3 month

Which of the following is not a sign of a typical “good prognosis” of a patient with schizophrenia: a. female sex b. older age of onset c. insidious onset d. absence of comorbid substance use disorders

The parietal lobe of the brain is mainly responsible for: a. sensory processing b. visual c. auditory d. language

According to Erikson, what stage occurs when an individual is 65 years old and older? a. Autonomy vs. Shame/Doubt b. Industry vs. Inferiority c. Intimacy vs. Isolation d. Ego/Identity vs. Despair

Although the cause of schizophrenia is likely multifactorial and not well understood, the biological theory that is hypothesized is: a. Dopamine b. Serotonin c. GABA d. Neuropeptides e. All of the above

A defense mechanism that consists of experiencing stress, and projecting the frustration one might feel onto a target that is not considered a threat to the individual (friend, family member, pet): a. denial b. repression c. displacement d. reaction formation

In order to meet the diagnostic criteria for schizoaffective disorder according to the DSM-5 TR, an individual must exhibit all the following except: a. uninterrupted period of illness with a major mood episode concurrent with criteria for schizophrenia b. delusions or hallucinations for 2 or more weeks c. suicidal ideation or attempt d. not attributed to the effects of a substance

It can be difficult to differentiate between normal and typical grief patterns after the loss of a loved one, and a major depressive disorder. Signs that a person needs further evaluation for the possibility of a psychopathological process include: a. guilt of commission, delusions, or reactivity to anniversaries b. acceptance of feelings of grief c. displacing belongings of the deceased, packing things away, removing processions d. feelings of guilt for not acting in a way that could have potentially saved their life (guilt of omission)

Ketamine functions as an effective option in treatment-resistant depression by inhibiting which receptor: a. dopamine b. serotonin c. GABA d. NMDA (N-methyl-D-aspartate)

Your lifetime risk of being depressed at some point is: a. 10% b. 17% c. 25% d. 30%

The signs and symptoms of major depressive disorder include all of the following except: a. feelings of hopelessness b. loss of interest or pleasure in activities c. insomnia or excessive sleeping d. worry and concern over future events

Where are basic facial expressions thought to be processed? A. Hypothalamus B. Cortical Brain Stem C. Amygdala D. Pituitary gland

What are the two pathways that convey visual information from the retina to relevant brain areas? A. Sympathetic and parasympathetic pathways B. M & P pathways C. Frontal and prefrontal pathways D. Adrenal-pituitary pathway

The ability to think, reason and imagine originate in the? A. Hippocampus B. Cerebral Cortex C. Amygdala D. Cerebellum

A degeneration of dopamine neurotransmitters in the substantia nigra can result in? A. Depression and anxiety B. Homicidal Ideation C. Parkinson’s disease D. Bipolar disorder

More than 50% of the brains total neurons are found in the? A. Hippocampus B. Prefrontal cortex C. Cerebellum D. Hypothalamus

Neurons release chemicals known as neurotransmitters for communication with other neurons through? A. Dendrites B. Synapses C. Axons D. Nucleus

Where do fear responses, panic and anxiety arise from which area of the brain? A. Limbic system B. Broca’s area C. Pituitary gland D. Substania nigra

Serotonin is synthesized in which structure? A. Basal ganglia B. Frontal cortex C. Axon terminal D. Amygdala

Disorders of the hypothalamic-pituitary axis can result in which of the following? A. PTSD B. Dementia C. Alzheimer’s D. All of the above

In schizophrenia disorder, structural neuroimaging supports the conclusion that the hippocampus is what when compared to non-schizophrenic brains: A. Larger than average B. Smaller than average C. Shaped differently than average D. Flatter than average

A medical review of systems that can serve as an approach for reviewing critical psychopathological domains is knowns as: A. Cross Cutting Measures B. Severity Measures C. WHODAS 2.0 D. PHQ 9

__________ is a culturally constructed group identify use to define peoples and communities? A. Race B. Ethnicity C. Culture

Cultural concepts are important to psychiatric diagnosis for several reasons, with the exception of: A. to avoid misdiagnosis B. to disprove clinical rapport and engagement C. to improve therapeutic efficiency D. to help guide clinical research

According to Smolla, et al. adults tend to pay attention to externalizing behavior problems, while children and adolescents are better at: A. Identifying their internal behaviors B. Have a high level of sophistication and comprehension C. Have high reliability when interviewed D. Have high levels of concentration than adults

Child and adolescent psychological assessment (CAPA)is for: A. 9-17 year olds B. needs no training to complete C. takes a minimum of 2 hours to complete with patient D. tends to be used more than the K-SADs diagnostic assessment tool.

Medical conditions manifesting as neuropsychological symptoms can be which of the following? A. Hypothyroidism B. SLE C. Vitamin B12 deficiency D. Intoxication E. All of the above

Who founded psychiatric classification? A. Hippocrates B. Emil Kraeplin C. Charles Darwin D. John Locke

One of the interesting things about the DSM-5 is that it A. Deals mainly with disorders later in life B. looks across the lifespan C. maximizes personality and intellectual disorders D. has separate sections between children and adults

19. Which of the following is a new classification in the DSM-5? A. Hoarding B. Social Communication disorder C. Central Sleep Apnea D. Cannabis withdrawal E. All of the above

Functions of diagnostic criteria can: A. Offer guidelines for making a diagnosis B. Help make informed clinic judgement C. Text descriptions can help rule out diagnoses D. Helps with consideration of subtypes and specifiers

Eugen Bleurer’s well know four A’s – affect, associations, ambivalence, and autism refer to which mental illness? a. Bipolar b. Depression c. Schizophrenia d. Autism

Schizophrenia is a multifactorial disorder that includes both genetic and environmental factors. Some of the relevant factors in the development of this disorder at the prenatal stage does not include? a. Hypoxia b. Infection c. Toxic exposure d. Trauma

It has been suggested that there are non-biological risk factors in the development of Schizophrenia. Which of the options below is not one of those factors? a. seasonality of birth b. childhood trauma c. cannabis use d. rural upbringing

Which is an not an example of a mood stabilizer? a. Lithium b. Depakote c. Gabapentin d. Geodon

22-year-old female extrovert with history of grandiose, racing and expansive thoughts, hyperactivity, and insomnia. She has numerous episodes each lasting between 3 -6 months. Which diagnosis is she mostly likely to have? a. Bipolar I Disorder b. Unipolar c. Bipolar II Dis

The most important lab diagnostic test to perform when prescribing Lithium is? a. Liver Function Tests b. Lipid panel c. Hemoglobin A1C d. Renal Function

What is the correct maintenance range of lithium for treat of bipolar disorder? a. 0.5-1.0mEq/L b. 1.0-2.0mEq/L c. 0.6-1.2mEq/L d. 1.5-2.0mEq/L

Symptoms of Schizophrenia can be divided in 3 groupings. These groupings are classified as Negative, Positive, and Cognitive Symptoms. Which of the options below are considered a negative symptom? a. Hallucinations b. Incoherence c. Adehonia d. Delusions

Tardive Dyskinesia occurs in about 20 to 30 percent of Schizophrenic patients who are on long term treatment with a first-generation antipsychotic. Which of the following is not a recommendation to prevent/manage this side effect? a. using lowest effective dose b. disregard age as factor c. consider dosage reduction if observed d. clozapine is effective in reducing TD

Which of the following statements are false regarding the prevalence and incidence of depression? a. Correlated with lower socioeconomic status b. More common in rural than urban areas c. No difference in race d. 2.5% of children in the U.S. suffer from depression

Which of the following dichotomous signs and symptoms are not associated with Major Depressive Disorder (MDD)? Insomnia or excessive sleeping Weight loss or weight gain Psychomotor agitation or retardation Elevated or low energy

Within the context of bipolar disorders, what is rapid cycling? Frequent mood swings between depressive and hypomanic episodes The onset of manic symptoms without prior depressive episodes Experiencing four or more mood episodes within a year Recurrent depressive episodes without any manic or hypomanic episodes

Which of the following options contains two, hallmark symptoms that are associated with early onset schizophrenia? Disorganized speech and catatonia Delusions and manic episodes Hallucinationsandhypersomnia Abnormal psychomotor behavior and substance abuse

What distinguishes schizoaffective disorder from schizophrenia? The presence of hallucinations The presence of delusions The co-occurrence of mood episodes Symptoms last 1-6 months

What is the primary difference between Bipolar I Disorder and Bipolar II Disorder? The severity of manic episodes The presence of depressive episodes The age of onset The gender prevalence

Which of the following options contains a characteristic of someone’s schizophrenia diagnosis that would indicate that they have a poor prognosis? Late and acute onset Presence of negative symptoms Presence of positive symptoms Family history of mood disorders

How is dysthymia differentiated from major depressive disorder? Dysthymia is having depressive symptoms, but less in severity than major depressive disorder. Major depressive disorder is characterized by hypersomnia and insomnia whereas dysthymia is characterized only by hypersomnia Dysthymia lasts up to 2 weeks while major depressive disorder is characterized as chronic There is no difference, dysthymia is another term for major depressive disorder

Which SSRI below is not known to be effective against the symptoms of PMDD (premenstrual dysphoric disorder). A. Sertraline B. Escitalopram C. Paroxetine D. Fluoxetine

Which of the following is not a reason that a patient may opt for ECT (electroconvulsive therapy)? Patient has suicidal ideation/severe illness that cannot wait for therapeutic effects of medication Patient conditions that have not been effectively treated by medications in the past Medications are contradicted for the patient ECT can safely and effectively be self-administered at home with the proper equipment

Which of the following options is not an example of a defense mechanism? Narcissistic Defenses / Distortion Mature Defenses / Projection NeuroticDefenses/Repression Immature Defenses / Acting Out

The circadian rhythm and thermostat of the body is regulated in the following part of the brain: Midbrain Hypothalamus Substantia Nigra Amygdala

The hypothalmic-pituitary -adrenal axis dysregulation is evident in which disease process? ADHD Diabetes PTSD Bipolar Disorder

.While monitoring patients on some FGA/SGA, checking prolactin levels is important because which of the following is impacted by these drugs: A. Pituitary gland B. Pre frontal cortex C. Na Ion channels D. Glutamate

75 year old Bob has been changing jobs frequently, estranged from friends and family for many years. Based on Ericksons, developmental theory, failure in this stage results in: Isolation Incompetence Depression Despair

Which of the following is not an example of a defense mechanism? Mature Ambivalent Neurotic Narcissistic

New diagnosis included in latest edition of DSR 5 include all but the following: A. Restless Leg Syndrome B. Excoriation (Skin Picking) Syndrome C. Central Sleep Apnea D. Social Media Addiction

Chase, a 35 yo male presents to ER with altered mental status, auditory hallucinations and agitation. What objective data would not be indicated? A. Comprehensive chemistry panel B. Urine drug screen C. Vitamin D level D. Delirium screening tool

Neuropathologic basis for schizophrenia involves: A. Limbic system and basal ganglia B. Lack of dopaminergic receptors C. Degeneration of the substantial nigra and dopamine pathways D. Deficiency of acetylcholine

Mrs Jones continues to talk and worry about the threat of severe weather and cannot engage on any other topic of conversation with anyone without returning to the subject. This is an example of what type of thought disorder? A. Thought blocking B. Delusions C. Perseveration D. Echolalia

Elizabeth a 28 yo female, with recent diagnosis of schizophrenia, as well as, diabetes mellitus, hypertension and severe obesity. Which atypical antipsychotic would be the most weight neutral? Risperdal Latuda Zyprexa Abilify

In the teenage brain between the ages of 13-18, they lose what percentage of gray matter? A. 1 % B. 15% C. 30% D. 50%

According to new studies, it is determined that the prefrontal cortex grows before puberty. A. True B. False C. None of the above

Defense Mechanisms are automatic and usually unconscious processes and occur to: A. Protect against anxiety. B. Decrease self-esteem C. Resolves emotional conflict D. A and B E. A and C

Neuronal Theory consists of A. Individual neuronal transmitters B. Individual cells C. Individual synapse D. Individual messages

Which of the following minerals is 15 to 20 times more concentrated in neurons and which is 8-15 times less concentrated? A. Potassium and Sodium B. Potassium and Calcium C. Calcium and Sodium D. Chloride and Sodium

Synapses are made up of which of the following component(s)? A. Mitochondrion B. Vesicles C. Ion channels D. Postsynaptic membrane E. All the above

There are numerous neurotransmitters. Which of the following are biogenic amine groups? A. Dopamine B. Norepinephrine C. Epinephrine D. Serotonin E. Histamine F. All the above

Where is serotonin synthesized? A. Axel terminal B. Axon terminal C. Synaptic terminal D. Ionic channel

Circadian rhythm dysregulation or disruption can lead to an imbalance in which of the following biological rhythms? A. Sleep-wake cycle and body temperature B. Hormonal levels C. Menstrual D. All the above E. None of the above

In Erikson’s stages of psychosocial development what psycho-social crisis is associated with the age group of 12- 21 years old? A. Autonomy vs shame and doubt B. Initiative vs Guilt C. Industry vs Inferiority D. Identity vs Role Confusion

Amy is recovering from a stroke and it has affected her visual color perception. She is physically able to point and identify blue, but she is unable to verbally communicate that the color is blue. What type of visual perception disorder is Amy experiencing? a. Color agnosia b. Color anomia c. Central achromatopsia d. Anton syndrome

The DSM 5 is a guide for clinicians to help with mental diagnoses. Which of the following is not included? a. Diagnostic code b. Diagnostic Features c. Differential Diagnosis d. Treatment e. Prevalence

A schizophrenic patient comes into the clinic and is speaking rapidly, stumbling over words, and not making much sense. Which of Bleuler’s four A’s would this be categorized in? a. Association b. Affective disturbances c. Autism d. Ambivalence

Susie is planning on skipping school to go to the beach tomorrow without her parents knowing. She knows it will be fun, but she is unsure if she wants to go and risk getting in trouble. Which of Freud’s ego psychology is Susie exhibiting by not wanting to get in trouble? a. Freuds theory b. Id c. Ego d. Superego

Sam is in high school and is having a hard time knowing who he is, what he likes, and belonging to a social group. What Erikson psychological stage is Sam experiencing? a. Intimacy vs. Isolation b. Autonomy vs. shame and doubt c. Identity vs. role confusion d. Industry vs. inferiority

Brian grew up surfing and enjoys going almost every weekend. A year after being diagnosed with schizophrenia he doesn’t enjoy surfing anymore. What symptom is Brian experiencing? a. Anhedonia b. Alogia c. Avolition d. Affective blunting

Which statement is true regarding bipolar 1 disorder? a. Manic episodes are more common in women b. Bipolar is more common in married persons than divorced persons c. Bipolar has an equal prevalence among men and women d. Depressive episodes are more common in men

Ashley is being evaluated in the clinic and scores 19 on the Hamilton Rating Scale for Depression. What does the score of 19 indicate? a. No Depression b. Mild Depression c. Moderate Depression d. Severe Depression

Mary is receiving psychotherapy for her major depressive disorder. Her intervention therapy includes, increasing her activity level, setting self-goals, and working on interpersonal skills. What type of therapy is Mary receiving? a. Behavioral therapy b. Cognitive Behavioral Therapy c. Interpersonal Psychotherapy d. Behavioral Marital Therapy

Harris is being evaluated in the clinic and has been diagnosed with Major Depressive Disorder. Which treatment would be the best for Harris? a. Pharmacotherapy b. Psychotherapy c. Neurostimulation d. Phototherapy e. Both A & B

A patient presents with symptoms such as hallucinations, delusions, disorganized speech, and impaired social functioning. Which of the following conditions should be considered in the differential diagnosis for schizophrenia to rule out potential alternative explanations for these symptoms? A) Major depressive disorder B) Social anxiety disorder C) Substance-induced psychotic disorder D) Obsessive-compulsive disorder

Which statement best describes the relationship between dopamine, the mesolimbic pathway, and schizophrenia? A) Increased dopamine activity in the mesolimbic pathway is associated with the negative symptoms of schizophrenia. B) Dopamine dysregulation in the mesolimbic pathway is primarily responsible for the cognitive symptoms of schizophrenia. C) Hyperactivity of dopamine in the mesolimbic pathway is implicated in the development of positive symptoms like hallucinations and delusions in schizophrenia. D) Schizophrenia does not involve the mesolimbic pathway, and dopamine plays no role in the condition.

What is the primary precursor molecule required for the synthesis of norepinephrine in the human body? A) Serotonin B) Acetylcholine C) Tyrosine D) Glutamate

In a teenage brain, the __________ (part of the brain) is larger in females, which offers protection against childhood illnesses. Basal ganglia cerebellum Frontal cortex Thalamus

Select all that apply: Cyclothymic disorder is often confused with personality disorder due to mild nature of symptoms and chronic type of disease Cyclothymic disorder is characterized by the presence of extreme and long-lasting mood swings between depression and mania. Cyclothymic disorder involves recurrent episodes of major depression, separated by periods of normal mood. Cyclothymic disorder is a chronic mood disorder marked by numerous periods of hypomanic and depressive symptoms that do not meet the criteria for a major depressive episode or manic episode. Cyclothymic disorder is a rare disorder that typically leads to full-blown bipolar I disorder within a few years of diagnosis.

a,d,

method of learning that uses rewards and punishment to modify behavior Classic conditioning Operant conditioning Social learning theory Positive reinforcement

In the context of language and brain function, which of the following accurately describes the roles of Broca's area and Wernicke's area in the brain? A) Broca's area is responsible for comprehending language, while Wernicke's area is responsible for speech production. B) Broca's area is primarily involved in speech production, while Wernicke's area is responsible for language comprehension. C) Both Broca's area and Wernicke's area are exclusively involved in language production. D) Broca's area and Wernicke's area have identical functions and are interchangeable in their roles in language processing.

Which of the following is incorrect about the DSM 5 It only focuses on the adult population Should be used to enhance clinical decision making and not as the sole basis for daignosing. Draws attention to symptoms across diagnoses Helps to identify future areas of inquiry

All are true regarding Clozapine except: Agranulocytosis Seizures DKA Increases risk for suicidality.

Which neurotransmitter system is primarily targeted by antipsychotic medications to alleviate the positive symptoms of schizophrenia, such as hallucinations and delusions? A) Serotonin B) Norepinephrine C) GABA (Gamma-Aminobutyric Acid) D) Dopamine

A 58-year-old male was in a motorcycle accident and now has damage to his frontal cortex. The PMHNP would expect him to have difficulties with a. ability to brush his teeth b. recites his new address c. folding his laundry

Which of Freud’s structure of the mind concepts utilizes defense mechanisms to reduce anxiety a. Super ego b. Id c. ego

What is the safe blood maintenance, reference range for lithium a. 0.6-1.2 mEq/ml b. 0.6-1.2 ng/ml c. 0.6-1.2 mg/ml

Which drug is most effective in improving both positive and negative symptoms in treatment-resistant schizophrenia in youth a. haloperidol b. risperidone c. clozapine

Nonpsychotic children experiencing extreme stress can present with a self-limiting sign of a. catatonia b. auditory hallucinations c. paranoid delusions

What medical condition should be a part of the PMHNP differential diagnosing when a youth is presenting with psychotic features a. thyroid disease b. rheumatoid arthritis c. occipital lobe disease

Confident in one’s ability to achieve goals is mastery of which stage of Erikson’s development theory: a. Initiative vs. guilt b. Generativity vs. stagnation c. Industry vs. inferiority

. Individuals diagnosed with Schizophrenia who have better clinical outcomes, fewer negative symptoms, better abstract thinking, and a capacity to change have a suicide risk that is: a. increased b. decreased c. no different

What condition should be ruled out before starting a selective serotonin reuptake inhibitor (SSRI)? a. generalized anxiety disorder b. bipolar I disorder c. dysthymia

First-line treatment for acute mania in bipolar I disorder is a. Paxil b. Bupropion c. Lithium

The mental status variation that the PMHNP can expect to observe in a client with borderline personality disorder is: Euphoria Hallucinations good insight and judgment mood liability

Psychotherapeutic interventions that can be utilized when addressing anti-social personality disorder include all of the following except: Confronting an appropriate behavior group psychotherapy Supervised structured living outpatient supportive therapy

Lithium carbonate is contraindicated when a client has a dysfunction of which one of the following body systems: Reproductive Renal Endocrine

The most serious side effect of electroconvulsive therapy is: Memory loss cardiac arrhythmias Hypotension agitation

An impulse control disorder that is characterized by deliberate and purposeful fire setting is known as: Intermittent explosive disorder Trichotillomania Kleptomania Pyromania

Which of the following is not a symptom of opiate withdrawal? Muscle cramps tachycardia pupillary constriction diarrhea

Memory impairment that is associated with alcohol use disorders is attributed to: Decrease dopamine levels elevated liver enzymes Gastritis vitamin B (thiamine) deficiency

Medical complications associated with cocaine use include all of the following except: Seizures Stroke cardiac arrhythmia kidney failure

Selective Serotonin Reuptake Inhibitors are first-line medication options to treat the following anxiety Related Disorders: Generalized anxiety disorder obsessive compulsive personality disorder panic disorder A and C are correct

A key symptom of Alzheimer's dementia includes: Emotional distress Hallucinations Depression Progressive memory decline