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Flashcards in Psychiatric 1-12 Deck (130)
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1

Temperament—a genetically influenced early form of personality—describes an infant’s pattern of central nervous system responses and behaviors. Among the different types of temperament, which one is associated with more impairment of brain functioning and, in the absence of positive, nurturing parenting, is a risk factor for later development of psychiatric disorders?
A. Easy
B. Slow-to-warm-up/inhibited
C. Mixed
D. Difficult

D. Difficult

2

According to psychosocial developmental theory, in the recently described “ninth age of man,” beyond the life cycle,
A. There are no further tasks to accomplish.
B. The tasks that are the most important are generative versus stagnation.
C. There is an emphasis on intimacy versus isolation.
D. Tasks include overcoming life transitions.

D. Tasks include overcoming life transitions.

3

Which attachment pattern is more likely to be found among children who have been abused?
A. Secure
B. Inhibited
C. Disorganized
D. Avoidant

C. Disorganized

4

Nobel Prize winner Eric Kandel demonstrated that the brain
A. Is plastic before birth but becomes hard-wired at birth
B. Has plasticity and can change during the first 3 years of life
C. Has plasticity that allows it to make new connections in response to learning
D. Is unable to make new connections after age 26

C. Has plasticity that allows it to make new connections in response to learning.

5

The primary relevance of Bowlby’s attachment theory for psychiatric advanced practice nurses is that
A. Toddlers develop primitive defense mechanisms such as denial.
B. Toddlers develop an inner working model of how adults will respond to them.
C. Toddlers face the psychosocial task of autonomy versus shame.
D. Toddlers develop a fear of engulfment and enmeshment.

B. Toddlers develop an inner working model of how adults will respond to them.

6

Early attachment experiences are transformed into inner working models of the self and mother by age
A. 7 years
B. 5 years
C. 3 years
D. 1 year

D. 1 year

7

In a cantilevered model of needs such as Hansell’s model,
A. Basic needs must be met first
B. There is a hierarchy of needs
C. Each need supports all other needs
D. Self-actualization is the last need to be met

C. Each need supports all other needs

8

Freud’s drive theory proposes that individuals are motivated by
A. Basic drives for survival and reproduction.
B. Need to reduce anxiety.
C. Need to resolve interpersonal conflicts.
D. Basic drives for altruism.

A. Basic drives for survival and reproduction.

9

Brain plasticity, which refers to the brain’s capacity to change in response to an event,
A. Is the same for all individuals
B. Involves physical changes of the brain
C. Is absent in older adults
D. Is independent of genetic influence

B. Involves physical changes of the brain

10

It is believed that recovery can be promoted in children by all of the following except
A. Teaching problem-solving skills
B. Providing social support
C. Limiting challenging experiences
D. Providing structure to daily life

c. Limiting challenging experiences

11

The primary focus of the biopsychosocial model is
A. Heritability of psychiatric disorders
B. Domains of functioning
C. Abnormalities of neurotransmission
D. Abnormalities of systems and circuits

B. Domains of functioning.

12

On evaluation, the patient appears to be having difficulty with working memory, planning, and insight into his problems. The psychiatric advanced practice nurse recognizes that these symptoms are associated with problems with the
A. Frontal lobe
B. Temporal lobe
C. Parietal lobe
D. Occipital lobe

A.Frontal lobe

13

On mental status examination, the patient’s thoughts reveal lack of directedness, excessive details, and difficulty with closure. This pattern is called
A. Concrete thinking
B. Circumstantiality
C. Perseveration
D. Thought blocking

B.Circumstantiality

14

The brain structure that is believed to have a gating/filtering function and is the area of the brain through which all sensory information passes en route to various cortical areas is which of the following:
A. Brainstem
B. Reticular activating system
C. Thalamus
D. Hypothalamus

C.Thalamus

15

Which area of the brain is a very primitive in terms of evolution and is involved in swallowing, arousal, and breathing?
A. Parietal lobe
B. Insula
C. Cerebellum
D. Brainstem

D. Brainstem

16

Which of these brain structures puts emotional meaning on a stimulus, forms emotional memories, and is involved with rage and fear?
A. Hippocampus
B. Temporal lobe
C. Amygdala
D. Midbrain

C. Amygdala

17

The principal excitatory neurotransmitter in the central nervous system is
A. Gamma-aminobuytric acid (GABA)
B. Serotonin
C. Glutamate
D. Acetylcholine

C. Glutamate

18

Which structure of the brain is involved in learning, processing information into memories, and assigning the time and the place to memories?
A. Hippocampus
B. Olfactory bulb
C. Limbic system
D. Occipital lobe

A.Hippocampus

19

Which one of the following is not one of the meninges, the three layers that cover the brain?
A. Arachnoid
B. Pia
C. Reticular formation
D. Dura

C. Reticular formation

20

Which of the following structures provides for communication between the two hemispheres of the brain?
A. Lateral ventricle
B. Basal ganglia
C. Corpus callosum
D. Hypothalamus

C. Corpus callosum

21

Which of the lobes of the brain is primarily involved in auditory hallucinations?
A. Occipital lobe
B. Parietal lobe
C. Frontal lobe
D. Temporal lobe

D. Temporal lobe

22

The function of this brain structure was formerly believed to be limited to maintaining balance and learning motor skills but is now believed to be involved in learning and emotions and may be involved in autism. It is the
A. Cerebellum
B. Insula
C. Corpus callosum
D. Pons

A. Cerebellum

23

This area of the brain is called a system and is made up of the rim of the medial (innermost) portions of the frontal, parietal, and temporal lobes and overlies the brainstem. It is involved with emotions and is referred to as the
A. Ventricular system
B. Limbic system
C. Reticular activating system
D. Blood-brain barrier system

B. Limbic System

24

It is known that childhood exposure to maltreatment
A. Is associated with increased rates of physical and psychiatric disorders
B. Occurs in 10% of U.S. children
C. Is most often exposure to sexual abuse
D. Usually involves a perpetrator who is unknown to the child

A. Is associated with increased rates of physical and psychiatric disorders

25

Genetic influence on prenatal brain development is different for different areas of the brain and may underlie psychopathology. There is strong genetic influence on the development of which of the following areas?
A. Sensorimotor
B. Cerebellum
C. Frontal cortex
D. Corpus callosum

C. Frontal cortex

26

Cell synaptogenesis refers to
A. Birth of new neuronal cells
B. Migration of neurons
C. Programmed cell death
D. Establishment of connections between neurons

D. Establishment of connections between neurons

27

In considering fetal exposure to prenatal risk factors, it is known that
A. Damage due to maternal stress is greatest during the third trimester.
B. Nutritional deficits can damage the brain as well as the spinal cord.
C. Radiation exposure has no effect on brain development during the first trimester.
D. There are safe periods of time for maternal consumption of alcohol.

B. Nutritional deficits can damage the brain as well as the spinal cord.

28

Premature birth disrupts brain development in specific areas. Disruption of brain development in the sensorimotor area is thought to be associated with later development of
A. Cerebral palsy
B. Language impairment
C. Hearing impairment
D. Depression

A. Cerebral palsy

29

Impairment of ability to self-regulate emotions is thought to be related to
A. A slow-to-warm-up temperament
B. An insecure pattern of attachment
C. Poverty and poor housing
D. An authoritarian style of parenting

B. An insecure pattern of attachment

30

In the biopsychosocial theory of the development of psychiatric disorders, it is proposed that psychiatric disorders are due to a combination of
A. Exposure to adverse experiences and a large social support network
B. Compromised brain development and adverse experiences
C. Small family size and challenging learning experiences
D. Democratic parenting style and limited financial resources

B. Compromised brain development and adverse experiences

31

Among children who have experienced chronic exposure to family violence, it has been found that
A. The children may lack capacity for emotional self-regulation.
B. Most of the children are able to integrate their experiences into a positive inner model of the world.
C. As adolescents, they have lower rates of aggressive behavior problems.
D. The rate of adult psychopathology is the same as that of the general population.

A. The children may lack capacity for emotional self-regulation.

32

Among children who use an accommodating response to maltreatment, there is increased likelihood of impaired capacity for
A. Controlling impulsivity
B. Knowing their own feelings and emotions
C. Showing regressive behaviors
D. Integrating memories of pain and fear

B. Knowing their own feelings and emotions

33

Following prenatal exposure to neurotoxic drugs, an adverse effect that is shared by many infants is
A. Abnormalities of finger ridges
B. High-steepled palate
C. Microencephaly
D. Curved little finger

C. Microencephaly

34

During an initial assessment, the relevant features of communication are its ability to
A. Promote a therapeutic alliance and increase understanding.
B. Prompt a disclosure of past successes and failures.
C. Bring about changes in behavior.
D. Educate the patient about what is important to disclose.

A. Promote a therapeutic alliance and increase understanding.

35

During the initial assessment of a patient with schizophrenia, in response to the question “What brought you to the clinic today?” a patient’s response of “the van” is an example of
A. Poverty of speech
B. Concrete thinking
C. Oppositional behavior
D. Tangentiality

B. Concrete thinking

36

Patients’ perceptual difficulties may have an adverse effect on the therapeutic alliance. Which of the following is likely to have the greatest negative effect?
A. The patient perceives the office seating arrangement as belittling.
B. The patient perceives the clinician as being part of her delusional system.
C. The patient perceives the sound in the hall as messages for the patient.
D. The patient perceives the clinician’s glancing at his watch as nonvalidating.

B. The patient perceives the clinician as being part of her delusional system.

37

Open-ended questions
A. Are useful in obtaining direct responses
B. Define the focus of interest
C. Are useful in the beginning of an interview
D. Define the boundaries of the therapeutic alliance

C. Are useful in the beginning of an interview

38

Closed-ended questions
A. Are used to gather specific information
B. Allow the patient to talk without interruption
C. Are characterized by the use of reflection
D. Are used to obtain difficult or emotionally laden material

A. Are used to gather specific information

39

In using the communication technique of reflection, the clinician
A. Interprets the difference between a patient’s thoughts and his or her behaviors
B. Repeats something that the patient has said to encourage the patient to give more information
C. Provides prompts such as “tell me more”
D. Seeks more information in order to have a more clear understanding

B. Repeats something that the patient has said to encourage the patient to give more information

40

Validation is a communication strategy used to
A. Let the patient know that his or her feelings are reasonable.
B. Evaluate change in symptoms or behaviors.
C. Prompt the patient to continue talking.
D. Elicit more information about a response.

A. Let the patient know that his or her feelings are reasonable.

41

The purposes of the psychiatric interview include all except
A. Gaining an understanding of the patient’s illness
B. Obtaining information efficiently
C. Providing education about psychiatric disorders
D. Establishing a therapeutic alliance

C. Providing education about psychiatric disorders

42

To encourage the patient to talk freely during the interview, the clinician
A. Uses direct questioning
B. Explains behavior/brain interaction theory
C. Takes notes conscientiously
D. Provides empathetic response.

D. Provides empathetic response.

43

For a patient who is overinclusive or rambling, the clinician
A. Asks the patient to tell his story
B. Uses direction and redirection
C. Increases the amount of eye contact
D. Interviews the person accompanying the patient

B. Uses direction and redirection

44

In a biopsychosocial assessment, which of the following questions might be used to assess the social domain?
A. Did any medical conditions precipitate the psychiatric symptoms?
B. Did the patient have any childhood attentional problems or school phobia?
C. Has the patient ever attempted suicide or harmed himself?
D. Have the symptoms affected the patient’s social and work functioning?

D. Have the symptoms affected the patient’s social and work functioning?

45

The primary function of a biopsychosocial case formulation is to
A. Generate an understanding of the person as a whole
B. Identify comorbid medical illnesses
C. Assess the maturity of the patient’s defense mechanisms
D. Determine patient’s level of social support

A. Generate an understanding of the person as a whole

46

The primary purpose of a biopsychosocial case formulation is to
A. Predict response to different treatment modalities
B. Organize key facts around a cause, the source of the problem
C. Provide information required for reimbursement
D. Determine the level of care required

B. Organize key facts around a cause, the source of the problem

47

Sociocultural factors have the strongest influence on
A. How diagnosis of a psychiatric disorder is accepted
B. The age of onset of symptoms of a psychiatric disorder
C. The gender distribution of the disorder
D. Prediction of response to psychoeducation

A. How diagnosis of a psychiatric disorder is accepted

48

In a biopsychosocial case formulation, social contributions would be considered to be
A. Genetic influences and adverse circumstances of birth
B. Substance use and medical disorders
C. Cognitive deficits and dysregulation of emotions
D. Religious/cultural factors and living situations

D. Religious/cultural factors and living situations

49

A predisposing event would be all of the following except
A. Early prolonged separation from the mother
B. Having been born unwanted
C. Recent arrests or incarcerations
D. History of childhood neglect or abuse

C. Recent arrests or incarcerations

50

A precipitating event might be
A. Financial losses or loss of housing
B. Chronic health problems
C. Childhood separations and anxiety disorders
D. Genetic influences and premature birth

A. Financial losses or loss of housing

51

Mechanisms that maintain a problem are biopsychosocial causes or sources of the problem. Psychological causes might include
A. Poverty and social isolation
B. Impaired neural circuitry
C. Impaired ability to regulation emotions
D. Abnormalities of neurotransmission

C. Impaired ability to regulation emotions

52

Effective case formulation outcomes are stated
A. In terms of behaviors that must be changed
B. As incorporating efforts of others to achieve goal
C. In broad terms such as life satisfaction
D. As directly related to patients’ identified problem or problems

D. As directly related to patients’ identified problem or problems

53

In developing a biopsychosocial plan of treatment, focus in the biological domain is on
A. Identification and treatment of comorbid medical illnesses
B. Social skills training and social support enhancement
C. Vocational rehabilitation and supported employment
D. Interpersonal therapy or cognitive behavioral therapy

A. Identification and treatment of comorbid medical illnesses

54

In the problem-oriented method of case formulation, the patient’s problems are defined as a solvable target of treatment. Which of the following is an example of a problem-oriented case formulation description?
A. “Lack of interpersonal communication skills”
B. “Due to early childhood conflicts”
C. “Due to use of immature defense mechanisms”
D. “Caused by stigma and discrimination”

A. “Lack of interpersonal communication skills”

55

The tricyclic antidepressant class of medications can be characterized by all of the following properties except
A. Long half-life
B. Inexpensive cost
C. Safety in overdose
D. High rate of side effects

C. Safety in overdose

56

Antidepressants are used with caution in which of the following disorders?
A. Major depression with atypical features
B. Adjustment disorder with depression
C. Bipolar disorders
D. Dysthymia

C. Bipolar disorders

57

Which class of antidepressants has the most anticholinergic side effects?
A. Monoamine oxidase inhibitors (MAOIs)
B. Selective serotonin reuptake inhibitors (SSRIs)
C. Tricyclic antidepressants (TCAs)
D. Serotonin norepinephrine reuptake inhibitors (SNRIs)

C. Tricyclic antidepressants (TCAs)

58

TCAs are effective in treatment of depression because they block
A. Reuptake of serotonin and dopamine
B. Reuptake of serotonin and norepinephrine
C. Action of monoamine oxidase enzyme
D. Histamine receptors

B. Reuptake of serotonin and norepinephrine

59

In treating a patient with depression for whom you want to increase norepinephrine, which of the following antidepressants would you choose because it specifically increases levels of norepinephrine?
A. Reboxetine (Vestra)
B. Fluoxetine (Prozac)
C. Phenelzine (Nardil)
D. Venlafaxine (Effexor)

A. Reboxetine (Vestra

60

A patient with bipolar disorder who has been on lithium for 3 months has a blood lithium level of 0.3 mEq/L when tested. You anticipate
A. Improvement of manic symptoms
B. No improvement of manic symptoms
C. Improvement of depressive symptoms
D. Symptoms of moderate lithium toxicity

B. No improvement of manic symptoms

61

The older typical antipsychotic medications would be expected to be most effective for which of the following target symptoms?
A. Social isolation
B. Apathy
C. Hallucinations
D. Lack of motivation

C. Hallucinations

62

Because of the severe problems caused by chronic extrapyramidal side effects (EPSs), patients receiving long-term use of antipsychotics must be carefully monitored for the development of EPS symptoms. One of the most commonly used screeners is
A. Beck’s inventory scale
B. Ham-D scale
C. Zung scale
D. AIMS scale

D. AIMS scale

63

Neuroleptic malignant syndrome is a serious complication of the use of antipsychotic medications. One of the first indicators of this complication is
A. Increased motor activity
B. Rapid temperature elevation to 103°F
C. Increase of aggressive behavior
D. Nose twitching and abnormal tongue movements

B. Rapid temperature elevation to 103°F

64

A patient has been taking haloperidol (Haldol) IM, an antipsychotic drug, for years. You notice that he is grinding his teeth and smacking his lips frequently. You think that he may have
A. Tardive dyskinesia
B. Gustatory hallucinations
C. Spasms of the jaw
D. Parkinsonian symptoms

A. Tardive dyskinesia

65

A patient who is receiving the typical antipsychotic medication haloperidol is stepping back and forth from foot to foot and says that he feels very restless. This could be a manifestation of
A. Neuroleptic malignant syndrome
B. Akathisia
C. Increasing psychosis
D. An anticholinergic response

B. Akathisia

66

A patient has been treated for the past several years with fluphenazine (Prolixin). You notice that he is drooling and has a tremor and slight pill-rolling movement of the fingers. These are the extrapyramidal symptoms known as
A. Anticholinergic effects
B. Pseudoparkinsonism
C. Tardive dyskinesia
D. Dystonic reaction

B. Pseudoparkinsonism

67

Among the following statements, which best describes the action of older typical antipsychotic medications such as Haldol?
A. They block dopamine receptors in all four dopamine pathways.
B. They decrease available amounts of serotonin and norepinephrine.
C. They decrease the metabolism of dopamine in the synaptic cleft.
D. They selectively block reuptake of dopamine.

A. They block dopamine receptors in all four dopamine pathways.

68

Which of the following reactions is indicative of a dystonic reaction?
A. Oculogyric crisis and spasms of the back muscles
B. Tongue thrusting and lip-smacking movements
C. Pill-rolling hand movement and mask-like facial expression
D. Urinary retention and orthostatic hypotension

A. Oculogyric crisis and spasms of the back muscles

69

The primary purpose of psychotherapy is to facilitate changes by the patient in order to
A. Reduce symptoms of distress
B. Address identified problems
C. Reduce burden on the family
D. Improve vocational functioning

B. Address identified problem

70

Which of the following statements provides the most appropriate comment about therapists’ sharing of personal information with patients?
A. Sharing may be used to enhance trust or show interest.
B. Sharing may be used to show that the therapist has similar difficulties.
C. Sharing may include offering friendship outside of sessions.
D. Sharing may be used to reduce therapists’ discomfort with silence in the session.

A. Sharing may be used to enhance trust or show interest

71

Among factors believed to be involved in the development of psychopathology, which of the following factors is most amenable to psychotherapy?
A. Temperament
B. Genetic influenced brain development
C. Adverse circumstances of birth
D. Mastery of psychosocial tasks at different ages

D. Mastery of psychosocial tasks at different ages

72

Which of the following criteria would preclude the use of brief dynamic therapy?
A. Adequate ego strengths
B. Psychological problems in multiple domains
C. Use of mature defense mechanisms
D. Adequate ability to process information

B. Psychological problems in multiple domains

73

Among the following disorders, which one would most likely be amenable to brief dynamic therapy?
A. Bipolar disorder
B. Substance dependence
C. Psychotic disorder
D. Avoidant personality disorder

D. Avoidant personality disorder

74

Brief psychotherapy refers to a category of psychotherapies that brings about changes in patients through
A. Therapist-initiated, focused, emotionally corrective interventions
B. Helping patients to develop an understanding of childhood conflicts
C. Participation of family members in treatment sessions
D. Helping patients to develop insight through self-exploration

A. Therapist-initiated, focused, emotionally corrective interventions

75

The core principle of relational therapies that include psychodynamic psychotherapy and interpersonal psychotherapy is that current problems reflect
A. Learned behavioral responses
B. Failure to integrate life experiences
C. Problems with relationships with others
D. Distorted perceptions of ability to cope

C. Problems with relationships with others

76

In cognitive therapy, therapists focuses on patients’
A. Use of immature defense mechanisms
B. Learned behavior of helplessness
C. Automatic negative thoughts
D. Attachment patterns

C. Automatic negative thoughts

77

In supportive therapy, the focus is on
A. Strengthening self-esteem and ego functioning
B. Promoting insight
C. Remediating cognitive functioning
D. Exposure and response prevention

A. Strengthening self-esteem and ego functioning

78

Psychotherapy is a form of learning that has the potential to do all of the following except
A. Alter gene expression
B. Influence production of neurotransmitters
C. Promote creation of new synaptic connections
D. Eradicate traumatic memories

D. Eradicate traumatic memories

79

The primary goal of psychological first aid is to
A. Provide a debriefing opportunity
B. Help the patient come to terms with the traumatic event
C. Promote material assistance
D. Educate victims of the possible sequelae such as post-traumatic stress disorder

B. Help the patient come to terms with the traumatic event

80

Family psychoeducation is designed to do all of the following except
A. Provide information about the illness
B. Reduce criticism of the patient by the family
C. Promote problem-solving skills of the family
D. Advocate for vocational rehabilitation

D. Advocate for vocational rehabilitation

81

Research has found that sleep therapy is effective in reducing symptoms of which of the following disorders?
A. Social anxiety disorder (nongeneralized)
B. Agoraphobia
C. Depression
D. Obsessive-compulsive disorder

C. Depression

82

It can be said of social rhythms therapy that
A. It is involved in establishing regular patterns of sleep.
B. It has been found to be effective for major depressive disorder but not for bipolar disorder.
C. It is involved in establishing regular patterns of sleeping, eating, exercising, and engaging in other daily activities.
D. It has not been found to be effective as adjunctive treatment in obesity.

C. It is involved in establishing regular patterns of sleeping, eating, exercising, and engaging in other daily activities.

83

Effective interventions to build social networks have been found to include all of the following except
A. Participating in groups that focus on adherence to medication
B. Building new relationships
C. Strengthening existing networks
D. Using ready-made friends or companions

A. Participating in groups that focus on adherence to medication

84

When considering how to increase a patient’s social network, which of the following interventions provides training for volunteers in working with people with mental illnesses?
A. Self-help groups
B. Compeer
C. Mutual-help groups
D. Drop-in centers

B. Compeer

85

The primary goal of compensatory interventions is to help patients improve coping through the use of all of the following except
A. Brief dynamic therapy
B. Social skills training
C. Stress management
D. Problem-solving therapy

A. Brief dynamic therapy

86

Support groups differ from self-help groups by
A. Use of a drop-in approach
B. Professional leadership
C. Theory of empowerment
D. Emphasis on mastery

B. Professional leadership

87

Selection of level of case management for a patient is influenced by the
A. Type of psychiatric disorder
B. Degree of impairment of functioning
C. Legal status of the patient
D. Presence of a comorbid substance-related disorder

B. Degree of impairment of functioning

88

Remedial psychosocial interventions include
A. Psychological first aid and reminiscence therapy
B. Social rhythms therapy and sleep therapy
C. Case management and intensive case management
D. Cognitive restructuring and vocational rehabilitation

D. Cognitive restructuring and vocational rehabilitation

89

As administrator of a mental health care agency, you know that augmenting pharmacotherapy with psychosocial interventions will produce better outcomes than pharmacotherapy alone. To target loneliness and social isolation, which of the following would be the most likely choice?
A. Psychological first aid
B. Psychoeducation
C. Compeer
D. Social rhythms therapy

C. Compeer

90

The key feature of adjustment disorder is
A. An anxiety response to a social event such as speaking in public
B. The response to a known stressor that occurs within 3 months of the stressor
C. A response to an event that is catastrophic, such as witnessing a murder
D. Pervasive anxiety related to a fear of being trapped in an enclosed place

B. The response to a known stressor that occurs within 3 months of the stressor

91

Adjustment disorder is often associated with
A. Symptoms of dissociation
B. Time lost from work
C. Flashbacks and nightmares
D. Delusions of persecution

B. Time lost from work

92

In general, the treatment of choice for adjustment disorder is
A. Pharmacotherapy
B. Light therapy
C. Psychotherapy
D. Electroconvulsive therapy

C. Psychotherapy

93

Patients who use direct methods of coping strategies when confronted with a stressful event would likely engage in
A. Seeking to understand the value to be extracted from negative experiences
B. Following the steps of problem-solving
C. Increasing their sense of control over the situation
D. Asking other people to manage the situation

B. Following the steps of problem-solving

94

It can be said of exposure to traumatic events that
A. The majority of people develop some form of psychopathology.
B. The development of adjustment disorder is likely to follow exposure to life-threatening traumatic events.
C. The normal reaction includes grief, anxiety, and thoughts of suicide.
D. Cognitive appraisal and style of coping have greater influence on outcome than the physical aspects of the traumatic event.

D. Cognitive appraisal and style of coping have greater influence on outcome than the physical aspects of the traumatic event.

95

The response of exposure to stressors
A. Is the same response in all humans
B. Is the same for males and females
C. Is followed by homeostasis
D. Is buffered by the presence of three or more social contacts

D. Is buffered by the presence of three or more social contacts

96

The process of allostasis includes
A. Mobilization of energy, activation of cognition, and behavioral changes
B. Reduction of production of cortisol
C. Decreased levels of norepinephrine
D. Development of a state of exhaustion

A. Mobilization of energy, activation of cognition, and behavioral changes

97

The fear/anxiety circuit of the brain includes which of the following brain structures?
A. Reticular activating system
B. Amygdala and hippocampus
C. Parietal lobe and cerebellum
D. Corpus callosum

B. Amygdala and hippocampus

98

Complicated grief differs from normal grief by the presence of
A. Emotions of anger and regret
B. Persistent longing and yearning for the deceased
C. Physical symptoms of headaches and indigestion
D. Problems with concentration and planning

B. Persistent longing and yearning for the deceased

99

An important evidence-based finding about adjustment disorder among adolescents and young adults is that
A. Pharmacotherapy is the frontline for treatment.
B. The course of adjustment disorder is brief, with good outcomes.
C. There is a short time between thoughts of suicide and carrying out suicide.
D. Academic functioning is well preserved.

C. There is a short time between thoughts of suicide and carrying out suicide.

100

It can be said that in the fear system, the amygdala
A. Serves as a response center for danger and fear
B. Imprints the time and place of an event
C. Evaluates the event in relation to memories of previous experiences
D. Releases hormones that start a cascade of neurohormones and neurotransmitters that prepare the body to respond to a threat

A. Serves as a response center for danger and fear

101

Types of specific phobias include all of the following except
A. Blood, injury, or injection
B. Public speaking
C. Situational phobias—elevators, bridges
D. Environmental phobias—storms, water

B. Public speaking

102

Regarding generalized anxiety disorder (GAD), which of the following is true?
A. GAD is rare in older adults.
B. Comorbidity for major depression and other anxiety disorders is not common.
C. GAD is considered to be a chronic condition.
D. GAD is characterized by seasonal cycles.

C. GAD is considered to be a chronic condition.

103

For a patient with GAD and a history of substance abuse, one of the primary reasons for choosing buspirone (Buspar) is because it
A. Inhibits reuptake of serotonin
B. Is effective for somatic complaints—sweaty palms, shortness of breath, etc.
C. Does not cause dependency
D. Has a strong antidepressant effect

C. Does not cause dependency

104

In considering maintenance treatment for a patient with GAD who is anxious, agitated, and irritable and has sleep problems, which medication(s) might you select?
A. Bupropion (Wellbutrin)
B. A dopamine agonist
C. Paroxetine (Paxil) or sertraline (Zoloft)
D. Alprazolam (Xanax)

C. Paroxetine (Paxil) or sertraline (Zoloft)

105

Chris, a successful music major, is preparing for his recital next week. He has experienced severe stage fright in the past. Which of the following classes of medication would most likely be recommended?
A. Monoamine oxidase inhibitor
B. Tricyclic antidepressant
C. Norepinephrine reuptake inhibitor
D. Beta blocker

D. Beta blocker

106

Leonard avoids going out to eat with his family at restaurants. He is concerned that others may watch him and criticize his table manners. Which is the most likely diagnosis?
A. Agoraphobia
B. Specific situational phobia
C. Social anxiety disorder
D. Generalized anxiety disorder

C. Social anxiety disorder

107

Susan, a 35-year-old single female who has a history of panic attacks that interfere with her working, has become afraid to go out alone and prefers to have a family member stay with her at home at all times. The most appropriate diagnosis based on this limited information is
A. Schizophrenia with delusions
B. Panic disorder with agoraphobia
C. Avoidant personality disorder
D. Social anxiety disorder

B. Panic disorder with agoraphobia

108

Medical disorders that should be considered as differential diagnoses of panic disorder include all of the following except
A. Hyperthyroidism
B. Hypothyroidism
C. Mitral valve prolapse
D. Hyperparathyroidism

D. Hyperparathyroidism

109

In GAD, which of the following is true?
A. GAD is rare in older adults.
B. Worrying may be associated with the belief that it keeps the family safe.
C. Worrying is usually limited to one type of worry, such as locking doors.
D. Worrying is usually accompanied by ritualistic behaviors.

B. Worrying may be associated with the belief that it keeps the family safe

110

Which mental status variation are you most likely to expect for a client diagnosed as having post-traumatic stress disorder?
A. Thought: delusions of grandeur
B. Perceptual: derealization and depersonalization
C. Memory: impaired recent memory
D. Mood: inappropriate, silly

B. Perceptual: derealization and depersonalization

111

Three days ago, a woman was raped by a man who drove her home from a party. She notified the police and the man was arrested. She has memory loss related to the rape and feels depressed and lethargic. Which of the following would be the most immediate beneficial intervention?
A. Providing an opportunity to confront her assailant
B. Providing medication
C. Referring her to a support group
D. Creating a safe environment

D. Creating a safe environment

112

The key feature of acute stress disorder is the presence of
A. Sleep disturbances
B. Symptoms of dissociation
C. Increased arousal
D. Recurrent, intrusive thoughts

B. Symptoms of dissociation

113

The current frontline treatment for acute stress disorder is
A. Mood stabilizer medications
B. Interpersonal psychotherapy
C. Antianxiety medications
D. Trauma-focused cognitive behavioral therapy

D. Trauma-focused cognitive behavioral therapy

114

Following exposure to a traumatic event, post-traumatic stress disorder occurs more often
A. Among men
B. Among individuals who have experienced prior traumas
C. Among individuals with high levels of education
D. Among those who are married or in a stable relationship

B. Among individuals who have experienced prior traumas

115

The brain structure that is involved with encoding the time and place of a trauma is the
A. Amygdala
B. Thalamus
C. Hippocampus
D. Hypothalamus

C. Hippocampus

116

The model of psychotherapy that is most effective for acute post-traumatic stress disorder is
A. Supportive psychotherapy
B. Exposure therapy
C. Stress inoculation therapy
D. Debriefing therapy

B. Exposure therapy

117

Ninety percent of Americans experience a trauma in their lifetime that is severe enough to cause post-traumatic stress disorder. What percent develop post-traumatic stress disorder?
A. 10%
B. 20%
C. 30%
D. 40%

A. 10%

118

The primary goal of treatment for patients with post-traumatic stress disorder is to help them to
A. Eradicate memories of the traumatic event
B. Prevent response to triggers of the traumatic event
C. Learn to live with intrusive images
D. Place the trauma in the larger perspective of their lives

D. Place the trauma in the larger perspective of their lives

119

Which one of the following exposure treatments for post-traumatic stress disorder has been found to be effective among veterans with chronic post-traumatic stress disorder that has not responded to other forms of treatment?
A. Cognitive behavioral therapy
B. Eye movement desensitization and reprocessing therapy
C. Structured writing therapy
D. Virtual reality exposure therapy

D. Virtual reality exposure therapy

120

Nonpharmacological treatment of obsessive-compulsive disorder (OCD) would most likely include which of the following?
A. Electroconvulsive therapy
B. Cognitive behavioral therapy
C. Milieu therapy
D. Dialectical behavioral therapy

B. Cognitive behavioral therapy

121

Which of the following tricyclic antidepressants is most effective in the treatment of OCD?
A. Imipramine
B. Amitriptyline
C. Desipramine
D. Clomipramine

D. Clomipramine

122

In obsessive-compulsive disorder, obsession/compulsion symptom cluster types include all of the following except
A. Dirt and contamination
B. Counting and checking
C. Lying and stealing
D. Hoarding and collecting, saving

C. Lying and stealing

123

For one-third to one-half of patients with OCD, the onset of the symptoms is
A. After the age of 30 years
B. In the 30s and 40s
C. During childhood or adolescence
D. In middle age

C. During childhood or adolescence

124

On clinical presentation, patients with OCD tend to
A. Be eager to discuss their symptoms
B. Have good insight into their obsessions and compulsions
C. Describe a sudden intrusion of unwanted distressful thoughts and the need to do something to reduce their distress
D. Be aware of the influence of their symptoms on their families

C. Describe a sudden intrusion of unwanted distressful thoughts and the need to do something to reduce their distress

125

It can be said of the obsession of hoarding that it is associated with
A. A fear of making a wrong decision in discarding things that might be needed in the future
B. Abnormalities of the fear/anxiety circuitry
C. A feeling that hoarding is ego-syntonic
D. Less severe symptoms and impairment of functioning than other obsessions

A. A fear of making a wrong decision in discarding things that might be needed in the future

126

In selecting treatment for a patient with trichotillomania, which of the following evidence-based treatment options would be a logical first choice?
A. Reminiscence therapy
B. Monotherapy with clomipramine (Anafranil)
C. Habit reversal therapy
D. Exposure and ritual prevention therapy

C. Habit reversal therapy

127

Deficits of functioning of the striatum (part of the basal ganglia) are believed to be involved in the symptoms of OCD through impaired ability to
A. Receive information from the amygdala
B. Filter information going to the thalamus
C. Receive sensory information
D. Receive information from the cerebral cortex

B. Filter information going to the thalamus

128

In obsessive-compulsive disorder, patients are likely to experience
A. Obsessions as ego-syntonic
B. Extreme worrying about everyday concerns such as being late
C. Specific worries about the sight of blood
D. Obsessions of symmetry and need to have things just right

D. Obsessions of symmetry and need to have things just right

129

Obsessions are often accompanied by compulsive behaviors. Which of the following is not true?
A. Obsession of contamination is linked with excessive cleaning.
B. Obsession of pathological doubt is linked with hoarding.
C. Obsession of symmetry is linked with arranging things until they are perfect.
D. Somatic obsession is linked with checking the body for signs of illness.

B. Obsession of pathological doubt is linked with hoarding.

130

The obsessive-compulsive spectrum disorder that is characterized by pulling out hair is
A. Erotomania
B. Pyromania
C. Trichotillomania
D. Dermatillomania

C. Trichotillomania