Section 13. Psychosocial Problems
MULTIPLE CHOICE
1. The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the
following neurotransmitters plays a role in anxiety?
A.
Acetylcholine
B.
Gamma-aminobutyric acid (GABA)
C.
Dopamine
D.
Serotonin
2. The criteria for diagnosing generalized anxiety disorder in the American Psychiatric
Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text
revision) state that excessive worry or apprehension must be present more days than not for at
least:
A.
1 month
B.
3 months
C.
6 months
D.
12 months
3. A patient presents to the clinician after experiencing four episodes in the last month of
sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes.
The patient is now becoming very fearful of future events and has been reluctant to leave the
house. The clinician suspects panic disorder but wants to rule out any possible medical causes.
Which of the following medical conditions can mimic the symptoms of a panic attack?
A.
Pheochromocytoma
B.
Hyperthyroidism
C.
Cardiac arrhythmias
D.
All of the above
4. Which of the following is considered first-line treatment for panic disorders?
A.
Benzodiazepines
B.
Selective serotonin reuptake inhibitors (SSRIs)
C.
Tricyclic antidepressants
D.
Cognitive behavioral therapy
5. Which of the following symptoms is NOT part of the diagnostic criteria for post-traumatic
stress disorder (PTSD)?
A.
Hypersomnolence
B.
Blunted feelings
C.
Loss of interest in significant activities
D.
Intrusive recurrent recollections of the event
6. Which of the following neuroendocrine abnormalities is implicated in depression?
A.
Decrease in adrenal size
B.
Hypersecretion of cortisol
C.
An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing
hormone
D.
Increased inhibitory response of glucocorticoids to dexamethasone
7. The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a
patient fitting the diagnostic criteria for depression. Which of the following is NOT true
concerning SSRIs in comparison to tricyclic antidepressants?
A.
SSRIs are more effective than TCAs.
B.
SSRIs take less time to work than TCAs.
C.
SSRIs have a more favorable side-effect profile than TCAs.
D.
SSRIs are not lethal in overdose.
8. After discontinuing fluoxetine, how long must a person wait before starting a monoamine
oxidase inhibitor?
A.
2 weeks
B.
3 weeks
C.
4 weeks
D.
5 weeks
9. It is important to educate patients with depression and their family members about reporting
signs of increasing depression and suicidal thoughts. This is especially true during which time
period?
A.
Prior to the antidepressant reaching therapeutic levels
B.
As the mood lifts in response to antidepressant treatment
C.
During dosage or medication adjustments
D.
After the patient reveals suicidal thoughts or plans
10. A patient is experiencing extrapyramidal side effects from his antipsychotic medications. The
clinician would most likely take which of the following approaches to treating these side
effects?
A.
Give the patient a “drug holiday” until the symptoms resolve and then restart the
medication.
B.
Switch the patient to a different antipsychotic.
C.
Treat the patient with anticholinergics.
D.
Treat the patient with anticonvulsants.
11. According to Kübler-Ross, the stages of grief occur in which order?
A.
Anger, denial, depression, bargaining, acceptance
B.
Anger, denial, bargaining, acceptance, depression
C.
Denial, anger, depression, bargaining, acceptance
D.
Denial, anger, bargaining, depression, acceptance
12. The clinician is educating a patient about the effects of marijuana. The patient stated that she
has been smoking for years and believes the use does not interfere with her life. What is the
potential long-term sequelae of marijuana use that the clinician should educate this patient
about?
A.
Memory impairment
B.
Sexual dysfunction
C.
Dry mouth
D.
There are no long-term consequences of marijuana use
13. Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?
A.
GABA
B.
Acetylcholine
C.
Dopamine
D.
Serotonin
14. What blood alcohol level corresponds with the signs of stupor and confusion?
A.
0.05
B.
0.1
C.
0.2
D.
0.3
15. Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep?
A.
Every 30 to 40 minutes
B.
Every 60 to 80 minutes
C.
Every 90 to 100 minutes
D.
Every 180 to 200 minutes
16. Which of the following is a laboratory finding commonly found in patients with anorexia
nervosa?
A.
Hypophosphatemia
B.
Hypermagnesmia
C.
Leukocytosis
D.
Decreased TRH
17. Which of the following is the only drug used to treat bulimia that is approved by the U.S.
Food and Drug Administration?
A.
Sertraline
B.
Fluoxetine
C.
Citalopram
D.
Imipramine
18. Which of the following would be important to monitor in a child receiving methylphenidate
for treatment of attention deficit-hyperactivity disorder (ADHD)?
A.
Liver function
B.
Vision
C.
Growth parameters
D.
Renal function
19. It is important for the clinician to discuss the long-term effects of sexual assault with
survivors. Which of the following is the most common long-term effect of sexual assault?
A.
Depression
B.
Obsessive-compulsive disorder
C.
Substance abuse
D.
PTSD
20. Women are at the highest risk for developing peripartum depression for up to how long after
childbirth?
A.
1 to 3 weeks
B.
1 month
C.
3 to 6 months
D.
7 months to 1 year
21. Which is the most prevalent psychiatric condition in the United States?
A.
Depression
B.
Anxiety
C.
Substance-related addictions
D.
Gambling addiction
22. What is recorded as clinical category two of the American Psychiatric Association’s
Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision)?
A.
Clinical disorder or focus of clinical attention
B.
Personality or environmental problems
C.
Environmental and psychosocial stressors
D.
Global assessment of functioning
23. Which of the following may be used to evaluate a person’s suicide risk?
A.
CAGE
B.
SANE
C.
SAD PERSONAS
D.
DIGFAST
24. What is the essential feature of bipolar-I?
A.
Hyperactivity
B.
Mania
C.
Depression
D.
Anxiety
25. Bipolar disorder requires differential diagnosis from all of the following except?
A.
Substance abuse and medication effects
B.
Medical and neurological disorders
C.
Cluster B personality disorders and depression
D.
Obsessive-compulsive disorder
26. All benzodiazepines are associated with:
A.
Potential anterograde amnesia
B.
Dopamine-related movement disorders
C.
Serotonin syndrome
D.
Xerostomia and agitation
27. Which medication is used as a first-line treatment in the management of bipolar disorder?
A.
Gabapentin
B.
Lamotrigine
C.
Carbamazepine
D.
Topiramate
28. HITS is a validated instrument used to identifying intimate partner violence. What does HITS
stand for?
A.
Hit, Injured, Threatened, Scared
B.
Hurt, Insult, Threaten, Scream
C.
Humiliated, Isolated, Tortured, Scarred
D.
Harm, Injury, Terror, Shame
29. Emotional dysregulation is common in:
A.
Children with obsessive-compulsive disorder
B.
Adults with schizophrenia
C.
Adults with attention deficit-hyperactivity disorder
D.
Children with tic disorders
30. The stooped posture, motor slowness, and minor cognitive impairments of patients with major
depressive disorders are similar to the signs of disorders of the basal ganglia, such as:
A.
Parkinson’s disease
B.
Stevens-Johnson syndrome
C.
Neurological disease
D.
Huntington’s disease
31. A serious physical illness in any organ category is:
A.
An independent risk factor for geriatric suicide
B.
Likely to occur with body dysmorphic disorder
C.
Associated with mood disorders
D.
Likely to produce anxiety or panic disorders
32. Suicide plans are assessed on all of the following, EXCEPT:
A.
Specificity
B.
Possibility
C.
Availability
D.
Lethality
33. What is the median reduction in life expectancy among those with mental illness?
A.
15.4 years
B.
10.1 years
C.
5.7 years
D.
9.2 years
34. Which of the following is a potential adverse reaction to clozapine (Clozaril)?
A.
Prolonged QT interval
B.
Hyperprolactinemia
C.
Postural hypotension
D.
Myocarditis
35. Each of the following antidepressants does NOT have significant liver CYP P450 interaction
effects?
A.
Paroxetine
B.
Fluoxetine
C.
Fluvoxamine
D.
Olanzapine
36. What term describes random quick jerking movements that flow from joint to joint?
A.
Dystonia
B.
Chorea
C.
Myoclonus
D.
Compulsions
37. Instead of reporting symptoms of body dysmorphic disorder (BDD) to the primary-care
provider, patients often request which of the following?
A.
Referrals to plastic surgeons, orthodontists, or dermatologists
B.
Antidepressant medications
C.
Nutritional counseling services
D.
Unnecessary laboratory tests
38. What is the leading preventable cause of death and disability?
A.
Opioid addiction
B.
Obesity
C.
Tobacco use
D.
Stress
39. What is a common adverse reaction for children prescribed Risperdal for autism-associated
irritability?
A.
Gynecomastia
B.
Parkinsonian-like syndrome
C.
Bradycardia
D.
Rebound hypertension
40. What is the advantage of guanfacine (i.e., Tenex, Intuniv) over clonidine (i.e., Catapres,
Kapvay) for the treatment of ADHD?
A.
Tapering off is not required on discontinuation
B.
Therapeutic effect is instantaneous
C.
Wider range of available dosages
D.
Less sedation and longer duration of action
41. What is a differential diagnosis of autism spectrum disorder?
A.
Speech sound disorder
B.
Duchenne muscular dystrophy
C.
Structural brain malformations
D.
Hypoxic ischemic brain injury
42. Which intervention has been shown to diminish feelings of isolation, improve coping skills,
and decrease the need for hospitalization in schizophrenia?
A.
Cognitive behavioral therapy
B.
Peer-delivered services
C.
Family-based therapy
D.
Assertive community treatment (ACT) model of care
43. What is the likely result of the over-prescription, over-supply, and over-production of
opioids?
A.
Opioid use
B.
Opioid abuse
C.
Opioid dependence
D.
Opioid resistance
44. What is the health impact of low-dose alcohol consumption?
A.
Increased risk of developing alcohol addiction
B.
Increased risk of coronary artery disease
C.
Increased excitation of critical ion channels
D.
Increased high-density lipoproteins
45. Echolalia is sometimes demonstrated by people with which disorder?
A.
Autism
B.
Alcoholism
C.
ADHD
D.
Asperger’s
46. What prenatal factor could increase risk for ADHD?
A.
Exposure to lead
B.
Zinc deficiency
C.
Maternal allergies
D.
Central nervous system (CNS) infections
47. If stimulant drugs are not tolerated or contraindicated for the treatment of ADHD, what
medication may produce a therapeutic effect?
A.
Daytrana
B.
Vyvanse
C.
Warfarin
D.
Atomoxetine
48. What is the presentation of a complex motor tic?
A.
Simultaneous shoulder shrugs and head turns
B.
Eye blinks and extension of extremities
C.
Throat clearing and finger raising
D.
Barking, screaming, and snorting
49. What is the most prevalent psychiatric comorbidity of ADHD?
A.
Antisocial personality disorder
B.
Generalized anxiety disorder
C.
Oppositional defiant disorder
D.
Social phobias
50. What severity level of intellectual disability is demonstrated by a child whose language and
academic skills markedly lagging behind peers, misperceive social cues, and have a simpler
spoken language than their peers?
A.
Mild
B.
Moderate
C.
Severe
D.
Profound