7-Emotional and Mental Well-Being, Assessment and Interventions Flashcards

LMBR Manual 2nd edition MCQ's

1
Q

Primary care physicians (PCP) note that lifestyles contribute greatly to an individual’s health. Which of the following observations is true?

A) Health habits can be engaged equally by a moderately stressed individual as compared to a mildly stressed individual.

B) The mood of an individual can be altered and equally impacted by healthy behavior change when engaged by a highly stressed individual as compared to an unstressed individual over the long follow-up period.

C) Roughly 70% of primary care physician visits are related to stress and lifestyle, despite this being a single-factorial relationship.

D) Multifactorial lifestyle variables contribute to nearly 70% of primary care provider visits and can be successfully diagnosed and treated.

A

D.
Multifactorial lifestyle variables contribute to nearly 70% of primary care provider visits and can be successfully diagnosed and treated.
Lifestyle medicine: contributes to 70% of primary care provider visits; is multifactorial both in disease generation and treatment; is less likely to be engaged by over-stressed and overwhelmed individuals; and is more likely to be impactful when people in need of close follow up are identified.

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2
Q

Well-being and absence of disease is correlated to a healthy mental state. Depression can propagate further disease when it is noted in a primary care setting that:

A) A low scoring psychiatric assessment has been completed.

B) DSM-IV criteria has been met.

C) A diagnosis of depression has been made and is now under initial medication therapy.

D) A prior self-harm episode via ingestion of only three pills without hospitalization was not documented in the patient’s chart.

E) The patient decides to not use medications for their first time acute depression and wants to start tai chi as an alternative

A

D. A prior self-harm episode via ingestion of only three pills without hospitalization was not documented in the patient’s chart.
Depression causes more harm when it’s untreated, unrecognized or undocumented in a patient’s past medical history. It’s diagnosed with DSM-V and a high psychometric assessment score upon screening. Depression can be treated with lifestyle modifications rather than pharmaceuticals based on certain screening protocols

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3
Q

Fitness and exercise is comparable to which of the following as it pertains to its effects on mental health?

A) Cognitive Behavioral Therapy (CBT)

B) MAO’s

C) Increasing omega 3 fatty acids when treating bipolar patients with mania

D) Reducing omega 3 fatty acids when treating bipolar patients with depression

A

A. Cognitive Behavioral Therapy (CBT).
Fitness and exercise is comparable to cognitive behavioral therapy (CBT), but it’s not as directly effective as pharmacotherapies. Increasing omega 3 fatty acids demonstrates a good response with bipolar depression and not mania

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4
Q

With stress being identifiable and leading to pathological stress reactions, which of the following is a type of “suffering and unnecessary” that can lead to a stress reaction?

A) Old age

B) Separation from those we love

C) Illness

D) Death

E) Egocentricity

A

E. Egocentricity.
Unnecessary suffering is wanting a different outcome than the one that has happened. It begins with egocentricity (wants, likes, dislikes, attachments, cravings and aversions), has anticipatory thinking (imagining the worst), can include repeating stories about the past and trying to resist pain.

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5
Q

Mindfulness-Based Stress Reduction (MBSR) has been noted to increase all of the following except?

A) Self-esteem

B) Empathy

C) Pain threshold

D) Stress threshold

E) Pain level

A

E.

Pain level.

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6
Q

A woman presents to you and appears to be crying. She is a home health aid working 36 hours per week. Her husband is nearly bedridden at home and has been needing increased healthcare daily from her for nearly five years, as he has a history of cerebral vascular accident (stroke). She says to you that she is now having panic attacks intermittently when she goes to patient’s homes for work because she can relate so strongly to the suffering of the families. She feels guilty taking time for herself and has even missed her own doctor’s appointments. She hasn’t exercised for four years. She states, “How can I tell my husband I am exercising when he can barely move?” This is an example of which of the following:

A) Compassion fatigue

B) Compassion burnout

C) Normal compassion stress

D) Failed cognitive agility

A

A.
Compassion fatigue is distress and tension in which the helper is traumatized and preoccupied with suffering. Compassion fatigue can lead to poor coping, poor self-care and self-sacrifice, which is similar to PTSD. Compassion burnout is associated with lack of job satisfaction, to many hours, low pay and stress.

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7
Q

Which of the following combinations is correct when describing mindfulness-based skills affecting the pre-frontal cortex and its respective task function?

A) The patient-physician relationship and interpersonal mindfulness

B) Cognitive agility and deep focus

C) Tight jaw or “TMJ” and increased fitness daily

D) Positive psychology and maintaining a journal about spiritual needs

A

B. Cognitive agility and deep focus.
Mindfulness skills enable presence, clarity and curiosity in a clinical encounter. These skills directly affect the pre-frontal cortex, thereby decreasing scattered brain states and allowing for deep focus inside of sequential tasking. This kind of focus is how roughly 95% of the population processes information and performs tasks, as opposed to the less than 5% of the population who are able to perform multitasking.

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8
Q

According to the philosophy that the provider is a coach facilitating health behavior change, which of the following combinations have nearly the same effectiveness?

A) In-person coaching and phone coaching

B) Placebo and phone coaching

C) Self-awareness reflection by a wellness coach and a nutritionist

D) In-person coaching and use of medication with psychotherapy

A

A. In-person coaching and phone coaching.
Phone coaching has a 38% effectiveness rate, while in-person coaching has a 41% effectiveness rate. A placebo has a 19% effectiveness rate.

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9
Q

A good patient-provider relationship directly impacts measurable patient health outcomes. All of the following are examples of “Coaching Mechanisms of Change and Action” except:

A) Developing growth-promoting relationship(s)

B) Eliciting self-motivation

C) Building confidence

D) Facilitating the change process

E) Measuring disease alteration and prevalence

A

E. Measuring disease alteration and prevalence.
Facilitating health behavior change is a process of altering a behavioral pattern from stimulus, to thought, to action via both internal and external resources. It isn’t a tool to measure an already existing disease pathology, the prevalence of that disease pathology, or the observable change of that disease pathology (regardless of mental or physical symptomatology and disease pathology).

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