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Chapter 18 Psychsocial Disorders Flashcards

1
Q 
*******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

____

A

. b.

Gamma-aminobutyric acid (GABA)

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2
Q

***6. Which of the following neuroendocrine abnormalities is implicated in depression?
a.
Decrease in adrenal size
b.
Increased cortisol and corticotrophin-releasing hormone
c.
An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone
d.
Increased inhibitory response of glucocorticoids to dexamethasone

____

A

. b.

Increased cortisol and corticotrophin-releasing hormone

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3
Q
  1. 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

____

A

. d.

Denial, anger, bargaining, depression, acceptance

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4
Q 
16.    ?   Which of the following is a laboratory finding commonly found in patients with anorexia nervosa?
a.
Hypercholesterolemia
b.
Hypermagnesmia
c.
Leukocytosis
d.
Decreased TRH
A

. a.

Hypercholesterolemia

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5
Q 
*******21.  Which is the most prevalent psychiatric condition in the United States?
a.
Depression
b.
Anxiety
c.
Substance-related addictions
d.
Gambling
A

. b.

Anxiety

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6
Q

***The use of benzodiazepines in the patient with generalized anxiety disorder and comorbid depression can exacerbate depressive symptoms.

A

.TF1

True

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7
Q

Answer card questions

A

ANS: B PTS: 1

2. ANS:	C	PTS:	1
3. ANS:	D	PTS:	1
4. ANS:	D	PTS:	1
5. ANS:	A	PTS:	1
6. ANS:	B	PTS:	1
7. ANS:	A	PTS:	1
8. ANS:	D	PTS:	1
9. ANS:	B	PTS:	1
10. ANS:	C	PTS:	1
11. ANS:	D	PTS:	1
12. ANS:	A	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	D	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	A	PTS:	1
17. ANS:	B	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	D	PTS:	1
20. ANS:	D	PTS:	1
21. ANS:	B	PTS:	1
22. ANS:	C	PTS:	1
23. ANS:	C	PTS:	1
24. ANS:	B	PTS:	1

25.	ANS:	D	PTS:	1 O
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8
Q

T F answers

A
  1. ANS: T PTS: 1
    1. ANS: F PTS: 1
    2. ANS: T PTS: 1
    3. ANS: T PTS: 1
    4. ANS: T PTS: 1
    5. ANS: T PTS: 1
    6. ANS: F PTS: 1
    7. ANS: F PTS: 1
    8. ANS: T PTS: 1
    9. ANS: T PTS: 1
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9
Q 
*******\_\_\_\_	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
A

. c.

6 months

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10
Q 
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
A

. d.

All of the above

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11
Q 
\_\_\_\_******	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
A

. d.

Cognitive behavioral therapy

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12
Q
  1. 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
A

. a.

Hypersomnolence

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13
Q 
*******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.

____

A

. a.

SSRIs are more effective than TCAs.

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14
Q 
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

____

A

. d.

5 weeks

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15
Q

***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.
Before the initiation of treatment
b.
1 to 2 weeks after the initiation of treatment
c.
When switching to a different medication
d.
1 to 2 weeks after tapering off medications

____

A

. b.

1 to 2 weeks after the initiation of treatment

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16
Q
  1. 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.
A

. c.

Treat the patient with anticholinergics.

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17
Q 
12.	The clinician is educating a patient about the effects of marijuana. The patient stated she has been smoking for years and believes the use does not interfere with her life. What is a significant 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.
A

. a.

Memory impairment

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18
Q 
\_\_\_\_	13.	Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?
a.
GABA
b.
Acetylcholine
c.
Dopamine
d.
Serotonin
A

. c.

Dopamine

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19
Q 
\_\_\_\_	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
A

. d.

0.3

20
Q 
\_\_\_\_	15.	Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep?
a.
Every 30 minutes
b.
Every 60 minutes
c.
Every 90 minutes
d.
Every 180 minutes
A

. c.

Every 90 minutes

21
Q 
\_\_\_\_	17.	Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?
a.
Sertraline
b.
Fluoxetine
c.
Citoprolam
d.
Imipramine
A

.b.

Fluoxetine

22
Q 
\_\_\_\_	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
A

. c.

Growth parameters

23
Q 
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
A

. d.

PTSD

24
Q 
*******20.	Women are at the highest risk for developing postpartum depression for up to how long after childbirth?
a.
2 weeks
b.
1 month
c.
3 months
d.
6 months
A

. d.

6 months

25
Q 
\_\_\_\_	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

____

A

. c.

Environmental and psychosocial stressors

26
Q 
23.	Which of the following may be used to evaluate a person’s suicide risk?
a.
CAGE
b.
SANE
c.
SAD PERSONAS
d.
DIGFAST
A

C.

SAD PERSONAS

27
Q 
24.  Assessing for adherence with prescribed medications and developing a plan for what to do if they are stopped is a major treatment issue for which of the following diagnostic groups?
a.
ADHD
b.
Bipolar
c.
Depression
d.
Anxiety
A

B. Bipolar

28
Q 
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
A

D. Obsessive - compulsive disorder

29
Q

***2. Depressive episodes associated with bipolar disorder are treated the same as major depressive disorder.

A

False

30
Q
  1. Women in abusive relationships have a greater chance of being killed by their batterers when they leave the relationship than women who stay.
A

True

31
Q
  1. Adults must show childhood onset of symptoms to receive a diagnosis of ADHD.
A

True

32
Q
  1. Parkinson’s disease and dementing illnesses may commonly manifest depressive symptoms.
A

True

33
Q

____ 6. The best predictor of suicide risk is a history of suicide attempts.

A

True

34
Q
  1. A no-suicide contract can prevent a suicide attempt.

____

A

False

35
Q

***8. Depression is the most chronic disabling and economically catastrophic medical disorder of the severe mental illnesses.

A

False

36
Q

____ 9. Clozapine (Clozaril) requires laboratory monitoring at specified frequencies with results reported to a national registry.

A

True

37
Q

***____ 10. When combined with certain other medications, serotonin-specific antidepressants can have significant liver P450-interaction effects.
Chapter 18. Psychosocial Problems

A

True

38
Q

FROM STUDY GUIDE

Chapter 18

Panic disorders- Patient presentation and treatment
• Depression- Patient and family education regarding treatment
• Depression- Diagnosis
• Anxiety- patient presentation and diagnosis

A

FROM STUDY GUIDE

Chapter 18

Panic disorders- Patient presentation and treatment
• Depression- Patient and family education regarding treatment
• Depression- Diagnosis
• Anxiety- patient presentation and diagnosis

39
Q
  1. A 24-year-old woman has a new onset of panic disorder. As part of her clinical presentation, you expect to find all of following except:
    A. peak symptoms at 10 minutes into the panic attack.
    B. history of agoraphobia.
    C. report of chest pain during panic attack.
    D. history of thought disorder.
A

D. history of thought disorder.

D

40
Q 
93. As you develop the initial treatment plan for a woman with panic disorder, you consider prescribing:
A. carbamazepine (Tegretol®).
B. risperidone (Risperdal®).
C. citalopram (Celexa®).
D. bupropion (Wellbutrin®).
A

C. citalopram (Celexa®).

41
Q
  1. Which of the following statements concerning panic disorder is false?
    A. Panic disorder rarely occurs with depression.
    B. Up to 4% of the general population suffers from panic disorder.
    C. New-onset panic disorder rarely occurs after 45 years of age.
    D. Family history of panic disorder is a risk factor for the condition.
A

A. Panic disorder rarely occurs with depression.

42
Q
  1. Which of the following is true regarding panic disorder and agoraphobia?
    A. More men than women experience panic disorder without agoraphobia.
    B. More women than men experience panic disorder without agoraphobia.
    C. More men than women experience panic disorder with agoraphobia.
    D. More women than men experience panic disorder with agoraphobia.
A

D. More women than men experience panic disorder with agoraphobia.

43
Q 
105. Concomitant health problems found in a patient with panic disorder often include:
A. irritable bowel syndrome.
B. thought disorders.
C. hypothyroidism.
D. inflammatory bowel disease.
A

A. irritable bowel syndrome.

44
Q
  1. When initiating SSRI therapy for a patient with panic disorder, the NP should consider all of the following except:
    A. starting with a low dose and slowly escalating doses as necessary.
    B. it is preferable to use agents that are more energizing than those that are less energizing.
    C. selecting agents with a low rate of insomnia and akathisia.
    D. SSRI therapy can precipitate panic attacks with early use.
A

B. it is preferable to use agents that are more energizing than those that are less energizing.

45
Q 
111. In treatment-resistant patients with panic disorder, which drug class is occasionally used?
A. atypical antipsychotic
B. selective dopamine reuptake inhibitor
C. monoamine oxidase inhibitor
D. neuroleptic
A

C. monoamine oxidase inhibitor

46
Q
  1. In treating a person with panic disorder using an SSRI, the NP should consider that there is:
    A. considerable abuse potential with these medications.
    B. no significant therapeutic advantage over TCAs.
    C. a reduction in number and severity of panic attacks.
    D. significant toxicity in overdose.
A

C. a reduction in number and severity of panic attacks.

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