MFT Practice Exam - DSM 5

Question 1

Question

Answer 1

Answer

Question 2

<p>A therapist is asked to evaluate a 5-year-old boy whose parents are concerned about his inability to sit still periodically at school. During the interview, the boy makes multiple barking noises, blinks almost constantly, and jerks his right arm back and forth. His parents report that these symptoms started in preschool and are getting in the way of their son learning and making friends. What is the MOST likely diagnosis at this time?</p>

<p>a. Tourette's Disorder</p>

<p>b. Attention-Deficit/Hyperactivity Disorder</p>

<p>c. Stereotypic Movement Disorder</p>

<p>d. Autism Spectrum Disorder</p>

Answer 2

<p>a. Tourette's Disorder</p>

Question 3

<p>An 11-year-old boy is referred to the school therapist for excessive truancy. An assessment with the boy's parents reveals several incarcerations at the juvenile detention center for selling drugs and the parents' report a longstanding inability to enforce limits or consequences with him. His teacher describes him as quiet and disinterested in school, although the therapist knows the boy has a reputation as a bully. What diagnosis is MOST likely:</p>

<p>a. Oppositional Defiant Disorder</p>

<p>b. Antisocial Personality Disorder</p>

<p>c. Bipolar I Disorder</p>

<p>d. Conduct Disorder</p>

Answer 3

<p>d. Conduct Disorder because with conduct disorder requires symptoms in 4 categories: 1. aggressive behavior 2. destructive behavior 3. deceitful behavior 4. violation of rules all seen in the stem</p>

Question 4

<p>A school therapist begins treatment with a 16-year-old girl who was referred after being caught stealing from lockers after school. When the therapist asks about the theft, the girl guiltily says that it was just "stupid stuff" and that she gave it all to her friends. Later in the assessment, the girl's parents report that they've found multiple items in the house that they know they did not buy. The girl's DSM-V diagnosis is MOST likely:</p>

<p>a. Antisocial Personality Disorder</p>

<p>b. Unspecified Impulse-Control Disorder</p>

<p>c. Kleptomania</p>

Answer 4

<p>c. Kleptomania</p>

Question 5

<p>A therapist at a community mental health clinic conducts an intake interview with a 20-year-old male who has been referred by his mother. He states that his mother is concerned about his lack of relationships and tendency to isolate himself in his room playing computer games. When prompted, he tells the therapist that he is lonely and wishes he could go out and meet people, but they would just be disappointed when they got to know him; he reports feeling comfortable interacting online because he knows the people "on there" will accept him. The therapist is MOST likely to treat him for:</p>

<p>a. Major Depressive Disorder</p>

<p>b. Avoidant Personality Disorder</p>

<p>c. Schizoid Personality Disorder</p>

<p>d. Panic Disorder With Agoraphobia</p>

Answer 5

<p>b. Avoidant Personality Disorder. B is the correct answer because the stem reports that the client has a lack of relationships and also fears being around others or interacting with them. Individuals with Avoidant. Personality Disorder express a fear of being ridiculed, poor self-image, a preoccupation with being criticized, loneliness, and social isolation. Despite this, they have a strong desire for social relationships, but find it difficult to take that personal risk. The biggest differential here is C because while an individual with Schizoid Personality Disorder has a detachment from social relationships, they actually prefer to be alone.</p>

Question 6

<p>A school therapist receives a referral from one of the third-grade teachers. The teacher complains that the child will not sit in his seat, interrupts his peers, does not finish assigned work, and has difficulty making friends. A developmental history from the parents indicates that the child has been impulsive since preschool and that he has difficulty following directions. According to the DSM-V classification, the diagnosis will MOST likely be:</p>

<p>a. Oppositional Defiant Disorder</p>

<p>b. Conduct Disorder</p>

<p>c. Attention-Deficit/Hyperactivity Disorder</p>

<p>d. Autism Spectrum Disorder</p>

Answer 6

<p>c. Attention-Deficit/Hyperactivity Disorder. A and B are incorrect because the child is not displaying any disobedient, defiant, or violent behaviors. D is incorrect because while the child has difficulty making friends, this appears to be more related to his impulsivity. Therefore, C is correct because the child is displaying symptoms that are common with ADHD such as trouble sitting still, difficulty concentrating and impulsivities.</p>

Question 7

<p>A therapist meets with a 19-year-old college student who reports that for the past year she has had trouble getting out of bed to go to class. She states that she doesn't want to be around her friends anymore and overall feels very hopeless. When asked about her interests the client states that she recently dropped her extracurricular activities. The client's MOST likely diagnosis is:</p>

<p>a. Adjustment Disorder</p>

<p>b. Major Depressive Disorder</p>

<p>c. Generalized Anxiety Disorder</p>

<p>d. Persistent Depressive Disorder</p>

Answer 7

<p>b. Major Depressive Disorder (MDD) is the best answer because the client is reporting many symptoms that indicate depression including a loss of interest in activities that were once pleasurable, feelings of hopelessness, and fatigue. A is incorrect because the client is not reporting a recent stressful event. C is incorrect because the stem does not state any symptoms such as worry or anxiety. D is incorrect because the client's symptoms have only been going on for a year, whereas they would need to exist for two years for a Persistent Depressive Disorder diagnosis to be made.</p>

Question 8

<p>A clinical therapist is evaluating a friendly, 5-year-old child who has difficulty making friends in school. He is very verbal but has a hard time answering questions about his feelings. He is eager to talk about all the different types of reptiles. What diagnosis is MOST likely?</p>

<p>a. Unspecified Anxiety Disorder</p>

<p>b. Autism Spectrum Disorder</p>

<p>c. Down Syndrome</p>

<p>d. Tourette's Disorder</p>

Answer 8

<p>b. Autism Spectrum Disorder. Individuals with Autism Spectrum Disorder have trouble in three areas including social interaction, communication, and behaviors/interests. These individuals also many times will become heavily interested in knowledgeable in one particular subject. All of these symptoms are displayed in the stem, therefore B is correct.</p>

Question 9

<p>A client was physically attacked 2 weeks ago while walking home from work. The client states that since then she feels like she is in a daze and is afraid to leave her house at night. She reports difficulty sleeping and says that she keeps snapping at her boyfriend when he tries to comfort her. The client's MOST likely diagnosis is:</p>

<p>a. Posttraumatic Stress Disorder</p>

<p>b. Acute Stress Disorder</p>

<p>c. Adjustment Disorder</p>

<p>d. Major Depressive Disorder</p>

Answer 9

<p>b. Acute Stress Disorder. B is the best answer because the client's symptoms have been occurring for greater than 3 days and less than a month. The client also experienced a life-threatening event and her symptoms are in reaction to that. A (PTSD )is incorrect because the client would need to experience these symptoms for over a month to be diagnosed with PTSD. C (Acute Stress Disorder) is incorrect because the event was a life-threatening event and not a normal life stressors (such as divorce or losing a job). Lastly, D is incorrect because the client's symptoms are related to the attack and therefore D cannot be diagnosed. A therapist would not diagnose this client with PTSD because the client would need to experience these symptoms for over a month to be diagnosed with PTSD, and it is reported in the stem that it has only been 2 weeks that she has been experiencing these symptoms. A therapist would not diagnose this client with an Adjustment Disorder because the event was life-threatening and not related to normal life stressors.</p>

Question 10

<p>A college counselor starts brief treatment with a senior who was referred by his honors thesis advisor. The student denies any need for treatment but engages in the intake, telling the therapist that he prefers to be alone and rarely goes home to see his family. He reports confusion around what his peers do on the weekends and denies any interest in romantic or sexual relationships. He tells the therapist that he's had the same roommate since freshman year but does not really know much about him. What is the MOST likely diagnosis?</p>

<p>a. Schizotypal Personality Disorder</p>

<p>b. Antisocial Personality Disorder</p>

<p>c. Avoidant Personality Disorder</p>

<p>d. Schizoid Personality Disorder</p>

Answer 10

<p>d. (Schizoid Personality Disorder) is correct because individuals with Schizoid Personality Disorder have a sense of detachment for social relationships, a lack of close relationships, and what sets this apart is that they don't have a desire for relationships. A (Schizotypal Personality Disorder) is incorrect because an individual with Schizotypal Personality Disorder have more irrational beliefs, extreme social anxiety, paranoid ideation, and ideas of reference which is not all seen in the stem. B (Antisocial Personality Disorder) is incorrect because the client is not violating the rights of others in any way. C (Avoidant Personality Disorder) is incorrect because an individual with Avoidant Personality Disorder also has social inhibition, however, they have a greater fear of being ridiculed or rejected in social situations. Additionally, they have a desire for social relationships which isn't displayed in the stem here.</p>

Question 11

<p>A therapist meets with a client who was recently released from the hospital following a suicidal threat. The client reports she has been in a relationship on and off for the past year and is fearful that he is going to leave her soon. She states that the last time he told her he was going to leave she cut her arms and told him she was going to kill herself if he left. The client's diagnosis is MOST likely:</p>

<p>a. Borderline Personality Disorder</p>

<p>b. Schizoid Personality Disorder</p>

<p>c. Antisocial Personality Disorder</p>

<p>d. Schizotypal Personality Disorder</p>

Answer 11

<p>a. Borderline Personality Disorder - because many who have this dx experience unstable relationships, are impulsive, and often fear abandonment. Self-mutilating behaviors and suicidal threats are also an aspect of this disorder. Schizoid Personality Disorder is incorrect because the client is not illustrating a preference to be alone or an indifference to relationships. Antisocial Personality Disorder is incorrect because the client is not violating the rights of others. Schizotypal Personality Disorder is incorrect because the client is not displaying any ideas of reference or magical thinking.</p>

Question 12

<p>A 24-year-old woman calls a therapist at a community services agency for case management and therapy. She describes a variety of physical symptoms and reports difficulty in keeping all of her health care providers straight. When asked, she reports that she doesn't have any formal medical diagnoses but was seen most recently by an allergy specialist for "puffy eyelids." She's been unable to maintain employment or friendships because of frequent appointments and bouts of "illness." This client's provisional diagnosis is MOST likely:</p>

<p>a. Somatic Symptom Disorder</p>

<p>b. Conversion Disorder</p>

<p>c. Pain Disorder</p>

<p>d. Malingering</p>

<p>Explain why the other diagnoses are not approriate when you answer</p>

Answer 12

<p>a. Somatic Symptom Disorder, is correct because the client is displaying physical symptoms however there is no medical cause to be found for these symptoms. b. Conversion Disorder is incorrect because the client reports that she doesn't have any formal medical diagnoses, yet complains about many physical symptoms. An individual with Conversion Disorder would have actual physical symptoms such as blindness or paralysis that have no medical explanation. C (Pain Disorder) is incorrect because for a pain disorder to be diagnosed other disorders such as somatization or conversion disorder need to be ruled out first. D (Malingering) is incorrect because individuals with malingering fabricate or exaggerate mental or physical disorders for secondary gain. Secondary gain may include things such as financial compensation, avoiding school or work, or getting lighter criminal sentences.</p>

Question 13

<p>A 45-year-old man seeks the services of a therapist for work-related stress. He notes in the intake that he is a mail carrier and was recently assigned a new route but cannot get a solid grasp on where he is supposed to go; he has difficulty concentrating and has become lost on several occasions. The therapist notices that he is limping noticeably and appears to tire during the interview. The therapist should FIRST consider:</p>

<p>a. Medical or neurological problem</p>

<p>b. Mild/Major Neurocognitive Disorder</p>

<p>c. Catatonia Due to Another Medical Disorder</p>

<p>d. Conversion Disorder</p>

Answer 13

<p>a. medical or neurological disorder should be considered FIRST in this question because the client is displaying a change in behavior that was not there previously. While B, C, and D may need to be considered at a later time we first need to make sure the client has a medical evaluation to see why these physical symptoms are occurring before he is treated psychologically.</p>

Question 14

<p>A 15-year-old girl is brought to therapy by her stepmom who reports that the client obsessively pulls out her hair and eyebrows. What diagnosis is MOST likely?</p>

<p>a. Obsessive-Compulsive Disorder</p>

<p>b. Trichotillomania</p>

<p>c. Obsessive-Compulsive Personality Disorder</p>

<p>d. Generalized Anxiety Disorder</p>

Answer 14

<p>b. Trichotillomania is characterized by a compulsive urge to pull out one's own hair</p>

Question 15

<p>A therapist is called to the emergency room to evaluate a 25-year-old man who was brought in by police for public indecency. The therapist attempts to interview the man but has difficulty due to his rapid, tangential speech and his refusal to answer questions because he fears the therapist will "pass the info along to the wrong people." The client adds that he has been awake for three days. The therapist notes that he is sweating profusely. A likely diagnosis is:</p>

<p>a. Opioid Intoxication</p>

<p>b. Alcohol Intoxication</p>

<p>c. Cocaine Intoxication</p>

<p>d. Amphetamine Intoxication</p>

Answer 15

<p>d. Amphetamine Intoxication. Individuals with Amphetamine Intoxication may experience psychosis, particularly in individuals who are heavy users. This is seen in the stem by the man's fear that the therapist will "pass the info to the wrong people." These individuals may also experience palpitations, disorientation, and rapid/tangential speech. Therefore D is correct. While these symptoms may overlap with A, B, and C, the biggest difference is that a sense of paranoia or delusions would not be present.</p>

Question 16

<p>A therapist in a skilled nursing facility receives a referral for a new resident, an 85-year-old wheelchair-confined woman. The referral states that the woman has refused to take meals in the dining room and has been isolating herself since she arrived 3 days ago. The woman's behavior indicates:</p>

<p>a. Passive-Aggressive Personality Disorder</p>

<p>b. Major Depressive Disorder</p>

<p>c. Mild/Major Neurocognitive Disorder</p>

<p>d. Typical adjustment to a new situation</p>

Answer 16

<p>d. Typical adjustment to a new situation. The client is displaying normal behaviors, particularly because the client is a new referral and has only been in the skilled nursing facility for 3 days. If the woman continued to engage in these behaviors for two weeks, we may then consider B at that point, however, at this point her behaviors are typical for the situation.</p>

Question 17

<p>A 34-year-old single female is referred to a therapist by her real estate company's Employee Assistance Program. She has missed a significant amount of work since her mother's death 6 months ago and has been unable to complete previously easy tasks. During the assessment, the woman reports that she spends hours every day preparing food and repeatedly cleaning her house. She adds that she can't stop thinking that the house isn't clean enough to meet her mother's standards. What diagnosis should be considered?</p>

<p>a. Generalized Anxiety Disorder</p>

<p>b. Major Depression</p>

<p>c. Obsessive-Compulsive Disorder</p>

<p>d. Obsessive-Compulsive Personality Disorder</p>

Answer 17

<p>c. Obsessive Compulsive Disorder. The client is displaying compulsions such as spending hours every day preparing food, and repeatedly cleaning her house. These compulsions coincide with an Obsessive-Compulsive Disorder diagnosis. A(Generalized Anxiety Disorder) and B (Major Depressive Disorder) are incorrect because the client is not displaying symptoms such as anxiety, worry, or a feeling of hopelessness. d. OCPD is incorrect because individuals with Obsessive-Compulsive Personality Disorder do not display compulsions</p>

Question 18

<p>A therapist in private practice receives a referral from a daycare for a 20-month-old girl. During the assessment, the therapist notices that the girl has no functional language, does not respond to prompts from her mother, and sits listlessly while wringing her hands. Her mother is very upset and reports that she doesn't understand her daughter's behavior. She states, "She used to talk, play and have fun. Now she can't even feed herself." What is the MOST likely diagnosis in this case?</p>

<p>a. Autism Spectrum Disorder</p>

<p>b. Intellectual Disability</p>

<p>c. Social (Pragmatic) Communication Disorder</p>

<p>d. Mixed Receptive-Expressive Language Disorder</p>

Answer 18

<p>a. Autism Spectrum Disorder there is a language deficiency and repetitive movements.</p>

Question 19

<p>A 4-year-old child is brought to therapy by her foster parents. When the therapist enters the waiting room, the child runs up to her, wraps her arms around the therapist's legs, and says, "Am I going home with you?" The foster parents are embarrassed by this behavior and say, "We've only had her for 2 weeks, but she does this with everyone!" What conclusion should the therapist draw from this behavior?</p>

<p>a. The child may have Reactive Attachment Disorder.</p>

<p>b. The child has had positive relationships with adults and is securely attached.</p>

<p>c. The child may have Disinhibited Social Engagement Disorder.</p>

<p>d. The child has most likely been abused</p>

Answer 19

<p>c. Child may have Disinhibited Social Engagement Disorder. A child with Disinhibited Social Engagement Disorder often forms attachments with strangers while disregarding the regular caregiver. This is generally the result of having multiple caregivers or abusive caregivers and onset occurs before age 5.</p>

Question 20

<p>A therapist is completing a biopyschosocial with a new client. The client appears with a flat affect and when asked questions, he responds with tangential answers and very disorganized speech. The client states in a monotone voice that while riding the bus on the way to his appointment people were plotting against him and he believes he was followed here by one of them. The client's MOST likely initial diagnosis is:</p>

<p>a. Schizoaffective Disorder</p>

<p>b. Schizophrenia</p>

<p>c. Bipolar I</p>

<p>d. Schizoid Personality Disorder</p>

Answer 20

<p>a. (Schizoaffective Disorder) is incorrect because the client is not reporting symptoms of both a mood disorder (mania or depression) in addition to symptoms of schizophrenia. C (Bipolar I) is incorrect because the client is not reporting any manic episodes. D (Schizoid Personality Disorder) is incorrect because individuals with Schizoid Personality Disorder would not experience delusions or paranoia as is being seen in the stem. Therefore, B, Schizophrenia, is the best answer because the client is presenting with disorganized speech patterns, a flat affect/monotone voice, and paranoid delusions.</p>

Question 21

<p>A 36-year-old woman is referred to a therapist through her Employee Assistance Program due to ongoing difficulty in getting projects done in a timely manner and a refusal to delegate. In working to create treatment objectives, the woman states repeatedly that her slow production comes from her desire to "get it right," and that she does and then re-does her work several times in order to ensure its perfection. She says, "I don't see why my boss has a problem. Wouldn't he rather it be done right?" The therapist's initial diagnostic impression is MOST likely:</p>

<p>a. Obsessive-Compulsive Personality Disorder</p>

<p>b. Adjustment Disorder With Anxiety</p>

<p>c. Obsessive-Compulsive Disorder</p>

<p>d. No diagnosis: Symptoms do not cause clinically significant disturbance</p>

Answer 21

<p>b. (Adjustment Disorder with Anxiety) is incorrect because there is no event or stressor that would allow for a diagnosis of Adjustment Disorder to be made. C (Obsessive-Compulsive Disorder) is incorrect because the client is not displaying any compulsions (ex. excessive hand washing). Lastly, D is incorrect because the boss has noted that the client struggles in getting projects done in a timely manner, therefore her symptoms are impairing her ability to work effectively. A (Obsessive-Compulsive Personality Disorder) is correct because the client is preoccupied with the details of her work and is inflexible in regards to how she believes the work should be done.</p>

Question 22

<p>A man seeks treatment from a therapist on the advice of his doctor, who is concerned about the man's tendency to pick at his skin until it bleeds. The man reports that he only does this because of blemishes on his skin that embarrass him greatly. During the assessment, the therapist notes that the man appears to have only minor blemishes but observes him continually checking his appearance in the window glass. What is the MOST likely diagnosis in this case?</p>

<p>a. Narcissistic Personality Disorder</p>

<p>b. Delusional Disorder</p>

<p>c. Obsessive-Compulsive Disorder</p>

<p>d. Body Dysmorphic Disorder</p>

Answer 22

<p>d. Body Dysmorphic Disorder is when an individual has persistent and intrusive preoccupations with an imagined or slight defect in their appearance. In this case, the man has minor blemishes, but believes that they are much greater, therefore D is the best answer. A (Narcissistic Personality Disorder) is incorrect because the client does not have a grandiose sense of self. B (Delusional Disorder) is incorrect because Delusional Disorder can only be diagnosed as the primary disorder which is not seen in this case. C (OCD) is incorrect because while the client is picking at his skin until it bleeds, he is not doing this compulsively which is needed for this diagnosis.</p>

Question 23

<p>A 17-year-old girl is referred to the school therapist after her teacher observes her "completely zoning out" on several occasions in class. When the therapist asks the girl about this, she has difficulty describing the experience and says, "I think I'm going crazy." The therapist tries to clarify the girl's meaning, but the girl is only able to say, "It's like I'm there, but I'm not, you know? I know I should be paying attention, but it's like I can't control my own body." The therapist is MOST likely to diagnose the girl with:</p>

<p>a. Attention Deficit-Hyperactivity Disorder, Predominantly Inattentive Type</p>

<p>b. Depersonalization Disorder</p>

<p>c. Schizophrenia</p>

<p>d. Dissociative Amnesia</p>

Answer 23

<p>b. Depersonalization Disorder. Depersonalization Disorder is a Dissociative Disorder where an individual experiences persistent or recurrent feelings of depersonalization or derealization. Symptoms that are displayed in the stem such as zoning out, and feeling like she is not in her body are all indicative of Depersonalization Disorder</p>

Question 24

<p>During an initial appointment, the therapist asks a husband and wife their reasons for seeking treatment. The wife hesitantly tells the therapist that it is because of "bedroom issues." Her husband cuts in and states that approximately a year ago, his wife seemed to lose interest in him sexually and that nothing he has done has been able to change this; he ends by saying, "I think she's having an affair." The wife insists, "I'm just feeling stressed with work and haven't found sex pleasurable for a while. " What is the MOST likely diagnosis in this case?</p>

<p>a. Female Sexual Interest/Arousal Disorder</p>

<p>b. Genito-Pelvic Pain/Penetration Disorder</p>

<p>c. Adjustment Disorder</p>

<p>d. Gender Dysphoria</p>

Answer 24

<p>b. (Genito-Pelvic Pain/Penetration Disorder) is incorrect because the client isn't reporting any actual pain during sexual intercourse. C (Adjustment Disorder) is incorrect because there is no identified stressor in the stem that would be required for an Adjustment Disorder diagnosis. D (Gender Dysphoria) is incorrect because the client is not reporting any conflict between her physical gender and her identified gender. Therefore, A (Female Sexual Interest/Arousal Disorder) is correct because the client is reporting an aversion to and lack of interest in sexual contact with her husband which as a result is causing conflict between the two of them.</p>

Question 25

<p>A man is referred to a therapist by his Employee Assistance Program for several incidents of falling asleep on the job. During the initial interview, the man confirms that he feels sleepy almost constantly and "just can't seem to catch up" on rest. He reports that he often can't get himself out of bed on the weekends and has been sneaking naps in at work but has been caught on several occasions. After ruling out substance abuse and a medical issue, the therapist will likely diagnose the client with:</p>

<p>a. Non-Rapid Eye Movement Sleep Disorder</p>

<p>b. Insomnia Disorder</p>

<p>c. Hypersomnolence Disorder</p>

<p>d. Major Depressive Disorder</p>

Answer 25

<p>c. Hypersomnolence Disorder. Because the client is reporting excessive sleepiness during the day. Insomnia is incorrect because the client would need to report difficulties falling asleep, or staying asleep at night which is not stated in the stem. A and D are incorrect because the client is not reporting any symptoms that would coincide with these disorders.</p>

Question 26

<p>Parents seek the services of a therapist for their 5-year-old son; they explain that their son has been waking around 11 p.m. several nights a week for the last month, screaming hysterically and "staring into space." They are frightened by the fact that they are often unable to rouse their son and report that he often falls back asleep without acknowledging their presence in the room. They have been unable to get him to tell them anything about his dreams and are confused by the fact that he seems to have no memory of the events the next morning. The MOST likely diagnosis in this case is:</p>

<p>a. Non-Rapid Eye Movement Sleep Disorder, Sleep Terror Subtype</p>

<p>b. Nightmare Disorder</p>

<p>c. Narcolepsy</p>

<p>d. Panic Disorder</p>

Answer 26

<p>b. (Nightmare Disorder) is incorrect because the client reports that is has no memory of the events that are happening. Individuals with Nightmare Disorder are generally able to remember the nightmares they have, therefore B is incorrect. C (Narcolepsy) is incorrect because the client is not having recurrent daytime naps. D (Panic Disorder) is incorrect because Panic Disorder does not occur during sleep. Therefore, A (Non-Rapid Eye Movement Sleep Disorder, Sleep Terror Subtype) is correct because the nightmares are occurring during the first ⅓ of sleep time and the boy has an incomplete waking and is difficult to comfort. Additionally, the client doesn't remember the dreams that have occurred.</p>

Question 27

<p>All of the following are diagnostic criteria for Substance Use Disorder EXCEPT:</p>

<p>a. Failure to fulfill major role obligations at work, school, or home.</p>

<p>b. A need for markedly increased amounts of the substance to achieve intoxication or desired effect.</p>

<p>c. Legal problems related to substance use.</p>

<p>d. Cravings or a strong desire to for substance use.</p>

Answer 27

<p>c. Legal problems related to substance use is the only answer that is NOT part of the criteria for Substance Use Disorder</p>

Question 28

<p>30-year-old man presents for treatment on the advice of his mother, who is concerned that he has not yet found someone with whom he can "settle down." The therapist notes during the assessment that the man fails to make eye contact and regards the therapist in a suspicious manner. When asked about his personal relationships, the man notes that he does not have any close friends because "no one likes a person who can read minds" and that he just doesn't "fit in" with his co-workers. What is the MOST likely diagnosis in this case?</p>

<p>a. Paranoid Personality Disorder</p>

<p>b. Schizophrenia</p>

<p>c. Schizotypal Personality Disorder</p>

<p>d. Schizoid Personality Disorder</p>

Answer 28

<p>a. (paranoid Personality Disorder) is incorrect because the client is not displaying any paranoid behaviors such as believing someone will sabotage him. B (Schizophrenia) is incorrect because the client is not displaying a flat affect, or any hallucinations. D (Schizoid Personality Disorder) is incorrect because individuals with Schizoid Personality Disorder are viewed as being more of loners, whereas the client in this stem has a relationship with his mom. C (Schizotypal Personality Disorder) is correct because the client is displaying odd behaviors, does not fit in with others, and the biggest defining factor in this stem is that the client reports magical thinking when stating that he can read minds.</p>

Question 29

<p>A therapist begins an assessment on a nine-year-old boy whose parents are reporting impulsive, aggressive, and argumentative behavior at home. The child refuses to follow directions and tries to hit and kick his parents when they intervene. Reports from the client's teacher indicate the he often challenges her but has several friends. The parents state that this has been going on for over a year and has gotten progressively worse. What is the MOST likely diagnosis in this case?</p>

<p>a. Major Depressive Disorder, Childhood Onset</p>

<p>b. ADHD</p>

<p>c. Bipolar I Disorder</p>

<p>d. Oppositional Defiant Disorder</p>

Answer 29

<p>a. Major Depressive Disorder, Childhood Onset, is incorrect because while the client is displaying anger, he is not showing any other signs of depression such as feelings of sadness or hopelessness. B, ADHD, is incorrect because children with ADHD would not be displaying the aggressive behaviors that are seen in the stem such as hitting and kicking his parents. C, Bipolar I Disorder, is incorrect because the client is not displaying any manic behaviors. D, Oppositional Defiant Behavior, is the best answer because the client is displaying hostile and disobedient behavior towards authority figures (parents and teachers).</p>

Question 30

<p>A college student seeks therapy for problems with schoolwork. She states that sometimes she is really productive and can go without much sleep for a few days straight. The problem is that she'll end up crashing. She reports that she'll feel bad about herself and not want to get out of bed for a few days because she is so unmotivated. What diagnosis is MOST likely?</p>

<p>a. Bipolar I Disorder</p>

<p>b. Bipolar II Disorder</p>

<p>c. Schizoaffective Disorder</p>

<p>d. Cyclothymic Disorder</p>

Answer 30

<p>d. Cyclothymic Disorder. because the client is displaying a milder form of Bipolar Disorder. The client reports hypomanic symptoms when she states that she can go for a few days straight without much sleep followed by depressive symptoms that do not fit the criteria for Major Depression. Bipolar I and Bipolar II, are incorrect because the client is not experiencing full-blown mania or Major Depression. C, Schizoaffective Disorder, is incorrect because the client is not displaying any symptoms of psychosis</p>

Question 31

<p>A 22-year-old client reports that when he starts to feel anxious or stressed he picks at his skin to the point that it will bleed. The therapist notes multiple lesions on the clients arms and face. The MOST likely diagnosis is:</p>

<p>a. Excoriation Disorder</p>

<p>b. Obsessive-Compulsive Disorder</p>

<p>c. Generalized Anxiety Disorder</p>

<p>d. Trichotillomania</p>

Answer 31

<p>a. Excoriation Disorder, is the best answer here because individuals with Excoriation (skin picking) Disorder will pick or scratch at their skin to the point where damage is caused. This is often done when the individual is feeling anxious or stressed. B, OCD, is incorrect because his compulsion is better defined by Excoriation Disorder, therefore Obsessive-Compulsive Disorder cannot be diagnosed. C, Generalized Anxiety Disorder, is incorrect because the client is not expressing enough symptoms to fit a GAD diagnosis. Lastly, D is incorrect because individuals with Trichotillomania will pull out their hair when stressed which is not indicated in the stem.</p>

Question 32

<p>A client reports that despite going to bed at an early hour, he continues to struggle falling asleep, often laying in bed for 3 hours before he is able to fall asleep. The client reports that he is exhausted and has been happening more often than not throughout the week for the past 6 months. What is the client's MOST likely diagnosis:</p>

<p>a. Insomnia Disorder</p>

<p>b. Hypersomnolence Disorder</p>

<p>c. Major Depressive Disorder</p>

<p>d. Non-REM Sleep Disorder</p>

Answer 32

<p>a. Insomnia Disorder. Since the client reports that he is having trouble falling asleep and that this has been occurring for more than 3 months, the client's most likely diagnosis is A, Insomnia Disorder. B, Hypersomnolence Disorder, is incorrect because the client does not report excessive sleepiness during the daytime. C, Major Depressive Disorder, is incorrect because the client is not reporting any symptoms of depression. D, Non-REM Sleep Disorder, is incorrect because the client is not reporting waking during the first ⅓ of sleep time with nightmares or night terrors</p>

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Question 33

<p>A mother brings in her young daughter to see a therapist. The mother reports that her daughter is very quiet and appears anxious when speaking. She also states that teachers have reported that she does not participate frequently in class. When the therapist asks the girl a question, the therapist notices that her words are often repeated while she speaks, and the syllables last longer than normal. The MOST likely diagnosis here is:</p>

<p>a. Language Disorder</p>

<p>b. Childhood-Onset Fluency Disorder</p>

<p>c. Autism Spectrum Disorder</p>

<p>d. Specific Learning Disorder</p>

Answer 33

<p>b. Childhood-Onset Fluency Disorder, is the best answer here because the girl is struggling with the time patterning of her speech which is displayed by her repetition of words and prolonged syllables. A, Language Disorder, is incorrect because individuals with Language Disorder have trouble getting their meaning across to others, but they are able to produce sounds and their speech can be understood. C, Autism Spectrum Disorder, is incorrect because the child is not displaying deficits that indicate Autism Spectrum Disorder such as repetitive patterns of behavior, social interaction difficulties, or a disinterest in activities. D, Specific Learning Disorder, is incorrect because the stem does not indicate that the girl is having difficulties with academic learning.</p>

Question 34

<p>A 25-year-old woman sees a therapist after complaining about feelings of hopelessness and anxiety. She states that the feelings are most severe within the week before she starts her menstrual cycle and go away once her cycle starts. She reports that during this time she loses interest in activities she usually enjoys and has trouble focusing. The client's initial diagnosis is MOST likely:</p>

<p>a. Generalized Anxiety Disorder</p>

<p>b. Bipolar II</p>

<p>c. Premenstrual Dysphoric Disorder</p>

<p>d. Persistent Depressive Disorder</p>

Answer 34

<p>c. Premenstrual Dysphoric Disorder, because the client is reporting that these symptoms occur within the week before her menstrual cycle and then disappear. Individuals with Premenstrual Dysphoric Disorder experience depressive symptoms within 5-11 days before their menstrual cycle. These symptoms then lessen or disappear completely once it has started.</p>

Question 35

<p>A mother brings her 9-year-old son in to see a therapist due to ongoing temper tantrums and outbursts at home and school. The mother reports that the tantrums have been going on for the past two years and that when he isn't having a tantrum he appears very irritable and angry. The mother tearfully states that these outbursts occur more often than not and that this morning he started aggressively throwing books at the wall after learning that he couldn't go to a friends house. What diagnosis should the therapist initially consider?</p>

<p>a. Major Depressive Disorder</p>

<p>b. Conduct Disorder</p>

<p>c. Disruptive Mood Dysregulation Disorder</p>

<p>d. Reactive Attachment Disorder</p>

Answer 35

<p>c. Disruptive Mood Dysregulation Disorder is correct. a. Major Depressive Disorder, is incorrect because individuals with Major Depression would not have the severe temper tantrums that are occurring here. B, Conduct Disorder, is incorrect because individuals with conduct disorder display behaviors that violate the rights of others, which isn't occurring at this point with the child. d. ReactiveAttachment Disorder, is incorrect because the boy's symptoms started two years ago, whereas individuals with RAD must have an onset before age 5. Therefore, C, Disruptive Mood Dysregulation Disorder, is correct because the boy is displaying chronic irritability and severe temper tantrums that are not developmentally appropriate. Onset must occur between ages 6-10, but it can be diagnosed up to age 17.</p>

Question 36

<p>A 12-year-old child is displaying difficulties with reading comprehension and when asked to read out loud frequently makes mistakes in reading the words. The child's MOST likely diagnosis is:</p>

<p>a. Specific Learning Disorder with Impaired Reading</p>

<p>b. Specific Learning Disorder with Impaired Written Expression</p>

<p>c. Childhood-Onset Fluency Disorder</p>

<p>d. Intellectual Disability</p>

Answer 36

<p>a. Specific Learning Disorder with Impaired Reading, is the best answer here because the child is displaying difficulties with reading comprehension and fluency. B, Specific Learning Disorder with Impaired Written Expression, is incorrect because a child with Impaired Written Expression would experience difficulties with spelling accuracy, grammar and punctuation, and clarity or organization of written expression. C, Childhood-Onset Fluency Disorder, is incorrect because the child is not struggling with the sounds or syllables of the words but rather the accuracy of comprehending the words. Lastly, D, Intellectual Disability, is incorrect because the boy is not displaying symptoms that would be indicative of an Intellectual Disability.</p>

Question 37

<p>A woman comes in to see a therapist with her partner. The women reports that within the past year she feels like their relationship has become more conflictual and states that she feels like a lot of it has to do to their lack of sex. The partner states that he has a desire for more sex and feels frustrated that she feels so anxious every time he starts to initiate sexual intercourse. The woman tearfully reports that she wants to have more sex but she experiences a lot of pain during intercourse because her pelvic muscles tense during penetration. The woman's MOST likely diagnosis is:</p>

<p>a. Generalized Anxiety Disorder</p>

<p>b. Genito-Pelvic Pain/Penetration Disorder</p>

<p>c. Sexual Interest/Arousal Disorder</p>

<p>d. Female Orgasmic Disorder</p>

Answer 37

<p>b. Genito-Pelvic Pain Penetration Disorder. The woman is reporting pain during vaginal penetration and intercourse. As a result the woman is experiencing fear and anxiety around having sexual intercourse which as a result affects her relationship with her partner.</p>

Question 38

<p>Kayla, age 15, is brought in for therapy by her Aunt Lynda who was given legal custody following the death of Kayla's mother three years ago. Lynda reports that Kayla is "running with the wrong crowd", has been skipping school and is lying to her about where she goes at night. Lynda states, "She told me that she was at her friend's house, but I went over there and nobody was home. I just can't trust her anymore." Kayla rolls her eyes and responds "Don't pretend like you care. I'm not afraid of you anymore." What legal obligations does the therapist have in the case described in this vignette?</p>

<p>a. File a child abuse report; Request documentation to verify custody; Obtain a release to speak to school counselor.</p>

<p>b. Set fee before the onset of therapy; Explore expectations of therapy; Assess for child abuse.</p>

<p>c. Obtain signed informed consent to treat a minor; File a child abuse report; Set fee prior to the onset of therapy.</p>

<p>d. Obtain signed informed consent to treat a minor; Set fee prior to treatment; Assess for child abuse.</p>

Answer 38

<p>d. Obtain signed informed consent to treat a minor; Set fee prior to treatment; Assess for child abuse.</p>

Question 39

<p>A lesbian couple, Michelle, a 44-year-old African American and Kara, a 38-year-old Caucasian, are referred by a friend. The couple reports that they fight all of the time and can't agree how to parent. They have two adopted children, Josh, 6 and Logan, 4. They report that Josh has been disruptive in class, won't stay seated and is aggressive with other children. Kara starts crying when she says, "I don't know what to do to help him. I am so worried about him. I can't sleep without taking something". Michelle complains angrily, "Well, she pops pills whenever she's stressed and she worries about everything. If she actually disciplined him, we wouldn't have this problem. He listens to me. Now, he's completely out of control like you with that sleep drug". Kara whimpers back, "He listens to you because he's afraid of what you'll do. " What interventions would a Bowenian therapist use in the beginning phase of treatment with Michelle and Kara?</p>

<p>a. Analyze the triangulation of substance abuse in Kara & Michelle's relationship and develop a
family history to identify Michelle and Kara's learned parenting styles.</p>

<p>b. Identify the role of substance abuse as intrusive in their partnership and assist the couple in understanding the role of parenting in their families of origin.</p>

<p>c. Reduce the emotional reactivity of Michelle and Kara's opposing responses to parenting and Interpret the multigenerational parenting styles of Michelle and Kara's families of origin.</p>

<p>d. Develop a family history to identify Michelle and Kara's learned parenting styles and analyze substance abuse as Kara's avoidance of relationship responsibility.</p>

Answer 39

<p>b. Identify the role of substance abuse as intrusive in their partnership and assist the couple in understanding the role of parenting in their families of origin.</p>