Psych Exam # 2

Question 0

What are the 4 characteristics of violent families?

Answer 0

1) Social Isolation - Abused member usually keeps to themselves and does not invite others into the home or tell them what’s happening.
2) Abuse of Power and Control - Abusive family member usually holds a position of power and control over the victim.
3) Alcohol and Other Drug Abuse - Substance abuse, especially alcoholism, has been associated with with family violence.
4) Intergenerational Transmission Process - Explains that patterns of violence are perpetuated from one generation to the next through role modeling and social learning.

Question 1

What does Family Violence encompass?

Answer 1

1) Spouse battering
2) Neglect
3) Physical, emotional or sexual abuse of children
4) Elder abuse
5) Marital rape

Question 2

Which group is at the most risk for domestic abuse and why?

Answer 2

Battered Immigrant Women - Because they may come from a country where domestic violence is socially acceptable, they may fear deportation, and they may not speak the language or have other cultural barriers.

Question 3

Distinguish the 4 different types of Dissociative Disorders.

Answer 3

1) Dissociative Amnesia - The client cannot remember important personal information.
2) Dissociative Fugue - The client has sudden episodes of suddenly leaving the home or place of work without any explanation, traveling to another city, and being unable to remember his or her past or identity.
3) Dissociative Identity Disorder - Multiple personality disorder.
4) Depersonalization Disorder - The client has a persistent or recurrent feeling of being detached from his or her mental processes or body.

Question 4

Which 2 meds are commonly given to patients with PTSD?

Answer 4

1) Paxil
2) Zoloft
* Both are SSRIs

Question 5

What’s the difference between PTSD and Acute Stress Disorder?

Answer 5

1) PTSD - Symptoms occur 3 months or more after the trauma.

2) Acute Stress Disorder - Symptoms appear within first month after the trauma and do not persist longer than 4 weeks.

Question 6

What are the 3 symptoms of PTSD?

Answer 6

1) Reliving the event
2) Avoiding reminders of the event
3) Being on guard or experiencing hyperarousal

Question 7

Discuss the 4 types of male rapists.

Answer 7

1) Sexual Sadists - Aroused by the pain of their victims
2) Exploitive Predators - Use their victims as objects for gratification
3) Inadequate Men - Believe that no women would voluntarily have sex with them, and obsessed with sex fantasies
4) Angry Men - Use rape as a displaced expression of anger and rage.

Question 8

Describe Kubler Ross’ 5 stages of grieving.

Answer 8

1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance

Question 9

Describe Disenfranchised Grieving and give some examples of it.

Answer 9

Disenfranchised Grieving - Grief over a loss that is not or cannot be acknowledged openly, mourned publicly, or supported socially. Circumstances that can result in disenfranchised grief include:

1) A relationship that has no legitimacy
2) The loss involves social stigma

Question 10

Define Complicated Grieving

Answer 10

Complicated Grieving - A response outside the norm, occurring when a person is void of emotion, grieves for prolonged periods, or has expressions of grief that seem disproportionate to the event.

Question 11

Which 5 types of people are at increased risk for Complicated Grieving?

Answer 11

1) Low self-esteem
2) Low trust in others
3) Previous psychiatric disorders
4) Previous suicide attempts
5) Absent or unhelpful family members

Question 12

Describe the 3 types of attachments

Answer 12

1) Ambivalent Attachment - At least one partner is unclear about how the couple loves or does not love each other. i.e., when a woman is uncertain about and feels pressure from others to have an abortion, she is experiencing ambivalence about her unborn child.
2) Dependent Attachment - One partner relies on the other to provide for his or her needs without necessarily meeting the partner’s needs.
3) Insecure Attachment - Usually forms during childhood, especially if a child has learned fear and helplessness.

Question 13

What are the 4 Physiological Responses to Complicated Grieving?

Answer 13

1) Impaired immune system
2) Increased adrenal corticosteroids activity
3) Increased levels of serum prolactin, growth hormone and psychosomatic disorders.
4) Increased mortality from heart disease

Question 14

What are the Physiologic Responses to Grieving that were discussed in the book?

Answer 14

1) Headaches and insomnia
2) Impaired appetite and weight loss
3) Palpitations and indigestion
4) Lack of energy
5) Changes in immune and endocrine systems

Question 15

Briefly describe Mardi Horowitz’s 4 stages of loss and adaptation.

Answer 15

1) Outcry - 1st realization of the loss expressed by crying, screaming or the opposite, stoicism.
2) Denial and Intrusion - People move back and forth between activities that distract them from the memory of the loss and having the loss become an overwhelming intrusion in their lives.
3) Working Through - The person still thinks about the loss but is finding new ways to cope.
4) Completion - Life begins to feel normal again.

Question 16

Describe Bowlby’s 4 phases of Grieving.

Answer 16

1) Numbness and denial
2) Yearning and protesting the permanence of the loss
3) Cognitive disorganization and emotional despair
4) Reorganizing and reintegrating

Question 17

Describe Engel’s 5 stages of Grieving

Answer 17

1) Shock and Disbelief
2) Developing awareness - Includes anger over the loss
3) Restitution - Participating in rituals such as funerals
4) Resolution of the Loss - Individual becomes preoccupied with the lost person or object
5) Recovery - Preoccupation ends and individual moves on with life

Question 18

Define the following terms:

1) Grief
2) Grieving (aka Bereavement)
3) Mourning

Answer 18

1) Grief - Refers to the emotions and affect that are a normal response to the experience of loss.
2) Grieving (aka Bereavement) - The process by which a person experiences grief.
3) Mourning - The outward expression of grief.

Question 19

Identify the personality types included in each personality disorder category: Cluster A, B and C.

Answer 19

1) Cluster A - Paranoid, Schizoid, & Schizotypal
2) Cluster B - Borderline, Histrionic and Narcissistic
3) Cluster C - Avoidant, Dependent & OCPD

Question 20

Briefly describe the following Cluster A personality disorders:

1) Paranoid
2) Schizoid
3) Schizotypal

Answer 20

1) Paranoid - Characterized by mistrust and suspiciousness of others.
2) Schizoid - Characterized by detachment from social relationships; restricted affect and involvement with things more than people.
3) Schizotypal - Characterized by acute discomfort in relationships; perceptual distortions and eccentric behavior.

Question 21

What are the appropriate Nursing Interventions (how should these clients be approached) for the following Cluster A personality disorders:

1) Paranoid
2) Schizoid
3) Schizotypal

Answer 21

1) Paranoid - Serious, straightforward approach; teach clients to validate ideas before taking action and involve client in Tx plan because the feel the need to be in control.
2) Schizoid - Improve client’s functioning in the community; Assist client to find a case manager if no primary relationship with a family member is present.
3) Schizotypal - Improve client’s functioning in the community; Help to develop self-care skills.

Question 22

Briefly describe the following Cluster B personality disorders:

1) Antisocial
2) Borderline
3) Histrionic
4) Narcissistic

Answer 22

1) Antisocial - Characterized by a disregard for rights of others, rules and laws.
2) Borderline - Polarized extreme thinking and acting in a single conversation or short amount of time. This client is at high risk for self-harm.
3) Histrionic - Excessive emotionality and attention seeking.
4) Narcissistic - Grandiose; lack of empathy and need for admiration.

Question 23

What are the appropriate Nursing Interventions (how should these clients be approached) for the following Cluster B personality disorders:

1) Antisocial
2) Borderline
3) Histrionic
4) Narcissistic

Answer 23

1) Antisocial - Set limits; confront client and then teach them how to solve problems appropriately by managing emotions of anger and frustration.
2) Borderline - Promote safety (use “no self-harm” contract) and teach social skills; Reshape thinking patterns using the 4 different techniques.
3) Histrionic - Teach social skills and provide factual feedback about behavior about what is and is not appropriate.
4) Narcissistic - Use a matter-of-fact approach and try to gain cooperation for needed Tx.

Question 24

Briefly describe the following Cluster C personality disorders:

1) Avoidant
2) Dependent
3) Obsessive Compulsive Personality Disorder

Answer 24

1) Avoidant - Socially inhibited; has feelings of inadequacy; hypersensitivity to negative evaluation.
2) Dependent - Submissive and clinging behavior; need to be taken cared of.
3) Obsessive Compulsive Personality Disorder - Preoccupation with orderliness, perfectionism and control.

Question 25

What are the appropriate Nursing Interventions (how should these clients be approached) for the following Cluster C personality disorders:

1) Avoidant
2) Dependent
3) Obsessive Compulsive Personality Disorder

Answer 25

1) Avoidant - Support and reassurance; Cognitive restructuring techniques, promote self-esteem.
2) Dependent - Promote self-reliance and autonomy; teach problem solving and decision making.
3) Obsessive Compulsive Personality Disorder - Encourage client to negotiate with others; Assist client to make timely decisions and and complete work.

Question 26

Describe the 4 techniques that can be used by the nurse to reshape the thinking patterns of a a client with Borderline Personality Disorder.

Answer 26

1) Cognitive Restructuring - Helping clients to recognize negative thoughts and feeling and replacing them with positive ones.
2) Thought Stopping - Actual stopping of negative or self-critical thought patterns. i.e., actually saying “STOP” when negative thoughts enter your mind.
3) Positive Self-Talk - Reframing negative thoughts into positive ones. i.e., “I made a mistake, but it’s not the end of the world”.
4) Decatastrophizing - Looking at the situation realistically instead of pessimistically.

Question 27

Describe the 2 uncategorized Personality Disorders and the appropriate nursing interventions for each.

Answer 27

1) Depressive - Pattern of depressive behaviors. Asses self-harm risk; Promote self-esteem and increase involvement in activities.
2) Passive Aggressive - Pattern of negative attitudes and passive resistance to demands for adequate performance in social and occupational situations. Help client to identify feeling and express them appropriately.

Question 28

Describe the 3 stages of physiological reaction to stress identified by Hans Selye.

Answer 28

1) Alarm - Stress stimulates the body to release adrenaline and norepinephrine for fuel, and also stimulates glucose production by the liver.
2) Resistance - Digestive system ⬇ Fx to shunt blood to needed areas. Lungs and heart work harder to circulate needed oxygen and nutrients (via the blood) to needed areas. Person responds by flight, fight or freeze.
3) Exhaustion - Results if body stores are depleted.

Question 29

What are the 5 Psychological and 5 Physiological Responses to Mild Anxiety?

Answer 29

PSYCHOLOGICAL 
1) Wide perceptual field 
2) Sharpened senses
3) Increased motivation and increased ability to learn
4) Effective problem solving 
5) Irritability
PHYSIOLOGICAL
1) Restlessness
2) Fidgeting
3) GI "butterflies"
4) Difficulty sleeping
5) Hypersensitivity to noise

Question 30

What are the 4 Psychological and 6 Physiological Responses to Moderate Anxiety?

Answer 30

PSYCHOLOGICAL 
1) Perceptual field narrowed to immediate task
2) Selectively attentive 
3) Cannot connect thoughts or events independently
4) ⬆ use of automatisms 
PHYSIOLOGICAL
1) ⬆ Muscle tension
2) Diaphoresis
3) Pounding pulse
4) Headache 
5) Dry mouth 
5) High voice pitch & faster speech
6) GI upset and ⬆ urination

Question 31

What are the 7 Psychological and 8 Physiological Responses to Severe Anxiety?

Answer 31

PSYCHOLOGICAL 
1) Perceptual field reduced to one detail or scattered detail
2) Cannot complete tasks, solve problems or learn
3) Behavior geared toward anxiety relief
4) Doesn't respond to redirection
5) Feels awe, dread, or horror 
6) Cries
7) Ritualistic behavior
PHYSIOLOGICAL 
1) Severe headache 
2) Nausea, vomiting, and diarrhea
3) Trembling
4) Rigid stance
5) Vertigo
6) Pale
7) Tachycardia
8) Chest pain

Question 32

What are the 6 Psychological and 4 Physiological Responses to Panic Anxiety?

Answer 32

PSYCHOLOGICAL
1) Perceptual field reduced to focus on self
2) Unable to process environmental stimuli or recognize danger
3) Distorted perceptions & loss of rational thought
4) Cannot communicate verbally
5) Possible delusions or hallucinations
6) May be suicidal
PSYCHOLOGICAL
1) Person may bolt/run OR become immobile and mute
2) Pupils dilate
3) ⬆ BP and pulse
4) Flight, fight, or freeze response

Question 33

(T/F) Benzodiazepines have a high potential for abuse and dependence, so their use should be short-term (4-6 weeks).

Answer 33

True

Question 34

What is the one non-Benzodiazepine anxiolytic drug discusse i class? Describe the speed of onset, side effects, and nursing implications involved?

Answer 34

BUSPIRONE (BuSpar)

1) Speed of Onset - Very slow
2) Side Effects - Dizziness, restlessness, drowsiness, headache, weakness, nausea & vomiting, paradoxical excitement or euphoria.
3) Nursing Implications - Rise slowly from sitting position, no potentially hazardous activities such as driving, take with food.

Question 35

Describe Generalized Anxiety Disorder?

Answer 35

Generalized Anxiety Disorder is characterized by at least 6 months of persistent and excessive worry and anxiety.

Question 36

Which neurotransmitter is believed to be dysfunctional in clients with anxiety disorders?

Answer 36

GABA - An inhibitory NT that functions as the body’s natural anti anxiety agent by reducing cell excitability, thus ⬇ the rate of neuronal firing.

Question 37

Define Defense Mechanisms

Answer 37

Defense Mechanisms - Cognitive distortions that a person issue unconsciously to maintain a sense of being in control of a situation, to lessen discomfort, and to deal with stress.

Question 38

Describe the method of Assertive Training, used to help patients with anxiety disorders.

Answer 38

Assertive Training - Helps the person take more control over life situations and foster self-assurance. They involve using “I” statements

Question 39

What is the treatment of choice for the elderly patient suffering from an anxiety disorder?

Answer 39

An SSRI

Question 40

Distinguish between Primary Gains and Secondary Gains as it relates to anxiety disorders.

Answer 40

1) Primary Gains - The relief of anxiety achieved by performing the specific anxiety-driven behavior such as staying in the house to avoid the anxiety of leaving a safe place.
2) Secondary Gain - The attention received from others as a result of the behaviors performed in Primary gains.

Question 41

Which 4 class of medications (mentioned in the book) can be used to treat Panic Disorders?

Answer 41

1) Benzodiazepines
2) SSRIs
3) TCAs
4) Antihypertensives i.e., colonidine and propranolol

Question 42

Define Automatisms

Answer 42

Automatisms - Automatic and unconscious mannerisms that increase in frequency with a patient’s anxiety level.

Question 43

Define Depersonalization and Derealization as it relates a panic attack.

Answer 43

During a panic attack, the client may describe feelings of being disconnected from himself or herself (Depersonalization), or sensing that things are not real (Derealization).

Question 44

Define Systematic Desensitization and Flooding as they relate to Phobias.

Answer 44

1) Systematic Desensitization - When the therapist progressively exposes the client to the threatening object in a safe setting until the client’s anxiety decreases.
2) Flooding - A form of rapid desensitization in which a behavioral therapist confronts the client with the phobic object until it no longer produces anxiety.

Question 45

Distinguish between Obsession and Compulsion.

Answer 45

1) Obsession - The recurrent thoughts that cause anxiety.

2) Compulsion - The behaviors that a re carried out as a result of the recurrent thoughts.

Question 46

Describe the relationship between the levels of NTs (Norepinephrine, epinephrine, and serotonin) and eating.

Answer 46

1) Norepinephrine - ⬆ in response to eating in order to allow the body to metabolize and use nutrients.
2) Epinephrine - ⬇ When food intake is restricted (as in Anorexia), which is why we see ⬇ HT and BP in patients with anorexia.
3) Serotonin - ⬆ With Satiety and ⬇ binging and purging and bulimia.

Question 47

Define Enmeshment as it relates to eating disorders.

Answer 47

Enmeshment - A lack of clear role boundaries. If this occurs in the familial setting, it can lead to an adolescent struggling to develop autonomy and establish their identity, which can lead to an eating disorder in order to gain some control over their lives.

Question 48

Which specific medications have proven useful in treating patients with Anorexia Nervosa?

Answer 48

1) Elavil (TCA) - Promotes weight gain
2) Cyproheptadine (Antihistamine) - In high doses, up to 28 mg/day, promotes weight gain.
3) Zyprexa (Antipsychotic) - Used for bizarre body image distortions and to promote weight gain.
4) Prozac - Helps to prevent relapse in patients who have gained some weight by improving their mood, but can sometimes be anti productive because it can also cause weight loss it some patients.

Question 49

Define Alexythemia

Answer 49

Alexythemia - Difficulty identifying and expressing feelings.

Question 50

Define Hysteria

Answer 50

Hysteria - Refers to multiple physical complaints with no organic basis.

Question 51

Define Somatization Disorders and Conversion Disorders

Answer 51

1) Somatization Disorders - Multiple, recurrent physical symptoms in a variety of bodily systems that have no organic or medical basis.
2) Conversion Disorders - Sometimes called Conversion Reaction; Unexplained, sudden deficits in sensory or motor function related to an emotional conflict the client experiences but does not handle directly (i.e., blindness, paralysis). A key feature of Conversion Disorders is that the patient has an attitude of La Belle Indifférence, a seeming lack of concern or distress.

Question 52

Define Hypochondriasis and Body Dysmorphic Disorder

Answer 52

1) Hypochondriasis - Preoccupation with the fear that one has a disease or will get a disease.
2) Body Dysmorphic Disorder - Preoccupation with an imagines or exaggerated defect in physical appearance such as thinking one’s nose is too big.

Question 53

Define Factitious Disorder (aka Munchausen Syndrome)

Answer 53

Hypochondriasis and Body Dysmorphic Disorder - When a person intentionally produces or feigns physical or psychological symptoms solely to gain attention.

Question 54

Define Body Identity Integrity Disorder (BIID)

Answer 54

Body Identity Integrity Disorder (BIID) - Term given to people who feel alienated from a part of their body and desire amputation.

Question 55

Define Internalization as it relates to patients with Somataform disorders.

Answer 55

Internalization - When people with Somataform disorders keep stress, anxiety, or frustration inside rather than expressing them outwardly.

Question 56

Which 3 specific drugs (mentioned in the book) from the SSRI class are used in the treatment of Somataform disorders?

Answer 56

1) Prozac
2) Paxil
3) Zoloft

Question 57

Briefly describe the following Positive/Hard symptoms of Schizophrenia:

1) Ambivalence
2) Associative Looseness
3) Delusions
4) Echopraxia
5) Fight of Ideas
6) Hallucinations
7) Ideas or Reference
8) Preservation

Answer 57

1) Ambivalence - Holding seemingly contradictory beliefs or feelings about a single subject.
2) Associative Looseness - Fragmented or poorly related thoughts and ideas.
3) Delusions - False beliefs that have no basis in reality.
4) Echopraxia - Imitation of another person.
5) Fight of Ideas - Continuous talking while jumping from one topic to another.
6) Hallucinations - False sensory perceptions that do not exist in reality.
7) Ideas or Reference - False impressions that external events have special meaning for the person.
8) Preservation - Persistent adherence to a single idea or topic; verbal repetition of a sentence, word or phrase; Resisting attempts to change the topic.

Question 58

Briefly describe the following Negative/Soft symptoms of Schizophrenia:

1) Alogia
2) Anhedonia
3) Apathy
4) Blunted Affect
5) Flat Affect
6) Catatonia
7) Lack of Volition

Answer 58

1) Alogia - Tendency to speak very little or convey little substance of meaning.
2) Anhedonia - Feeling no joy pleasure from life or any activities or relationships.
3) Apathy - Feelings of indifference toward people, activities, and events.
4) Blunted Affect - Restricted range of emotional feeling, tone, or mood.
5) Flat Affect - Absence of any facial expression that would indicate emotions or mood
6) Catatonia - Psychologically induced immobility occasionally marked by periods of agitation or excitement; the client seems motionless as if in a trance.
7) Lack of Volition - Absence of will, ambition, or drive to take action or accomplish tasks.

Question 59

Briefly describe the following Schizophrenia related disorders:

1) Schizophreniform Disorder
2) Delusional Disorder
3) Brief Psychotic Disorder
4) Shared Psychotic Disorder

Answer 59

1) Schizophreniform Disorder - The patient has symptoms of Schizophrenia but for less than 6 months.
2) Delusional Disorder - Patient has one or more “non-bizarre” delusions (delusions are believable).
3) Brief Psychotic Disorder - Patient experiences sudden onset of at least one psychotic symptom such as hallucinations, which last from 1 day to 1 month.
4) Shared Psychotic Disorder (Folie à Deux) - When two people share a similar delusion.

Question 60

(T/F) People with Schizophrenia have relatively less brain tissue and cerebrospinal fluid than those who do not have Schizophrenia.

Answer 60

True

Question 61

Which lobes of the brain are affected by the Positive and Negative symptoms of Schizophrenia?

Answer 61

1) Temporal Lobes - ⬇ volume and function of temporal lobes associated with the positive signs, i.e., psychosis.
2) Frontal Lobes - ⬇ volume and function of frontal lobes associated with the negative signs, i.e., alogia and anhedonia.

Question 62

Which 2 Neurotransmitters are associated with Schizophrenia and how do certain drugs like levodopa and amphetamine affect the disease?

Answer 62

⬆ Levels of dopamine and seratonin are associated with psychosis, even though Serotonin helps to regulate levels of dopamine.
Levodopa and Amphetamies ⬆ dopaminergic activity and therefore ⬆ psychosis.

Question 63

What is the difference in the Mechanism of Actions between the Conventional and Atypical Antipsychotic drugs?

Answer 63

1) Conventional Antipsychotics - Dopamine antagonists that target the positive signs of Schizophrenia.
2) Atypical Antipsychotics - Dopamine and Serotonin antagonists that lessen the negative signs of Schizophrenia.

Question 64

Which two Antipsychotic medications are available as depot injections?

Answer 64

1) Prolixin

2) Haloperidol

Question 65

What are the symptoms of the following side effects associated with Antipsychotic drugs:

1) Extrapyramidal Syndrome
2) Neuroleptic Malignant Sysndrome
3) Tardive Dyskenesia
4) Anticholinergic Effects

Answer 65

1) Extrapyramidal Syndrome - Includes Acute Dystonia, Pseudoparkinsonism, and Akathisia.
2) Neuroleptic Malignant Syndrome - Ridgidity, high fever, unstable BP, diaphoresis, pallor, delirium, ⬆ phosphokinase.
3) Tardive Dyskenesia - Involuntary movements of the tongue, face, neck, extremities and truncal musculature.
4) Anticholinergic Effects - Dry mouth constipation, urinary retention, blurred vision, photophobia, nasal congestion and memory loss.

Question 66

What signs should the nurse look for in patient with the following Extrapyramidal Symptoms associated with the use of Antipsychotic drugs:

1) Dystonia
2) Pseudoparkinsonism
3) Akathisia

Answer 66

1) Dystonia - Acute muscular rigidity and cramping, a stiff or thick tongue with difficulty swallowing, and laryngospasms.
2) Pseudoparkinsonism - Stiff/stooped posture, mask-like facies, ⬇ arm swing, shuffling gait, drooling, tremor and bradycardia.
3) Akathisia - An intense need to move about. Client appears restless, anxious, and agitated.

Question 67

What is Serotonin Syndrome and what are the SxS?

Answer 67

Serotonin Syndrome is. Drug interaction that happens when a patient takes and SSRI in conjunction with an MAOI. SxS include agitation, sweating, fever, tachycardia, hypotension, rigidity, hyperreflexia, coma and death.

Question 68

What is the pharmacological Tx for the following side effects of Antipsychotics:

1) Dystonia
2) Pseudoparkinsonism
3) Akathesia
4) Tardive Dyskinesia
5) NMS
6) Siezures
7) Agranulocytosis

Answer 68

1) Dystonia - Cogentin or Benadryl (Anticholinergics)
2) Pseudoparkinsonism - Anticholinergics
3) Akathesia - Anticholinergics and Beta-Blockers such as Propranolol.
4) Tardive Dyskinesia - Irreversible, therefore, only Tx is to stop medication and change med to Clozapine (Clozaril) which is the an Atipical Antipsychotic that does not cause TD.
5) Siezures - Only Tx is to stop medication and change med to Clozapine (Clozaril) which is the an Atipical Antipsychotic that does not cause TD.
6) Neuroleptic Malignant Syndrome - Stop med and change to a different antipsychotic.
7) Agranulocytosis (caused by Clozapine) - Discontinue drug and get CBC.

Question 69

Briefly describe the following unusual speech patterns of clients with Schizophrenia:

1) Clang Associations
2) Neologisms
3) Verigeration
4) Echolalia
5) Stilted Language
6) Preservation
7) Word Salad

Answer 69

1) Clang Associations - Rhyming words
2) Neologisms - Words invented by the patient
3) Verbigeration - Repeating words or phrases
4) Echolalia - When the patient imitates what other people say
5) Stilted Language - Use of words that are flowery, excessive, and pompous.
6) Preservation - Persistent adherence to a single topic.
7) Word Salad - Combination of jumbled words that make no sense.

Question 70

The DSM criteria for a Major Depressive Disorder (MDD) diagnosis requires at least 4 out of 8 of the SxS of Depression. What are the 8 SxS?

Answer 70

1) Sleep disturbance
2) Interest ⬇
3) Guilt/Hopelessness
4) Energy ⬇
5) Concentration ⬇
6) Appetite ⬆ or ⬇
7) Psychomotor changes
8) Suicidal tendencies

Question 71

Define Pressured Speech

Answer 71

Pressured Speech - Unrelenting, rapid, often loud talking without pauses.

Question 72

Distinguish between Dysthymic and Cyclothymic Disorders.

Answer 72

1) Dysthymic Disorder - Characterized by at least 2 years of depressed mood for more days than not with some additional, less severe symptoms that do not meet the criteria for MDD.
2) Cyclothymic Disorder - Characterized by 2 years of numerous periods of both hypomaniac symptoms that do not meet the criteria for bipolar disorder.

Question 73

Which neurotransmitter is responsible for the manic and depressive moods related to mania?

Answer 73

Norepinephrine - ⬆ during mania and ⬇ during depression.

Question 74

(T/F) About 5-10% of people with depression have thyroid dysfunction, notably an elevated TSH level.

Answer 74

True

Question 75

What are the 5 drugs in the SSRI class that was covered in the book?

Answer 75

1) Prozac
2) Zoloft
3) Paxil
4) Lexapro
5) Celexa

Question 76

What are the 6 drugs in the TCA class that was covered in the book?

Answer 76

1) Elavil
2) Asendin
3) Sinequan
4) Tofranil
5) Norpramine
6) Pamelor

Question 77

What are the 5 drugs in the Atypical Antidessant (SSNRI) class that was covered in the book?

Answer 77

1) Effexor
2) Cymbalta
3) Wellbutrin
4) Serzone
5) Remeron

Question 78

What are the 3 drugs in the MAOI class that was covered in the book?

Answer 78

1) Marplan
2) Nardil
3) Parnate

Question 79

What are the 9 SxS of a Hypertensive Crisis caused when taking an MAOI and eating foods containing Tyramine at the same time?

Answer 79

1) Occipital headache
2) Nuchal Ridgidity
3) N & V
4) chills
5) Sweating
6) Restlessness
7) Dilated pupils
8) Fever
9) Motor Agitation

Question 80

Define Ruminate

Answer 80

Ruminate - Repeatedly going over the same thoughts

Question 81

Distinguish between the 3 types of Bipolar Disorders

Answer 81

1) Bipolar Type I - Manic episodes with at least 1 depressive episode.
2) Bipolar Type II - Recurrent depressive episodes with at least 1 hypomaniac episode.
3) Bipolar Mixed Type - Cycles alternate between periods of mania, normal mood and depression.

Question 82

What are the 8 typical symptoms of Maniamthat are listed in the book?

Answer 82

1) Heightened, grandiose, or agitated mood
2) Exaggerated self-esteem
3) Sleeplessness
4) Pressured Speech
5) Flight of Ideas
6) ⬇ Ability to filter out extraneous stimuli; easily distractible.
7) ⬆ Energy and number of activities
8) Multiple, grandiose, high-risk activities, using poor judgement, with severe consequences

Question 83

Briefly distinguish between the following:

1) Schizophrenia
2) Brief Psychotic Episode
3) Schizophreniform Disorder
4) Schizoaffective Disorder

Answer 83

1) Schizophrenia - Psychotic symptoms for 6 months or more.
2) Brief Psychotic Episode - Sudden onset of at least one psychotic symptom such as hallucinations that last from 1 day to 1 month.
3) Schizophreniform Disorder - Symptoms of Schizophrenia but for less than the required 6 month criteria.
4) Schizoaffective Disorder - When the client has psychotic symptoms of Schizophrenia and also meets the criteria for a major affective mood disorder such as mania or depression.