Practice Quiz
An important part of the psychiatric interview is to determine medical history. There are different medical conditions which can mimic a mental health disorder and vice versa. What is a medical condition which could be confused with a panic attack?
Hypothyroidism
Urinary Tract Infection
Anorexia
Congestive Heart failure
Congestive Heart failure
See Carlat book & (also MSE ppt), cardiac issues can frequently be mistaken for Panic Disorder (CHF, MI, etc). Anorexia is a more common condition for cancer or depression. Urinary Tract Infection can lead to a delirium or more depressed feelings. Hypothyroidism can be confused with depression. Hyperthyroidism can mimic a panic disorder.
If the PMHNP admits a patient with Borderline Personality Disorder (BPD) to a mental health unit after another suicide attempt, a discharge date should be established
within 1 to 2 days
when the patient stabilizes
on admission
when the patient expresses interest
on admission
As noted on the Personality Disorders PPT: A discharge date should be established on admission to avoid the dependency that is common and can prolong hospitalization. Many patients with BPD are chronically suicidal, so the focus should be on patient safety rather than on trying to solve the multiple problems that the patient exhibits.
Stephen comes to the clinic for therapy. He shares with the therapist about his ex-wife, who cheated multiple times on him. "She just gave me a birthday present." The therapist asks him, "How did you feel about this?" Stephen then shared, "It didn't bother me at all." What defense mechanism did he utilize?
Reaction Formation
Rationalization
Denial
Repression
Denial
In this case it is denial. He is expressing himself in a manner which denies any feelings at all and yet he brought it up to the therapist. It is not reaction formation because he is not forgetting negative emotions and transferring them to the opposite. It isn't rationalization because he isn't trying to unconsciously diminish his feelings of anxiety over the gift. Repression is not the answer because by holding feelings in with the resultant physical symptoms this is not expressed. This is review material covered in MSE ppt and Carlat book.
In order to diagnose a client with insomnia disorder, the disorder must have been present for a minimum of how long?
one month
two months
three months
six months
three months
Review DSM-5-TR required reading, the disorder must be present for a minimum of 3 months in order to Dx insomnia disorder.
A client presents to the emergency room with severe anxiety due to an automobile accident. Initially the vital signs of the client were the following: B/P 180/100, P 115, R 24, and the client was provided with Ativan 1 mg IV. Currently the vital signs are the following for the client: B/P 160/92, P 94, R 20, and the client admits to "starting to feel better." According to Hans Selye, which stage of the Stress reaction is the client in at this time with the beginnings of homeostasis?
Alarm
Resistance
Recovery
Exhaustion
Resistance
From the Group Therapy PPT:
Non-rapid Eye Movement Sleep Arousal Disorders would fall under the category of parasomnias.
True or False
True
That is true, Parasomnias are disorders characterized by abnormal behavior, experiential or physiological events occurring in association with sleep, specific sleep stages, or sleep-wake transitions. None-rapid eye movement sleep around disorders is a type of parasomnia.
Which of the following characteristics distinguishes borderline personality disorder from histrionic personality disorder?
The self-destructive reactions and angry disruptions in close relationships due to identity diffusion and fear of abandonment.
The manipulation aspect is for personal gain, profit, or power rather than for approval.
The desire for attention is for the purpose of being superior.
The lack of dramatic emotions with an excessive dependence on others for praise and guidance.
The self-destructive reactions and angry disruptions in close relationships due to identity diffusion and fear of abandonment.
Borderline PD is associated with self-destructive reactions to real or imagined abandonment. If the dramatic behavior is done for the purpose of manipulations and personal gain, this is consistent with APD. If the dramatic behavior is done in order that others may perceive one as superior this is consistent with Narcissistic PD> If the approval is sought without drama, this is consistent with dependent PD.
What is the term for transient loss of motor tone in the presence of strong emotions such as embarrassment, laughter, fear, etc.)?
Narcolepsy
Sleep Paralysis
Cataplexy
Hypersomnia
Cataplexy
Cataplexy is the term for transient loss of motor tone in the presence of strong emotions such as embarrassment, laughter, fear, etc. From your Sleep/Wake PowerPoint
Mr. B. was recently promoted to the position of vice president at his company. He is charming, articulate, well dressed, and admired from afar. On one occasion a new subordinate challenged his decisions. Mr. B. responded with anger and passive aggressive tactics, leading the subordinate to cancel weekend plans to implement Mr. B's idea. These personality traits are most consistent with which of the following disorders?
Antisocial personality disorder
Borderline personality disorder
Narcissistic personality disorder
Histrionic personality disorder
Narcissistic personality disorder
Narcissistic personality disorder is characterized by a persistent and consistent superiority complex overcompensated by an inflated sense of self-importance and need to be admired and perceived as special.
There are many different types of family therapies. One type of family therapy follows a functional analysis of maladaptive behaviors and thinking, so that families can interact more effectively and improve family satisfaction. This type of family therapy is called___________.
Integrative Model Therapy
Psychodynamical Informed Family Therapy
Cognitive Behavioral Family Therapy
Intergenerational Contextual Family Therapy
Cognitive Behavioral Family Therapy
The correct answer is CBFT or cognitive behavioral family therapy which does work on communication and problem-solving training within the family and focuses on changing behavior and thinking within the family. Integrative Model therapy incorporates psychoeducation and skills development, utilize data to organize therapy, etc. Psychodynamic informed family therapy focuses on psychoanalytic thinking, values the role of the unconscious and past history in determining behavior and motivations. Integrative Contextual family therapy emphasizes intrapsychic and interpersonal dynamics past and present, legacy, loyalty and indebtedness to one's family of origin and biological roots. Covered in your Family Therapy PPT.