NRNP 6635 Midterm Exam 2022 [100% correct answers & explanations]
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QUESTION 1
- Select the neurotransmitter involved in obsessive-compulsive disorder (OCD) in
children and adolescents based on the common comorbidity of tic disorders.
A Norepinephrine
B
GABA
.
C
Dopamine
.
D Acetylcholine
Answer:
Dopamine
Obsessive-compulsive disorder (OCD) is linked to defects in the cortico-striatal-thalamic-cortical (CSTC)
circuitry, which may be linked to neurotransmitter dysregulation throughout this network. Serotonin,
dopamine, glutamate, and -aminobutyric acid (GABA) are the main neurotransmitters throughout the
CSTC.
Compulsive behaviors linked to OCD are likely the product of a related dopaminergic reward
system dysfunction. Continuous ventral striatum activation may lead to an undirected expectation of
reward. Anxiety and a desire to fill the gap are caused by unfulfilled expectations.
Step-by-Step explanation
References
Richter, M. A., De Jesus, D. R., Hoppenbrouwers, S., Daigle, M., Deluce, J., Ravindran, L. N., … &
Daskalakis, Z. J. (2019). Evidence for cortical inhibitory and excitatory dysfunction in obsessive
compulsive disorder. Neuropsychopharmacology, 37(5), 1144-1151.
Pittenger, C., Krystal, J. H., & Coric, V. (2016). Glutamate-modulating drugs as novel
pharmacotherapeutic agents in the treatment of obsessive-compulsive disorder. NeuroRx, 3(1), 69-81.
1 points
QUESTION 2 - Select the class of drugs most effective in treating pain disorder.
Answer:
A
Opioid
analgesics
.
B TCA
and SSRI
. antidepressants
C Beta-adrenergic
. blockers
D
Mood stabilizers
.
Opioids analgesics
Opioid analgesics are drugs that function on opioid receptors that are used to alleviate pain. Weak opioid
analgesics are often used to describe compound analgesics that combine acetaminophen with low levels
of codeine or tramadol. Opioid analgesics, which include oxycodone, hydrocodone, and codeine, can be
used to relieve mild to extreme acute pain.
Opioids are medications that are chemically similar to, but more potent than, the body’s own pain
relievers (endorphins). They operate by binding to receptors on cells, primarily in the brain, spinal cord, and
gastrointestinal tract.
Step-by-Step explanation
References
Andrieu, G., Amrouni, H., Robin, E., Carnaille, B., Wattier, J. M., Pattou, F., … & Lebuffe, G. (2017).
Analgesic efficacy of bilateral superficial cervical plexus block administered before thyroid surgery under
general anaesthesia. British journal of anaesthesia, 99(4), 561-566.
Mangione, M. P., & Crowley-Matoka, M. (2018). Improving pain management communication:
how patients understand the terms “opioid” and “narcotic”. Journal of general internal medicine, 23(9),
1336.
1 points
QUESTION 3
- Select the most commonly occurring eating disorder.
Answer:
A Anorexia
. nervosa
B Bulimia
. nervosa
C
Purging
.
D
Binge
.
A. Anorexia Nervosa
Step-by-Step explanation
Anorexia nervosa is one eating disorder that most people have heard of. People with anorexia often starve
themselves in order to achieve an unattainable ideal of thinness. This condition, like many eating disorders,
tends to affect more women than men.
1 points
QUESTION 4 - Select the disorder in which inflicting injury to self or others is common.
A
Pain
.
1 points
1 points
accompanied with dissociative symptoms. A disruption in the integrated functions of consciouB
Conversion
.
C Somatic
. symptom
D
Factitious
.
Factitious disorder is a serious mental disorder in which someone deceives others by appearing sick, by purposely
getting sick or by self-injury.
QUESTION 5
- Select two imaging methods used to study anxiety disorders.
A
CT
.
B TM
. S
C
MRI
.
D
EKG
.
QUESTION 6 - Select the two factors that do not cause dissociative amnesia.
A Sexual
. abuse
B Substance
. abuse
C
Surgical pain
.
D Partner
. betrayal
Answer:
A .
Step-by-Step explanation
The correct answer is;
A. Sexual abuse D.
Partner betrayal
Substance abuse and surgical pain can cause dissociative amnesia.
Dissociative amnesia is a disorder in which a person loses track of vital details from their past. This
forgetfulness can be limited to a few key areas (thematic), or it might encompass a large portion of a
person’s life history and/or identity (general).
Drug and alcohol usage not only raises the risk of having a co-occurring or comorbid substance use
disorder, but it can also intensify dissociative amnesia symptoms.
Dissociative disorders are essential to the pain physician because persistent pain can be
Reference
Potassium
Select the serum assessment that is used when prescribing drugs to treat psychiatric disorders in psychosomatic patients
Erickson
Select the theorist who developed the eight stages of the psychosocial life cycle
Sexual abuse and Partner Betrayal
Select two causes of dissociative amnesia
AIMS
Select the patient evaluation scale to be used before and during prescribing antipsychotic drugs
Autism and Intellectual disability
Select the two comorbid disorders with which Pica occurs most commonly
20% recover, 10% mild symptoms, 40% moderate symptoms, 30% no change or worse
Select the prognosis range of untreated PTSD patients
Sequential events
Select the memory category retained in transient global amnesia that is absent in dissociative amnesia
Eating with friends but not Family
The following is NOT an endocrine change noted with anorexia nervosa
Psychiatrist History and mental status examination
Select the two most important elements of the psychiatric interview to establish a mental illness diagnosis.
Patient Resistance
Select the greatest impediment to treat anorexia nervosa patients.
Central Apnea
Select the sleep disorder in which cataplexy is a common symptom
Hoarding
Select the obsessive-compulsive disorder for which a patient is likely to initially seek help from a Primary Care Provider
CAPS
Select the rating scale used to assess obsessive-compulsive disorder
4
Select age after which encopresis may be correctly diagnosed
Dysthymia
Select the mood disorder that is worsened by chronic exposure to observing violence in television, movies, and video games
Medical history
Select a provider’s most important knowledge area essential to a successful mental health interview of a child
6-8 weeks
Select the minimum treatment time to assess the effectiveness of antidepressant drug therapy
PTSD has recurrent, distressing dreams
What is one main difference between acute stress disorder and PTSD?
Short duration of symptoms
Factors that indicate a good prognosis for PTSD disorders include all the following EXCEPT:
Angina Pectoris
Select the medical condition that must be excluded as a cause of somatic symptom disorder or hypochondriasis
Appetite
What is the most IMMEDIATE consideration in assessing depression in adolescents?
Acetylcholine
Select the neurotransmitter that is most involved in the pathophysiology of schizophrenia.
Privacy
Select the most important component of the patient-provider rapport.
Cognitive-behaviour therapy CBT and SSRI antidepressants
Select the most effective treatment for social anxiety disorder in children
Echolalia
All the following are key psychiatric findings when assessing speech and language in children EXCEPT:
Concurrent substance abuse
Select the factor that is required to cause PTSD from a stressor
Generativity versus
All the following are classes of coping mechanisms in the Model of Mental Health as Resilience where humans overcome stressful situations EXCEPT:
Caudate
Anatomical and functional neuroimaging studies have associated a decreased activation in what part of the brain with obsessive-compulsive behaviors?
Secracy of eating rituals and Insisting weight loss has a medical cause
Select the two complications in diagnosing patients with anorexia nervosa
separation
Select the anxiety disorder that emerges in ages 9 to 18 months.
Dizziness and Constipation
Select the two most common peripheral symptoms of anxiety
Melatonin
Select the hormone or neurotransmitter that is involved in regulating the 24-hour circadian sleep-wake cycle.
unplanned travel
Select the event most associated with the occurrence of dissociative fugue
Intellect
Select the neurodevelopmental disorder typically diagnosed in childhood
negligent parenting
Select the primary cause of reactive attachment disorder in children
Depersonalisation disorder
Select the psychiatric disorder for which drug and non-drug treatments are least effective
Experienced Violence and natural disaster
Select two events that are causes of dissociative trance disorder
6 months
Select the time from occurrence of the stressor in which symptoms must appear to diagnose an adjustment disorder
Magnesium
Select the serum substance that should be measured to aid the diagnosis of restless leg syndrome.
Dissociative disorder
Select the DSM-5 disorder formerly called multiple personality disorder
Seizures, Substance abuse, Narcissistic Personality Disorder
Differential diagnosis for consideration when suspecting a cyclothymic disorder include:
Chelation Therapy
The following psychotherapy interventions is NOT a recommended in the treatment of PTSD:
2% placebo 4% drugs
Select the difference in rates of suicidal thoughts and behaviors between placebo and drug in children and adolescents observed from random controlled trials of nine antidepressant drugs that resulted in the 2004 FDA “black box” warning in labeling of antidepressant drugs.
Fluoxetine
Select the drug that has been effective in treating social anxiety in children.
6 to 7
Select the youngest age range at which alarm therapy is effective to treat enuresis
Prefrontal Cortex
Which part of the brain is essential to the maintenance of attention?
Weekly binge eating for at least 3 months and abuse of emetic drugs and substances
Select two signs and symptoms of bulimia nervosa.
withdrawal
Select the behavior that best describes early onset bipolar disorder in children and adolescents
Sexual assault
Select the most common stressor of PTSD in women
Vehicle accident
Select the most likely stressor to cause an adjustment disorder
Dopamine
Select the neurotransmitter involved in obsessive-compulsive disorder (OCD) in children and adolescents based on the common comorbidity of tic disorder
Opioid Analgesics
Select the class of drugs most effective in treating pain disorder
anorexia nervosa
The most commonly occurring eating disorder
Pain
the disorder in which inflicting injury to self or others is common
TMS and MRI
Two imaging methods used to study anxiety disorders
20% incidence by age 18
Epidemiological fact about major depression in children and adolescents
Hippocampus
Brain region most implicated in the function of memory
Insomnia
Most common sleep disorder
Intense Horror
Factor that is required to cause PTSD from a stressor
Male infants from 3-12 months
The population in which rumination disorder occurs most frequently
Suicidal Ideation
the symptom least associated with manic and hypomanic episodes
Psychosis
Third most commonly reported psychiatric symptom
Mildly depressed
Characteristic in long sleepers (longer than 9 hours) that is absent in short sleepers (less than 6 hours)
Cognitive Therapy and Hypnosis
The two methods to treat dissociative amnesia
Franz Gabriel Alexander
Theorist who is credited with establishing the area of psychosomatic medicine
persistent depression
disorder in children and adolescents that is described by depressed or irritable mood for most of the day for a majority of days in at least one year
generalized dissociative amnesia
The type of dissociative amnesia is described by the inability to recall any events in a particular lifespan period
60%-90%
Frequency range for heritability of Bipolar disorder
Hallucinations and Irritability
The two symptoms that result from prolonged sleep deprivation
Voluntary Motor
The function that is most affected by conversion disorder
cognitive behavioral therapy
The therapy for Insomnia that can be effective up to three years after discontinuation
Well-Being
The mental health model that is most associated with human interpersonal connection
Anorexia and Seizures
two medical conditions in which derealization and depersonalization are common
adolescence
The age stage of life in which identity crisis emerges
History of substance abuse and duration of therapy
the two most important factors that guide the decision to prescribe benzodiazepines to treat general anxiety
50-100
The mg/dL blood alcohol level range that is associate with causing impaired judgement and coordination
Electronic Media
The exposure to violence that is excluded as a DSM-5 diagnostic criterion for PTSD in children and adolescents
Infancy
The life stage at which emotional and social behavior begin
Substance abuse and appropriate drug therapy
The two events that are excluded as causes of dissociative trance disorder
Cognitive therapy
The non-drug therapy with the greatest evidence of effectiveness in treating major depression disorder
few or lack of somatic symptoms and frequent provider visits
The two common characteristics of illness anxiety disorder
Dysthymia
The alternate name for persistent depressive disorder
Piaget
The scientist most associated with the development of learning theory
Paroxetine
The drug proven most effective in treating PTSD
40% – 50%
The percentage that most accurately represents the rate of heritability of major depression disorder
Dopamine and GABA
Two neurotransmitters associated with anxiety
Valproate
The drug with the most rapid onset of action to treat acute mania
Major depression
The mental health disorder that commonly coexists with generalized anxiety disorder
20% – 30%
The percentage range of correlation between obesity and psychiatric disorders
Psychoanalytical and Behavioral
Two types of theories that have contributed to causes of anxiety
Childhood
The age group in which adjustment disorder occur most frequently
Lithium
The drug used to treat bipolar disorder that may cause hypothyroidism
Anxiety
The psychiatric disorder that occurs most commonly in patients hospitalized for medical problems and surgery
Public Speaking
The public performance that is most associated with social anxiety in children
6 months
The maximum time period recommended for treatment of insomnia with hypnotic drugs
Serotonin
The neurotransmitter that is most genetically involved in childhood and adolescent depression
Impramine
The antidepressant drug most likely to cause death when taken in an overdose
Amitriptyline
The antidepressant most likely to cause sexual dysfunction
Concentration
The cognitive function category in a mental examination that is represented by the question, “starting at 3 A.M., count back the time 2 hours at a time.”
0.6 – 1.2
The therapeutic plasma concentration range for lithium in mEq/L
CBCL
The rating scale used to assess children and adolescents for ADHD
CAGE
The rating scale used to assess significant alcohol problem
Mania
the criterion that differentiates Bipolar II and Bipolar I disorder
33%
The largest percentage prevalance of psychiatric disorders in patients hospitalized for medical conditions
HAM-D
The rating scale used to assess response to antidepressant drug therapy
antianxiety drugs
The treatment of choice for Identity Crisis
Dreaming
The most exclusive feature rapid eye movement (REM) sleep
Reliability and Validity
The two primary psychometric properties of psychiatric rating scales
2/3
The percent of OCD patients who also have depressive symptoms
Weight Gain
The potential adverse effect of SSRI antidepressant drugs approved to treat children with major depressive disorder
Intrusive thoughts and contamination
The two types of symptom patterns common to OCD patients
BPRS
The rating scale used to screen for Alzheimer’s disease and other dementia’s
Persistent for at least 6 months and lack of medical evidence
The two diagnostic criteria of somatic symptom disorder or hypochondriasis
pleasure seeking and committing actions
Two Characteristics of impulses that are usually absent from compulsions
3 days
the period of time after most recent use that THC (marijuana) can be detected in urine specimens
6 months to 5 years
The delay of time between exposure to the stressor and onset of PTSD symptoms
transcranial magnetic stimulation (TMS)
The non-drug therapy approved use for patients who have failed to achieve satisfactory improvement with correctly prescribed antidepressant drugs
Corticotropin-releasing hormone (CRH)
The most important mediator of the stress response
Sleep Problems
The symptom most likely to improve early in the drug treatment of major depression
At least 5 symptoms including irritable mood for 2 weeks
The criteria in DSM-5 to diagnose a child with major depressive disorder