NUR631 Exam 3 -neuro,musculoskeletal,mental health | Exam questions and Answer
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NUR631
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NUR631
NUR631 Exam 3 -neuro,musculoskeletal,mental health | Exam questions and Answer
A 19-year-old college student, Todd, is brought to your clinic by his mother. She is concerned that there is something seriously wrong with him. She states for the past 6 months his behavior has become peculiar and he ...
NUR631 Exam 3 -neuro,musculoskeletal,mental health |
Exam questions and Answer
A 19-year-old college student, Todd, is brought to your clinic by his mother. She is
concerned that there is something seriously wrong with him. She states for the past 6
months his behavior has become peculiar and he has flunked out of college. Todd
denies any recent illness or injuries. His past medical history is remarkable only for a
broken foot. His parents are both healthy. He has a paternal uncle who had similar
symptoms in college. The patient admits to smoking cigarettes and drinking alcohol. He
also admits to marijuana use but none in the last week. He denies using any other
substances. He denies any feelings of depression or anxiety. While speaking with Todd
and his mother you do a complete physical examination, which is essentially normal.
When you question him on how he is feeling, he says that he is very worried that
Microsoft has stolen his software for creating a better browser. He tells you he has se
*** D) Schizophrenia
A 24-year-old secretary comes to your clinic, complaining of difficulty sleeping, severe
nightmares, and irritability. She states it all began 6 months ago when she went to a fast
food restaurant at midnight. While she was waiting in her car a man entered through the
passenger door and put a gun to her head. He had her drive to a remote area, where he
took her money and threatened to kill her. When the gun jammed he panicked and ran
off. Ever since this occurred the patient has been having these symptoms. She states
she jumps at every noise and refuses to drive at night. She states her anxiety has had
such a marked influence on her job performance she is afraid she will be fired. She
denies any recent illnesses or injuries. Her past medical history is unremarkable. On
examination you find a nervous woman appearing her stated age. Her physical
examination is unremarkable. You recommend medication and counseling.
What *** C) Post-traumatic stress disorder
A 75-year-old homemaker brings her 76-year-old husband to your clinic. She states that
4 months ago he had a stroke and ever since she has been frustrated with his problems
with communication. They were at a restaurant after church one Sunday when he
suddenly became quiet. When she realized something was wrong he was taken to the
hospital by EMS. He spent 2 weeks in the hospital with right-sided weakness and
difficulty speaking. After hospitalization he was in a rehab center, where he regained the
ability to walk and most of the use of his right hand. He also began to speak more, but
she says that much of the time "he doesn't make any sense." She gives an example
that when she reminded him the car needed to be serviced he told her "I will change the
Kool-Aid out of the sink myself with the ludrip." She says that these sayings are
becoming frustrating. She wants you to tell her what is wrong and what you can do
about *** A) Wernicke's aphasia
A 32-year-old white female comes to your clinic, complaining of overwhelming sadness.
She says for the past 2 months she has had crying episodes, difficulty sleeping, and
problems with overeating. She says she used to go out with her friends from work but
,now she just wants to go home and be by herself. She also thinks that her work
productivity has been dropping because she just is too tired to care or concentrate. She
denies any feelings of guilt or any suicidal ideation. She states that she has never felt
this way in the past. She denies any recent illness or injuries. Her past medical history
consists of an appendectomy when she was a teenager; otherwise, she has been
healthy. She is single and works as a clerk in a medical office. She denies tobacco,
alcohol, or illegal drug use. Her mother has high blood pressure and her father has had
a history of mental illness. On examination you see a woman appearing her st *** C)
Major depressive episode
A 27-year-old woman is brought to your office by her mother. The mother tells you that
her daughter has been schizophrenic for the last 8 years and is starting to
decompensate despite medication. The patient states that she has been taking her
antipsychotic and she is doing just fine. Her mother retorts that her daughter has
become quite paranoid. When asked why, the mother gives an example about the
mailman. She says that her daughter goes and gets the mail every day and then
microwaves the letters. The patient agrees that she does this but only because she
sees the mailman flipping through the envelopes and she knows he's putting anthrax on
the letters. Her mother turns to her and says, "He's only sorting the mail!"
Which best describes the patient's abnormality of perception?
A) Illusion
B) Hallucination
C) Fugue state *** A) Illusion
A 22-year-old man is brought to your office by his father to discuss his son's mental
health disorder. The patient was diagnosed with schizophrenia 6 months ago and has
been taking medication since. The father states that his son's dose isn't high enough
and you need to raise it. He states that his son has been hearing things that don't exist.
You ask the young man what is going on and he tells you that his father is just jealous
because his sister talks only to him. His father turns to him and says, "Son, you know
your sister died 2 years ago!" His son replies "Well, she still talks to me in my head all
the time!"
Which best describes this patient's abnormality of perception?
A) Illusion
B) Hallucination
C) Fugue state *** B) Hallucination
A 26-year-old violinist comes to your clinic, complaining of anxiety. He is a first chair
violinist in the local symphony orchestra and has started having symptoms during
performances, such as sweating, shaking, and hyperventilating. It has gotten so bad
that he has thought about giving up his first chair status so he does not have to play the
solo during one of the movements. He says that he never has these symptoms during
rehearsals or when he is practicing. He denies having any of these symptoms at any
other time. His past medical history is unremarkable. He denies any tobacco use, drug
use, or alcohol abuse. His parents are both healthy. On examination you see a young
man who appears worried. His vital signs and physical examination are unremarkable.
, What type of anxiety disorder best describes his situation?
A) Panic disorder
B) Specific phobia
C) Social phobia
D) Generalized anxiety disorder *** C) Social phobia
A 23-year-old ticket agent is brought in by her husband because he is concerned about
her recent behavior. He states that for the last 2 weeks she has been completely out of
control. He says that she hasn't showered in days, stays awake most of the night
cleaning their apartment, and has run up over $1,000 on their credit cards. While he is
talking, the patient interrupts him frequently and declares this is all untrue and she has
never been so happy and fulfilled in her whole life. She speaks very quickly, changing
the subject often. After a longer than normal interview you find out she has had no
recent illnesses or injuries. Her past medical history is unremarkable. Both her parents
are healthy but the husband has heard rumors about an aunt with similar symptoms.
She and her husband have no children. She smokes one pack of cigarettes a day
(although she has been chain-smoking in the last 2 weeks), drinks four to si *** B)
Manic episode
A 72-year-old African-American male is brought to your clinic by his daughter for a
follow-up visit after his recent hospitalization. He had been admitted to the local hospital
for speech problems and weakness in his right arm and leg. On admission his MRI
showed a small stroke. The patient was in rehab for 1 month following his initial
presentation. He is now walking with a walker and has good use of his arm. His
daughter complains, however, that everyone is still having trouble communicating with
the patient. You ask the patient how he thinks he is doing. Although it is hard for you to
make out his words you believe his answer is "well . . . fine . . . doing . . . okay." His
prior medical history involved high blood pressure and coronary artery disease. He is a
widower and retired handyman. He has three children who are healthy. He denies
tobacco, alcohol, or drug use. He has no other current symptoms. On examinati *** B)
Broca's aphasia
A 35-year-old stockbroker comes to your office, complaining of feeling tired and irritable.
She also says she feels like nothing ever goes her way and that nothing good ever
happens. When you ask her how long she has felt this way she laughs and says, "Since
when have I not?" She relates that she has felt pessimistic about life in general since
she was in high school. She denies any problems with sleep, appetite, or concentration,
and states she hasn't thought about killing herself. She reports no recent illnesses or
injuries. She is single. She smokes one pack of cigarettes a day, drinks occasionally,
and hasn't taken any illegal drugs since college. Her mother suffers from depression
and her father has high blood pressure. On examination her vital signs and physical
examination are unremarkable.
What mental health disorder best describes her symptoms?
A) Major depressive episode
B) Dysthymic disorder
C) Cyclothymi *** B) Dysthymic disorder
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