Phobia is an irrational, excessive, and persistent fear of a specific object, situation, or activity, leading to avoidance behavior and significant distress or functional impairment.
✅ Types of Phobia (As per DSM-5):
Type
Examples
Specific Phobia
Fear of specific objects/situations (e.g., heights, spiders, injections).
Social Phobia (Social Anxiety Disorder)
Fear of social situations where the person may be judged (e.g., public speaking, social gatherings).
Agoraphobia
Fear of open spaces, crowds, or situations where escape might be difficult (e.g., public transport, being outside alone).
Learned behavior through classical conditioning (e.g., traumatic event).
Cognitive distortions and anxiety sensitivity.
Social Factors:
Overprotective parenting.
Lack of social support.
✅ Clinical Features:
Intense, immediate anxiety or panic on exposure to the feared stimulus.
Physical symptoms: Palpitations, sweating, trembling, dizziness, shortness of breath.
Avoidance of the feared object/situation.
Insight is present (patient recognizes the fear is irrational but cannot control it).
✅ Prognosis:
Good prognosis with early intervention and treatment.
Untreated phobias can lead to social isolation, depression, and reduced quality of life.
✅ Management:
| Psychological Therapies:
Cognitive Behavioral Therapy (CBT): Corrects negative thought patterns.
Systematic Desensitization (Graduated Exposure): Gradual exposure to feared objects while practicing relaxation.
Flooding: Immediate intense exposure to the feared object (used cautiously).
| Pharmacotherapy (if severe):
Benzodiazepines (short-term use for acute anxiety).
SSRIs (especially in social phobia).
Beta-blockers (e.g., propranolol for performance anxiety).
📌 Golden One-Liners for Quick Revision:
🧠 “Phobia is an irrational fear leading to avoidance behavior.”
🧠 “Systematic desensitization is the most effective behavioral therapy for phobias.”
🧠 “Social phobia involves fear of being negatively evaluated by others.”
🧠 “Agoraphobia is fear of open or crowded places where escape is difficult.”
✅ 1. Which of the following is an example of a specific phobia?
A) Fear of public speaking B) Fear of spiders C) Fear of being alone in a crowd D) Fear of being judged
Correct Answer: B) Fear of spiders Rationale: Fear of specific objects or situations like spiders, heights, or injections is classified as a specific phobia.
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✅ 2. Which behavioral therapy technique is most commonly used in the treatment of phobia?
A) Psychoanalysis B) Systematic Desensitization C) Aversion Therapy D) Free Association
Correct Answer: B) Systematic Desensitization Rationale: This technique involves gradual exposure to the feared object or situation while practicing relaxation techniques.
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✅ 3. What is the key emotional response experienced during exposure to a phobic stimulus?
A) Depression B) Anxiety and Panic C) Anger D) Euphoria
Correct Answer: B) Anxiety and Panic Rationale: Phobic stimuli trigger immediate anxiety and panic symptoms such as palpitations, sweating, and breathlessness.
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✅ 4. Which class of drugs is commonly prescribed for short-term relief of phobic anxiety?
A) Antipsychotics B) Benzodiazepines C) Antibiotics D) Anticonvulsants
Correct Answer: B) Benzodiazepines Rationale: Benzodiazepines like lorazepam are used for immediate relief of acute anxiety but are not recommended for long-term use.
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✅ 5. Which of the following best describes agoraphobia?
A) Fear of closed spaces B) Fear of social interactions C) Fear of open spaces or situations where escape is difficult D) Fear of contamination
Correct Answer: C) Fear of open spaces or situations where escape is difficult Rationale: Agoraphobia is characterized by fear of being in places where help may not be available or escape may be challenging.
✅ Anxiety Disorders (5 MCQs)
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1. Which of the following is a hallmark psychological symptom of anxiety?
A) Euphoria B) Excessive worry and apprehension C) Flat affect D) Grandiosity
Correct Answer: B) Excessive worry and apprehension Rationale: Anxiety is characterized by persistent worry, tension, and fear, often without a specific cause.
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2. Which drug is commonly used for the long-term pharmacological management of Generalized Anxiety Disorder (GAD)?
A) Lorazepam B) Fluoxetine C) Diazepam D) Haloperidol
Correct Answer: B) Fluoxetine Rationale: SSRIs like fluoxetine are preferred for long-term treatment of anxiety disorders.
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3. Which nursing intervention is most appropriate during an acute anxiety attack?
A) Encourage detailed discussion of feelings. B) Provide a calm, quiet environment and use simple communication. C) Leave the patient alone to calm down. D) Encourage participation in group activities.
Correct Answer: B) Provide a calm, quiet environment and use simple communication. Rationale: Reducing environmental stimuli and providing reassurance helps in calming the patient.
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4. Which of the following is a common physical symptom seen in anxiety disorders?
A) Hypotension B) Bradycardia C) Palpitations D) Excessive energy
Correct Answer: C) Palpitations Rationale: Palpitations, sweating, dry mouth, and tremors are common somatic symptoms of anxiety.
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5. What is the most effective non-pharmacological therapy for managing anxiety?
A) Psychoanalysis B) Cognitive Behavioral Therapy (CBT) C) Hypnosis D) Aversion Therapy
Correct Answer: B) Cognitive Behavioral Therapy (CBT) Rationale: CBT is the most evidence-based therapy for anxiety, focusing on changing negative thinking patterns.
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✅ Obsessive-Compulsive Disorder (OCD) (5 MCQs)
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6. What is the primary difference between obsessions and compulsions?
A) Obsessions are behaviors; compulsions are thoughts. B) Obsessions are repetitive thoughts; compulsions are repetitive behaviors. C) Obsessions are physical symptoms; compulsions are emotional states. D) There is no difference.
Correct Answer: B) Obsessions are repetitive thoughts; compulsions are repetitive behaviors. Rationale: Obsessions are intrusive thoughts; compulsions are actions taken to reduce the anxiety caused by obsessions.
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7. Which neurotransmitter imbalance is primarily associated with OCD?
A) Dopamine B) GABA C) Serotonin D) Acetylcholine
Correct Answer: C) Serotonin Rationale: Low serotonin levels play a significant role in the development of OCD symptoms.
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8. Which of the following is an example of a compulsion?
A) Recurrent intrusive thoughts about contamination B) Excessive handwashing to reduce anxiety about germs C) Persistent doubts about locking the door D) Repeated thoughts of harming someone
Correct Answer: B) Excessive handwashing to reduce anxiety about germs Rationale: Compulsions are repetitive behaviors aimed at reducing distress caused by obsessions.
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9. Which therapeutic technique is most effective in managing OCD?
A) Flooding B) Cognitive Behavioral Therapy (CBT) with Exposure and Response Prevention (ERP) C) Aversion Therapy D) Hypnotherapy
Correct Answer: B) CBT with Exposure and Response Prevention (ERP) Rationale: ERP helps patients gradually face their fears and resist the urge to perform compulsions.
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10. Which medication is the first-line pharmacological treatment for OCD?
A) Diazepam B) Fluoxetine (SSRI) C) Chlorpromazine D) Carbamazepine
Correct Answer: B) Fluoxetine (SSRI) Rationale: SSRIs like fluoxetine and fluvoxamine are the first-line drugs for managing OCD.
📚 Anxiety Disorders
✅ Definition:
Anxiety Disorder is a mental health condition characterized by excessive, persistent, and irrational worry or fear, often without a realistic threat. It interferes with daily functioning and causes significant emotional and physical distress.
✅ Types of Anxiety Disorders (DSM-5):
Disorder
Key Features
Generalized Anxiety Disorder (GAD)
Persistent, excessive worry about everyday events for ≥6 months.
Panic Disorder
Recurrent unexpected panic attacks with intense fear and physical symptoms.
Social Anxiety Disorder (Social Phobia)
Fear of social situations and being negatively judged.
Specific Phobias
Intense fear of specific objects or situations (e.g., heights, animals, injections).
Agoraphobia
Fear of places or situations where escape is difficult.
Separation Anxiety (Common in children)
Excessive fear of being separated from attachment figures.
Beta-blockers: Propranolol for performance anxiety.
📌 Golden One-Liners for Quick Revision:
🧠 “GAD involves worry about multiple life situations for more than 6 months.”
🧠 “CBT is the most effective psychological treatment for anxiety disorders.”
🧠 “SSRIs are the drug of choice for long-term anxiety management.”
🧠 “Benzodiazepines provide rapid relief but are used short-term to prevent dependence.”
🧠 “Panic attacks occur suddenly and include intense physical symptoms like palpitations and chest pain.”
✅ 1. Which of the following is the first-line pharmacological treatment for Generalized Anxiety Disorder (GAD)?
A) Diazepam B) Haloperidol C) Fluoxetine D) Amitriptyline
Correct Answer: C) Fluoxetine Rationale: SSRIs like fluoxetine are preferred for long-term management of GAD due to their efficacy and safety profile.
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✅ 2. Which of the following is a hallmark physical symptom experienced during an acute anxiety attack?
A) Bradycardia B) Palpitations and sweating C) Slow breathing D) Hypothermia
Correct Answer: B) Palpitations and sweating Rationale: Autonomic hyperactivity such as palpitations, sweating, and rapid breathing are common physical symptoms during anxiety attacks.
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✅ 3. Which psychological therapy is most effective for treating anxiety disorders?
A) Psychoanalysis B) Cognitive Behavioral Therapy (CBT) C) Hypnosis D) Electroconvulsive Therapy (ECT)
Correct Answer: B) Cognitive Behavioral Therapy (CBT) Rationale: CBT helps correct maladaptive thought patterns and behaviors, making it the most effective non-pharmacological therapy for anxiety.
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✅ 4. A patient presents with sudden onset of chest pain, palpitations, shortness of breath, and fear of dying. Which anxiety disorder is most likely?
A) Generalized Anxiety Disorder B) Panic Disorder C) Social Phobia D) Specific Phobia
Correct Answer: B) Panic Disorder Rationale: These are classical features of a panic attack, a key component of panic disorder.
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✅ 5. What is the recommended nursing action during a patient’s acute panic attack?
A) Leave the patient alone to calm down. B) Encourage the patient to express long-term concerns. C) Stay with the patient, use calm, reassuring communication, and guide slow breathing. D) Provide stimulants like caffeine to increase alertness.
Correct Answer: C) Stay with the patient, use calm, reassuring communication, and guide slow breathing. Rationale: Providing a calming presence and helping the patient regulate breathing reduces anxiety symptoms effectively.
✅ 1. Which of the following is the most common anxiety disorder in the general population?
A) Panic Disorder B) Social Anxiety Disorder C) Generalized Anxiety Disorder (GAD) D) Specific Phobia
Correct Answer: D) Specific Phobia Rationale: Specific phobias are the most common, followed by GAD and social anxiety.
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✅ 2. Which neurotransmitter is most associated with the pathophysiology of anxiety disorders?
A) Serotonin B) Dopamine C) GABA D) Acetylcholine
Correct Answer: C) GABA Rationale: GABA has an inhibitory effect on the brain; low levels contribute to anxiety.
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✅ 3. Which drug class is used for short-term relief of acute anxiety symptoms?
A) SSRIs B) Benzodiazepines C) Antipsychotics D) Beta-blockers
Correct Answer: B) Benzodiazepines Rationale: Benzodiazepines provide rapid relief but have dependency risks and are used short-term.
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✅ 4. What is the first-line non-pharmacological therapy for anxiety disorders?
A) Psychoanalysis B) Cognitive Behavioral Therapy (CBT) C) Systematic Desensitization Only D) Hypnotherapy
Correct Answer: B) Cognitive Behavioral Therapy (CBT) Rationale: CBT is the most evidence-based and effective therapy for managing anxiety disorders.
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✅ 5. Which of the following is a typical feature of a panic attack?
A) Decreased heart rate B) Feeling of impending doom C) Increased appetite D) Euphoric mood
Correct Answer: B) Feeling of impending doom Rationale: Panic attacks include sudden intense fear with symptoms like palpitations and a fear of dying.
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✅ 6. Agoraphobia is characterized by:
A) Fear of social situations B) Fear of leaving home or being in crowded places C) Fear of closed spaces D) Fear of animals
Correct Answer: B) Fear of leaving home or being in crowded places Rationale: Agoraphobia involves anxiety about being in places where escape may be difficult.
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✅ 7. Which medication is the first-line pharmacological agent for long-term management of anxiety disorders?
A) Lorazepam B) Fluoxetine C) Diazepam D) Haloperidol
Correct Answer: B) Fluoxetine Rationale: SSRIs like fluoxetine are preferred for long-term anxiety management.
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✅ 8. Which of the following is a somatic symptom of anxiety?
A) Flat affect B) Dry mouth C) Grandiosity D) Euphoria
Correct Answer: B) Dry mouth Rationale: Physical symptoms of anxiety include dry mouth, sweating, palpitations, and tremors.
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✅ 9. What is the priority nursing action during an acute panic attack?
A) Provide a quiet environment and reassure the patient. B) Encourage the patient to talk about their childhood. C) Leave the patient alone for some time. D) Give caffeinated beverages to increase alertness.
Correct Answer: A) Provide a quiet environment and reassure the patient. Rationale: Reducing environmental stimuli and staying with the patient helps calm them.
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✅ 10. Which of the following therapies is most appropriate for treating specific phobias?
A) Aversion Therapy B) Systematic Desensitization C) Psychoanalysis D) ECT
Correct Answer: B) Systematic Desensitization Rationale: Gradual exposure to the feared object while practicing relaxation is effective.
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✅ 11. Social anxiety disorder is best described as:
A) Fear of open spaces B) Fear of specific objects C) Fear of being judged in social situations D) Fear of contamination
Correct Answer: C) Fear of being judged in social situations Rationale: Social anxiety involves fear of embarrassment or negative evaluation.
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✅ 12. Which of the following is a cognitive symptom of anxiety?
A) Palpitations B) Difficulty concentrating C) Increased sweating D) Tremors
Correct Answer: B) Difficulty concentrating Rationale: Anxiety affects focus and concentration due to constant worry.
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✅ 13. Which class of medication is used to manage performance anxiety before public speaking?
A) Beta-blockers (e.g., Propranolol) B) Benzodiazepines C) Antipsychotics D) MAO Inhibitors
Correct Answer: A) Beta-blockers (e.g., Propranolol) Rationale: Beta-blockers reduce physical symptoms like tachycardia and tremors.
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✅ 14. Which of the following is NOT a characteristic of Generalized Anxiety Disorder (GAD)?
A) Excessive worry for at least 6 months B) Sudden, unexpected panic attacks C) Restlessness and fatigue D) Sleep disturbances
Correct Answer: B) Sudden, unexpected panic attacks Rationale: Panic attacks are a feature of panic disorder, not GAD.
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✅ 15. Which breathing technique is helpful during anxiety attacks?
A) Shallow breathing B) Rapid breathing C) Deep diaphragmatic breathing D) Breath-holding
Correct Answer: C) Deep diaphragmatic breathing Rationale: This reduces hyperventilation and calms the nervous system.
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✅ 16. Which is a psychological symptom of anxiety?
A) Dry mouth B) Dizziness C) Constant fear and worry D) Tremors
Correct Answer: C) Constant fear and worry Rationale: Anxiety causes excessive and uncontrollable fear.
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✅ 17. Which of the following is NOT a recommended nursing intervention for anxiety management?
A) Promote relaxation techniques B) Stay with the patient during severe anxiety C) Avoid discussing the patient’s fears D) Use simple, calm communication
Correct Answer: C) Avoid discussing the patient’s fears Rationale: The nurse should help the patient verbalize and explore their fears.
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✅ 18. What is the primary focus of Cognitive Behavioral Therapy (CBT) for anxiety disorders?
A) Analyze dreams B) Modify negative thought patterns and behaviors C) Explore childhood trauma only D) Promote avoidance of anxiety-provoking situations
Correct Answer: B) Modify negative thought patterns and behaviors Rationale: CBT corrects distorted thinking and reduces maladaptive behaviors.
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✅ 19. Which anxiety disorder is often associated with excessive checking and reassurance seeking?
A) Panic Disorder B) Generalized Anxiety Disorder C) Obsessive-Compulsive Disorder (OCD) D) Social Phobia
Correct Answer: C) Obsessive-Compulsive Disorder (OCD) Rationale: Checking behaviors are common compulsions in OCD.
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✅ 20. Which is a common nursing diagnosis for a patient with severe anxiety?
A) Risk for Violence B) Risk for Impaired Social Interaction C) Ineffective Coping D) Risk for Fluid Volume Deficit
Correct Answer: C) Ineffective Coping Rationale: Patients with anxiety struggle with managing stress effectively.
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✅ 21. Which is the most important nursing action before administering benzodiazepines?
A) Monitor liver enzymes. B) Assess for history of substance abuse. C) Provide caffeine to counter sedation. D) Recommend long-term use.
Correct Answer: B) Assess for history of substance abuse. Rationale: Benzodiazepines have high potential for dependence and should be used cautiously.
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✅ 22. Which physical activity is beneficial in managing anxiety?
A) Running only during anxiety attacks B) Regular moderate exercise like walking or yoga C) Complete physical inactivity D) Engage only in competitive sports
Correct Answer: B) Regular moderate exercise like walking or yoga Rationale: Regular physical activity reduces anxiety symptoms and improves mood.
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✅ 23. What is the characteristic feature of panic disorder?
A) Continuous low-grade anxiety B) Fear of public speaking C) Recurrent, unexpected panic attacks D) Excessive worry about multiple life events
Correct Answer: C) Recurrent, unexpected panic attacks Rationale: Panic disorder is characterized by sudden and intense panic attacks.
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✅ 24. Which of the following interventions helps reduce hyperventilation during a panic attack?
A) Instruct the patient to hold their breath. B) Guide slow, deep breathing. C) Encourage fast breathing to release tension. D) Administer oxygen immediately.
Correct Answer: B) Guide slow, deep breathing. Rationale: Slow breathing helps balance oxygen and carbon dioxide levels.
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✅ 25. Which statement by a patient indicates effective coping with anxiety?
A) “I avoid all situations that make me anxious.” B) “I use breathing exercises when I feel anxious.” C) “I drink alcohol to relax when I’m stressed.” D) “I don’t talk about my worries with anyone.”
Correct Answer: B) “I use breathing exercises when I feel anxious.” Rationale: This indicates a healthy coping mechanism to manage anxiety.
📚 Obsessive-Compulsive Disorder (OCD)
✅ Definition:
OCD is a chronic psychiatric disorder characterized by recurrent, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce the anxiety caused by these thoughts.
✅ Key Terminology:
Obsessions: Unwanted, intrusive, and distressing thoughts, images, or impulses (e.g., fear of contamination, fear of harming others).
Compulsions: Repetitive behaviors or mental acts aimed at reducing anxiety (e.g., handwashing, checking, counting).
Clomipramine (TCA): Effective but with more side effects.
📌 Golden One-Liners for Quick Revision:
🧠 “Exposure and Response Prevention (ERP) is the most effective therapy for OCD.”
🧠 “Fluoxetine and Fluvoxamine are the first-line medications for OCD.”
🧠 “Insight is often present; the patient knows thoughts and behaviors are irrational but cannot stop them.”
🧠 “Compulsions are performed to relieve anxiety caused by obsessions.”
✅ 1. Which of the following is an example of a compulsion?
A) Persistent fear of contamination B) Repeated handwashing to relieve anxiety C) Intrusive thoughts of harming others D) Recurring worries about the future
Correct Answer: B) Repeated handwashing to relieve anxiety Rationale: Compulsions are repetitive behaviors performed to reduce the anxiety caused by obsessions. Handwashing is a common compulsion in OCD.
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✅ 2. Which of the following neurotransmitters is primarily associated with OCD?
A) Dopamine B) Serotonin C) GABA D) Acetylcholine
Correct Answer: B) Serotonin Rationale: Low serotonin levels are implicated in the development of OCD, which is why SSRIs are effective in its management.
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✅ 3. Which therapy is considered the gold standard for the treatment of OCD?
A) Psychoanalysis B) Exposure and Response Prevention (ERP) C) Aversion Therapy D) Systematic Desensitization
Correct Answer: B) Exposure and Response Prevention (ERP) Rationale: ERP is a form of Cognitive Behavioral Therapy (CBT) that exposes patients to their fears and prevents them from performing compulsive behaviors.
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✅ 4. Which of the following medications is the first-line treatment for OCD?
A) Fluoxetine (SSRI) B) Diazepam C) Amitriptyline D) Lithium
Correct Answer: A) Fluoxetine (SSRI) Rationale: SSRIs like fluoxetine and fluvoxamine are the first-line pharmacological treatments for OCD.
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✅ 5. Which of the following statements about OCD is TRUE?
A) Patients have no insight into their condition. B) Compulsions increase anxiety in patients. C) Patients recognize their thoughts and behaviors as irrational but struggle to control them. D) OCD is always cured completely with medication alone.
Correct Answer: C) Patients recognize their thoughts and behaviors as irrational but struggle to control them. Rationale: Insight is typically present in OCD, but patients feel helpless to stop their compulsions without therapy or medication.
✅ 1. Which of the following is an obsession in OCD?
A) Repeated handwashing B) Recurrent intrusive thoughts about contamination C) Checking door locks repeatedly D) Repeating prayers silently
Correct Answer: B) Recurrent intrusive thoughts about contamination Rationale: Obsessions are intrusive, distressing thoughts. Handwashing and checking are compulsions.
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✅ 2. Which of the following is a classic example of a compulsion?
A) Fear of contamination B) Repeated checking of door locks C) Thoughts of harming someone D) Fear of speaking in public
Correct Answer: B) Repeated checking of door locks Rationale: This is a repetitive behavior aimed at reducing anxiety.
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✅ 3. Which therapy is considered the most effective for OCD?
A) Aversion Therapy B) Systematic Desensitization C) Exposure and Response Prevention (ERP) D) Hypnosis
Correct Answer: C) Exposure and Response Prevention (ERP) Rationale: ERP gradually exposes the patient to feared situations while preventing compulsive responses.
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✅ 4. Which neurotransmitter imbalance is primarily involved in OCD?
A) Dopamine B) Serotonin C) Acetylcholine D) GABA
Correct Answer: B) Serotonin Rationale: Low serotonin levels are linked to OCD; hence SSRIs are effective treatments.
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✅ 5. Which is the first-line drug for OCD management?
A) Diazepam B) Fluoxetine C) Chlorpromazine D) Imipramine
Correct Answer: B) Fluoxetine Rationale: SSRIs like fluoxetine are the first-line pharmacological agents in OCD.
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✅ 6. Which of the following is TRUE regarding insight in OCD?
A) Patients lack insight completely. B) Patients have partial or full insight but feel unable to resist compulsions. C) Patients believe their thoughts are completely true. D) Insight is never assessed in OCD.
Correct Answer: B) Patients have partial or full insight but feel unable to resist compulsions. Rationale: Insight is often present; patients recognize their thoughts and behaviors as irrational but can’t control them.
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✅ 7. Which of the following is NOT a common obsession?
A) Contamination fear B) Fear of harming others C) Checking rituals D) Need for symmetry
Correct Answer: C) Checking rituals Rationale: Checking is a compulsion, not an obsession.
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✅ 8. Which of the following statements best defines compulsions?
A) Thoughts that cause distress. B) Actions performed to reduce anxiety. C) Memories of past traumatic events. D) Feelings of happiness and satisfaction.
Correct Answer: B) Actions performed to reduce anxiety. Rationale: Compulsions are repetitive behaviors aimed at reducing the distress caused by obsessions.
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✅ 9. Which medication is a second-line treatment for OCD if SSRIs fail?
A) Clomipramine (TCA) B) Haloperidol C) Lithium D) Risperidone
Correct Answer: A) Clomipramine (TCA) Rationale: Clomipramine is effective for OCD but has more side effects than SSRIs.
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✅ 10. What is the primary goal of Exposure and Response Prevention (ERP) therapy?
A) Increase the number of rituals. B) Completely avoid anxiety-provoking situations. C) Reduce anxiety by preventing compulsive behaviors. D) Reinforce compulsive behavior to reduce fear.
Correct Answer: C) Reduce anxiety by preventing compulsive behaviors. Rationale: ERP helps patients confront their fears without resorting to compulsive behaviors.
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✅ 11. Which of the following is NOT a characteristic of OCD?
A) Recurrent intrusive thoughts B) Repetitive behaviors C) Complete absence of insight D) Significant distress and functional impairment
Correct Answer: C) Complete absence of insight Rationale: Most patients with OCD have at least partial insight.
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✅ 12. Which brain area is most commonly associated with OCD pathology?
A) Occipital Lobe B) Basal Ganglia C) Temporal Lobe D) Cerebellum
Correct Answer: B) Basal Ganglia Rationale: Dysfunction in the basal ganglia and orbitofrontal cortex is linked to OCD.
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✅ 13. Which is a commonly used assessment scale for OCD severity?
A) MMSE B) Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) C) Glasgow Coma Scale D) Apgar Score
Correct Answer: B) Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) Rationale: Y-BOCS is specifically used to assess the severity of OCD symptoms.
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✅ 14. Which behavioral technique involves blocking compulsive rituals after exposure to anxiety-provoking stimuli?
A) Flooding B) Response Prevention C) Aversion Therapy D) Token Economy
Correct Answer: B) Response Prevention Rationale: It is a key component of ERP therapy.
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✅ 15. What is the primary nursing goal for a patient with OCD?
A) Encourage immediate cessation of rituals. B) Help identify triggers and reduce anxiety through therapy. C) Avoid discussing obsessive thoughts. D) Promote dependence on medications only.
Correct Answer: B) Help identify triggers and reduce anxiety through therapy. Rationale: The goal is to help patients understand and manage their anxiety without compulsions.
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✅ 16. Which is a cognitive symptom commonly seen in OCD?
A) Grandiosity B) Intrusive thoughts of harming others C) Hypomanic episodes D) Euphoria
Correct Answer: B) Intrusive thoughts of harming others Rationale: Obsessions often involve distressing, intrusive thoughts.
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✅ 17. Which of the following is a risk factor for developing OCD?
A) High serotonin levels B) Family history of OCD C) Lack of insight D) Hyperactivity
Correct Answer: B) Family history of OCD Rationale: OCD has a strong genetic component.
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✅ 18. What is the role of benzodiazepines in OCD management?
A) Long-term therapy B) First-line treatment C) Short-term relief of anxiety symptoms only D) Permanent cure
Correct Answer: C) Short-term relief of anxiety symptoms only Rationale: Benzodiazepines are used temporarily to manage acute anxiety but are not a primary treatment for OCD.
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✅ 19. Which of the following is NOT a common compulsion?
A) Repeated handwashing B) Checking the stove multiple times C) Persistent intrusive thoughts of contamination D) Counting rituals
Correct Answer: C) Persistent intrusive thoughts of contamination Rationale: This is an obsession, not a compulsion.
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✅ 20. Which of the following is the primary nursing intervention for a patient engaging in compulsive behavior?
A) Immediately stop the patient from performing the ritual. B) Ignore the compulsive behavior. C) Encourage the patient to discuss feelings before the ritual. D) Force the patient to perform the ritual faster.
Correct Answer: C) Encourage the patient to discuss feelings before the ritual. Rationale: Helping the patient explore underlying anxiety reduces reliance on compulsive behavior.
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✅ 21. Which of the following is a positive indicator of treatment effectiveness in OCD?
A) Increased ritual frequency B) Improved insight and reduced compulsive behaviors C) Complete social withdrawal D) Increased anxiety after stopping rituals
Correct Answer: B) Improved insight and reduced compulsive behaviors Rationale: These are signs that the patient is successfully managing OCD symptoms.
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✅ 22. Which statement by a patient indicates poor understanding of OCD?
A) “I know these thoughts are irrational, but I can’t stop them.” B) “I must wash my hands or something bad will happen.” C) “I am practicing relaxation exercises when I feel anxious.” D) “I have been attending therapy sessions regularly.”
Correct Answer: B) “I must wash my hands or something bad will happen.” Rationale: This reflects magical thinking and poor insight.
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✅ 23. Which class of medications is preferred for long-term pharmacological management of OCD?
A) Benzodiazepines B) SSRIs C) Antipsychotics D) MAO Inhibitors
Correct Answer: B) SSRIs Rationale: SSRIs like fluoxetine are the first-line drugs for OCD.
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✅ 24. Which is the primary purpose of using Clomipramine in OCD?
A) Relieve psychotic symptoms B) Manage depressive episodes only C) Control obsessions and compulsions when SSRIs fail D) Induce sedation
Correct Answer: C) Control obsessions and compulsions when SSRIs fail Rationale: Clomipramine is a TCA effective for treatment-resistant OCD.
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✅ 25. Which of the following is the most important nursing diagnosis for a patient with severe OCD?
A) Risk for Fluid Volume Deficit B) Ineffective Coping C) Risk for Aspiration D) Disturbed Sensory Perception
Correct Answer: B) Ineffective Coping Rationale: Patients with OCD rely on maladaptive coping mechanisms (compulsions) to relieve anxiety.
📚 Depressive Neurosis (Dysthymia / PDD)
✅ Definition:
Depressive neurosis refers to a chronic, low-grade, persistent depressive state lasting for at least 2 years in adults (1 year in children/adolescents), characterized by continuous feelings of sadness and hopelessness but not meeting the full criteria for major depressive disorder.
✅ Key Characteristics:
Low mood present most of the day, more days than not.
Chronic nature (≥2 years in adults, ≥1 year in children).
Symptoms are less severe but more persistent than major depression.
Functional impairment in social, occupational, or other important areas.
Chronic life stress, neglect, or abuse in childhood.
Low self-esteem and learned helplessness.
Personality Factors:
Dependent or avoidant personality traits.
✅ Clinical Features (Mnemonic: HE’S 2 SAD):
| H – Hopelessness | E – Energy loss or fatigue | S – Self-esteem is low | 2 – 2 Years minimum duration | S – Sleep disturbances | A – Appetite disturbances | D – Decision-making difficulty or concentration problems
No major depressive episodes during the initial 2-year period.
✅ Prognosis:
Chronic but generally milder than major depressive disorder.
Risk of developing Double Depression (dysthymia + major depressive episodes).
Better prognosis with early treatment and supportive therapy.
✅ Management:
| Psychotherapy:
Cognitive Behavioral Therapy (CBT) – Most effective.
🧠 “Depressive neurosis is now termed as Persistent Depressive Disorder (PDD) in DSM-5.”
🧠 “Duration of symptoms must be at least 2 years in adults to diagnose PDD.”
🧠 “CBT combined with SSRIs is the best management approach.”
🧠 “Patients are often described as having a chronic, gloomy personality.”
🧠 “Watch for double depression—PDD coexisting with episodes of major depression.”
✅ 1. What is the minimum duration of symptoms required to diagnose Persistent Depressive Disorder (PDD) in adults?
A) 6 weeks B) 6 months C) 1 year D) 2 years
Correct Answer: D) 2 years Rationale: PDD (previously known as depressive neurosis or dysthymia) requires a persistent low mood for at least 2 years in adults.
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✅ 2. Which of the following is the most commonly used first-line pharmacological treatment for PDD?
A) Lithium B) Fluoxetine (SSRI) C) Haloperidol D) Diazepam
Correct Answer: B) Fluoxetine (SSRI) Rationale: SSRIs like fluoxetine are the first-line drugs for treating PDD due to their safety and effectiveness.
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✅ 3. Which of the following symptoms is most characteristic of depressive neurosis (PDD)?
A) Episodes of psychosis B) Persistent low self-esteem and hopelessness C) Elevated mood alternating with irritability D) Hallucinations and delusions
Correct Answer: B) Persistent low self-esteem and hopelessness Rationale: Chronic low mood, feelings of hopelessness, and low self-esteem are hallmark symptoms of PDD.
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✅ 4. Which non-pharmacological therapy is considered most effective in treating PDD?
A) Psychoanalysis B) Cognitive Behavioral Therapy (CBT) C) Hypnotherapy D) ECT
Correct Answer: B) Cognitive Behavioral Therapy (CBT) Rationale: CBT helps patients identify and modify negative thought patterns, making it the most effective therapy for PDD.
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✅ 5. What is the term used when a patient with PDD develops an episode of Major Depressive Disorder?
A) Mixed Depression B) Double Depression C) Acute Depression D) Cyclothymia
Correct Answer: B) Double Depression Rationale: Double depression occurs when a patient with PDD experiences superimposed episodes of major depression.
✅ 1. What is the minimum duration required to diagnose Persistent Depressive Disorder (PDD) in adults?
A) 6 months B) 1 year C) 2 years D) 5 years
Correct Answer: C) 2 years Rationale: PDD requires a low mood lasting at least 2 years in adults.
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✅ 2. Which of the following is NOT a symptom of Major Depressive Disorder (MDD)?
A) Anhedonia B) Decreased energy C) Grandiosity D) Suicidal thoughts
Correct Answer: C) Grandiosity Rationale: Grandiosity is a feature of mania, not depression.
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✅ 3. Which antidepressant class is considered first-line treatment for both MDD and PDD?
A) MAO Inhibitors B) Tricyclic Antidepressants C) SSRIs D) Benzodiazepines
Correct Answer: C) SSRIs Rationale: SSRIs like fluoxetine are first-line due to fewer side effects and high efficacy.
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✅ 4. Which neurotransmitter is most commonly associated with the pathophysiology of depression?
A) Dopamine B) Serotonin C) GABA D) Glutamate
Correct Answer: B) Serotonin Rationale: Low levels of serotonin are linked to depressive symptoms.
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✅ 5. Which of the following therapies is considered most effective for treating depressive disorders?
A) Cognitive Behavioral Therapy (CBT) B) Hypnosis C) Aversion Therapy D) Play Therapy
Correct Answer: A) CBT Rationale: CBT focuses on correcting negative thought patterns and behaviors.
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✅ 6. What is the term used when a patient with PDD experiences an episode of Major Depression?
A) Double Depression B) Mixed Depression C) Cyclothymia D) Bipolar Disorder
Correct Answer: A) Double Depression Rationale: Double Depression occurs when MDD episodes are superimposed on PDD.
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✅ 7. Which of the following is a key psychological symptom of depression?
A) Flight of ideas B) Hopelessness C) Hyperactivity D) Euphoric mood
Correct Answer: B) Hopelessness Rationale: Persistent feelings of hopelessness are hallmark signs of depression.
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✅ 8. Which hormone is often elevated in depressive patients due to HPA axis dysregulation?
A) Insulin B) Thyroxine C) Cortisol D) Estrogen
Correct Answer: C) Cortisol Rationale: Hyperactivity of the HPA axis leads to elevated cortisol levels in depression.
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✅ 9. Which scale is most commonly used to assess depression severity?
A) MMSE B) Hamilton Depression Rating Scale (HAM-D) C) GCS D) Apgar Score
Correct Answer: B) Hamilton Depression Rating Scale (HAM-D) Rationale: HAM-D is widely used in clinical settings to assess depression severity.
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✅ 10. Which of the following medications is a Tricyclic Antidepressant (TCA)?
A) Sertraline B) Amitriptyline C) Fluoxetine D) Escitalopram
Correct Answer: B) Amitriptyline Rationale: Amitriptyline is a TCA, effective but associated with more side effects.
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✅ 11. Which of the following is NOT a physical symptom of depression?
A) Weight loss or gain B) Insomnia or hypersomnia C) Psychomotor agitation or retardation D) Rapid speech
Correct Answer: D) Rapid speech Rationale: Rapid speech is a feature of mania, not depression.
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✅ 12. Which is the most serious complication of untreated depression?
A) Insomnia B) Weight loss C) Suicide D) Headache
Correct Answer: C) Suicide Rationale: Suicide is the most life-threatening complication of severe depression.
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✅ 13. Which non-pharmacological intervention is highly effective for depression?
A) Psychoanalysis B) CBT and Interpersonal Therapy (IPT) C) Flooding Technique D) Electroconvulsive Therapy Only
Correct Answer: B) CBT and Interpersonal Therapy (IPT) Rationale: These therapies address negative thinking and interpersonal issues.
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✅ 14. Which antidepressant is also used for smoking cessation?
A) Bupropion B) Fluoxetine C) Amitriptyline D) Clomipramine
Correct Answer: A) Bupropion Rationale: Bupropion is an atypical antidepressant effective in smoking cessation.
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✅ 15. Which sleep pattern disturbance is commonly seen in depression?
A) Prolonged REM latency B) Early morning awakening C) Excessive deep sleep D) Night terrors
Correct Answer: B) Early morning awakening Rationale: Depressed patients often wake early and cannot return to sleep.
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✅ 16. Which of the following is considered a vegetative symptom of depression?
A) Suicidal ideation B) Guilt feelings C) Decreased appetite D) Negative self-image
Correct Answer: C) Decreased appetite Rationale: Vegetative symptoms involve disturbances in basic bodily functions like sleep, appetite, and energy.
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✅ 17. What is the minimum duration required to diagnose Major Depressive Disorder?
A) 1 week B) 2 weeks C) 1 month D) 6 months
Correct Answer: B) 2 weeks Rationale: MDD is diagnosed when symptoms persist for at least 2 weeks.
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✅ 18. Which medication is associated with a risk of hypertensive crisis if taken with tyramine-rich foods?
A) Fluoxetine B) Phenelzine (MAOI) C) Sertraline D) Mirtazapine
Correct Answer: B) Phenelzine (MAOI) Rationale: MAOIs require dietary restrictions to avoid hypertensive crisis.
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✅ 19. Which of the following is a sign of improvement in a depressed patient?
A) Continues to stay isolated B) Begins participating in social activities C) Refuses to take medications D) Frequently expresses suicidal thoughts
Correct Answer: B) Begins participating in social activities Rationale: Resumption of normal activities indicates clinical improvement.
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✅ 20. Which is a critical nursing intervention for a severely depressed patient expressing suicidal thoughts?
A) Ignore the patient’s statements. B) Encourage the patient to suppress emotions. C) Implement suicide precautions and ensure safety. D) Leave the patient alone to calm down.
Correct Answer: C) Implement suicide precautions and ensure safety. Rationale: Safety is the top priority in managing suicidal patients.
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✅ 21. Which lifestyle change helps improve depressive symptoms?
A) Social isolation B) Regular physical exercise and balanced diet C) Increased alcohol consumption D) Sleeping throughout the day
Correct Answer: B) Regular physical exercise and balanced diet Rationale: Regular exercise improves mood and reduces depressive symptoms.
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✅ 22. Which of the following is an affective symptom of depression?
A) Anhedonia B) Weight loss C) Psychomotor retardation D) Sleep disturbances
Correct Answer: A) Anhedonia Rationale: Anhedonia (loss of interest in pleasurable activities) is a key affective symptom.
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✅ 23. Which is the most effective treatment for severe depression with high suicide risk?
A) Cognitive therapy only B) Electroconvulsive Therapy (ECT) C) Benzodiazepines D) Play therapy
Correct Answer: B) Electroconvulsive Therapy (ECT) Rationale: ECT is effective for severe, treatment-resistant depression or immediate suicide risk.
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✅ 24. Which class of medications can cause sexual dysfunction as a side effect?
A) SSRIs B) Beta-blockers C) Anticonvulsants D) NSAIDs
Correct Answer: A) SSRIs Rationale: Sexual dysfunction is a common side effect of SSRIs.
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✅ 25. Which of the following is a hallmark feature of PDD (Depressive Neurosis)?
A) Severe depressive episodes only B) Chronic low-grade depression lasting ≥2 years C) Mania alternating with depression D) Sudden onset of severe depressive symptoms
Correct Answer: B) Chronic low-grade depression lasting ≥2 years Rationale: PDD is characterized by a persistent low mood for at least 2 years in adults.
Conversion Disorder is a mental health condition in which psychological stress is unconsciously converted into neurological symptoms, affecting motor or sensory function, without any identifiable medical cause.
✅ Key Characteristics:
Sudden onset of neurological symptoms (motor or sensory).
Symptoms are inconsistent with known medical or neurological conditions.
The patient is often unaware that symptoms are psychological in origin.
Symptoms often develop after psychological stress or conflict.
✅ Common Symptoms:
Motor Symptoms
Sensory Symptoms
Paralysis or weakness
Loss of sensation (anesthesia)
Abnormal movements (tremors)
Blindness or visual disturbances
Gait disturbances
Deafness
Non-epileptic seizures (pseudoseizures)
Loss of pain sensation
Mutism
Double vision (Diplopia)
📌 Important Sign: La Belle Indifference — A surprising lack of concern about the severity of symptoms.
✅ Etiology (Causes):
Psychological stress or trauma.
Unresolved unconscious conflicts.
Maladaptive coping mechanisms.
Associated with personality disorders (histrionic, dependent).
✅ Diagnosis:
Clinical diagnosis by exclusion (after ruling out organic causes).
Positive signs like Hoover’s Sign (for leg weakness) and inconsistent examination findings.
No structural or functional abnormalities found on investigations.
Treat comorbid anxiety or depression with SSRIs if needed.
| Nursing Interventions:
Establish a supportive, nonjudgmental relationship.
Avoid reinforcing the sick role.
Encourage gradual resumption of normal activities.
Educate the patient and family about the psychological basis of symptoms.
📌 Golden One-Liners for Quick Revision:
🧠 “Conversion Disorder involves the unconscious expression of emotional conflict as physical symptoms.”
🧠 “La Belle Indifference is classically seen in conversion disorder.”
🧠 “Symptoms often appear suddenly after a psychological stressor.”
🧠 “CBT is the most effective treatment for conversion disorder.”
✅ 1. Which of the following is a classic feature of Conversion Disorder?
A) Conscious feigning of symptoms B) Sudden onset of neurological symptoms without organic cause C) Intentional exaggeration of illness for financial gain D) Gradual onset of irreversible neurological damage
Correct Answer: B) Sudden onset of neurological symptoms without organic cause Rationale: Conversion Disorder presents with sudden neurological symptoms (motor or sensory) without any identifiable medical or neurological condition.
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✅ 2. Which of the following terms describes a patient’s surprising lack of concern about serious symptoms?
A) La Belle Indifference B) Negative Reinforcement C) Primary Gain D) Secondary Gain
Correct Answer: A) La Belle Indifference Rationale: La Belle Indifference refers to the inappropriate lack of concern or indifference toward serious symptoms, often seen in Conversion Disorder.
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✅ 3. What is the first-line psychological therapy for Conversion Disorder?
A) Psychoanalysis B) Cognitive Behavioral Therapy (CBT) C) Hypnosis D) Aversion Therapy
Correct Answer: B) Cognitive Behavioral Therapy (CBT) Rationale: CBT is the most effective therapy to help patients address underlying stress and develop better coping mechanisms.
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✅ 4. Which of the following is an example of a motor symptom seen in Conversion Disorder?
A) Paralysis of a limb B) Blindness C) Loss of hearing D) Loss of pain sensation
Correct Answer: A) Paralysis of a limb Rationale: Motor symptoms include paralysis, tremors, abnormal movements, and gait disturbances.
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✅ 5. Which of the following is the most appropriate nursing approach for a patient with Conversion Disorder?
A) Encourage immediate confrontation about the psychological cause. B) Provide supportive care and gradually encourage normal activity. C) Reinforce the sick role to gain trust. D) Ignore the patient’s symptoms to avoid attention-seeking behavior.
Correct Answer: B) Provide supportive care and gradually encourage normal activity. Rationale: Supportive care without reinforcing the illness behavior helps patients gradually resume normal functioning.
✅ Conversion Disorder MCQs
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1. Which of the following is a hallmark psychological mechanism in Conversion Disorder?
A) Conscious simulation of symptoms B) Unconscious conversion of psychological stress into physical symptoms C) Deliberate exaggeration of illness for external rewards D) Desire to obtain sick leave
Correct Answer: B) Unconscious conversion of psychological stress into physical symptoms Rationale: In Conversion Disorder, symptoms are produced unconsciously, and the patient is unaware of the psychological origin.
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2. What is “La Belle Indifference”?
A) Severe distress over symptoms B) Indifference toward serious symptoms C) Intentional exaggeration of symptoms D) Emotional outbursts during therapy
Correct Answer: B) Indifference toward serious symptoms Rationale: It is a surprising lack of concern about severe symptoms, seen in some Conversion Disorder cases.
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3. Which motor symptom is commonly seen in Conversion Disorder?
A) Hallucinations B) Limb paralysis C) Delusions D) Hyperactivity
Correct Answer: B) Limb paralysis Rationale: Motor symptoms like paralysis and tremors are common presentations.
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4. What is the primary treatment for Conversion Disorder?
A) Benzodiazepines B) Cognitive Behavioral Therapy (CBT) C) Antipsychotics D) Electroconvulsive Therapy (ECT)
Correct Answer: B) Cognitive Behavioral Therapy (CBT) Rationale: CBT addresses underlying stress and helps patients develop healthier coping mechanisms.
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5. What is the nursing priority when managing a patient with Conversion Disorder?
A) Confront the patient about psychological causes. B) Encourage gradual resumption of normal activities. C) Force the patient to acknowledge the psychological problem. D) Ignore the symptoms to discourage attention-seeking.
Correct Answer: B) Encourage gradual resumption of normal activities. Rationale: Supportive care with activity encouragement helps patients recover without reinforcing sick behavior.
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✅ Somatoform Disorders MCQs
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6. What is the primary difference between Somatization Disorder and Conversion Disorder?
A) Somatization involves neurological symptoms only. B) Conversion symptoms are sudden and specific; somatization is multiple vague physical complaints. C) Conversion disorder lasts longer. D) Somatization is always intentional.
Correct Answer: B) Conversion symptoms are sudden and specific; somatization is multiple vague physical complaints. Rationale: Somatization involves chronic, multiple unexplained symptoms across various body systems.
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7. Which of the following is an example of a Somatization Disorder symptom?
A) Recurrent unexplained headaches B) Hallucinations C) Auditory delusions D) Compulsive rituals
Correct Answer: A) Recurrent unexplained headaches Rationale: Vague physical complaints without medical explanation are typical of Somatization Disorder.
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8. Which term describes obtaining emotional relief through physical symptoms?
A) Primary Gain B) Secondary Gain C) La Belle Indifference D) Conversion
Correct Answer: A) Primary Gain Rationale: Primary gain reduces psychological conflict through physical symptoms.
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9. Which of the following is an example of Secondary Gain?
A) Unconscious reduction of guilt B) Receiving sympathy and financial benefits due to illness C) Repressing emotions D) Improving self-esteem through hard work
Correct Answer: B) Receiving sympathy and financial benefits due to illness Rationale: Secondary gain refers to external rewards received because of illness.
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10. Which drug class is used when Somatoform Disorders are accompanied by significant anxiety or depression?
A) Antipsychotics B) SSRIs (e.g., Fluoxetine) C) Beta-blockers D) MAO Inhibitors
Correct Answer: B) SSRIs (e.g., Fluoxetine) Rationale: SSRIs are effective in treating comorbid anxiety and depression.
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✅ Hypochondriasis (Illness Anxiety Disorder) MCQs
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11. Which of the following is characteristic of Illness Anxiety Disorder?
A) Multiple physical symptoms with no concern for health B) Persistent belief of having a serious illness despite medical reassurance C) Dramatic motor symptoms D) Complete denial of physical symptoms
Correct Answer: B) Persistent belief of having a serious illness despite medical reassurance Rationale: Patients excessively worry about health despite negative evaluations.
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12. What is the recommended therapy for Hypochondriasis?
A) Flooding B) Reassurance only C) CBT and supportive counseling D) Electroconvulsive Therapy
Correct Answer: C) CBT and supportive counseling Rationale: CBT helps patients address anxiety and misinterpretation of body sensations.
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✅ Factitious and Malingering Disorders MCQs
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13. Which of the following statements is TRUE regarding Factitious Disorder?
A) Symptoms are consciously produced for external gain. B) Symptoms are intentionally produced to assume the sick role without external rewards. C) The patient is unaware of producing symptoms. D) Symptoms are always real and require medical attention.
Correct Answer: B) Symptoms are intentionally produced to assume the sick role without external rewards. Rationale: Factitious Disorder involves conscious symptom production without external incentives.
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14. Which of the following best describes Malingering?
A) Unconscious symptom production B) Conscious faking of symptoms for clear external rewards C) Sudden resolution of symptoms D) Indifference toward symptoms
Correct Answer: B) Conscious faking of symptoms for clear external rewards Rationale: Malingering is motivated by external incentives like financial compensation or avoiding work.
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15. What is the key difference between Factitious Disorder and Malingering?
A) Factitious is unconscious, Malingering is conscious. B) Both involve external rewards. C) Factitious Disorder involves no external gain; Malingering does. D) Both are unconscious processes.
Correct Answer: C) Factitious Disorder involves no external gain; Malingering does. Rationale: This is the primary distinguishing factor.
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✅ Remaining Mixed MCQs
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16. What is the focus of nursing care in somatoform disorders?
A) Encourage focus on physical symptoms. B) Encourage verbalization of feelings and stress management. C) Reinforce dependency on medical care. D) Ignore the patient’s complaints completely.
Correct Answer: B) Encourage verbalization of feelings and stress management. Rationale: This helps reduce symptom-focused behaviors.
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17. Which of the following is NOT a typical feature of Conversion Disorder?
A) Sudden onset of paralysis B) Inconsistent neurological examination findings C) Evidence of organic brain disease D) Pseudoseizures
Correct Answer: C) Evidence of organic brain disease Rationale: No organic cause is found in Conversion Disorder.
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18. Which behavioral intervention is most appropriate for somatoform disorders?
A) CBT B) Aversion Therapy C) Flooding D) Psychoanalysis
Correct Answer: A) CBT Rationale: CBT is effective in managing somatic symptoms by addressing maladaptive thoughts.
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19. Which nursing diagnosis is most appropriate for a patient with Conversion Disorder?
A) Risk for Imbalanced Nutrition B) Ineffective Coping C) Risk for Aspiration D) Risk for Infection
Correct Answer: B) Ineffective Coping Rationale: The primary issue is maladaptive coping mechanisms expressed as physical symptoms.
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20. Which sign differentiates Conversion Disorder from a true neurological disorder?
A) Positive Babinski Reflex B) Inconsistent test results during examination C) Presence of fever D) Lab abnormalities
Correct Answer: B) Inconsistent test results during examination Rationale: In Conversion Disorder, findings are inconsistent or do not match known anatomical patterns.
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21. Which of the following is a characteristic feature of pseudoseizures?
A) Cyanosis during episodes B) Unresponsiveness to external stimuli C) Lack of injury despite violent movements D) EEG shows epileptiform activity
Correct Answer: C) Lack of injury despite violent movements Rationale: Unlike true seizures, pseudoseizures rarely cause injuries.
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22. What is the primary purpose of Secondary Gain in somatoform disorders?
A) To resolve unconscious conflict B) To receive sympathy and avoid responsibilities C) To achieve mental relaxation D) To improve self-esteem
Correct Answer: B) To receive sympathy and avoid responsibilities Rationale: This is an external benefit gained from the sick role.
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23. Which of the following nursing interventions is inappropriate for managing Conversion Disorder?
A) Provide reassurance. B) Focus solely on physical symptoms. C) Encourage normal activity gradually. D) Address underlying stressors.
Correct Answer: B) Focus solely on physical symptoms. Rationale: This reinforces illness behavior and should be avoided.
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24. Which therapy focuses on helping patients recognize the psychological factors behind their physical symptoms?
A) Psychoanalysis B) CBT C) Hypnosis D) ECT
Correct Answer: B) CBT Rationale: CBT is the most effective therapy for identifying and managing maladaptive thoughts and behaviors.
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25. Which of the following is a key difference between Somatic Symptom Disorder and Illness Anxiety Disorder?
A) In Somatic Symptom Disorder, the patient is more focused on anxiety about illness rather than actual symptoms. B) Somatic Symptom Disorder involves significant physical symptoms; Illness Anxiety Disorder focuses on health anxiety with minimal symptoms. C) Both conditions involve no physical symptoms. D) Illness Anxiety Disorder is only seen in the elderly.
Correct Answer: B) Somatic Symptom Disorder involves significant physical symptoms; Illness Anxiety Disorder focuses on health anxiety with minimal symptoms. Rationale: This is the main distinguishing feature between the two.
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📚 Dissociative Reaction (Dissociative Disorders)
✅ Definition:
A Dissociative Reaction involves a disruption or breakdown in the normal integration of consciousness, memory, identity, emotion, perception, and behavior, usually triggered by severe psychological stress or trauma.
✅ Key Characteristics:
Sudden, temporary loss of memory, identity, or awareness.
Often occurs as a coping mechanism to deal with overwhelming emotional conflict or trauma.
Can present as amnesia, identity confusion, or detachment from reality.
✅ Types of Dissociative Reactions (DSM-5 Classification):
Type
Key Features
Dissociative Amnesia
Inability to recall important personal information, usually of a traumatic nature.
Dissociative Fugue
Sudden travel away from home with inability to recall the past and confusion about identity.
Dissociative Identity Disorder (DID)
Presence of two or more distinct personality states (formerly known as Multiple Personality Disorder).
Depersonalization/Derealization Disorder
Feeling detached from one’s own body (depersonalization) or from reality/environment (derealization).
✅ Etiology (Causes):
Severe psychological trauma (e.g., abuse, accidents, combat stress).
Childhood neglect or maltreatment.
Defense mechanism to protect against overwhelming emotional conflict.
✅ Clinical Features:
Sudden memory loss (amnesia).
Unexpected travel or wandering (fugue state).
Presence of distinct identities or personalities (DID).
Feelings of detachment from self or surroundings.
Lack of awareness of the dissociation (in some cases).
✅ Prognosis:
Good with early psychological intervention.
Risk of self-harm or suicide in severe cases if untreated.
✅ Management:
| Psychological Therapies:
Cognitive Behavioral Therapy (CBT)
Trauma-Focused Therapy (e.g., EMDR)
Hypnotherapy (in carefully selected cases).
| Pharmacotherapy:
No specific drugs to treat dissociation directly.
Antidepressants or anxiolytics may be used to treat associated anxiety or depression.
| Nursing Interventions:
Establish trust and provide a safe environment.
Help the patient identify stress triggers.
Encourage verbal expression of feelings.
Avoid confronting the patient forcefully about memory gaps or identity confusion.
📌 Golden One-Liners for Quick Revision:
🧠 “Dissociation is an unconscious defense mechanism to escape from psychological distress.”
🧠 “Dissociative Fugue involves sudden travel with loss of memory and identity confusion.”
🧠 “DID presents with two or more distinct personality states.”
🧠 “Depersonalization is detachment from self; Derealization is detachment from environment.”
🧠 “Supportive psychotherapy is the cornerstone of treatment.”
✅ 1. Which of the following is the most characteristic feature of Dissociative Fugue?
A) Multiple personalities B) Sudden travel away from home with inability to recall the past C) Persistent intrusive thoughts D) Sudden loss of consciousness
Correct Answer: B) Sudden travel away from home with inability to recall the past Rationale: Dissociative Fugue involves unexpected travel along with memory loss about personal identity and past events.
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✅ 2. In which dissociative disorder does the patient experience a sense of detachment from their own body or mental processes?
A) Dissociative Amnesia B) Dissociative Fugue C) Depersonalization Disorder D) Dissociative Identity Disorder
Correct Answer: C) Depersonalization Disorder Rationale: Depersonalization involves a sense of unreality or detachment from the self.
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✅ 3. Which of the following is the first-line treatment approach for Dissociative Disorders?
A) Electroconvulsive Therapy (ECT) B) Cognitive Behavioral Therapy (CBT) and Supportive Psychotherapy C) Long-term use of benzodiazepines D) Hypnosis as the only therapy
Correct Answer: B) Cognitive Behavioral Therapy (CBT) and Supportive Psychotherapy Rationale: Psychotherapy helps patients process trauma and integrate dissociated memories and experiences.
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✅ 4. Dissociative Identity Disorder (DID) was previously known as:
A) Multiple Personality Disorder B) Conversion Disorder C) Bipolar Disorder D) Schizophrenia
Correct Answer: A) Multiple Personality Disorder Rationale: DID involves the presence of two or more distinct identities or personality states.
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✅ 5. What is the priority nursing intervention for a patient experiencing dissociative amnesia?
A) Confront the patient about their forgotten memories. B) Provide a safe environment and reduce anxiety. C) Ignore the patient’s symptoms. D) Encourage the patient to travel alone to regain memory.
Correct Answer: B) Provide a safe environment and reduce anxiety. Rationale: Creating a supportive, stress-free environment helps the patient feel secure and reduces the risk of further dissociation.
✅ 1. Which of the following is the key feature of Dissociative Amnesia?
A) Loss of consciousness B) Inability to recall important personal information, usually after trauma C) Persistent hallucinations D) Compulsive rituals
Correct Answer: B) Inability to recall important personal information, usually after trauma Rationale: Dissociative amnesia involves memory loss related to personal identity, often following psychological stress.
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✅ 2. Dissociative Fugue is characterized by:
A) Hallucinations and delusions B) Traveling away from home with memory loss about identity C) Continuous low mood and hopelessness D) Repetitive obsessive thoughts
Correct Answer: B) Traveling away from home with memory loss about identity Rationale: Fugue states involve sudden travel and confusion about personal identity.
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✅ 3. Which dissociative disorder involves the presence of two or more distinct identities?
A) Dissociative Amnesia B) Dissociative Identity Disorder (DID) C) Depersonalization Disorder D) Conversion Disorder
Correct Answer: B) Dissociative Identity Disorder (DID) Rationale: DID, formerly known as Multiple Personality Disorder, involves distinct personality states.
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✅ 4. Which therapy is most effective for treating Dissociative Disorders?
A) Electroconvulsive Therapy (ECT) B) Cognitive Behavioral Therapy (CBT) and Trauma-Focused Therapy C) Hypnosis as the only therapy D) Long-term use of sedatives
Correct Answer: B) CBT and Trauma-Focused Therapy Rationale: These therapies help patients process underlying trauma and reintegrate dissociated memories.
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✅ 5. Which term describes the feeling of detachment from one’s own thoughts or body?
A) Derealization B) Depersonalization C) Delusion D) Fugue
Correct Answer: B) Depersonalization Rationale: Depersonalization involves a sense of being detached from the self.
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✅ 6. Which of the following best describes Derealization?
A) Detachment from one’s own body B) Detachment from the environment, feeling that surroundings are unreal C) Experiencing multiple personalities D) Inability to recall past events
Correct Answer: B) Detachment from the environment, feeling that surroundings are unreal Rationale: Derealization involves a sense of unreality regarding external surroundings.
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✅ 7. Which of the following is a primary cause of Dissociative Disorders?
A) Genetic mutation B) Severe psychological trauma C) Viral infection D) Endocrine imbalance
Correct Answer: B) Severe psychological trauma Rationale: Psychological trauma, especially in childhood, is a major cause.
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✅ 8. What is the primary defense mechanism involved in Dissociative Disorders?
A) Projection B) Regression C) Dissociation D) Suppression
Correct Answer: C) Dissociation Rationale: Dissociation allows the mind to escape overwhelming trauma.
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✅ 9. Which nursing intervention is most appropriate for a patient with Dissociative Amnesia?
A) Force the patient to recall memories. B) Create a calm, supportive environment. C) Insist the patient remember their past before discharge. D) Ignore the patient’s emotional needs.
Correct Answer: B) Create a calm, supportive environment. Rationale: Reducing anxiety promotes recovery and safety.
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✅ 10. Which symptom is most characteristic of DID?
A) Persistent depressive mood B) Presence of distinct and separate personalities C) Fear of contamination D) Repeated handwashing
Correct Answer: B) Presence of distinct and separate personalities Rationale: DID involves the switching between distinct identities.
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✅ 11. What is the priority nursing diagnosis for a patient with Dissociative Fugue?
A) Risk for injury related to confusion about identity B) Risk for fluid imbalance C) Impaired skin integrity D) Excess fluid volume
Correct Answer: A) Risk for injury related to confusion about identity Rationale: Patients in fugue states may wander and become injured due to confusion.
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✅ 12. In Depersonalization-Derealization Disorder, insight is usually:
A) Absent B) Present; the patient knows the experiences are unreal C) Always impaired D) Completely lost
Correct Answer: B) Present; the patient knows the experiences are unreal Rationale: Patients recognize their feelings are abnormal but cannot control them.
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✅ 13. Which of the following is NOT a typical symptom of Dissociative Identity Disorder?
A) Amnesia between identity changes B) Feeling detached from reality C) Repeated switching between identities D) Hallucinations
Correct Answer: D) Hallucinations Rationale: Hallucinations are not a core symptom of DID.
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✅ 14. Which class of medications may be used to manage associated anxiety in Dissociative Disorders?
A) Antibiotics B) SSRIs C) MAOIs D) Beta-blockers
Correct Answer: B) SSRIs Rationale: SSRIs help manage coexisting anxiety or depression.
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✅ 15. What is the priority goal in managing Dissociative Disorders?
A) Improve physical health only B) Facilitate integration of fragmented identities and memories C) Encourage withdrawal from social interaction D) Promote avoidance of trauma discussions
Correct Answer: B) Facilitate integration of fragmented identities and memories Rationale: The goal is to help patients process trauma and integrate dissociated parts of the self.
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✅ 16. What is the most appropriate nursing intervention when a patient presents with dissociative symptoms during stress?
A) Ignore the behavior. B) Provide grounding techniques and reduce anxiety. C) Immediately confront the dissociative experience. D) Encourage the patient to isolate themselves.
Correct Answer: B) Provide grounding techniques and reduce anxiety. Rationale: Grounding helps the patient stay connected to reality.
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✅ 17. Which of the following is an example of a grounding technique?
A) Encourage the patient to vividly recall traumatic events. B) Ask the patient to describe their immediate surroundings. C) Ask the patient to focus on hallucinations. D) Ignore the patient’s environment.
Correct Answer: B) Ask the patient to describe their immediate surroundings. Rationale: Grounding focuses attention on the present and physical surroundings.
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✅ 18. Dissociative Amnesia with Fugue is often precipitated by:
A) Financial gain B) Severe psychological stress or trauma C) Physical illness only D) Medication side effects
Correct Answer: B) Severe psychological stress or trauma Rationale: It often follows overwhelming psychological distress.
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✅ 19. What is the most effective way to prevent dissociative episodes?
A) Stress management and coping strategies B) Long-term use of sedatives C) Isolating the patient D) Forcing recall of traumatic events
Correct Answer: A) Stress management and coping strategies Rationale: Healthy coping mechanisms prevent dissociative reactions to stress.
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✅ 20. Which symptom is seen in both Depersonalization and Derealization Disorders?
A) Persistent memory loss B) Feeling of unreality C) Repetitive compulsive behaviors D) Hallucinations
Correct Answer: B) Feeling of unreality Rationale: Both involve detachment from reality but in different ways.
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✅ 21. Which defense mechanism is predominantly used in Dissociative Disorders?
A) Projection B) Dissociation C) Rationalization D) Denial
Correct Answer: B) Dissociation Rationale: Dissociation is the primary defense mechanism.
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✅ 22. Which approach is most helpful for reintegrating fragmented identities in DID?
A) Frequent confrontation B) Supportive psychotherapy and trauma-focused therapy C) Medication only D) Complete avoidance of discussing trauma
Correct Answer: B) Supportive psychotherapy and trauma-focused therapy Rationale: These therapies address trauma and promote identity integration.
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✅ 23. Which of the following is a potential risk during dissociative episodes?
A) Enhanced concentration B) Risk of self-harm or injury C) Increased social interaction D) Improved reality orientation
Correct Answer: B) Risk of self-harm or injury Rationale: Patients may unknowingly harm themselves during episodes.
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✅ 24. Which nursing diagnosis is most appropriate for a patient with frequent dissociative reactions?
A) Risk for Imbalanced Nutrition B) Risk for Injury C) Risk for Fluid Volume Deficit D) Ineffective Airway Clearance
Correct Answer: B) Risk for Injury Rationale: Safety is a top priority due to disorientation and confusion.
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✅ 25. What is the most appropriate nursing outcome for patients with Dissociative Disorders?
A) Patient will remain isolated to avoid stress. B) Patient will demonstrate effective coping strategies and reduced dissociative episodes. C) Patient will refuse to discuss traumatic events. D) Patient will rely solely on medications.
Correct Answer: B) Patient will demonstrate effective coping strategies and reduced dissociative episodes. Rationale: This reflects successful therapy and improved mental health outcomes.
Psychosomatic Disorders are conditions where psychological factors contribute significantly to the development, exacerbation, or maintenance of physical (somatic) symptoms or diseases.
📌 “Mind affects the body leading to real physical illness or symptoms.”
✅ Key Characteristics:
Physical symptoms have a clear organic basis, but their onset or severity is influenced by emotional stress or psychological conflicts.
Unlike somatoform disorders, in psychosomatic disorders, a genuine medical illness is present.
Monitor for compliance with both medical and psychological treatments.
📌 Golden One-Liners for Quick Revision:
🧠 “Psychosomatic Disorders involve real physical illnesses triggered or worsened by psychological factors.”
🧠 “Common examples include hypertension, peptic ulcer, and asthma.”
🧠 “Type A personality is prone to psychosomatic illnesses like hypertension and heart disease.”
🧠 “CBT is the most effective therapy to address underlying stress.”
🧠 “Nursing care focuses on holistic management—treating both body and mind.”
✅ 1. Which of the following best defines a psychosomatic disorder?
A) Physical symptoms without any organic basis B) Psychological factors influencing the onset or severity of real physical illness C) Intentionally faked physical symptoms D) Imaginary illnesses with no real symptoms
Correct Answer: B) Psychological factors influencing the onset or severity of real physical illness Rationale: Psychosomatic disorders involve real physical illnesses affected by psychological stress or emotional conflicts.
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✅ 2. Which personality type is most commonly associated with psychosomatic illnesses like hypertension and heart disease?
A) Type B Personality B) Type C Personality C) Type A Personality D) Type D Personality
Correct Answer: C) Type A Personality Rationale: Type A personality is competitive, perfectionist, and prone to hostility and stress, increasing the risk of cardiovascular diseases.
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✅ 3. Which of the following is a common psychosomatic disorder affecting the gastrointestinal system?
A) Bronchial Asthma B) Peptic Ulcer Disease C) Psoriasis D) Rheumatoid Arthritis
Correct Answer: B) Peptic Ulcer Disease Rationale: Stress and emotional conflicts contribute to increased gastric acid secretion, leading to peptic ulcer formation.
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✅ 4. What is the most effective psychological therapy for managing psychosomatic disorders?
A) Psychoanalysis B) Aversion Therapy C) Cognitive Behavioral Therapy (CBT) D) Hypnosis
Correct Answer: C) Cognitive Behavioral Therapy (CBT) Rationale: CBT helps patients develop better coping mechanisms and manage stress, reducing the impact of psychological factors on physical health.
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✅ 5. What is the primary focus of nursing management in psychosomatic disorders?
A) Only treat the physical illness. B) Encourage lifestyle changes and teach stress management techniques. C) Ignore the psychological components of illness. D) Administer sedatives regularly.
Correct Answer: B) Encourage lifestyle changes and teach stress management techniques. Rationale: Nursing care focuses on holistic management, addressing both physical and psychological aspects of illness.
Here is the Complete Set of 25 High-Quality MCQs on Psychosomatic and Stress-Related Disorders for NORCET and Nursing Competitive Exams:
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✅ 1. Which of the following is a characteristic of psychosomatic disorders?
A) No real physical illness is present. B) Physical illness is caused or worsened by psychological stress. C) Symptoms are intentionally produced. D) The patient is fully aware of producing symptoms.
Correct Answer: B) Physical illness is caused or worsened by psychological stress. Rationale: Psychosomatic disorders involve real physical conditions influenced by psychological factors.
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✅ 2. Which endocrine-related disorder is commonly associated with stress?
A) Hypothyroidism B) Addison’s Disease C) Type 2 Diabetes Mellitus D) Diabetes Insipidus
Correct Answer: C) Type 2 Diabetes Mellitus Rationale: Chronic stress affects glucose metabolism, increasing the risk of Type 2 Diabetes.
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✅ 3. Which is a common psychosomatic skin disorder?
A) Psoriasis B) Acne C) Ringworm D) Scabies
Correct Answer: A) Psoriasis Rationale: Psoriasis can flare up under emotional stress, though it has an organic basis.
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✅ 4. Which of the following systems is most affected by psychosomatic disorders?
A) Nervous System B) Circulatory System C) Gastrointestinal System D) All of the above
Correct Answer: D) All of the above Rationale: Stress can affect multiple systems, including cardiovascular, GI, and nervous systems.
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✅ 5. What is the key neurotransmitter involved in stress responses?
A) Acetylcholine B) Dopamine C) Norepinephrine D) Histamine
Correct Answer: C) Norepinephrine Rationale: Norepinephrine is involved in the body’s “fight or flight” stress response.
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✅ 6. Which lifestyle factor contributes to increased risk of psychosomatic disorders?
A) Balanced diet B) Regular physical exercise C) Chronic stress and poor coping mechanisms D) Adequate sleep
Correct Answer: C) Chronic stress and poor coping mechanisms Rationale: Inability to manage stress leads to physical health issues.
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✅ 7. Which therapy is most effective for long-term management of psychosomatic disorders?
A) CBT (Cognitive Behavioral Therapy) B) Electroconvulsive Therapy C) Psychoanalysis only D) Pharmacotherapy alone
Correct Answer: A) CBT (Cognitive Behavioral Therapy) Rationale: CBT addresses maladaptive thoughts and teaches effective stress management.
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✅ 8. Which psychosomatic disorder is most commonly seen in the cardiovascular system?
A) Hypotension B) Hypertension C) Bradycardia D) Aneurysm
Correct Answer: B) Hypertension Rationale: Hypertension is often triggered or worsened by psychological stress.
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✅ 9. What is the typical nursing intervention for managing a patient with stress-related disorders?
A) Encourage isolation. B) Teach relaxation techniques and stress management. C) Focus only on medication compliance. D) Avoid discussing emotional factors.
Correct Answer: B) Teach relaxation techniques and stress management. Rationale: Nurses play a key role in holistic care, addressing both mind and body.
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✅ 10. Which hormone is known as the “stress hormone”?
A) Insulin B) Thyroxine C) Cortisol D) Melatonin
Correct Answer: C) Cortisol Rationale: Cortisol is released during stress and contributes to various physical effects.
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✅ 11. Which of the following is a common psychosomatic respiratory disorder?
A) Asthma B) Tuberculosis C) COPD D) Pneumonia
Correct Answer: A) Asthma Rationale: Emotional stress can trigger asthma attacks.
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✅ 12. Which personality type is at a higher risk for developing stress-related illnesses?
A) Type A Personality B) Type B Personality C) Type C Personality D) Introverted Personality
Correct Answer: A) Type A Personality Rationale: Type A individuals are highly competitive and prone to stress.
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✅ 13. Which of the following is an example of a stress-reducing intervention?
A) Yoga and Meditation B) Consumption of caffeine C) Increased workload D) Social isolation
Correct Answer: A) Yoga and Meditation Rationale: These help manage stress and promote relaxation.
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✅ 14. What is the best nursing diagnosis for a patient experiencing chronic stress?
A) Ineffective Coping B) Risk for Fluid Volume Deficit C) Deficient Knowledge D) Risk for Aspiration
✅ 15. Which nursing action is appropriate when caring for a patient with hypertension linked to stress?
A) Focus only on antihypertensive medications. B) Teach stress management and relaxation techniques. C) Discourage physical activity. D) Ignore the emotional aspects.
Correct Answer: B) Teach stress management and relaxation techniques. Rationale: Addressing stress helps in long-term control of blood pressure.
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✅ 16. Which gastrointestinal disorder is most commonly associated with stress?
A) Appendicitis B) Peptic Ulcer Disease C) Gastroenteritis D) Pancreatitis
Correct Answer: B) Peptic Ulcer Disease Rationale: Stress increases gastric acid secretion, leading to ulcer formation.
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✅ 17. Which coping strategy is most effective for managing stress-related disorders?
A) Alcohol consumption B) Problem-solving and relaxation techniques C) Avoidance of all stressful situations D) Denial of emotional issues
Correct Answer: B) Problem-solving and relaxation techniques Rationale: Positive coping skills improve emotional well-being.
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✅ 18. Which therapy is helpful in teaching patients to control physiological responses to stress?
A) CBT B) Biofeedback Therapy C) Play Therapy D) Aversion Therapy
Correct Answer: B) Biofeedback Therapy Rationale: Biofeedback helps patients gain control over physiological functions like heart rate and muscle tension.
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✅ 19. Which of the following indicates successful coping in a patient with psychosomatic illness?
A) Frequent hospital admissions B) Reports using relaxation techniques during stress C) Increased dependency on medications D) Avoidance of daily activities
Correct Answer: B) Reports using relaxation techniques during stress Rationale: This indicates healthy coping mechanisms.
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✅ 20. Which stress hormone contributes to hyperglycemia during chronic stress?
A) Cortisol B) Insulin C) Thyroxine D) ADH
Correct Answer: A) Cortisol Rationale: Cortisol increases blood glucose levels during stress.
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✅ 21. Which of the following is NOT a typical psychosomatic disorder?
A) Asthma B) Hypertension C) Schizophrenia D) Peptic Ulcer Disease
Correct Answer: C) Schizophrenia Rationale: Schizophrenia is a psychiatric disorder, not a psychosomatic disorder.
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✅ 22. What is the priority nursing outcome for patients with stress-related physical symptoms?
A) Verbalizes understanding of the mind-body connection. B) Avoids discussing emotional concerns. C) Takes medications without understanding their purpose. D) Remains isolated to avoid stressful environments.
Correct Answer: A) Verbalizes understanding of the mind-body connection. Rationale: Patient education is key to holistic recovery.
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✅ 23. Which term describes the tendency to experience physical symptoms as a result of psychological stress?
A) Projection B) Somatization C) Sublimation D) Rationalization
Correct Answer: B) Somatization Rationale: Somatization is the expression of psychological distress through physical symptoms.
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✅ 24. Which behavioral technique helps patients reduce physiological responses to stress?
A) Progressive Muscle Relaxation B) Excessive physical exertion C) Sleep deprivation D) Avoiding all social contacts
Correct Answer: A) Progressive Muscle Relaxation Rationale: This helps calm the nervous system and reduce tension.
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✅ 25. What is the role of the nurse in the management of psychosomatic disorders?
A) Treat physical illness only. B) Provide holistic care addressing both physical and psychological needs. C) Ignore emotional issues and focus on lab values. D) Reinforce the sick role.
Correct Answer: B) Provide holistic care addressing both physical and psychological needs. Rationale: Nursing care should be holistic, addressing both body and mind.
📚 Post-Traumatic Stress Disorder (PTSD)
✅ Definition:
PTSD is a mental health condition that develops after experiencing or witnessing a traumatic event, leading to severe anxiety, intrusive memories, and emotional numbness.
✅ Common Traumatic Triggers:
War or combat exposure
Physical or sexual assault
Natural disasters (earthquakes, floods)
Serious accidents (road accidents, explosions)
Death of a loved one
Childhood abuse or neglect
✅ DSM-5 Diagnostic Criteria (Key Features):
Intrusion Symptoms:
Recurrent, distressing memories or flashbacks of the trauma
Nightmares related to the event
Avoidance Symptoms:
Avoiding places, people, or conversations related to the trauma
Negative Alterations in Cognition and Mood:
Feelings of guilt, hopelessness, or emotional numbness
Difficulty remembering aspects of the trauma
Hyperarousal Symptoms:
Irritability and anger outbursts
Hypervigilance (being “on edge”)
Sleep disturbances
📌 Duration: Symptoms must persist for more than 1 month to be diagnosed as PTSD.
✅ Etiology (Causes):
Exposure to life-threatening events
History of prior trauma or psychiatric illness
Poor social support systems
Biological vulnerability (e.g., overactive amygdala, high cortisol levels)
Prazosin: Effective in reducing PTSD-related nightmares
| Nursing Interventions:
Establish trust and maintain a calm, safe environment
Encourage verbal expression of feelings at the patient’s own pace
Teach relaxation and coping strategies
Monitor for suicidal ideation or self-harm behaviors
📌 Golden One-Liners for Quick Revision:
🧠 “PTSD develops after exposure to severe trauma, leading to anxiety, flashbacks, and emotional numbing.”
🧠 “CBT and SSRIs are the first-line treatments for PTSD.”
🧠 “Prazosin is specifically effective in managing nightmares associated with PTSD.”
🧠 “Avoid forcing trauma recall; allow expression at the patient’s pace.”
🧠 “Hyperarousal and avoidance behaviors are hallmark signs of PTSD.”
✅ 1. What is the minimum duration of symptoms required to diagnose PTSD?
A) 1 week B) 2 weeks C) 1 month D) 6 months
Correct Answer: C) 1 month Rationale: According to DSM-5, symptoms must persist for at least 1 month after the traumatic event to diagnose PTSD.
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✅ 2. Which of the following medications is specifically used to manage nightmares in PTSD patients?
A) Fluoxetine B) Prazosin C) Diazepam D) Haloperidol
Correct Answer: B) Prazosin Rationale: Prazosin, an alpha-1 blocker, is effective in reducing PTSD-related nightmares.
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✅ 3. Which therapy is considered the most effective first-line psychological treatment for PTSD?
A) Psychoanalysis B) Cognitive Behavioral Therapy (CBT) C) Hypnosis D) Aversion Therapy
Correct Answer: B) Cognitive Behavioral Therapy (CBT) Rationale: CBT, particularly Trauma-Focused CBT, is the gold standard for treating PTSD.
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✅ 4. Which of the following is an example of an intrusion symptom in PTSD?
A) Avoiding trauma reminders B) Recurrent distressing dreams about the trauma C) Emotional numbness D) Feeling detached from others
Correct Answer: B) Recurrent distressing dreams about the trauma Rationale: Intrusion symptoms include flashbacks, nightmares, and distressing memories of the traumatic event.
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✅ 5. What is the most important nursing action when a PTSD patient is experiencing flashbacks?
A) Leave the patient alone to process their emotions. B) Reassure the patient of their safety and stay with them. C) Force the patient to discuss the traumatic event immediately. D) Encourage the patient to ignore their feelings.
Correct Answer: B) Reassure the patient of their safety and stay with them. Rationale: Providing a calm, safe environment and reassurance is crucial during flashbacks.
✅ 1. Which of the following is NOT a core symptom cluster of PTSD according to DSM-5?
A) Intrusion symptoms B) Avoidance behaviors C) Hallucinations and delusions D) Hyperarousal symptoms
Correct Answer: C) Hallucinations and delusions Rationale: These are psychotic symptoms, not characteristic of PTSD.
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✅ 2. What is the first-line pharmacological treatment for PTSD?
A) Benzodiazepines B) SSRIs (Selective Serotonin Reuptake Inhibitors) C) Antipsychotics D) MAO Inhibitors
Correct Answer: B) SSRIs Rationale: SSRIs like Sertraline and Paroxetine are FDA-approved for PTSD.
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✅ 3. Which of the following is a hyperarousal symptom in PTSD?
A) Avoiding reminders of trauma B) Exaggerated startle response C) Emotional numbness D) Flashbacks
Correct Answer: B) Exaggerated startle response Rationale: Hypervigilance and exaggerated startle response are key hyperarousal symptoms.
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✅ 4. PTSD is most commonly associated with which brain structure being hyperactive?
A) Hypothalamus B) Amygdala C) Occipital Lobe D) Basal Ganglia
Correct Answer: B) Amygdala Rationale: The amygdala, which processes fear and emotions, is hyperactive in PTSD patients.
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✅ 5. Which of the following is an effective therapy specifically used to process trauma in PTSD?
A) Aversion Therapy B) Eye Movement Desensitization and Reprocessing (EMDR) C) Hypnotherapy D) Psychoanalysis
Correct Answer: B) EMDR Rationale: EMDR is a trauma-focused therapy effective for PTSD.
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✅ 6. What is the typical emotional response seen during intrusive flashbacks in PTSD?
A) Calmness B) Fear and helplessness C) Joyful excitement D) Euphoria
Correct Answer: B) Fear and helplessness Rationale: Flashbacks often evoke intense distress, fear, and helplessness.
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✅ 7. Which nursing diagnosis is most appropriate for a patient with PTSD?
A) Ineffective Airway Clearance B) Risk for Injury related to flashbacks and hypervigilance C) Impaired Physical Mobility D) Deficient Fluid Volume
Correct Answer: B) Risk for Injury related to flashbacks and hypervigilance Rationale: Flashbacks and hyperarousal increase the risk of self-harm or injury.
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✅ 8. Which statement by a PTSD patient indicates avoidance behavior?
A) “I have frequent nightmares about the event.” B) “I try not to go near that place where it happened.” C) “I feel on edge all the time.” D) “I have trouble concentrating.”
Correct Answer: B) “I try not to go near that place where it happened.” Rationale: This is classic avoidance behavior, avoiding trauma-related stimuli.
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✅ 9. Which medication is most effective for reducing PTSD-related nightmares?
A) Prazosin B) Fluoxetine C) Diazepam D) Risperidone
Correct Answer: A) Prazosin Rationale: Prazosin is specifically effective in reducing trauma-related nightmares.
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✅ 10. How long after a traumatic event can Acute Stress Disorder be diagnosed instead of PTSD?
A) Within 3 days to 4 weeks B) After 6 months C) Immediately after the event D) Only after 1 year
Correct Answer: A) Within 3 days to 4 weeks Rationale: Symptoms lasting between 3 days and 4 weeks are classified as Acute Stress Disorder.
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✅ 11. Which of the following physiological systems is hyperactivated in PTSD?
A) Renal System B) Hypothalamic-Pituitary-Adrenal (HPA) Axis C) Endocrine System only D) Digestive System
Correct Answer: B) HPA Axis Rationale: Chronic activation of the HPA axis leads to high cortisol levels, affecting stress responses.
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✅ 12. Which of the following is a priority nursing intervention during a patient’s flashback episode?
A) Leave the patient alone to calm down. B) Reorient the patient and ensure safety. C) Ask the patient to recall every detail of the trauma. D) Administer sedatives immediately.
Correct Answer: B) Reorient the patient and ensure safety. Rationale: Providing reassurance and ensuring safety during flashbacks is critical.
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✅ 13. Which is a key goal of therapy for a PTSD patient?
A) Suppress all traumatic memories. B) Assist the patient in integrating traumatic memories into daily life without distress. C) Encourage avoidance of all trauma-related thoughts. D) Promote complete isolation to avoid triggers.
Correct Answer: B) Assist the patient in integrating traumatic memories into daily life without distress. Rationale: Successful therapy helps reduce emotional distress when recalling trauma.
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✅ 14. Which of the following is a common cognitive distortion in PTSD patients?
A) Positive reframing B) Self-blame and survivor’s guilt C) Overconfidence D) Excessive euphoria
Correct Answer: B) Self-blame and survivor’s guilt Rationale: Patients often irrationally blame themselves for surviving traumatic events.
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✅ 15. What is the best approach when a PTSD patient expresses readiness to talk about the trauma?
A) Change the subject immediately. B) Encourage the patient to express feelings at their own pace. C) Force the patient to describe details quickly. D) Ignore the patient’s emotions.
Correct Answer: B) Encourage the patient to express feelings at their own pace. Rationale: Therapy should proceed at a pace comfortable for the patient.
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✅ 16. Which neurotransmitter dysfunction is involved in PTSD?
A) Increased serotonin activity B) Decreased norepinephrine and increased dopamine C) Decreased serotonin and increased norepinephrine D) Increased GABA activity
Correct Answer: C) Decreased serotonin and increased norepinephrine Rationale: This imbalance contributes to mood disturbances and hypervigilance.
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✅ 17. What is the priority nursing outcome for a patient with PTSD?
A) The patient will avoid discussing traumatic experiences. B) The patient will remain isolated to prevent anxiety. C) The patient will demonstrate effective coping strategies to manage anxiety. D) The patient will rely solely on medications.
Correct Answer: C) The patient will demonstrate effective coping strategies to manage anxiety. Rationale: Effective coping reduces the severity of PTSD symptoms.
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✅ 18. Which physiological sign is often associated with hyperarousal in PTSD?
A) Bradycardia B) Hypotension C) Tachycardia D) Hypoglycemia
Correct Answer: C) Tachycardia Rationale: The body remains in a fight-or-flight state, causing elevated heart rate.
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✅ 19. Which defense mechanism is most commonly used in PTSD?
A) Suppression B) Dissociation C) Rationalization D) Sublimation
✅ 20. Which patient statement indicates a positive outcome of PTSD therapy?
A) “I avoid thinking about what happened at all costs.” B) “I don’t feel safe even when I’m at home.” C) “I can think about the event without becoming overwhelmed.” D) “I need to stay away from everyone to feel better.”
Correct Answer: C) “I can think about the event without becoming overwhelmed.” Rationale: This shows the patient has processed the trauma and can cope effectively.
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✅ 21. Which medication class is NOT typically used for PTSD management?
A) SSRIs B) Benzodiazepines (short-term) C) Antipsychotics (only in severe cases) D) Antibiotics
Correct Answer: D) Antibiotics Rationale: Antibiotics have no role in PTSD management.
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✅ 22. Which behavioral sign indicates a PTSD patient is experiencing avoidance?
A) Frequently visits trauma-related places. B) Engages in conversations about trauma openly. C) Refuses to attend therapy sessions discussing trauma. D) Shows hyperalertness to surroundings.
Correct Answer: C) Refuses to attend therapy sessions discussing trauma. Rationale: This is a classic example of avoidance behavior.
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✅ 23. What is the primary purpose of psychoeducation for PTSD patients and their families?
A) Encourage permanent avoidance of trauma discussions. B) Help understand PTSD symptoms and the recovery process. C) Focus only on medication adherence. D) Teach methods to suppress all traumatic thoughts.
Correct Answer: B) Help understand PTSD symptoms and the recovery process. Rationale: Education empowers patients and families to support recovery.
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✅ 24. Which of the following is a common emotional response seen in PTSD patients?
A) Excessive joy B) Guilt and emotional numbness C) Complete contentment D) Unrealistic optimism
Correct Answer: B) Guilt and emotional numbness Rationale: Emotional blunting and guilt are common emotional disturbances in PTSD.
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✅ 25. Which of the following is a safe and effective relaxation technique for PTSD management?
A) Progressive Muscle Relaxation B) Stress-Induced Eating C) Sleep Avoidance D) Excessive Use of Social Media
Correct Answer: A) Progressive Muscle Relaxation Rationale: This helps reduce anxiety and physical tension in PTSD patients.