ROSH – Psych UPDATED ACTUAL Questions and CORRECT Answers
1. B. Avoidant personality A 29-year-old woman presents to the psychiatric clinic for a "lifetime"
disorder of intense anxiety not relieved by 12-weeks on fluoxetine. She reports
low self-esteem, feeling "very uneasy" in social situations, and says she
Avoidant personality wishes she could make friends but worries that she'll say something
disorder is charac- "dumb" to people. Which of the following personality disorders does
terized by this pa- she most likely have?
tient's symptoms of low
self-esteem and desire A. Antisocial personality disorder
for relationships which B. Avoidant personality disorder
remains fruitless due to C. Dependent personality disorder
persistent fear of rejec- D. Paranoid personality disorder
tion.
2. C. Paroxetine A 38-year-old man presents to the oflce, reporting diflculty sleeping,
with nightmares and anxiety for the past 2 months that have gotten
PTSD more frequent. He returned from an overseas tour with the military 3
months ago. He also reports having flashbacks of his time in combat,
especially when recalling his time there. The patient is alert and orient-
ed but appears slightly withdrawn. A physical exam is unremarkable.
Which of the following is the most appropriate pharmacotherapy for
this patient in addition to immediate psychotherapy?
A. Buspirone
B. Clonidine
C. Paroxetine
D. Temazepam
E. Trazodone
3. B. Conduct disorder A 15-year-old boy is brought to your oflce by his mother. She states over
the past year he has been repeatedly in trouble at school for engaging
Frequent fighting, tru- in or starting fights. He is frequently truant and has subsequently been
ancy, theft and discred- held back from advancing to 10th grade. He has also been arrested
, iting those with con- for stealing at a local mall. The patient denies that any of his mother's
cerns about behavior concerns are valid and says "everyone else is doing the same stuff".
are indicative of con- Which of the following do you suspect?
duct disorder. An affect-
ed individual can also A. Attention deficit hyperactivity disorder
display cruelty to ani- B. Conduct disorder
mals or people, destroy C. Intermittent explosive disorder
property, or intimidate D. Oppositional defiant disorder
others, and generally
shows no remorse for
his or her actions
4. C. Denial, anger, bar- Which of the following represents the classic order of the stages of
gaining, depression, ac- grief?
ceptance
A. Anger, denial, bargaining, depression, acceptance
B. Bargaining, anger, denial, depression, acceptance
C. Denial, anger, bargaining, depression, acceptance
D. Depression, denial, anger, bargaining, acceptance
5. C. Malingering A 34-year-old woman has been seen multiple times in the past sever-
al months for various pain-related complaints. On each occasion, no
This patient most like- physical or laboratory findings were found to explain the symptoms.
ly is malingering, which The patient is involved in a worker's compensation case and could make
is to purposefully feign a significant amount of money if it is demonstrated that her physical
physical symptoms for complaints are related to work conditions. Which one of the following
external gain. diagnoses characterizes her unexplained physical symptoms?
A. Conversion disorder
B. Factitious disorder imposed on self
C. Malingering
D. Somatic symptom and related disorders
,6. D. Cognitive behavioral A 28-year-old woman presents to your oflce with a complaint of mood
therapy swings. She tells you that she constantly fights with her boyfriend and
gets angry easily. She often uses cocaine and binge eats when under
Bipolar personality dis- stress. Last month, she held a knife to her wrist during an argument with
order her boyfriend but did not follow through with the suicide attempt. Which
of the following is the most appropriate next step in management?
First-line treatment for
patients with BPD is A. Admission to an inpatient psychiatric unit
psychotherapy, with dif- B. Begin course of amitriptyline
ferent types of cogni- C. Begin course of lorazepam
tive behavioral therapy D. Cognitive behavioral therapy
being most effective.
7. B. Neglect What is the most common form of child abuse in the United States?
Neglect is the most A. Emotional
common type of child B. Neglect
maltreatment in the C. Physical
United States (78.5%) D. Sexual
and is caregiver failure
to meet basic nutrition-
al, medical, education-
al, and emotional needs
of a child.
8. A. Blood pressure A 35-year-old woman has a follow-up appointment in the oflce for
unipolar major depression. On her initial visit 3 months ago, she stated
Venlafaxine is a sero- she had recently lost her spouse tragically. She noted crying extensively,
tonin and norepineph- feeling down and sad, excessive sleepiness, weight loss, and poor ener-
rine reuptake inhibitor gy level. Her symptoms have been persistent since her spouse's passing.
(SNRI) At the initial visit, you began the patient on sertraline and titrated to a
dosage of 150 mg daily. The patient noticed minimal to no improvement
Common side effects
on sertraline. You decided to trial her on venlafaxine. She has been
, include nausea, dizzi- titrated to the maximum extended-release dose of 225 mg daily. She
ness, dry mouth, and is now feeling much better and has had improvement in her symptoms.
an increased risk of gas- Her vital signs show a HR of 80 bpm, BP of 125/82 mm Hg, oxygen
trointestinal bleeding. It saturation of 98% SpO2, and T of 98°F. What should be monitored
can also cause elevat- based on the patient's current medication class and dosage?
ed blood pressure sec-
ondary to the norepi- A. Blood pressure
nephrine effects, espe- B. Complete blood cell counts
cially at the maximum C. Electrocardiogram
dose. It is recommend- D. Kidney function
ed to monitor a pa- E. Thyroid function tests
tient's blood pressure
every 2-6 months after
initiating treatment.
9. D. Propranolol A 22-year-old woman with a history of anxiety presents to your oflce,
reporting a racing heart, sweating, and intense fear every time she has
This patient has social to give a presentation in her college class. This is a requirement for her
anxiety disorder, perfor- class approximately every 4 months. She reports these symptoms have
mance type. been ongoing for the past year and only occur when she is in front
of large groups of peers because she is worried about embarrassing
Propranolol is typically
herself. Her blood work from her last visit was within normal limits,
used prior to a pub-
her urine drug screen was negative, and her physical exam reveals
lic speaking situation in
no abnormalities. She reports occasional alcohol use on the weekend.
performance anxiety
Which of the following is the most appropriate management of the
suspected diagnosis?
A. Buspirone
B. Lorazepam
C. Paroxetine
D. Propranolol
E. Venlafaxine
1. B. Avoidant personality A 29-year-old woman presents to the psychiatric clinic for a "lifetime"
disorder of intense anxiety not relieved by 12-weeks on fluoxetine. She reports
low self-esteem, feeling "very uneasy" in social situations, and says she
Avoidant personality wishes she could make friends but worries that she'll say something
disorder is charac- "dumb" to people. Which of the following personality disorders does
terized by this pa- she most likely have?
tient's symptoms of low
self-esteem and desire A. Antisocial personality disorder
for relationships which B. Avoidant personality disorder
remains fruitless due to C. Dependent personality disorder
persistent fear of rejec- D. Paranoid personality disorder
tion.
2. C. Paroxetine A 38-year-old man presents to the oflce, reporting diflculty sleeping,
with nightmares and anxiety for the past 2 months that have gotten
PTSD more frequent. He returned from an overseas tour with the military 3
months ago. He also reports having flashbacks of his time in combat,
especially when recalling his time there. The patient is alert and orient-
ed but appears slightly withdrawn. A physical exam is unremarkable.
Which of the following is the most appropriate pharmacotherapy for
this patient in addition to immediate psychotherapy?
A. Buspirone
B. Clonidine
C. Paroxetine
D. Temazepam
E. Trazodone
3. B. Conduct disorder A 15-year-old boy is brought to your oflce by his mother. She states over
the past year he has been repeatedly in trouble at school for engaging
Frequent fighting, tru- in or starting fights. He is frequently truant and has subsequently been
ancy, theft and discred- held back from advancing to 10th grade. He has also been arrested
, iting those with con- for stealing at a local mall. The patient denies that any of his mother's
cerns about behavior concerns are valid and says "everyone else is doing the same stuff".
are indicative of con- Which of the following do you suspect?
duct disorder. An affect-
ed individual can also A. Attention deficit hyperactivity disorder
display cruelty to ani- B. Conduct disorder
mals or people, destroy C. Intermittent explosive disorder
property, or intimidate D. Oppositional defiant disorder
others, and generally
shows no remorse for
his or her actions
4. C. Denial, anger, bar- Which of the following represents the classic order of the stages of
gaining, depression, ac- grief?
ceptance
A. Anger, denial, bargaining, depression, acceptance
B. Bargaining, anger, denial, depression, acceptance
C. Denial, anger, bargaining, depression, acceptance
D. Depression, denial, anger, bargaining, acceptance
5. C. Malingering A 34-year-old woman has been seen multiple times in the past sever-
al months for various pain-related complaints. On each occasion, no
This patient most like- physical or laboratory findings were found to explain the symptoms.
ly is malingering, which The patient is involved in a worker's compensation case and could make
is to purposefully feign a significant amount of money if it is demonstrated that her physical
physical symptoms for complaints are related to work conditions. Which one of the following
external gain. diagnoses characterizes her unexplained physical symptoms?
A. Conversion disorder
B. Factitious disorder imposed on self
C. Malingering
D. Somatic symptom and related disorders
,6. D. Cognitive behavioral A 28-year-old woman presents to your oflce with a complaint of mood
therapy swings. She tells you that she constantly fights with her boyfriend and
gets angry easily. She often uses cocaine and binge eats when under
Bipolar personality dis- stress. Last month, she held a knife to her wrist during an argument with
order her boyfriend but did not follow through with the suicide attempt. Which
of the following is the most appropriate next step in management?
First-line treatment for
patients with BPD is A. Admission to an inpatient psychiatric unit
psychotherapy, with dif- B. Begin course of amitriptyline
ferent types of cogni- C. Begin course of lorazepam
tive behavioral therapy D. Cognitive behavioral therapy
being most effective.
7. B. Neglect What is the most common form of child abuse in the United States?
Neglect is the most A. Emotional
common type of child B. Neglect
maltreatment in the C. Physical
United States (78.5%) D. Sexual
and is caregiver failure
to meet basic nutrition-
al, medical, education-
al, and emotional needs
of a child.
8. A. Blood pressure A 35-year-old woman has a follow-up appointment in the oflce for
unipolar major depression. On her initial visit 3 months ago, she stated
Venlafaxine is a sero- she had recently lost her spouse tragically. She noted crying extensively,
tonin and norepineph- feeling down and sad, excessive sleepiness, weight loss, and poor ener-
rine reuptake inhibitor gy level. Her symptoms have been persistent since her spouse's passing.
(SNRI) At the initial visit, you began the patient on sertraline and titrated to a
dosage of 150 mg daily. The patient noticed minimal to no improvement
Common side effects
on sertraline. You decided to trial her on venlafaxine. She has been
, include nausea, dizzi- titrated to the maximum extended-release dose of 225 mg daily. She
ness, dry mouth, and is now feeling much better and has had improvement in her symptoms.
an increased risk of gas- Her vital signs show a HR of 80 bpm, BP of 125/82 mm Hg, oxygen
trointestinal bleeding. It saturation of 98% SpO2, and T of 98°F. What should be monitored
can also cause elevat- based on the patient's current medication class and dosage?
ed blood pressure sec-
ondary to the norepi- A. Blood pressure
nephrine effects, espe- B. Complete blood cell counts
cially at the maximum C. Electrocardiogram
dose. It is recommend- D. Kidney function
ed to monitor a pa- E. Thyroid function tests
tient's blood pressure
every 2-6 months after
initiating treatment.
9. D. Propranolol A 22-year-old woman with a history of anxiety presents to your oflce,
reporting a racing heart, sweating, and intense fear every time she has
This patient has social to give a presentation in her college class. This is a requirement for her
anxiety disorder, perfor- class approximately every 4 months. She reports these symptoms have
mance type. been ongoing for the past year and only occur when she is in front
of large groups of peers because she is worried about embarrassing
Propranolol is typically
herself. Her blood work from her last visit was within normal limits,
used prior to a pub-
her urine drug screen was negative, and her physical exam reveals
lic speaking situation in
no abnormalities. She reports occasional alcohol use on the weekend.
performance anxiety
Which of the following is the most appropriate management of the
suspected diagnosis?
A. Buspirone
B. Lorazepam
C. Paroxetine
D. Propranolol
E. Venlafaxine
