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Exam (elaborations)

Wilkes NSG 552 Exam 2 – Psychopharmacology

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Wilkes NSG 552 Exam 2 – Psychopharmacology

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Wilkes NSG 552 Exam 2 –
Psychopharmacology (2026)
Actual Questions & Study Guide |
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Section 1: Somatic Symptom & Related Disorders




Q1. A patient presents with multiple physical symptoms including
pain, fatigue, and GI distress over the past 8 months. She genuinely
believes she has a serious illness despite normal exam and testing.
What is the most likely diagnosis?

A) Illness Anxiety Disorder
B) Factitious Disorder
C) Somatic Symptom Disorder
D) Conversion Disorder

Rationale: Somatic Symptom Disorder is characterized by one or more
distressing somatic symptoms that disrupt daily life, with excessive
thoughts, feelings, or behaviors related to these symptoms lasting ≥6
months. The patient has genuine belief of illness with physical symptoms .




Q2. Which key feature distinguishes Illness Anxiety Disorder from
Somatic Symptom Disorder?

A) Presence of physical symptoms
B) Duration of symptoms
C) Absence or mildness of physical symptoms
D) Presence of external reward

,Rationale: In Illness Anxiety Disorder, physical symptoms are absent or
mild, with preoccupation about having or acquiring a serious illness. In
Somatic Symptom Disorder, patients have one or more distressing somatic
symptoms. Both conditions involve genuine belief of illness .




Q3. A patient presents with symptoms of severe illness that appear
to be intentionally produced. No external reward is identified. What
is the most likely diagnosis?

A) Somatic Symptom Disorder
B) Factitious Disorder
C) Malingering
D) Illness Anxiety Disorder

Rationale: Factitious Disorder involves falsification of physical or
psychological signs/symptoms, deceptive behavior, and no obvious external
reward. Malingering involves external reward (e.g., disability benefits, time
off work). Illness Anxiety Disorder does not involve intentional production of
symptoms .




Q4. A patient reports recurrent skin picking resulting in lesions
despite attempts to stop. What is the diagnosis?

A) Trichotillomania
B) Excoriation Disorder
C) Body Dysmorphic Disorder
D) OCD

Rationale: Excoriation (Skin-Picking) Disorder is characterized by
recurrent skin picking resulting in lesions, despite repeated attempts to stop.
Suggested treatments include psychotherapy, SSRIs for concurrent
anxiety/depression, antipsychotics, and anxiolytics .

,Q5. A patient reports recurrent pulling out of hair despite attempts
to stop. What is the diagnosis?

A) Excoriation Disorder
B) Trichotillomania
C) Body Dysmorphic Disorder
D) OCD

Rationale: Trichotillomania (Hair-Pulling Disorder) involves recurrent
pulling out of one's hair, resulting in hair loss, despite repeated attempts to
decrease or stop the behavior. Suggested treatments include psychotherapy,
SSRIs for concurrent anxiety/depression, clomipramine, and atypical
antipsychotics such as lithium or N-acetylcysteine .




Q6. A patient presents with persistent difficulty discarding
possessions, regardless of value, resulting in clutter that
compromises living space. What is the diagnosis?

A) Excoriation Disorder
B) Trichotillomania
C) Hoarding Disorder
D) Body Dysmorphic Disorder

Rationale: Hoarding Disorder is characterized by persistent difficulty
discarding possessions regardless of their value, resulting in accumulation
that compromises living space and ability to function. Patients are often
resistant to treatment. Suggested treatment includes CBT specific for
hoarding and SSRIs for concurrent anxiety/depression .




Q7. A patient is preoccupied with a perceived defect in their
appearance that is not observable to others, performing repetitive
behaviors (checking mirrors, excessive grooming). What is the
diagnosis?

A) Excoriation Disorder
B) Trichotillomania
C) Hoarding Disorder
D) Body Dysmorphic Disorder

, Rationale: Body Dysmorphic Disorder involves preoccupation with one
or more perceived defects or flaws in physical appearance that are not
observable or appear slight to others. Repetitive behaviors (mirror checking,
grooming, reassurance seeking) are performed in response to appearance
concerns .




Section 2: Dissociative Disorders




Q8. Which disorder predominantly develops in victims of significant
chronic childhood trauma, often co-occurs with PTSD, and has >70%
suicide attempt/self-harm rate?

A) Depersonalization/Derealization Disorder
B) Dissociative Amnesia
C) Dissociative Identity Disorder
D) Somatic Symptom Disorder

Rationale: Dissociative Identity Disorder (DID) is characterized by the
presence of two or more distinct personality states or identities. It
predominantly develops in victims of significant and chronic childhood
trauma (often as a coping mechanism). It frequently co-occurs with PTSD,
and >70% of patients attempt suicide or self-harm .




Q9. What is the recommended treatment for Dissociative Identity
Disorder?

A) Psychotherapy, SSRIs for comorbid depressive/PTSD symptoms,
Prazosin for nightmares, Naltrexone to decrease self-injurious
behaviors
B) Benzodiazepines only
C) ECT only
D) Antipsychotics only

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