MARYVILLE UNIVERSITY NURS 661 EXAM 3
MEGADECK QUESTIONS AND ANSWERS 2025
What area of the brain is most often linked to violence among
patients? - CORRECT ANSWER Prefrontal- cortex
Which personality disorder is often associated with self-harming
behavior? - CORRECT ANSWER BPD
Know the risk factors associated with suicide among patients -
CORRECT ANSWER Family history of suicide
Family history of child maltreatment
Previous suicide attempt(s)
History of mental disorders, particularly clinical depression
History of alcohol and substance abuse
Feelings of hopelessness
Impulsive or aggressive tendencies
Cultural and religious beliefs (e.g., belief that suicide is noble
resolution of a personal dilemma)
Local epidemics of suicide
Isolation, a feeling of being cut off from other people
Barriers to accessing mental health treatment
Loss (relational, social, work, or financial)
Physical illness
Easy access to lethal methods
Unwillingness to seek help because of the stigma attached to mental
health and substance abuse disorders or to suicidal thoughts
Single, living alone
Be able to identify protective factors among patients at risk for suicide
- CORRECT ANSWER Effective clinical care for mental, physical, and
substance abuse disorders
Easy access to a variety of clinical interventions and support for help
seeking
Family and community support (connectedness)
,Support from ongoing medical and mental health care relationships
Skills in problem solving, conflict resolution, and nonviolent ways of
handling disputes
Cultural and religious beliefs that discourage suicide and support
instincts for self-preservation
difference between suicidal gestures and self mutilation - CORRECT
ANSWER **INTENT
**suicide: experiencing stressors for which they see no escape from,
and choose to end life- feel worthless and hopeless
** the infliction of pain reassures them that they are still alive, which
is especially true if they are experiencing emotional numbness or are
feeling disconnected from the world around them. Additionally, self-
injury can result in a rush as a result of chemical changes in the brain,
which can easily become addictive and highly dangerous.
What is self harm? - CORRECT ANSWER Self-harm is a form of
mutilation while suicide is the deliberate act of taking one's own life.
Know which medication has been linked to reducing suicidal ideation
among patients - CORRECT ANSWER Lithium
Understand what lethality means - CORRECT ANSWER the capacity
to cause death or serious harm or damage.
who are the patients with the highest lethality? - CORRECT ANSWER
Narcissists
What compulsion is most commonly seen in patients with OCD? -
CORRECT ANSWER Checking 63%
Washing 50%
Counting 36%
Need to ask or confess 31%
Symmetry and precision 28%
Hoarding 18%
What is an obsession? - CORRECT ANSWER intrusive thoughts
,What is a compulsion? - CORRECT ANSWER irrational behavior
performed repeatedly
How would these (obsession and compulsion) present in a case
scenario (Hoarding) - CORRECT ANSWER Characterized by acquiring
and not discarding things deemed to be of little to no value; was
originally considered a subtype of OCD, but now considered its own
diagnostic entity
Epidemiology of obsession and compulsion (Hoarding - CORRECT
ANSWER ~2-5% of population, some research shows prevalence as
high as 14%
Etiology of compulsion and obsession (Hoarding) - CORRECT ANSWER
80% of hoarders with one 1st degree relative
Biological of compulsion and obsession (Hoarding) - CORRECT
ANSWER lower metabolism in the posterior cingulate cortex and
occipital cortex or hoarders, may account for cognitive impairments,
such as attention and decision making deficits
Genetics of compulsion and obsession (Hoarding) - CORRECT
ANSWER link between hoarding behavior and markers on
chromosome 4q, 5q, 17q; another study found COMT gene on
chromosome 22q11.21 might contribute to susceptibility
Clinical features of compulsion and obsession (Hoarding) - CORRECT
ANSWER accumulate possessions passively rather than intentionally;
hoarding can interfere with work, social interactions, and basic
activities like eating and sleeping; inability to organize possessions; at
the core, hoarders are driven by the fear of losing items (ie. keeping
piles of old newspapers, because of the belief that forgetting
information will lead to serious consequences; onset due to stressful
event
treatment of compulsion and obsession (Hoarding) - CORRECT
ANSWER does not usually occur until 40-50s, even if began in
adolescence; patient have very little insight into their behavior, usually
, seek treatment under pressure; difficult to treat, effective treatments
for OCD show little benefit with hoarding; in one study 18% responded
to CBT and meds
What is the first line treatment for hoarding disorder? - CORRECT
ANSWER CBT, includes training in decision making and categorizing,
exposure and habituation to discarding, and cognitive restructuring;
include home and in office sessions; studies show 25-34% reduction in
hoarding behaviors using this method
Goal of treatment of hoarding - CORRECT ANSWER get rid of a
significant amount of possessions
pharmacological treatment of hoarding disorder - CORRECT ANSWER
SSRIs (produce mixed results)
Know the most common co-morbid psychiatric diagnosis associated
with OCD - CORRECT ANSWER Major depressive disorder (MDD) 67%
Social phobia 25%
Tourette's disorder 5-7%
Tics 20-30%
**Other comorbid dx, alcohol use, GAD, specific disorders, panic
disorder, eating disorder, personality disorders
Treatment for body dysmorphic disorder - CORRECT ANSWER
Tricyclic drugs, MOAIs, and pimozide (Orap) -individual studies
Cloripramine (Anafranil), and fluoxetine (Prozac) -reduce symptoms
50%
Augment with buspirone (BuSpar), lithium (Eskalith), methylphenidate
(Ritalin) or antipsychotic
Psychotherapy for body dysmorphic disorder - CORRECT ANSWER
CBT
Clinical presentation of hoarding disorder - CORRECT ANSWER
persistent difficulty discarding items, the desire to save items to avoid
negative feelings associated with discarding them, significant
MEGADECK QUESTIONS AND ANSWERS 2025
What area of the brain is most often linked to violence among
patients? - CORRECT ANSWER Prefrontal- cortex
Which personality disorder is often associated with self-harming
behavior? - CORRECT ANSWER BPD
Know the risk factors associated with suicide among patients -
CORRECT ANSWER Family history of suicide
Family history of child maltreatment
Previous suicide attempt(s)
History of mental disorders, particularly clinical depression
History of alcohol and substance abuse
Feelings of hopelessness
Impulsive or aggressive tendencies
Cultural and religious beliefs (e.g., belief that suicide is noble
resolution of a personal dilemma)
Local epidemics of suicide
Isolation, a feeling of being cut off from other people
Barriers to accessing mental health treatment
Loss (relational, social, work, or financial)
Physical illness
Easy access to lethal methods
Unwillingness to seek help because of the stigma attached to mental
health and substance abuse disorders or to suicidal thoughts
Single, living alone
Be able to identify protective factors among patients at risk for suicide
- CORRECT ANSWER Effective clinical care for mental, physical, and
substance abuse disorders
Easy access to a variety of clinical interventions and support for help
seeking
Family and community support (connectedness)
,Support from ongoing medical and mental health care relationships
Skills in problem solving, conflict resolution, and nonviolent ways of
handling disputes
Cultural and religious beliefs that discourage suicide and support
instincts for self-preservation
difference between suicidal gestures and self mutilation - CORRECT
ANSWER **INTENT
**suicide: experiencing stressors for which they see no escape from,
and choose to end life- feel worthless and hopeless
** the infliction of pain reassures them that they are still alive, which
is especially true if they are experiencing emotional numbness or are
feeling disconnected from the world around them. Additionally, self-
injury can result in a rush as a result of chemical changes in the brain,
which can easily become addictive and highly dangerous.
What is self harm? - CORRECT ANSWER Self-harm is a form of
mutilation while suicide is the deliberate act of taking one's own life.
Know which medication has been linked to reducing suicidal ideation
among patients - CORRECT ANSWER Lithium
Understand what lethality means - CORRECT ANSWER the capacity
to cause death or serious harm or damage.
who are the patients with the highest lethality? - CORRECT ANSWER
Narcissists
What compulsion is most commonly seen in patients with OCD? -
CORRECT ANSWER Checking 63%
Washing 50%
Counting 36%
Need to ask or confess 31%
Symmetry and precision 28%
Hoarding 18%
What is an obsession? - CORRECT ANSWER intrusive thoughts
,What is a compulsion? - CORRECT ANSWER irrational behavior
performed repeatedly
How would these (obsession and compulsion) present in a case
scenario (Hoarding) - CORRECT ANSWER Characterized by acquiring
and not discarding things deemed to be of little to no value; was
originally considered a subtype of OCD, but now considered its own
diagnostic entity
Epidemiology of obsession and compulsion (Hoarding - CORRECT
ANSWER ~2-5% of population, some research shows prevalence as
high as 14%
Etiology of compulsion and obsession (Hoarding) - CORRECT ANSWER
80% of hoarders with one 1st degree relative
Biological of compulsion and obsession (Hoarding) - CORRECT
ANSWER lower metabolism in the posterior cingulate cortex and
occipital cortex or hoarders, may account for cognitive impairments,
such as attention and decision making deficits
Genetics of compulsion and obsession (Hoarding) - CORRECT
ANSWER link between hoarding behavior and markers on
chromosome 4q, 5q, 17q; another study found COMT gene on
chromosome 22q11.21 might contribute to susceptibility
Clinical features of compulsion and obsession (Hoarding) - CORRECT
ANSWER accumulate possessions passively rather than intentionally;
hoarding can interfere with work, social interactions, and basic
activities like eating and sleeping; inability to organize possessions; at
the core, hoarders are driven by the fear of losing items (ie. keeping
piles of old newspapers, because of the belief that forgetting
information will lead to serious consequences; onset due to stressful
event
treatment of compulsion and obsession (Hoarding) - CORRECT
ANSWER does not usually occur until 40-50s, even if began in
adolescence; patient have very little insight into their behavior, usually
, seek treatment under pressure; difficult to treat, effective treatments
for OCD show little benefit with hoarding; in one study 18% responded
to CBT and meds
What is the first line treatment for hoarding disorder? - CORRECT
ANSWER CBT, includes training in decision making and categorizing,
exposure and habituation to discarding, and cognitive restructuring;
include home and in office sessions; studies show 25-34% reduction in
hoarding behaviors using this method
Goal of treatment of hoarding - CORRECT ANSWER get rid of a
significant amount of possessions
pharmacological treatment of hoarding disorder - CORRECT ANSWER
SSRIs (produce mixed results)
Know the most common co-morbid psychiatric diagnosis associated
with OCD - CORRECT ANSWER Major depressive disorder (MDD) 67%
Social phobia 25%
Tourette's disorder 5-7%
Tics 20-30%
**Other comorbid dx, alcohol use, GAD, specific disorders, panic
disorder, eating disorder, personality disorders
Treatment for body dysmorphic disorder - CORRECT ANSWER
Tricyclic drugs, MOAIs, and pimozide (Orap) -individual studies
Cloripramine (Anafranil), and fluoxetine (Prozac) -reduce symptoms
50%
Augment with buspirone (BuSpar), lithium (Eskalith), methylphenidate
(Ritalin) or antipsychotic
Psychotherapy for body dysmorphic disorder - CORRECT ANSWER
CBT
Clinical presentation of hoarding disorder - CORRECT ANSWER
persistent difficulty discarding items, the desire to save items to avoid
negative feelings associated with discarding them, significant
