flat affect (blunted affect) - CORRECT ANSWER -lack of emotional response; no expression of feelings;
voice monotonous and face immobile
depression - CORRECT ANSWER -sad, gloomy, dejected; symptoms may occur with rainy weather, after a
holiday, or with an illness; if the situation is temporary, symptoms fade quickly
depersonalization (lack of ego boundaries - CORRECT ANSWER -loss of identity, feels estranged,
perplexed about own identity and meaning of existence
elation - CORRECT ANSWER -joy and optimism, overconfidence, increased motor activity; not necessarily
pathologic
euphoria - CORRECT ANSWER -excessive well-being; unusually cheerful or elated, which is inappropriate
considering physical and mental condition; implies a pathologic mood
anxiety - CORRECT ANSWER -worried, uneasy, apprehensive from the anticipation of a danger whose
source is unknown
fear - CORRECT ANSWER -worried, uneasy, apprehensive; the external danger is known and identified
irritability - CORRECT ANSWER -annoyed, easily provoked, impatient
rage - CORRECT ANSWER -furious, loss of control
,ambivalence - CORRECT ANSWER -the existence of opposing emotions towards an idea, object, person
lability - CORRECT ANSWER -a rapid shift of emotions
inappropriate affect - CORRECT ANSWER -affect clearly discordant with content of person's speech
orientation - CORRECT ANSWER -assessment of this through the interview by asking time, place, or
person
delirium - CORRECT ANSWER -acute confusional state, potentially preventable in hospitalized persons.
Characterized by disorientation, disordered thinking, and perceptions (illusions and hallucinations),
defective memory, agitation, inattention.
Onset: sudden, over hours to days
Cause or Contributing Factors: hypoglycemia, fever, dehydration, hypotension; infection, other
conditions that disrupt body homeostasis; adverse drug reaction; head injury; change in environment
(e.g., hospitalization); pain; emotional stress; substance abuse
Cognition: impaired memory, judgment, calculations, attention span; can fluctuate through the day
Level of Consciousness: altered
Activity Level: can be increased or reduced; restlessness; behaviors may worsen in the evening
(sundowning); sleep/wake cycle may be reversed
Emotional State: rapid swings; can be fearful, anxious, suspicious, aggressive, have hallucinations and/or
delusions
Speech and Language: rapid, inappropriate, incoherent, rambling
Prognosis: reversible with proper and timely treatment
depression - CORRECT ANSWER -long-term depressed mood ( greater than/ equal to 2 weeks) with lack
of pleasure; disturbed sleep and appetite; feelings of hopelessness, guilt, worthlessness, sadness,
loneliness, and despair; suicide ideation
Onset: may be gradual, with exacerbation during crisis or stress
Cause or Contributing Factors: lifelong history, losses, loneliness, crises, declining health, medical
conditions
, Cognition: difficulty concentrating, forgetfulness, inattention
Level of Consciousness: not altered
Activity Level: usually decreased; lethargy, fatigue, lack of motivation; may sleep poorly and awaken in
early morning
Emotional State: extreme sadness, apathy, irritability, anxiety, paranoid, ideation
Speech and Language: slow, flat, low
Prognosis: reversible with proper and timely treatment
dementia - CORRECT ANSWER -chronic progressive loss of cognitive and intellectual functions, although
perception and consciousness are intact. Characterized by disorientation, impaired judgment, memory
loss
Onset: slowly, over months
Cause or Contributing Factors: Alzheimer disease, vascular disease, human immunodeficiency virus
infection, neurologic disease, chronic alcoholism, head trauma
Cognition: impaired memory, judgment, calculations, attention span, abstract thinking; agnosia
Level of Consciousness: not altered
Activity Level: not altered; behaviors may worsen in the evening (sundowning)
Emotional State: flat; agitation
Speech and Language: incoherent, slow (sometimes due to effort to find the right word), inappropriate,
rambling, repetitious
Prognosis: not reversible; progressive
substances - CORRECT ANSWER -refer to agents taken non-medically to alter mood or behavior
intoxication - CORRECT ANSWER -ingestion of substance produces maladaptive behavioral changes
because of effects on the central nervous system
abuse - CORRECT ANSWER -daily use needed to function, inability to stop, impaired social and
occupational functioning, recurrent use when it is physically hazardous, substance-related legal
problems
dependence - CORRECT ANSWER -physiologic dependence on a substance
voice monotonous and face immobile
depression - CORRECT ANSWER -sad, gloomy, dejected; symptoms may occur with rainy weather, after a
holiday, or with an illness; if the situation is temporary, symptoms fade quickly
depersonalization (lack of ego boundaries - CORRECT ANSWER -loss of identity, feels estranged,
perplexed about own identity and meaning of existence
elation - CORRECT ANSWER -joy and optimism, overconfidence, increased motor activity; not necessarily
pathologic
euphoria - CORRECT ANSWER -excessive well-being; unusually cheerful or elated, which is inappropriate
considering physical and mental condition; implies a pathologic mood
anxiety - CORRECT ANSWER -worried, uneasy, apprehensive from the anticipation of a danger whose
source is unknown
fear - CORRECT ANSWER -worried, uneasy, apprehensive; the external danger is known and identified
irritability - CORRECT ANSWER -annoyed, easily provoked, impatient
rage - CORRECT ANSWER -furious, loss of control
,ambivalence - CORRECT ANSWER -the existence of opposing emotions towards an idea, object, person
lability - CORRECT ANSWER -a rapid shift of emotions
inappropriate affect - CORRECT ANSWER -affect clearly discordant with content of person's speech
orientation - CORRECT ANSWER -assessment of this through the interview by asking time, place, or
person
delirium - CORRECT ANSWER -acute confusional state, potentially preventable in hospitalized persons.
Characterized by disorientation, disordered thinking, and perceptions (illusions and hallucinations),
defective memory, agitation, inattention.
Onset: sudden, over hours to days
Cause or Contributing Factors: hypoglycemia, fever, dehydration, hypotension; infection, other
conditions that disrupt body homeostasis; adverse drug reaction; head injury; change in environment
(e.g., hospitalization); pain; emotional stress; substance abuse
Cognition: impaired memory, judgment, calculations, attention span; can fluctuate through the day
Level of Consciousness: altered
Activity Level: can be increased or reduced; restlessness; behaviors may worsen in the evening
(sundowning); sleep/wake cycle may be reversed
Emotional State: rapid swings; can be fearful, anxious, suspicious, aggressive, have hallucinations and/or
delusions
Speech and Language: rapid, inappropriate, incoherent, rambling
Prognosis: reversible with proper and timely treatment
depression - CORRECT ANSWER -long-term depressed mood ( greater than/ equal to 2 weeks) with lack
of pleasure; disturbed sleep and appetite; feelings of hopelessness, guilt, worthlessness, sadness,
loneliness, and despair; suicide ideation
Onset: may be gradual, with exacerbation during crisis or stress
Cause or Contributing Factors: lifelong history, losses, loneliness, crises, declining health, medical
conditions
, Cognition: difficulty concentrating, forgetfulness, inattention
Level of Consciousness: not altered
Activity Level: usually decreased; lethargy, fatigue, lack of motivation; may sleep poorly and awaken in
early morning
Emotional State: extreme sadness, apathy, irritability, anxiety, paranoid, ideation
Speech and Language: slow, flat, low
Prognosis: reversible with proper and timely treatment
dementia - CORRECT ANSWER -chronic progressive loss of cognitive and intellectual functions, although
perception and consciousness are intact. Characterized by disorientation, impaired judgment, memory
loss
Onset: slowly, over months
Cause or Contributing Factors: Alzheimer disease, vascular disease, human immunodeficiency virus
infection, neurologic disease, chronic alcoholism, head trauma
Cognition: impaired memory, judgment, calculations, attention span, abstract thinking; agnosia
Level of Consciousness: not altered
Activity Level: not altered; behaviors may worsen in the evening (sundowning)
Emotional State: flat; agitation
Speech and Language: incoherent, slow (sometimes due to effort to find the right word), inappropriate,
rambling, repetitious
Prognosis: not reversible; progressive
substances - CORRECT ANSWER -refer to agents taken non-medically to alter mood or behavior
intoxication - CORRECT ANSWER -ingestion of substance produces maladaptive behavioral changes
because of effects on the central nervous system
abuse - CORRECT ANSWER -daily use needed to function, inability to stop, impaired social and
occupational functioning, recurrent use when it is physically hazardous, substance-related legal
problems
dependence - CORRECT ANSWER -physiologic dependence on a substance
