Psych EOR Test Questions with Verified Answers Graded A+
1) A 15-year-old boy is brought to the office by shows a thin, diaphoretic man with poor
his mother due to "odd behavior." Since moving grooming and dentition. He clenches his teeth,
to a new school 8 months ago, the boy has picks at his skin, and has multiple sores on his
started talking to his imaginary friend Henry face and body. Which of the following is the most
again. His mother reports that he had this likely diagnosis in this patient?
imaginary friend for a few months in a. Alcohol withdrawal
kindergarten. The boy has been spending more b. Bipolar I disorder
time alone, and he spends time laughing and c. Delusional disorder, somatic subty -
talking to Henry. His teachers report that the ANSWER -D
patient has not been paying attention in class or
completing his homework. He no longer spends Methamphetamine intoxication:
time with his siblings and says he "would rather • Euphoric/dysphoric mood (anxiety, irritability)
play video games with Henry." The patient • Agitation (restlessness, tremor)
states, "Henry is always with me and likes to • Bruxism/poor dentition
comment on what I am doing." He has tried • Psychotic symptoms (delusions, hallucinations,
marijuana in the past but does not use other "bugs crawling under the skin", excoriations from
drugs. On mental status examination, the patient skin picking)
avoids eye contact and has a flat affect. Which of • Anorexia
the following is the most likely explanation for the • Decreased need for sleep
patient's behavior? • Sympathomimetic effects (tachycardia,
a. Schizoid personality disorder hypertension, mydriasis, diaphoresis)
b. - ANSWER -B
8-month history of auditory hallucinations plus
negative symptoms (social withdrawal, flat affect)3) A 59-year-old woman comes to the office due
resulting in significant functional decline = to upper respiratory symptoms for the past 3
consistent with schizophrenia. Hallucinations = days. She arrives an hour late for her
more common than delusions in pediatric appointment, blaming it on an emergency at work
schizophrenia. that "only I could take care of." The patient is
angry that the provider refused to prescribe
antibiotics for her over the phone, and she paces
at the reception desk, insisting that the office staff
2) A 42-year-old man is brought to the work her into the schedule because "I'm very
emergency department by his wife after he busy and must be seen immediately." The patient
assaulted her. The patient has not slept or eaten then talks at length about feeling depressed
for days; he became agitated and started because her children no longer want to see her
accusing her of plotting to murder him. The even though she is a "great mother." She is upset
patient also feels as though bugs are crawling that her daughter recently canceled plans to visit
under his skin. He had a prior psychiatric in order to help a friend who was in a near-fatal
hospitalization 8 months ago when he was motor vehicle collision. Which of the following is
admitted for paranoid delusions and visual the best explanation for this patient's behavior?
hallucinations. He is uncooperative, speaks a. Borderline personality disorder
rapidly and loudly, gets up to pace during the b. Histrionic personality disorder
interview, and shouts "I don't trust any of you; c. Narcissistic personality disorder
you're in this together." Temperature is 100º F, d. P - ANSWER -C
BP is 140/90, pulse is 104, and RR is 20. Exam
,Psych EOR Test Questions with Verified Answers Graded A+
helping my mother chop vegetables, and terrible
3. Narcissistic personality disorder (cluster B): images of stabbing her in the back with a knife
grandiosity, need for admiration, sense of would pop into my head." The patient is
entitlement, lack of empathy; difficulty sustaining overwhelmed with anxiety each time this occurs,
relationships resulting in putting the knife down and running
out of the kitchen. She counts down from 5 to 1
several times to try to "get rid" of the thoughts.
The patient has a tense and anxious affect, and
4) A 42-year-old man comes to the office for a becomes tearful when discussing how she would
follow-up. Last year, the patient was hospitalized never want to hurt her mother. She reports no
for acute gastritis. During the hospitalization, he depressed mood or suicidal ideation. Which of
went into alcohol withdrawal that was treated the following is the most appropriate
with chlordiazepoxide. The patient was abstinent pharmacotherapy for this patient?
for 2 weeks following discharge, but then started a. Aripiprazole
drinking again. Over the past several months, he b. Buspirone
has been drinking 6-10 beers daily. The patient c. Haloperidol
says "I want to cut down, but the cravings are too d. Lorazepam
strong." He fears he will lose his job and family if e. Sertraline - ANSWER -E
he continues to drink. Vital signs and physical
exam are normal. Which of the following is the 5. Diagnosis = OCD; treatment = SSRI, CBT
most appropriate pharmacotherapy for this
patient's alcohol use disorder?
a. Buprenorphine
b. Bupropion 6) A 40-year-old woman comes to the emergency
c. Chlordiazepoxide department fearing she is having a heart attack.
d. Naltrexone While clutching her chest and breathing heavily,
e. Varenicline - ANSWER -D she says "I feel like I'm dying." BP is 125/86 and
pulse is 110 and regular. Laboratory evaluation
4. Pharmacotherapy for alcohol use disorder: and ECG show no abnormalities. The pain
• Naltrexone: decreases cravings, reduces heavy resolves within 10 minutes without treatment, and
drinking days, increases days of abstinence, can the patient reports, "I was taking the bus home
be initiated while patient is still drinking from work when my chest started feeling really
o CI in patients taking opioids (can precipitate tight. I'm lucky my friend was there and able to
withdrawal) help me get to the hospital. What if she's not
o CI in patients with acute hepatitis or liver failure there next time?" She describes experiencing
• Acamprosate (preferred for patients with liver similar episodes that are characterized by a
disease or opioid use, CI in patients with renal pounding heart, trembling, dizziness, and
impairment) sweating. This patient most likely has which of
• Disulfiram (only used second-line; patient must the following additional disorders?
be highly-motivated) a. Acute stress disorder
b. Agoraphobia
c. Brief psychotic disorder
d. Dependent personality disorder
5) A 17-year-old girl comes to the office due to e. Separation anxiety disorder - ANSWER -
"disturbing images" she has seen over the past B
year. She says, "I'd be standing in the kitchen
,Psych EOR Test Questions with Verified Answers Graded A+
function is otherwise intact. A search of his
6. Patient's diagnosis = panic disorder; patients personal belongings reveals an airline ticket from
with panic disorder often develop agoraphobia Las Vegas to Arlington, Virginia. An emergency
(avoidance of situations in which they may feel contact on the patient's phone leads to his wife in
trapped/helpless) Nevada, who reports that her husband "just
disappeared" after he found out that his father
had passed away that morning. Which of the
following is the most likely diagnosis?
7) A 34-year-old man comes to the clinic for a. Acute stress disorder
follow-up of schizophrenia. The patient has had b. depersonalization/derealization disorder
multiple trials of antipsychotic medications with c. Dissociative amnesia
minimal improvement and is now taking d. dissociative iden - ANSWER -C
aripiprazole. Despite adherence to his
medication regimen, he has persistent psychotic 8. Dissociative amnesia:
symptoms. The patient has been unable to work, • Inability to recall important personal info
hears voices throughout the day, and is too • Usually precipitated by traumatic/stressful event
paranoid to attend group therapy. He has no • Not explained by another disorder (e.g. PTSD,
other medical conditions. After a discussion of substance abuse)
the risks and benefits, the patient agrees to a
trial of clozapine. Which of the following should
be performed with use of this medication?
a. Baseline and periodic liver function tests 9) A 65-year-old woman comes to the office due
b. Baseline electrocardiography and serum to deteriorating memory. She used to pride
electrolytes herself on her sharp memory, but over the past 6
c. Periodic clozapine plasma levels months, has been forgetting minor things. The
d. Regular CBCs patient has had to delegate household chores
e. Regular thyroid and kidney function tests - and cooking to her husband because of her poor
ANSWER -D memory and "cloudy thinking." "I have been
feeling useless and worthless since retiring last
7. Clozapine adverse effects: year." The patient used to garden every day, but
agranulocytosis/neutropenia; CBC monitoring is now spends her days watching television and
mandatory for routine absolute neutrophil counts barely has enough energy to eat. She's lost 5 kg
(clozapine is 2nd-line for this reason) (11 lb) over the last 2 months. On testing with the
Montreal Cognitive Assessment, she scores
24/30 (normal: ≥ 26) with deficits in delayed recall
and attention. Laboratory results and MRI of the
8) A 42-year-old man is brought to the head are unremarkable. Which of the following is
emergency department after he was found the next best step in management?
wandering aimlessly at an airport. The man is a. Donepezil
alert and answers questions appropriately; b. Escitalopram
however, he appears to be confused about his c. Memantine
identity and does not recognize the name on his d. Memory training and vitamin E
Nevada driver's license in his wallet. The patient e. Reassure that this is age-related memory
is perplexed and does not remember where he change - ANSWER -B
lives, how he got to the airport, his family
members, or his profession. His cognitive
, Psych EOR Test Questions with Verified Answers Graded A+
9. Diagnosis = major depressive disorder otherwise cognitively intact, calm, and
(anhedonia, feelings of worthlessness, weight cooperative. Over the past 24 hours, she has
loss, low energy, impaired thinking/memory); become increasingly combative and agitated and
severe depression in older adults can cause stayed up all night. Temperature is 99º F, BP is
depression-related cognitive impairment; Tx = 110/80, pulse is 84, and RR is 18. Neurological
SSRI (&/or psychotherapy) exam is normal, but the patient is mildly
disoriented. Without provocation, she strikes out
at a nurses' aide standing next to her. Urinalysis
is positive for nitrites and leukocyte esterase.
10) A 4-year-old boy is brought to the office for a Head CT scan is negative. In addition to starting
routine visit. He is growing well and talking in antibiotics, which of the following medications is
short sentences. He has started to play board most appropriate to treat this patient's behavioral
games with his brothers and sister but symptoms?
occasionally hits his siblings when he loses a a. Clozapine
game. His parents ask if it is normal for him to b. Doxepin
occasionally fondle his genitals in public or try to c. Haloperidol
touch his brother's genitals while bathing. The d. Lithium
boy has been found playing with dolls in which e. Lorazepam - ANSWER -C
they have kissed each other's private parts a few
times. The parents are also concerned that the 11. Acute treatment of agitation/psychosis
patient occasionally wets his bed at night. Which associated with delirium = 1st-generation
of the following behaviors is concerning in this antipsychotics (or some 2nd-gen, e.g.
patient? quetiapine); appropriate for patients at risk of
a. Becoming physically aggressive when losing a acute harm to self or others, after behavioral
game interventions have failed.
b. Fondling one's own genitals in public
c. Nocturnal enuresis
d. Simulating oral sex using dolls
e. Touching the genitals of a sibling while bathing 12) An 11-year-old girl is brought to the office due
- ANSWER -D to disruptive behavior at home and at school. Her
parents report that she gets in trouble for talking
10. Abnormal sexual behavior in preadolescents: during class and not following instructions.
• Repeated insertion of objects into vagina/anus Although the patient is of above-average
• Sex play involving genital-genital, oral-genital, intelligence, her grades are poor. She makes
or anal-genital contact careless mistakes while rushing through tests
• Use of force, threats, or bribes in sex play and frequently forgets to hand in assignments. At
• Age-inappropriate sexual knowledge home, she is easily distracted while trying to
• (Choices B and E are normal sexual behaviors focus on her homework. The patient has frequent
in toddlers) conflicts with her mother, who says, "Getting her
ready for school in the morning is impossible.
We're frequently late because she always
misplaces her books." A medication with which of
11) An 83-year-old woman is sent to the the following mechanisms of action is most
emergency department from her nursing home appropriate for this patient?
for evaluation of mental status changes. At a. Antagonism of alpha-2 adrenergic receptors
baseline, she has mild memory impairment but is b. Antagonism of dopamine D2 receptors
1) A 15-year-old boy is brought to the office by shows a thin, diaphoretic man with poor
his mother due to "odd behavior." Since moving grooming and dentition. He clenches his teeth,
to a new school 8 months ago, the boy has picks at his skin, and has multiple sores on his
started talking to his imaginary friend Henry face and body. Which of the following is the most
again. His mother reports that he had this likely diagnosis in this patient?
imaginary friend for a few months in a. Alcohol withdrawal
kindergarten. The boy has been spending more b. Bipolar I disorder
time alone, and he spends time laughing and c. Delusional disorder, somatic subty -
talking to Henry. His teachers report that the ANSWER -D
patient has not been paying attention in class or
completing his homework. He no longer spends Methamphetamine intoxication:
time with his siblings and says he "would rather • Euphoric/dysphoric mood (anxiety, irritability)
play video games with Henry." The patient • Agitation (restlessness, tremor)
states, "Henry is always with me and likes to • Bruxism/poor dentition
comment on what I am doing." He has tried • Psychotic symptoms (delusions, hallucinations,
marijuana in the past but does not use other "bugs crawling under the skin", excoriations from
drugs. On mental status examination, the patient skin picking)
avoids eye contact and has a flat affect. Which of • Anorexia
the following is the most likely explanation for the • Decreased need for sleep
patient's behavior? • Sympathomimetic effects (tachycardia,
a. Schizoid personality disorder hypertension, mydriasis, diaphoresis)
b. - ANSWER -B
8-month history of auditory hallucinations plus
negative symptoms (social withdrawal, flat affect)3) A 59-year-old woman comes to the office due
resulting in significant functional decline = to upper respiratory symptoms for the past 3
consistent with schizophrenia. Hallucinations = days. She arrives an hour late for her
more common than delusions in pediatric appointment, blaming it on an emergency at work
schizophrenia. that "only I could take care of." The patient is
angry that the provider refused to prescribe
antibiotics for her over the phone, and she paces
at the reception desk, insisting that the office staff
2) A 42-year-old man is brought to the work her into the schedule because "I'm very
emergency department by his wife after he busy and must be seen immediately." The patient
assaulted her. The patient has not slept or eaten then talks at length about feeling depressed
for days; he became agitated and started because her children no longer want to see her
accusing her of plotting to murder him. The even though she is a "great mother." She is upset
patient also feels as though bugs are crawling that her daughter recently canceled plans to visit
under his skin. He had a prior psychiatric in order to help a friend who was in a near-fatal
hospitalization 8 months ago when he was motor vehicle collision. Which of the following is
admitted for paranoid delusions and visual the best explanation for this patient's behavior?
hallucinations. He is uncooperative, speaks a. Borderline personality disorder
rapidly and loudly, gets up to pace during the b. Histrionic personality disorder
interview, and shouts "I don't trust any of you; c. Narcissistic personality disorder
you're in this together." Temperature is 100º F, d. P - ANSWER -C
BP is 140/90, pulse is 104, and RR is 20. Exam
,Psych EOR Test Questions with Verified Answers Graded A+
helping my mother chop vegetables, and terrible
3. Narcissistic personality disorder (cluster B): images of stabbing her in the back with a knife
grandiosity, need for admiration, sense of would pop into my head." The patient is
entitlement, lack of empathy; difficulty sustaining overwhelmed with anxiety each time this occurs,
relationships resulting in putting the knife down and running
out of the kitchen. She counts down from 5 to 1
several times to try to "get rid" of the thoughts.
The patient has a tense and anxious affect, and
4) A 42-year-old man comes to the office for a becomes tearful when discussing how she would
follow-up. Last year, the patient was hospitalized never want to hurt her mother. She reports no
for acute gastritis. During the hospitalization, he depressed mood or suicidal ideation. Which of
went into alcohol withdrawal that was treated the following is the most appropriate
with chlordiazepoxide. The patient was abstinent pharmacotherapy for this patient?
for 2 weeks following discharge, but then started a. Aripiprazole
drinking again. Over the past several months, he b. Buspirone
has been drinking 6-10 beers daily. The patient c. Haloperidol
says "I want to cut down, but the cravings are too d. Lorazepam
strong." He fears he will lose his job and family if e. Sertraline - ANSWER -E
he continues to drink. Vital signs and physical
exam are normal. Which of the following is the 5. Diagnosis = OCD; treatment = SSRI, CBT
most appropriate pharmacotherapy for this
patient's alcohol use disorder?
a. Buprenorphine
b. Bupropion 6) A 40-year-old woman comes to the emergency
c. Chlordiazepoxide department fearing she is having a heart attack.
d. Naltrexone While clutching her chest and breathing heavily,
e. Varenicline - ANSWER -D she says "I feel like I'm dying." BP is 125/86 and
pulse is 110 and regular. Laboratory evaluation
4. Pharmacotherapy for alcohol use disorder: and ECG show no abnormalities. The pain
• Naltrexone: decreases cravings, reduces heavy resolves within 10 minutes without treatment, and
drinking days, increases days of abstinence, can the patient reports, "I was taking the bus home
be initiated while patient is still drinking from work when my chest started feeling really
o CI in patients taking opioids (can precipitate tight. I'm lucky my friend was there and able to
withdrawal) help me get to the hospital. What if she's not
o CI in patients with acute hepatitis or liver failure there next time?" She describes experiencing
• Acamprosate (preferred for patients with liver similar episodes that are characterized by a
disease or opioid use, CI in patients with renal pounding heart, trembling, dizziness, and
impairment) sweating. This patient most likely has which of
• Disulfiram (only used second-line; patient must the following additional disorders?
be highly-motivated) a. Acute stress disorder
b. Agoraphobia
c. Brief psychotic disorder
d. Dependent personality disorder
5) A 17-year-old girl comes to the office due to e. Separation anxiety disorder - ANSWER -
"disturbing images" she has seen over the past B
year. She says, "I'd be standing in the kitchen
,Psych EOR Test Questions with Verified Answers Graded A+
function is otherwise intact. A search of his
6. Patient's diagnosis = panic disorder; patients personal belongings reveals an airline ticket from
with panic disorder often develop agoraphobia Las Vegas to Arlington, Virginia. An emergency
(avoidance of situations in which they may feel contact on the patient's phone leads to his wife in
trapped/helpless) Nevada, who reports that her husband "just
disappeared" after he found out that his father
had passed away that morning. Which of the
following is the most likely diagnosis?
7) A 34-year-old man comes to the clinic for a. Acute stress disorder
follow-up of schizophrenia. The patient has had b. depersonalization/derealization disorder
multiple trials of antipsychotic medications with c. Dissociative amnesia
minimal improvement and is now taking d. dissociative iden - ANSWER -C
aripiprazole. Despite adherence to his
medication regimen, he has persistent psychotic 8. Dissociative amnesia:
symptoms. The patient has been unable to work, • Inability to recall important personal info
hears voices throughout the day, and is too • Usually precipitated by traumatic/stressful event
paranoid to attend group therapy. He has no • Not explained by another disorder (e.g. PTSD,
other medical conditions. After a discussion of substance abuse)
the risks and benefits, the patient agrees to a
trial of clozapine. Which of the following should
be performed with use of this medication?
a. Baseline and periodic liver function tests 9) A 65-year-old woman comes to the office due
b. Baseline electrocardiography and serum to deteriorating memory. She used to pride
electrolytes herself on her sharp memory, but over the past 6
c. Periodic clozapine plasma levels months, has been forgetting minor things. The
d. Regular CBCs patient has had to delegate household chores
e. Regular thyroid and kidney function tests - and cooking to her husband because of her poor
ANSWER -D memory and "cloudy thinking." "I have been
feeling useless and worthless since retiring last
7. Clozapine adverse effects: year." The patient used to garden every day, but
agranulocytosis/neutropenia; CBC monitoring is now spends her days watching television and
mandatory for routine absolute neutrophil counts barely has enough energy to eat. She's lost 5 kg
(clozapine is 2nd-line for this reason) (11 lb) over the last 2 months. On testing with the
Montreal Cognitive Assessment, she scores
24/30 (normal: ≥ 26) with deficits in delayed recall
and attention. Laboratory results and MRI of the
8) A 42-year-old man is brought to the head are unremarkable. Which of the following is
emergency department after he was found the next best step in management?
wandering aimlessly at an airport. The man is a. Donepezil
alert and answers questions appropriately; b. Escitalopram
however, he appears to be confused about his c. Memantine
identity and does not recognize the name on his d. Memory training and vitamin E
Nevada driver's license in his wallet. The patient e. Reassure that this is age-related memory
is perplexed and does not remember where he change - ANSWER -B
lives, how he got to the airport, his family
members, or his profession. His cognitive
, Psych EOR Test Questions with Verified Answers Graded A+
9. Diagnosis = major depressive disorder otherwise cognitively intact, calm, and
(anhedonia, feelings of worthlessness, weight cooperative. Over the past 24 hours, she has
loss, low energy, impaired thinking/memory); become increasingly combative and agitated and
severe depression in older adults can cause stayed up all night. Temperature is 99º F, BP is
depression-related cognitive impairment; Tx = 110/80, pulse is 84, and RR is 18. Neurological
SSRI (&/or psychotherapy) exam is normal, but the patient is mildly
disoriented. Without provocation, she strikes out
at a nurses' aide standing next to her. Urinalysis
is positive for nitrites and leukocyte esterase.
10) A 4-year-old boy is brought to the office for a Head CT scan is negative. In addition to starting
routine visit. He is growing well and talking in antibiotics, which of the following medications is
short sentences. He has started to play board most appropriate to treat this patient's behavioral
games with his brothers and sister but symptoms?
occasionally hits his siblings when he loses a a. Clozapine
game. His parents ask if it is normal for him to b. Doxepin
occasionally fondle his genitals in public or try to c. Haloperidol
touch his brother's genitals while bathing. The d. Lithium
boy has been found playing with dolls in which e. Lorazepam - ANSWER -C
they have kissed each other's private parts a few
times. The parents are also concerned that the 11. Acute treatment of agitation/psychosis
patient occasionally wets his bed at night. Which associated with delirium = 1st-generation
of the following behaviors is concerning in this antipsychotics (or some 2nd-gen, e.g.
patient? quetiapine); appropriate for patients at risk of
a. Becoming physically aggressive when losing a acute harm to self or others, after behavioral
game interventions have failed.
b. Fondling one's own genitals in public
c. Nocturnal enuresis
d. Simulating oral sex using dolls
e. Touching the genitals of a sibling while bathing 12) An 11-year-old girl is brought to the office due
- ANSWER -D to disruptive behavior at home and at school. Her
parents report that she gets in trouble for talking
10. Abnormal sexual behavior in preadolescents: during class and not following instructions.
• Repeated insertion of objects into vagina/anus Although the patient is of above-average
• Sex play involving genital-genital, oral-genital, intelligence, her grades are poor. She makes
or anal-genital contact careless mistakes while rushing through tests
• Use of force, threats, or bribes in sex play and frequently forgets to hand in assignments. At
• Age-inappropriate sexual knowledge home, she is easily distracted while trying to
• (Choices B and E are normal sexual behaviors focus on her homework. The patient has frequent
in toddlers) conflicts with her mother, who says, "Getting her
ready for school in the morning is impossible.
We're frequently late because she always
misplaces her books." A medication with which of
11) An 83-year-old woman is sent to the the following mechanisms of action is most
emergency department from her nursing home appropriate for this patient?
for evaluation of mental status changes. At a. Antagonism of alpha-2 adrenergic receptors
baseline, she has mild memory impairment but is b. Antagonism of dopamine D2 receptors
