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Question 1
The Confusion Assessment Methods Instrument (CAMI) is a standardized assessment tool
specifically designed for which of the following disorders?
A) Major Depressive Disorder
B) Alzheimer's Disease
C) Delirium
D) Generalized Anxiety Disorder
E) Schizophrenia
Correct Answer: C) Delirium
Rationale: The Confusion Assessment Method (CAM) is a widely used and validated tool to
help identify delirium quickly and accurately, even by non-psychiatric clinicians. It assesses
for acute onset, inattention, disorganized thinking, and altered level of consciousness.
Question 2
An acute onset, short-term confusion, with changes in cognition and level of awareness due to a
physiological cause is primarily known as which of the following?
A) Dementia
B) Depression
C) Psychosis
D) Delirium
E) Anxiety Disorder
Correct Answer: D) Delirium
Rationale: Delirium is characterized by its acute onset, fluctuating course, and disturbance
in attention and awareness, often accompanied by cognitive changes. It is always secondary
to an underlying medical condition, substance intoxication/withdrawal, or medication side
effect.
Question 3
Which of the following is a common sensory deficit of conversion disorder?
A) Auditory hallucinations
B) Tactile hallucinations
C) Blindness
D) Olfactory hallucinations
E) Gustatory hallucinations
Correct Answer: C) Blindness
Rationale: Conversion disorder (Functional Neurological Symptom Disorder) is
characterized by neurological symptoms that cannot be explained by a medical condition.
Common sensory deficits include blindness, deafness, and anesthesia, often presenting as a
sudden, dramatic loss of function without organic cause.
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Question 4
Delirium in a patient recovering from surgery is an example of which type of clinical problem in
psychosomatic medicine?
A) Psychiatric symptoms as a reaction to medical conditions or treatments
B) Co-occurring medical and psychiatric condition
C) Medical condition secondary to psychiatric illness
D) Psychiatric symptoms secondary to a medical condition
E) Somatic symptom disorder
Correct Answer: D) Psychiatric symptoms secondary to a medical condition
Rationale: In this scenario, delirium, a psychiatric symptom (acute confusion), is directly
caused by a physiological or medical issue (post-surgical state). This fits the definition of
psychiatric symptoms arising directly from a medical condition.
Question 5
Which medication is specifically approved for the treatment of Parkinson's disease psychosis?
A) Rivastigmine
B) Nuplazid (Pimavanserin)
C) Donepezil
D) Galantamine
E) Memantine
Correct Answer: B) Nuplazid (Pimavanserin)
Rationale: Nuplazid (pimavanserin) is an atypical antipsychotic specifically approved for
the treatment of hallucinations and delusions associated with Parkinson's disease psychosis.
It is a serotonin 5-HT2A receptor inverse agonist, working without dopamine receptor
blockade, which is important to avoid worsening Parkinsonian motor symptoms.
Question 6
Indicators of imitative dissociative identity disorder may include which of the following
symptoms?
A) Extreme consistency and clarity in recall of alter personalities.
B) Smooth and deliberate transitions between alter personalities.
C) Confusion and shame related to symptoms.
D) Complete absence of childhood trauma history.
E) Presence of a highly organized internal system of alters.
Correct Answer: C) Confusion and shame related to symptoms
Rationale: Patients with genuine Dissociative Identity Disorder (DID) often experience
significant confusion, distress, and shame regarding their symptoms, particularly the
presence of alters and memory gaps. Imitative or malingered DID might present with more
theatrical, well-rehearsed, or less distressing symptoms.
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Question 7
Which of the following can lower a person's resistance to control impulses?
A) Adequate sleep and rest
B) High levels of self-efficacy
C) Fatigue
D) Consistent mindfulness practice
E) Strong social support networks
Correct Answer: C) Fatigue
Rationale: Fatigue, along with other factors such as constant stimulation, stress, and psychic
trauma, can deplete an individual's psychological resources, weakening their ability to
exert conscious control over impulsive urges. Self-regulation requires energy and executive
function.
Question 8
Schizophrenia in a patient with end-stage renal disease is an example of which type of clinical
problem in psychosomatic medicine?
A) Psychiatric symptoms secondary to a medical condition
B) Medical condition secondary to psychiatric illness
C) Psychiatric symptoms as a reaction to medical conditions or treatments
D) Co-occurring medical and psychiatric condition
E) Somatic symptom disorder
Correct Answer: D) Co-occurring medical and psychiatric condition
Rationale: This scenario describes a patient with two distinct and chronic conditions –
schizophrenia (a psychiatric illness) and end-stage renal disease (a medical condition) –
that exist simultaneously and independently. They are co-occurring rather than one
directly causing the other.
Question 9
A patient expresses feelings of unreality or of being detached from their environment, describing
the perception of the outside world as unreal, dreamlike, and visually distorted. The ARNP
recognizes this as which of the following?
A) Depersonalization
B) Derealization
C) Psychosis
D) Dissociative amnesia
E) Conversion disorder
Correct Answer: B) Derealization
Rationale: Derealization is a dissociative symptom characterized by a sense of unreality or
detachment from one's surroundings. The external world is perceived as strange,
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dreamlike, foggy, or distorted, whereas depersonalization involves detachment from
oneself.
Question 10
A patient presents with persistent feelings of detachment from one's self, like watching one's self
in a movie. The ARNP recognizes this as which of the following?
A) Derealization
B) Delirium
C) Depersonalization
D) Psychosis
E) Dissociative fugue
Correct Answer: C) Depersonalization
Rationale: Depersonalization is a dissociative symptom characterized by persistent or
recurrent experiences of feeling detached from one's own body, thoughts, feelings,
sensations, or actions, as if observing oneself from an outside perspective.
Question 11
Which of the following is generally recommended as a primary treatment approach for
pyromania?
A) Psychopharmacology with antipsychotics
B) Long-term inpatient hospitalization
C) Electroconvulsive therapy (ECT)
D) Cognitive Behavioral Therapy (CBT)
E) Family therapy focusing on systemic issues
Correct Answer: D) Cognitive Behavioral Therapy (CBT)
Rationale: Pyromania, an impulse control disorder involving fire-setting, is best treated with
psychotherapy, particularly Cognitive Behavioral Therapy (CBT). CBT helps individuals
identify triggers, manage urges, develop coping strategies, and address underlying
psychological issues. Medications are often adjunctive for co-occurring conditions.
Question 12
Which of the following biological factors has been associated with kleptomania?
A) Decreased serotonin activity.
B) Increased dopamine levels in the reward pathway.
C) Cortical atrophy.
D) Enlarged lateral ventricles.
E) Abnormalities in the hippocampus.
Correct Answer: C) Cortical atrophy.
Rationale: While kleptomania is complex, some neuroimaging studies have shown
structural brain abnormalities, including cortical atrophy and enlarged lateral ventricles,