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Score for this attempt: 6 out of 10
Submitted Nov 6 at 11:23pm
This attempt took 10 minutes.
PartialQuestion 1
1 / 2 pts
A 27-year-old married electrician complains of dizziness, sweating palms, heart palpitations, and ringing of the ears of more than 18 months' duration. He has also experienced dry mouth and throat, periods of extreme muscle tension, and a constant "edgy" and watchful feeling that has often interfered with his ability to concentrate. These feelings have been present most of the time over the previous 2 years; they have not been limited to discrete periods. He constantly worries about the health of his parents. His father, in fact, had a myocardial infarction 2 years previously but is now feeling well. He also worries about whether he is "a good father," whether his wife will ever leave him (there is no indication that she is dissatisfied with the marriage), and whether co-workers on the job like him. Although he recognizes that his worries are often unfounded, he cannot stop worrying. Most likely the electrician is experiencing symptoms of Panic Disorder . The best treatment from the options below would be Relaxation Training :
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Question 2
2 / 2 pts
A 40-year old man is admitted to the emergency room (ER) with the following symptoms: shortness of breath, a sense of impending doom, profuse sweating and heart palpitations. The ER doctors check his blood pressure and heart rate which are elevated. They run an electrocardiogram (ECG), which is normal. They also run blood tests which come back normal too. An ER nurse speaks with him to get his medical history. The man mentions that he has had other similar episodes, which typically last a few minutes and each time he was released from the hospital without any evidence of heart issues. Upon further questioning, the man describes when these episodes began. They started about 2.5 years ago after a bad motorcycle accident in which he was severely injured. Most likely this man is experiencing symptoms of Panic Disorder . The best treatment from the options below would be Relaxation training and regular psychotherapy :
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PartialQuestion 3
1 / 2 pts
A 27-year old, upper-middle class woman has referred herself for therapy after her behaviors began to intrude on her ability to carry out her work, which was a source of meaning and satisfaction for her. She had always been a top student and recognized at her job. She was absorbed with her job and had very few friends. She complained of vague anxieties about dating, marriage, having a family and other related issues. Around the same time, she began experiencing symptoms that focused on cleanliness. Her concern with cleanliness gradually evolved into a thorough cleansing ritual, which usually was precipitated by touching her genital area. In her ritual, she would remove all of her clothing in a sequence. She would lie out each piece of clothing on specific areas of her bed and examine each one for any indications of “contamination”. She would then thoroughly scrub her body, starting at her feet and working meticulously up to the top of her head, using specific washcloths for certain body areas. Any articles of clothing that appeared to have been contaminated were thrown into the laundry. Clean clothing was put in the vacant spots on her bed. She would then dress herself in the opposite order from which she took the clothes off. If she deviated from this order, she would wonder if she had missed any contamination and began the sequence again. It was not uncommon that she did this 4-5 times in a row. As time passed, she developed other rituals in response to thoughts, usually related to using the toilet, sexual issues or encountering “contamination in public places”. As her rituals widened, her ability to function decreased more and more due to the time and energy she spent engaging in them. She was aware of the absurdities of her behaviors but felt compelled to engage in them. Most likely this woman is experiencing symptoms of Obsessive-Compulsive Disorder . The best treatment from the options below would be: Rational Emotive Therapy .
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PartialQuestion 4
1 / 2 pts
A 38-year old mother of four walks into an Emergency Room (ER) five hours from where she lives. She complains of a severe headache, dizziness and blurry vision. An ER nurse takes her vitals and everything is normal, but the mother insists she is really sick. The ER doctor orders a full blood work panel, and they come back normal as well. The mother gets more angry and agitated, then falls to the floor in what appears to be a seizure. The ER doctor orders Electroencephalography (EEG) of her brain, and this is also normal. The doctors decide to admit her to the hospital and continue to monitor her and notify her immediate family. Her husband responds to the nurse with "she is in the hospital again?! Where now?". The nurse asks what he means, and he goes on to explain that she has been hospitalized in four different hospitals on four separate occasions in the last 6 months with the same symptoms and that nothing has come back abnormal. He then goes on to say that these symptoms arose soon after he told her he wanted to file for divorce. He said she became "hysterical" begging him not to leave her and throwing items at the wall. He told her she needed to spend the night at a hotel to "cool off" and that they could discuss it further the next day. The next morning when she came back, she told him she felt ill, then suddenly fell to the floor seizing. He called 9-1-1, and she was admitted over night. He agreed he would not file for divorce as she was not physically well and needed help with the children. This then happened 3 more times while he brought up marital issues. He told the nurse "this is the last straw. She is manipulating me so I won't file for divorce." After hanging up with the patient's husband, the nurse notifies the doctors, and they refer the patient to psychiatry. She tells the hospital psychiatrist that it's her husband's fault. If he would just be a "good husband" and give her the attention she needs, none of this would have happened. The psychiatrist follows up asking what she means. She gets flustered and says she is feeling ill again and doesn't want to talk anymore. While the psychiatrist is leaving her room the patient experiences another "seizure". Doctors run additional tests and still find nothing wrong and release her from the hospital. Most likely the mother is experiencing symptoms of . The best treatment from the options below would be: .
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PartialQuestion 5
1 / 2 pts
A 31-year old nurse has received on and off in-patient psychiatric care over the past 5 years. Approximately 2 weeks after her most recent readmission, she became very confused about her surroundings and complained, “Everything had changed”. When staff tried to her calm her, she became verbally abusive, shouting obscenities and swinging her fists. She gave the present date as 8 months prior and believed she was at a hospital over a thousand miles away. The date and hospital description corresponded to a hospital she had been admitted to. She appeared not to remember much of the months that followed this stay. Amnesiac episodes were frequent for her. She is a quiet, demur and conscientious person, but her behavior often changes during these amnesiac episodes. According to reports made by her family and friends, and previous therapists, her behavior during these “black outs” was often hostile, angry and self-destructive. She did not remember these episodes, yet she would often find physical evidence, such as new cuts and bruises after a blackout. She often woke up to find herself in bed with a man she did not know. Most likely the nurse is experiencing symptoms of Borderline Personality Disorder . The best treatment from the options below would be Phase Approach Aimed at Safety and Integration :
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