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1. A patient reports persistent sadness, low energy, insomnia,
and loss of interest for 6 weeks. Most likely diagnosis?
A. Adjustment disorder only
B. Major depressive disorder
C. Panic disorder
D. Delirium
Rationale: Depressed mood or anhedonia with functional
impairment lasting at least 2 weeks supports major depressive
disorder.
2. Which symptom requires immediate suicide risk
assessment?
A. Mild fatigue only
B. Statements of hopelessness and wanting to die
C. Mild headache only
D. Seasonal allergies only
Rationale: Suicidal ideation or hopelessness warrants urgent
safety assessment.
, 3. Which question best assesses suicidal planning?
A. Do you like music?
B. Have you thought about how you would harm
yourself?
C. What is your favorite food?
D. Do you exercise daily?
Rationale: Asking about plan helps determine acuity and risk.
4. Which medication is commonly first-line for major
depression?
A. Haloperidol
B. Sertraline
C. Lithium
D. Benztropine
Rationale: SSRIs are commonly first-line due to efficacy and
tolerability.
5. Which counseling point is correct when starting SSRIs?
A. Effects occur in one hour
B. Improvement may take several weeks
C. Stop abruptly if nausea occurs once
D. Double dose if missed yesterday
Rationale: Antidepressant benefit often takes weeks.
, 6. Which adverse effect may occur early with SSRIs?
A. Cataracts immediately
B. GI upset or headache
C. Tooth fracture
D. Kidney stone instantly
Rationale: GI symptoms and headache are common early
effects.
7. Which symptom cluster suggests generalized anxiety
disorder?
A. Hallucinations only
B. Excessive worry with restlessness and muscle tension
C. Euphoria only
D. Memory loss only
Rationale: Persistent excessive worry with somatic symptoms
suggests GAD.
8. Which nonpharmacologic therapy is evidence-based for
anxiety disorders?
A. Isolation only
B. Cognitive behavioral therapy
C. Sleep deprivation
D. Excess caffeine
Rationale: CBT is effective for many anxiety disorders.
, 9. Which symptom suggests panic attack?
A. Gradual cough only
B. Sudden intense fear with palpitations and shortness
of breath
C. Chronic constipation only
D. Toenail pain only
Rationale: Panic attacks peak rapidly with intense autonomic
symptoms.
10. Which medical condition should be ruled out in panic-
like symptoms?
A. Dry skin only
B. Hyperthyroidism or arrhythmia
C. Hair color change
D. Mild freckles only
Rationale: Medical causes can mimic anxiety symptoms.
11. Which symptom suggests bipolar I disorder?
A. Worry only
B. Manic episode with elevated mood and decreased
need for sleep
C. Mild sadness only
D. Seasonal allergies only
Rationale: Mania defines bipolar I disorder.