Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 41-year-old Malaysian man is referred to the PMHNP following an incident at work. He says a coworker insulted him, and the next thing he knows the police were called. He does not remember attacking the coworker, but he was arrested for assault. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?
A. Ataque de nervios
Ataque de nervios is common in Latin American cultures and involves intense emotional upset with crying, trembling, and verbal or physical aggression, often in response to a stressor, but usually within a family context.
B. Khayal
Khayal is a Southeast Asian cultural syndrome involving anxiety with physical symptoms like palpitations and dizziness, not violent outbursts.
C. Possession syndrome
Possession syndrome involves acting under the control of a spirit or external entity but is distinct from culturally recognized violent episodes such as amok.
D. Amok
Amok is a culture-bound syndrome observed in Malaysia and other Southeast Asian regions, characterized by sudden, dissociative episodes of violent behavior, often followed by amnesia for the event. This aligns with the patient's presentation.
This question is an excerpt from Nurse Dive's nursing test bank - Mental Health Northern Kentucky University Proctored Exam 6. Take the full exam now
Full Explanation
Choice A reason: Ataque de nervios is common in Latin American cultures and involves intense emotional upset with crying, trembling, and verbal or physical aggression, often in response to a stressor, but usually within a family context.
Choice B reason: Khayal is a Southeast Asian cultural syndrome involving anxiety with physical symptoms like palpitations and dizziness, not violent outbursts.
Choice C reason: Possession syndrome involves acting under the control of a spirit or external entity but is distinct from culturally recognized violent episodes such as amok.
Choice D reason: Amok is a culture-bound syndrome observed in Malaysia and other Southeast Asian regions, characterized by sudden, dissociative episodes of violent behavior, often followed by amnesia for the event. This aligns with the patient's presentation.
Similar Questions
For a 39-year-old woman with a recent diagnosis of psoriatic arthritis who is treatment-naive with mild disease, which of the following would be considered an appropriate first-line therapy?
A. Intra-articular glucocorticoids
Intra-articular glucocorticoids may be used for flare management in specific joints but are not first-line systemic therapy for mild psoriatic arthritis.
B. NSAIDs
NSAIDs are first-line therapy for mild psoriatic arthritis, providing anti-inflammatory and analgesic effects without the risks associated with immunosuppressants.
C. Opioids
Opioids are not recommended for arthritis management due to risk of dependence and do not address inflammation.
D. Pregabalin (Lyrica)
Pregabalin is indicated for neuropathic pain, not inflammatory arthritis, and is not appropriate for first-line treatment of psoriatic arthritis.
Full Explanation
Choice A reason: Intra-articular glucocorticoids may be used for flare management in specific joints but are not first-line systemic therapy for mild psoriatic arthritis.
Choice B reason: NSAIDs are first-line therapy for mild psoriatic arthritis, providing anti-inflammatory and analgesic effects without the risks associated with immunosuppressants.
Choice C reason: Opioids are not recommended for arthritis management due to risk of dependence and do not address inflammation.
Choice D reason: Pregabalin is indicated for neuropathic pain, not inflammatory arthritis, and is not appropriate for first-line treatment of psoriatic arthritis.
The PMHNP is evaluating a new client who reports symptoms of one hypomanic episode and at least one major depressive episode. Which psychiatric condition is most closely associated with these experiences?
A. Bipolar I disorder
Bipolar I disorder requires at least one manic episode, not just hypomania, making this inconsistent with the presentation.
B. Bipolar II disorder
Bipolar II disorder is characterized by at least one hypomanic episode and at least one major depressive episode without a history of full mania, matching the client’s symptoms.
C. Cyclothymic disorder
Cyclothymic disorder involves chronic, milder mood fluctuations but does not meet criteria for full hypomanic or major depressive episodes.
D. Schizoaffective disorder
Schizoaffective disorder includes mood episodes along with psychotic symptoms, which are not reported in this client’s history.
Full Explanation
Choice A reason: Bipolar I disorder requires at least one manic episode, not just hypomania, making this inconsistent with the presentation.
Choice B reason: Bipolar II disorder is characterized by at least one hypomanic episode and at least one major depressive episode without a history of full mania, matching the client’s symptoms.
Choice C reason: Cyclothymic disorder involves chronic, milder mood fluctuations but does not meet criteria for full hypomanic or major depressive episodes.
Choice D reason: Schizoaffective disorder includes mood episodes along with psychotic symptoms, which are not reported in this client’s history.
The PMHNP is conducting a mental status exam (MSE) on a new client. He asks her to explain the meaning of the proverb, "A rolling stone gathers no moss." The PMHNP understands that the proverb portion of the MSE tests functioning in which areas of the brain?
A. Temporal lobe
The temporal lobe primarily processes auditory information and is involved in memory formation, but abstract reasoning and proverb interpretation are not localized to this area.
B. Parietal lobe
The parietal lobe integrates sensory information and contributes to spatial awareness, which is unrelated to abstract reasoning or interpretation of proverbs.
C. Occipital lobe
The occipital lobe is mainly responsible for visual processing and does not govern executive functions or abstract thought.
D. Frontal lobe
The frontal lobe, particularly the prefrontal cortex, is critical for executive functioning, abstract reasoning, planning, and judgment. Interpreting proverbs like “A rolling stone gathers no moss” requires conceptualization, abstraction, and insight, making this portion of the MSE a test of frontal lobe functioning.
Full Explanation
Choice A reason: The temporal lobe primarily processes auditory information and is involved in memory formation, but abstract reasoning and proverb interpretation are not localized to this area.
Choice B reason: The parietal lobe integrates sensory information and contributes to spatial awareness, which is unrelated to abstract reasoning or interpretation of proverbs.
Choice C reason: The occipital lobe is mainly responsible for visual processing and does not govern executive functions or abstract thought.
Choice D reason: The frontal lobe, particularly the prefrontal cortex, is critical for executive functioning, abstract reasoning, planning, and judgment. Interpreting proverbs like “A rolling stone gathers no moss” requires conceptualization, abstraction, and insight, making this portion of the MSE a test of frontal lobe functioning.