During a psychiatric evaluation, the PMHNP conducts a psychiatric review of systems (ROS) in which she reviews common psychiatric symptoms that may not have been elicited in the history of present illness (HPI). Which of the following questions is most likely designed to elicit a response for the system "personality"?
Do you ever feel that people are following you or trying to hurt you in some way?
Have you lost interest or pleasure in things you used to enjoy?
Do you ever feel as if people or places familiar to you are unreal, or that you are so detached from your body that you are standing outside your body watching yourself?
Can you identify patterns, such as thoughts, moods, and actions, that have caused you significant problems with your friends or family at work or in another setting?
The Correct Answer is D
Choice A reason: This question assesses paranoid ideation and is more relevant to psychotic symptoms rather than personality traits.
Choice B reason: This question targets anhedonia, a core symptom of depression, and is part of the mood assessment rather than personality.
Choice C reason: This question evaluates depersonalization and derealization, which are dissociative symptoms, not personality-related.
Choice D reason: This question directly addresses enduring patterns of thoughts, moods, and behaviors that affect interpersonal functioning, which is central to personality disorders. It is designed to elicit information about maladaptive personality traits.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Leukopenia and decreased creatine phosphokinase are not consistent with neuroleptic malignant syndrome (NMS). NMS typically presents with elevated muscle enzymes due to muscle breakdown.
Choice B reason: Leukocytosis and elevated creatine phosphokinase (CPK) are hallmark laboratory findings in NMS. The elevated CPK reflects rhabdomyolysis from severe muscle rigidity, and leukocytosis indicates systemic inflammation.
Choice C reason: Thrombocytosis may occur in various inflammatory conditions but is not a defining feature of NMS. The absence of elevated CPK makes this option less diagnostic.
Choice D reason: Leukopenia and thrombocytopenia are more indicative of bone marrow suppression or hematologic disorders, not NMS.
Correct Answer is C
Explanation
Choice A reason: Existential therapy focuses on exploring meaning, freedom, and responsibility. While it encourages clients to confront contradictions in life, it does not specifically teach the concept of dialectical thinking or how to hold opposing truths simultaneously.
Choice B reason: Humanistic therapy emphasizes personal growth, self-actualization, and empathy. It fosters acceptance and understanding but does not directly address the cognitive distortions or dichotomous thinking seen in borderline personality disorder.
Choice C reason: Dialectical behavioral therapy (DBT) was developed specifically for individuals with borderline personality disorder. It teaches clients to accept two opposing ideas at once—such as “I am doing the best I can” and “I need to try harder”—and helps reduce black-and-white thinking. DBT is the most appropriate modality for this presentation.
Choice D reason: Cognitive behavioral therapy (CBT) targets distorted thinking and maladaptive behaviors. While it is effective for many disorders, it does not emphasize dialectical reasoning as a core principle like DBT does.
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