What is psychomotor retardation as seen in psychiatric patients?

Repetitive, purposeless movements such as hand-wringing

Sudden, jerky muscle spasms typical of medication side effects

Rapid, involuntary movements often associated with anxiety

A slowed physical and emotional response commonly seen in depression

Answer and Explanation

The Correct Answer is D

Choice A reason: Repetitive, purposeless movements like hand-wringing are stereotypic behaviors often observed in anxiety disorders or obsessive-compulsive disorder. These actions stem from heightened psychological distress or neurological compulsions, not the slowed motor and emotional responses characteristic of psychomotor retardation. This condition, primarily linked to depression, involves reduced activity due to altered dopaminergic and serotonergic activity, making this choice incorrect.

Choice B reason: Sudden, jerky muscle spasms are typically extrapyramidal symptoms, such as tardive dyskinesia, caused by antipsychotic medications affecting dopamine pathways in the basal ganglia. These involuntary movements are abrupt and distinct from the generalized slowing of physical and emotional responses in psychomotor retardation, which is a hallmark of depression, rendering this choice incorrect.

Choice C reason: Rapid, involuntary movements are associated with anxiety or hyperkinetic disorders, reflecting increased autonomic arousal and motor activity. These contrast with psychomotor retardation, where patients exhibit slowed movements and emotional expression due to decreased neural activity in mood-regulating brain regions, such as the prefrontal cortex, making this choice incorrect for defining psychomotor retardation.

Choice D reason: Psychomotor retardation, common in major depressive disorder, involves slowed physical movements, speech, and emotional responses due to disruptions in dopaminergic and serotonergic neurotransmission. This leads to lethargy, delayed cognitive processing, and reduced expressiveness, accurately describing the condition and making this the correct choice for the clinical presentation described in the question.

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Correct Answer is A

Explanation

Choice A reason: Tangential thinking involves shifting topics without returning to the original point, common in schizophrenia or mania. It reflects disorganized thought processes due to impaired prefrontal cortex function, leading to irrelevant responses, making this the correct choice for the described speech pattern.

Choice B reason: Circumstantial thinking involves excessive detail but eventually returns to the original point. The scenario describes never returning to the question, indicating a more disorganized process than circumstantiality, making this choice incorrect for the patient’s speech pattern.

Choice C reason: Flight of ideas involves rapid topic shifts driven by associations, often in mania. While similar, it is less aimless than tangentiality, which does not return to the original topic, making this choice less precise for the described behavior.

Choice D reason: Concrete thinking involves literal interpretations without abstract reasoning, common in cognitive impairments. The scenario describes topic-shifting, not literal thinking, making this choice incorrect, as it does not address the disorganized speech pattern observed.

A. Durham Rule B. M’Naghten Rule C. Tarasoff Rule D. Irresistible impulse

Correct Answer is D

Explanation

Choice A reason: The Durham Rule holds that a defendant is not criminally responsible if their act was a product of mental disease. It is broad and does not specifically address the inability to control behavior despite knowing wrongfulness, making it less applicable than irresistible impulse.

Choice B reason: The M’Naghten Rule focuses on a defendant’s inability to understand the nature or wrongfulness of their actions due to mental illness. The scenario emphasizes inability to control behavior, not lack of understanding, making this choice incorrect.

Choice C reason: The Tarasoff Rule requires clinicians to warn potential victims of a patient’s threat, unrelated to insanity defenses. It addresses duty to protect, not the legal standard for criminal responsibility, making this choice irrelevant to the scenario.

Choice D reason: The irresistible impulse standard applies when a defendant understands their actions were wrong but cannot control their behavior due to mental illness. This matches the scenario, where the patient’s inability to control actions led to the insanity ruling, making this the correct choice.

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What is psychomotor retardation as seen in psychiatric patients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a psychiatric assessment, a patient frequently shifts from one topic to another and never returns to the original question asked by the nurse. This pattern of speech is best described as:

Correct Answer is A

Explanation

Correct Answer is D

Explanation

A patient recently lost her spouse and says, “I don’t know how I’m going to live without him.” Which of the following responses by the nurse is nontherapeutic?

The nurse uses a variety of therapeutic communication skills when working with patients. Which of the following is a therapeutic goal that can be accomplished through the use of therapeutic communication?

A patient recently diagnosed with type 2 diabetes tells the nurse, “This is all my fault. If I had taken better care of myself, I wouldn’t be in this situation.” Which response by the nurse is the most therapeutic?

A nurse is caring for a patient diagnosed with schizophrenia. During the interaction, the nurse notices that the patient’s facial expressions are minimal and do not seem to match the emotions being expressed verbally. This is an example of:

A patient becomes agitated and physically aggressive on the unit, requiring the use of restraints. Which of the following actions by the nurse is appropriate when applying and managing restraints?

A nurse is reviewing the medication orders for four patients. Which patient should the nurse anticipate receiving a lower dose of medication?

A patient with depression tells the nurse, “Sometimes I think people would be better off without me being alive.” Which closed-ended question should the nurse ask next to assess the patient’s safety?