Chapter 16: Psychological Disorders
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The prevalence of depression in nursing home residents is ____ greater than adults living in the
community.
A. 1-2 times
B. 2-3 times
C. 3-4 times
D. 5 times
____ 2. The majority of depressed older adults remain untreated because of:
A. Misdiagnosis
B. Social stigma
C. Environmental barriers
D. All of the above
____ 3. Symptoms of depression distinct to the elderly include:
A. Flat affect
B. Loss of pleasure in usual activities
C. Appetite and weight disturbances
D. Lack of emotions
____ 4. The justification for ordering a CBC, TSH, and serum B12 for a patient you suspect may have
clinical depression is:
A. To determine the cause of sadness
B. Because of overlapping symptoms with anemia, thyroid dysfunction, and
nutritional deficiencies
C. To differentiate between depression and metabolic disorders
D. To rule out vascular disease
____ 5. One major difference that is useful in the differential diagnosis of dementia versus delirium is that:
A. Dementia develops slowly and delirium develops quickly
B. The initial symptoms of dementia are more severe than the symptoms of delirium
C. Dementia symptoms are not associated with underlying medical conditions and
delirium symptoms usually result from underlying medical conditions
D. Symptoms of delirium involve memory and attention and symptoms of dementia
involve only memory
____ 6. Which of the following is the most appropriate screening tool for delirium?
A. Lawton Scale of Instrumental Activities of Daily Living
B. Confusion Assessment Method
C. Folstein’s Mini-Mental Status Examination
D. Montreal Cognitive Assessment
____ 7. The proposed mechanism by which diphenhydramine causes delirium is:
A. Serotinergic effects
B. Dopaminergic effects
C. Gabanergic effects
D. Anticholinergic effects
____ 8. The elderly are at high risk for delirium because of:
A. Multisensory declines
B. Polypharmacy
C. Multiple medical problems
D. All of the above
____ 9. A consistent finding in delirium, regardless of cause, is:
A. Dopamine deficiency
B. Serotinergic toxicity
C. Acetylcholine deficiency
D. Reduction in regional cerebral perfusion
____ 10. Older adults with dementia sometimes suffer from agnosia, which is defined as the inability to:
A. Use language
B. Understand language
C. Recognize objects
D. Remember events and places
____ 11. In late stages of dementia, a phenomenon called “sun downing” occurs, in which cognitive
disturbances tend to:
A. Improve as the day goes on
B. Become worse toward the evening
C. Fluctuate during the course of the day
D. Peak mid-day
____ 12. Of the following, which one is the most useful clinical evaluation tool to assist in the diagnosis of
dementia?
A. Folstein’s Mini-Mental Status Exam (MMSE)
B. St. Louis University Mental Status Exam (SLUMS)
C. Montreal Cognitive Assessment (MoCA)
D. Geriatric Depression Scale (GDS)
____ 13. The cornerstone of pharmacotherapy in treating Alzheimer’s disease is:
A. Cholinesterase inhibitors
B. NMDA receptor antagonist
C. Psychotropic medications
D. Anxiolytics
____ 14. The comorbid psychiatric problem with the highest frequency in dementia is:
A. Anxiety
B. Depression
C. Agitation and aggression
D. Psychosis
____ 15. When treating depression associated with dementia, which of the following would be a poor choice
and should not be prescribed?
A. Fluoxetine
B. Desipramine
C. Amitriptyline
D. Mirtazapine
Chapter 16: Psychological Disorders
Answer Section
MULTIPLE CHOICE
1. ANS: C PTS: 1
2. ANS: D PTS: 1
3. ANS: D PTS: 1
4. ANS: B PTS: 1
5. ANS: A PTS: 1
6. ANS: B PTS: 1
7. ANS: D PTS: 1
8. ANS: D PTS: 1
9. ANS: D PTS: 1
10. ANS: C PTS: 1
11. ANS: B PTS: 1
12. ANS: B PTS: 1
13. ANS: A PTS: 1
14. ANS: A PTS: 1
15. ANS: C PTS: 1
