Mansour

aUni
ver
sit
y

Facul
tyofNur
sing

Psy
chi
atr
ic&Ment
alHeal
thNur
singDepar
tment

Four
thLev
el

SecondSemest
er(
Credi
tHourSy
stem)

Cour
se:Psy
chi
atr
icNur
sing

Fi
nalWr
it
tenExam

Date:15/
5/2018 Ti
meal
lowed:3
hours

 Pl
easeansweral
lthef
oll
owi
ngquest
ions

Par
t Mar
ks Scor
e
I Multi
plechoi
cequest
ions(40 80
Questi
ons)
I
I Tr
ue&f al
se (
20 40
Questi
ons)
I
II Matching (15 30
Questi
ons)
I
V Si
tuati
on (8 90
Questi
ons)
Tot
al 240

I
nst
ruct
ions:

AnswerPar
tI,
II,
andI
IIi
nOMRsheet
.

AnswerPar
tIVi
ntheQuest
ionBookl
et.

Readeachquest
ionv
erycar
eful
l
y.

0
 NumberofQuest
ions'
pages:
15pages

Pl
easeansweral
lthef
oll
owi
ngquest
ions:

PartI:Mul t
ipl
e choi
ce quest
ions:Foreach oft
he fol
lowing
multi
ple-
choi
ce questi
ons,selectthe ONE mostappropri
ate
answer:(
80Marks)

1.
Thenonv
erbalcommuni
cat
iont
hatexpr
essesemot
ioni
s
a. Bodypositi
oning. c.Faci
al
expr
essions.
b. Cult
ural
artif
acts. d.Ey
econt
act
.

2.
Whi chsy
mpt om i
sanexampleofanaff
ect
iveal
ter
ati
onexhi
bit
edby
cl
ientsdi
agnosedwit
hsever
edepressi
on?

a.Apat
hy. c.Somaticdelusi
on.
b.Di
ffi
cul
tyf
all
i
ngasl
eep. d.Soci
ali
solati
on.

3.Thenurseexpect
stoassesswhichoft
hefol
lowi
ngi
nacl
ientwi
th
di
agnosisofschi
zophr
enia,
par
anoidty
pe?

a.Anger
,audi
tor
yhalluci
nations,persecutor
ydelusi
ons
b.Abnor
mal motoracti
vi
ty,frequentposturi
ng,
aut i
sm
c.Fl
ataf
fect,
anhedonia,al
ogi a
d.Si
ll
ybehavi
or,
poorper sonal hy
giene,i
ncoherentspeech

4.Thenur
seinstr
uctsacli
entr
ecei
vingt
heMAOIagentphenel
zine
(r
est
ri
cti
onsforfoodshi
ghintyr
aminetopr
eventwhi
chadver
seeff
ect
?

a.Gastroi
ntest
inal
upset c.Hy
per
tensi
ve
cri
sis
c.Neuromusculareff
ect
s d.Ur
inar
yret
ent
ion

5.Fort
hecl
ientr
ecei
vi
ngtheanti
psychot
icmedi
cat
ioncl
ozapi
ne(
Clozar
il
),
woul
dbemostimport
antf
orthenurset
omonit
or?

a.Completebl
oodcount c.Li
verf
unct
ion
study
b.Thyroi
dprof
il
e d.Renal
funct
ion
study

6.Acli
enttel
lsthenursethathi
sbodyi
smadeofwoodandi
squi
teheav
y.
Thenursei
nterpr
etsthi
saswhichoft
hef
oll
owi
ng?

1
a.Compulsi
on c.Hal
l
ucinat
ion
b.Deper
sonali
zat
ion d.Obsessi
on

7.Thenurseexpect
sacl
ientexhi
bit
ingf
li
ghtofi
deast
odowhi
choft
he
fol
lowi
ng?

a.Makesuddenst opsintheflowofconv ersati

on
b.Coinnewwor dsorcombi nati
onsofsev eralwords
c.Provi
deexcessi
v edetai
lthatdel
aysstartingapoint
d.Talkexcessi
vel
ywhi l
efrequentl
yshi
ft
ingf r
om oneideat
oanot
her

8.Whatar
ethemostcommont
ypesofsi
deef
fect
sfr
om SSRI
s?

a.Dizzi
ness,dr
owsiness,
drymout
h c.Di
arr
hea,
wei
ght
gain
b.Convulsi
ons,r
espir
ator
ydif
fi
cul
ti
es d.Agr
anul
ocy
tosi
s

9.Onewayt
opr
omot
eadequat
enut
ri
ti
onali
ntakef
orhy
per
act
ivepat
ienti
sto:

a.Sitwithpat i
entdur i
ngmealstoensurethatheeatsever
ythingonhertray.
b.Encour ager elat
ivest obri
ngfoodf r
om homebecauset heyknow pat i
ent’
s
li
kesanddi sl
ikes.
c.Providehi gh-cal
orie,nut
ri
ti
ousfingerfoodsandsnackst hatpat
ientcaneat
“onther un.”
d.Tellpatientthathewi l
lbeonroom restr
ict
ionunt
ilhest
artsgaini
ngwei ght.
10.
Thenursecanbestr
espondt
othepat
ientwi
theat
ingpr
obl
em duet
o
del
usi
onsby:

a.Provi
dingtr
ayforhiminhisroom.
b.Order
ingfoodsthathecanholdinhi
shand.
c.Tasti
ngthefoodinfrontofhi
m.
d.Point
ingoutthatt
heenergyheisbur
ningupmustber
epl
aced.

11.
Themostappr
opr
iat
enur
singi
nter
vent
ioni
mmedi
atel
yaf
terECT:

a.Restr
ainpatienttopr eventi
njury
.
b.Administer
ingpr escri
bedmedi cati
on.
c.Assessingvitalsigns.
d.Tal
kingwi t
ht hecl i
entabouthisprobl
em.

12.
Ant
ianxi
etymedi
cat
ionspr
oduceacal
mingef
fectby
:

a.Potenti
ateeff
ectofGABA.
b.Decreasi
nglevelsofnorepi
nephri
neandserot
oni
nint
hebr
ain.
c.Decreasi
nglevelsofdopamineinthebr
ain.
d.I
nhibit
ingproducti
onoftheenzymeMAO.

13.
Ini
ti
alsy
mpt
omsofl
it
hium t
oxi
cit
yincl
ude:

a.Const
ipat
ion,
drymout
h,dr
owsi
ness,
oli
gur
ia.

2
 b.Dizziness,t
hir
st,dysuri
a,arrhy
thmias.
c.Ataxia,ti
nni
tus,blur
redv i
sion,di
arr
hea.
d.Fatigue,ver
ti
go,anuria,weakness.

14.
Part of the nurse’
s cont
inual assessment of the cli
ent t
aking
anti
psychoti
cmedicati
onsistoobser v
ef orext
rapy
ramidalsymptoms.
Examplesincl
ude:

a.Muscul
arweakness,ri
gidity
,tremors,facialspasms.
b.Dr
ymout h,
blur
redv i
sion,uri
naryretention,or
thostat
ichypotensi
on.
c.Amenorr
hea,gynecomastia,retr
ogradeej acul
ati
on.
d.El
evat
edbloodpressure,severeoccipitalheadache,sti
ffneck.

15.
Adecreasei
nwhichofthef
oll
owi
ngneur
otr
ansmi
tt
ershasbeen
impl
icat
edindepr
essi
on?

a.GABA,acetyl
chol i
ne,andaspart
ate.
b.Norepi
nephrine,serot
onin,
anddopami ne.
c.Somatost
atin,substanceP,andglyci
ne.
d.Glut
amate,histamine,andopioi
dpepti
des.

16.
Thepriori
tyofnur
singdi
agnosi
sforapat
ientst
atedt
hat"
tomor
row
ever
ythingwil
lbeOk",woul
dbe:

a.I
mbalancednutr
iti
on:l
esst
hanbodyr
equi
rement
s.
b.Dysf
uncti
onalgr
ievi
ng.
c.Ri
skforsuici
de.
d.Soci
ali
solati
on.

17.
Dist
ract
ibi
li
tyi
sdef
inedast
he:

a.I
nabi
l
ityt
onot
icemeani
ngf
ulanxi
etypr
ovokeddet
ail
s.

b.I
mpai
redabi
l
ityt
oident
if
yti
me,
place,
&per
son.

c.Gi
vi
ngat
tent
iont
oev
erypassi
ngst
imul
i
.

d.Di
ff
icul
tyt
oar
ousepat
ient
'sat
tent
ion.

18.
A young woman wi t
h schizophreni
ai s undergoing a psychiat
ri
c
eval
uati
on.Thephy si
cianasksherwhyshehasmi ssedherl asttwo
appoi
ntments.Thewomansay sthatshedoesnotwantt obeputinthe
hospi
talagainassheisn'
tapatient.Whichofthefol
lowingareasofthe
mentalstat
usexaminati
onbestdescr i
bestheprobl
em?

a.Mood b.Del
usi
on c.I
nsi
ght d.Judgment
19. A cli
entis di
agnosed wit
h cat
atoni
c schi
zophr
eni
a.Whi
ch t
he
highestpr
ior
it
ynursi
ngdiagnosi
s?

3
 a.Riskforviol
ence. c.I
mpai
red
communi cat
ion.
b.Inef
fect
ivecoping. d.Sel
f-
car
edef
ici
t.

20.
At wentyt woy earsoldmanwi thdiagnosisofchr onicschizophreni
ais
admitted tot he psychi
atr
ic uni
t.He i st al
king loudly as t
he nurse
approacheshim.Whenaskedwhoi stal
kingto,hesaid,"IhearGod'svoi
ce"
.
Whichoft heseresponsesbythenursewouldbebest?
a.'
'Itmustmakeyouthinkimpor
tanttot alkwithGod.
'
'
b.'
'Idon'
thearavoi
ce,butIknowit'
sreal toyou.'
'
c.'
'Whydoy outhi
nkyou'r
eheari
ngav oice.'
'
?
d.'
'WhatcouldbeGod'sreasonf
ortalkingt oyou?'
'

21.
Whi
choft
hef
oll
owi
ngi
sanexampl
eofacl
osedendedquest
ion?

a.Howhaveyoubeenf eeli
nglat
ely?
b.Howisyourrel
ati
onshipwithyourwif
e?
c.Haveyouhadanyhealthprobl
emsr ecent
ly?
d.Whereareyouemployed?

22.
Thecli
ent
’sbel
iefthatanewsbr
oadcasthasspeci
almeani
ngf
orhi
m
isanexampl
eof :
a.Abst
ractt
hinki
ng c.Fl
i
ghtofi
deas
b.Del
usionofref
erence d.Thought
br
oadcast
ing

23.
ECTi
sindi
cat
edi
nwhi
choft
hef
oll
owi
ngcondi
ti
ons?

a.Sev
eredepr
essi
on c.Hy
pomani
a

b.Auti
sti
cdi
sor
der
s d.Tour
ett
e
syndr
ome

24.
Whichoft
hef
oll
owi
ngi
sachar
act
eri
sti
cfeat
ureofdepr
essi
ve
epi
sode?

a.
Elev
ated,
expansi
ve,
irr
it
abl
emood

b.
Psy
chomot
orr
etar
dat
ion

c.
Thoughtecho,
thoughti
nser
ti
onort
houghtwi
thdr
awal

d.
Fli
ghtofi
deas

25.
Mood-
congr
uentpsy
chot
icf
eat
uresi
ndepr
essedpat
ient
sincl
udeal
l,

4
 EXCEPT:

a.
Nihi
l
ist
icdel
usi
ons c.Del
usi
onofgui
l
t

b.
Del
usi
onofpov
ert
y d.Er
oti
cdel
usi
on

26.
Maniarepresent
sa_ __
___
___
___
__t
o depr
essi
on accor
ding t
o
psy
chodynamictheor
y.

a.
Reacti
onformat
ion b.Repr
essi
on c.Subl
i
mat
ion d.
Di
splacement

27.
Whatdi
ff
erent
iat
esneur
osi
sfr
om psy
chosi
s?

a.Unawarenessoft hemaladapti
vebehav
ior
.
b.Exhi
bit
inginappropri
ateaff
ect.
c.Nolossofcont actwit
hreali
ty.
d.Havi
ngadeni alreact
ion.

28.
NurseDal
iaisawar
ethatext
remel
ydepr
essedcl
ient
sseem t
odo
besti
nset
ti
ngswher
etheyhav
e:

a.Mult
ipl
est i
muli c.Si
mpl
edai
l
yli
vi
ng
Acti
vi
ti
es
b.Mini
mal decisi
onmaki
ng d.Monot
onousAct
ivi
ti
es

29.
APati
entdi
agnosedwithschi
zophreniaandadmit
tedtotheuni
tappe
ari
ngver
yanxi
ous,pacesbackandf orth,
ref
usi
ngtoeat,andmaki
ng
somecommentsthatheisbeingpoisoned.Whi
chofthefoll
owi
ngist
hepri
maryf
ocusofthenurse?
a.
Decreaseanxiet
yanddevelopi
ngt
rust
. c.Setl
i
mit
sonhi
sbehav
i
or.
b.
Ensurethathegetsonpsychot
her
apy. d.At
tendt
ohi
shy
gieni
c
needs.

30.
A32-year-oldmalegr aduatestudent,whohasbecomei ncreasi
ngly
wit
hdrawnandnegl ectfulofhi
swor kandpersonalhy giene,isbrought
tothepsychiatr
ichospitalbyhisparents.Af
terdetailedassessment ,
adiagnosisofschizophreniai
smade.I tisunli
kel
yt hatt heclientwil
l
demonstrate:

a.
Lowself-est
eem c.Concr
etet
hinki
ng
b.Ef
fect
iveself
-boundar
ies d.Weakego

31.
Toestabl
ishanopenandt r
ust
ingr
elat
ionshi
pwithafemal
ecli
ent
whohasbeenhospital
izedwit
hdelusi
onaldisor
der
s,t
henursein
char
geshould?

5
 a.
Encouragethestafftohavefrequentint
eract
ionwi
tht
hecl
i
ent
b.
Shareanact i
vit
ywiththecli
ent
c.
Giv
eclientfeedbackonbehav ior
d.
Respectcli
ent’
sneedf orpersonalspace

32.
Amali spacingthefloorandappearsext r
emel
yanxious.Theduty
nurseapproachesinanattempttoal
levi
ateAmal
’sanxi
ety.Themost
therapeut
icquest
ionbythenursewouldbe?

a.Woul
dyouli
ketowatchTV?
b.Woul
dyouli
kemet otal
kwit
hyourf
ami
l
y?
c.Whatar
eyoufeel
ingnow?
d.I
gnoret
hecl
ient

33.
Tofurt
herassessacl
ient’
ssuici
dalpot
ent
ial
.Nur
seHodashoul
dbe
especi
all
yal
erttot
heclientexpr
essi
onof:

a.
Frustr
ati
on&f earofdeat
h c.Anger&resent
ment
b.
Anxiety&lonel
iness d.Helpl
essness&
hopel
essness

34.
Anur si
ngcar
epl
anf
oramal
ecl
ientwi
thbi
pol
arIdi
sor
dershoul
d
incl
ude:

a.
Providi
ngast ructur
edenv ironment
b.
Designingactivi
ti
esthatwi llr
equir
ethecli
entt
omaintai
ncontact
wit
hrealit
y
c.
Engagingt hecli
entinconv ersi
ngaboutcurr
entaf
fai
rs
d.
Touchingt hecli
entprovideassurance
35.
A 23- y
ear-old cl i
ent has been admi t
ted wit
h a di agnosis
ofschi
zophr eniasayst ot henur se“ Yes,i
tsmarch,Marchisl i
tt
le
woman” .Thesestatement sill
ustrat
e:

a.Per
sev
erat
ion b.Echol
ali
a c.Fl
i
ghtofi
deas d.
Pal
l
ali
a

36.
Al ong-
ter
m goalforaparanoi
dmalecl
ientwhohasunjust
if
iabl
y
accusedhiswif
eofhav
ingmanyext
ramar
it
alaf
fai
rswoul
dbetohelp
thecli
entdev
elop:

a.I
nsighti
ntohi
sbehavi
or c.Bett
ersel
f-
cont
rol
b.Feeli
ngofsel
f-
wort
h d.Fai
thinhi
swif
e

37.
A mal
eclientwhoisexper
ienci
ngdisorderedthi
nkingaboutfood
bei
ngpoi
sonedisadmi
ttedt
ot hementalhealt
huni
t.Thenurseuses
whi
chcommunicat
iont
echni
quetoencouragethecl
ienttoeatdi
nner
?

a.Focusingonself
-di
sclosur eofownf oodpr
efer
ence
b.Usingopen-
endedquest ionandsilence
c.Offer
ingopi
nionaboutt heneedt oeat
d.Verbali
zi
ngreasonsthatt hecli
entmaynotchoosetoeat

6
 38.
NurseRawi aisassignedtocar
eforacli
entdiagnosedwithCatat
onic
Schizopher
nia.WhenNur seRawiaent
erstheclient
’sroom,thecli
ent
isfoundl y
ingont hebedwi t
habodypul ledintoaf etalposi
ti
on.
NurseRawi ashould:

a.Askt hecl
ientdi
rectquest
ionstoencouragetal
king
b.Mov ethecli
enti
ntotheday r
oom t
obewi t
hothercl
ient
s
c.Sitbesi
dethecli
entinsil
enceandoccasionall
yaskopen-ended
question
d.Leav et
hecli
entaloneandconti
nuewi t
hpr ov
idi
ngcaretotheother
cl
ients

39.
NurseDinaiscar
ingforacli
entwi
thdepressi
onwhohasnot
respondedtoant
idepr
essantmedi
cati
on.Thenurseant
ici
pat
est
hat
whattreat
mentprocedur
emaybepr escr
ibed?

a.Neurol
epti
cmedi
cat
ion c.Shor
tterm secl
usion
b.Psychosur
ger
y d.El
ect
roconvulsi
ve
t
her
apy

40.
Ramy i s admit
ted t
ot he Psychiat
ric emergencyr oom wit
h over
ingesti
on ofprescri
bed medicat
ion.The mosti mpor t
antpi
ece of
infor
mat i
onthenurseinchar
geshoul dobtai
niniti
all
yisthe:

a.
Lengthofti
meont hemedicati
on.
b.
Nameoft heingestedmedi cat
ion&t heamounti
ngest
ed
c.
Reasonforthesuicideatt
empt
d.
Nameoft henearestrelat
ive&t hei
rphonenumber

PartI
I:Tr
ue(T)&Fal
se(F)f
oreachoft
hef
oll
owingst
atement
s:
(Sel
ectonl
yoneansweri
nyourOMRsheet
,1fortr
ueand2for
fal
se)
(
40Marks)

St
atement Tr
ue Fal
se

41. Appl
yi
ngt
hepr
inci
plesofpsy
chi
atr
icandment
alheal
th T F
nur
singdependsonpat
ient
'sdi
agnosi
s.
42. Usi
ngmedi
calt
ermi
nol
ogyi
sconsi
der
edat
her
apeut
ic T F
communi
cat
iont
echni
que.
43. Pr
obi
ngi
sconsi
der
edoneoft
hef
act
orst
hatenhances T F
communi
cat
ion.
44. Focusi
ngonnon-
ver
balaspect
sofcommuni
cat
ioni
s T F

7
 mor
eef
fect
iveandgenui
net
hant
hev
erbal
aspect
s.
45. Meet
ing and di
scussi
on wi
th col
l
eagues enhance T F
nur
se'
ssel
f-
under
standi
ng.

46. Busparcar
ri
esahi
ghr
iskf
ordependenceandt
oler
ance. T F

47. Al
ogi
a ar
e consi
der
ed posi
ti
ve sy
mpt
oms of T F
schi
zophr
eni
a.
48. Aki
net
one st
abi
l
izes t
he nat
ural bal
ance bet
ween T F
Ser
otoni
nandAcet
ylchol
i
ne.
49. Thenur
seshoul
dav
oidaski
ngpat
ientdi
rect
lyabout T F
sui
cidal
thought
s
50. Age of onset of del
usi
onaldi
sor
der
sisi
n ear
ly T F
adul
thood.
51. Suspi
cious pat
ient
slooks unt
idy and negl
ectt
hei
r T F
per
sonal
hygi
ene
52. Get
ti
ng cl
ose t
osuspi
cious i
nspacecl
i
enti
ncr
ease T F
t
hei
rsaf
ety
53. Mani
cpat
ient
snegl
ectt
hei
rper
sonalhy
gieneast
hey T F
hav
enot
imet
oper
for
mthei
rdai
l
yli
vi
ngact
ivi
ti
es
54. I
rr
it
abl
e mood i
s one oft
he mai
n char
act
eri
sti
cs of T F
mani
cepi
sode.
55. Act
ivi
ty t
her
apy of depr
essed pat
ient shoul
d be T F
compet
it
ivet
oimpr
ovehi
ssel
f-
est
eem.
56. Shor
teni
ngt
hef
requencyofnur
singv
isi
tsi
sessent
ial T F
dur
ingt
hewor
kingphaseofnur
se-
pat
ientr
elat
ionshi
p.
57. Tangent
ial
i
tyi
srapi
djumpi
ngf
rom onei
deat
oanot
her
. T F
Theconnect
ionbet
weeni
deasi
sthr
oughst
imul
ifr
om
l
asti
deaorex
ter
nal
sti
mul
i
58. Mai
nfeat
ure ofpar
anoi
dty
pe ofSchi
zophr
eni
ais T F
di
sor
gani
zedbehav
ior
59. Needl
e wor
kis sui
tabl
efor pat
ient
s wi
th bi
pol
ar T F
di
sor
der
s.
60. Regr
essi
on i
s among t
he def
ence mechani
sms t
hat T F
f
ormul
atedel
usi
onal
disor
der
.
8
Par
tII
I:Mat
chi
ng:Mat
cheachst
atementf
rom col
umn(
A),t
othe
ONEmostappr
opr
iat
eanswerf
rom col
umn(
B): (
30
Mar
ks)

Col
umn(
A) Col
umn(
B)

61.
Obj
ecti
ve manif
est
ati
on r
efl
ect
ing t
he i
nner a.Bl
ocki
ng
emoti
onal
stat
e.
62.
Psychopat
hological r
epeti
ti
on of t he same b.Ambi
val
ence
answerinresponsetodif
fer
entquest
ions.
63.
Suddencessat
ioni
nthemi
dsent
ences. c.Pal
ali
a
64.
Havi
ngt woopposi
tefeel
i
ngstowar
dthesame
Pet
ersonorpl
aceatt
hesameti
me. d.Af
fect
e.Per
sev
erat
ion

Col
umn(
A) Col
umn(
B)

65.
The most di stur
bed neur
otr
ansmi
tt
er i
n a.GABA
schi
zophr
eni
cpati
ents
b.Ser
otoni
n
66.
A neur
otr
ansmit
terwhi
chisli
nkedtot
heext
ra
pyr
amidalsi
deeff
ect
sofHal
operi
dol c.Acet
ylchol
i
ne

67.
Aneur ot
ransmit
teri
sconsider
edanat ur
almood d.Dopami
ne
stabil
i
zer.It’
st he chemicalthat hel
ps wi
th
sleepi
ng,eati
ng,
anddigest
ing e.Nor
epi
nephr
ine
68.
Suppr
essesCNSinLi mbi
csyst
em andpl
ayan
impor
tantr
olei
nanxi
etydi
sor
der
s

Col
umn(
A) Col
umn(
B)

69.
Char
acter
ized bydistur
bances ofmov ementt hat a.Paranoid
may incl
ude r i
gidi
ty, stupor
, agit
ati
on, bi
zarre Schizophreni
a
post
uri
ng, and r epet
iti
ve i mit
ati
ons of t he
movementsorspeechofot herpeopl
e. b.Disorgani
zed
Schizophr
eni
a

9
70.
Preoccupati
onwithoneormor edel
usi
onorfr
equent c.Catatoni
c
auditor
y hal l
ucinat
ion (
content frequent
ly Schizophr
eni
a
persecutor
yand/orgrandi
ose)
.
d.Undi
ffer
enti
ated
71.
Pati
ents hav e atleastone acute schizophr
enic Schi
zophreni
a
epi
sode butdo notpr esent
ly have such strong
posit
ive psychoti
c symptoms as del usions and e.Resi
dual
hal
luci
nations. Schi
zophr
eni
a

72.
The mostsevereform of schi
zophr
eni
a which
char
act
eri
zedbydi
sor
gani
zedspeechandbehav
ior.

Col
umn(
A) Col
umn(
B)

73.Sudden,ov
erwhelmi
nganxiet
yofsuchint
ensi
tyt
hat a.Anxi
ety
i
tproducedisor
gani
zat
ionoftheper
sonal
it
y
b.Phobi
a
74.Ast ateoffeel
i
ng,uneasi
ness,uncer
taintyordr
ead
result
ing f
rom a realorpercei
ved threatwhose c.Appr
ehensi
on
actualsour
ceisunknownorunrecogni
zed.
d.Pani
c
75.Anint
ensei
rr
ati
onalf
earofanobj
ect
,si
tuat
ionor
pl
ace. e.Fear

Par
tIV:Si
tuat
ion:Readt
hef
oll
owi
ngsi
tuat
ionandansweral
lthe
f
oll
owi
ngquest
ions: (
90
mar
ks)

Sar
a,a23-
year
-ol
dsi
ngl
ewoman,hasj
ustbeenadmi
tt
edt
othe
psy
chi
atr
icuni
tbyherpar
ent
s.Theyexpl
aint
hatov
ert
hepastf
ewmont
hs

10
shehasbecomemor
eandmor
ewi
thdr
awn.Shest
aysi
nherr
oom al
one,
but
l
atel
yhasbeenhear
dtal
kingandl
aughi
ngt
oher
sel
f.Sar
alef
thomef
ort
he
f
ir
stt
imeatage18t
oat
tendcol
lege.Sheper
for
medwel
ldur
ingherf
ir
st
semest
er,butwhen she r
etur
ned af
tersemest
erhol
iday
,she began t
o
accuseherr
oommat
eofst
eal
ingherpossessi
ons.Shest
art
edwr
it
ingt
oher
par
ent
sthatherr
oommat
ewant
edt
oki
llher
.Shest
art
edmi
ssi
ngcl
asses
andst
ayedi
nherbedmostoft
het
ime.Sar
atel
lst
headmi
tt
ingnur
set
hat
she qui
ttaki
ng hermedi
cat
ion (
Saf
inace)4 weeks ago because t
he
phar
maci
stwhof
il
lst
hepr
escr
ipt
ionsi
spl
ott
ingt
ohav
eherki
ll
ed.She
bel
iev
eshei
str
yingt
opoi
sonher
.Shesay
sshegott
hisi
nfor
mat
ionf
rom a
t
elev
isi
onmessage.AsSar
aspeaks,t
henur
senot
icest
hatshesomet
imes
st
opsi
nmi
dsent
ence.

1-Basedont
hissi
tuat
ion,
assessSar
a'scondi
ti
on? (
10mar
ks)

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2-Basedonthi
ssit
uat
ion,i
dent
if
yfi
venur
singdi
agnosesbasedonthe
avai
labl
edat
a? (
10marks)

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3-Basedonthissi
tuat
ion,devel
opnur
singcar
epl
anf
orTWO nur
sing
di
agnosis(
Consi
deri
ngPr i
ori
ti
es)
? (20
marks)

Thef
ir
stpr
obl
em (
10mar
ks)
:

11
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Thesecondpr
obl
em (
10mar
ks)
:

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12
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4-Based on thi
s si
tuat
ion,di
scuss t
he mostsui
tabl
etr
eat
ments
(bi
ologi
cal and psychol
ogi
cal
) for Sar
a?
(10marks)

Bi
logical
:…………………………………………………………………………………………………………
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.…………………
Psychologi
cal:
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13
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5-ApplyHeal
thteachi
ngt
hathel
pSar
atodealwi
thant
ichol
iner
gicsi
de
ef
fectsofSaf
inace (
10
marks)

…………………………………………………………………………………………………………………………
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6-Whataret
heDSM-
IV di
agnost
iccr
it
eri
aforSar
a'sdi
agnosi
s?(
10
marks)

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14
7-Appl
yAct
ivi
tyt
her
apyt
hati
ssui
tabl
etoSar
a (
10mar
ks)

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8-Menti
onf
ivet
alki
ngcommuni
cat
iont
echni
quet
hatar
esui
tabl
efor
Sar
a

(
10mar
ks)

…………………………………………………………………………………………………………………………
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GoodLuck
Dr/Rani
aRabie
Dr/NashwaIbrahi
m
Dr/AzzaIbr
ahim
Dr
/MohamedZor omba

15
 Dr
/AhmedHashem

16