PRITE 2024 - Assorted Pertinent Topics
with Complete Solutions
14 yo Native American Indian girl brought to mental health center b/c she has visions of
spirits. Tells psychiatrist spirits are elders who appear, give her advice. No hx of
substance abuse/mental disorder. Interview w/ parents reveals they are traditional Θ
feel daughter's visions are a gift. But they are worried about schoolwork, which has
deteriorated b/c she has been preoccupied with spirits. Tx should focus on: (3x)" -
ANSWER-DEALING WITH HER SCHOOL PROBLEMS
"16 yo says she thinks she may be pregnant but does not want to involve her parents.
What should guide the psychiatrist's actions?" - ANSWER-"THE PATIENT'S ABILITY
TO GIVE CONSENT WILL VARY FROM STATE TO STATE TO STATE"
"20 yo western trained psychiatrist of northern European descent has been asked to
treat a 40 yo Hindu patient who emigrated to the US 2 years ago. The patient presents
with complaints of weakness, fatigue, headaches, insomnia, palpitations, and
decreased appetite. The patient also reports a 5 lb weight loss over the last month,
dysphoric mood with intermittent anxiety, and suicidal ideation. In addition to assessing
the patient's level of suicidality, it would be appropriate for the psychiatrist to do which of
the following when beginning treatment? (3x)" - ANSWER-ASK THE PATIENT WHAT
HE BELIEVES EXPLAINS THE SYMPTOMS
"29 yo severely depressed with SI. Threatens to kill his wife and daughter to ͞take them
with me.͟ Legal responsibility is what" - ANSWER-NOTIFY THE WIFE
"3 yo girl hurts self with a tricycle. Then she hit the tricycle and asks, ͞Why did you hurt
me?͟ Which thought process does this behavior exemplify?" - ANSWER-ANIMISM
"4 yo child upset when ice cream melts. 10 yo puts it in the freezer and tells him it will
be ok. ϰ yo insists it is ruined. Piaget's concept of this is:" - ANSWER-CONSERVATION
(ALSO REVERSIBILITY)
"7 yo states he knows dad died, but why didn't he come to the birthday party? Defense
mechanism?" - ANSWER-DENIAL
"A benefit to unrestricted access to mental health information in the EHR for all
specialties" - ANSWER-READMISSION RATES TEND TO BE LOWER IN HOSPITALS
WITH UNRESTRICTED ACCESS TO THE EHR
"A clinical trial will assess the impact of two atypical antipsychotic meds on glucose
intolerance. Half of the participants will start on drug 1 and then be treated with drug 2,
while the other half will start on Drug 2 then drug 1. What type of experimental design?"
- ANSWER-CROSSOVER DESIGN
,"A cross sectional study shows less depressive disorders in people who use a natural
pill. They then observe people from the same population for a year and find that
prevalence of depression is lower in those who regularly used the pill. They then recruit
a sample from the same population and randomly assign people to pill or placebo for
one year. This didn't show any difference. Assuming no major flaws in design or
analysis, what is the most likely explanation for the discrepancies in results?" -
ANSWER-SOME UNKNOWN VARIABLE CONFOUNDED THE NON-RANDOM
RESULTS
"A group of researchers studied the temperament of a group of children at age 3
months, 2 years, 5 years, and 20 years to determine relationships between initial
temperamental characteristics of children who eventually had psychiatric problems. This
is an example of what type of study? (2x)" - ANSWER-COHORT
"A patient requests an alternative tx for depression. His psychiatrist does not practice
this tx himself but refers the pt to one who does. In 6 months the pt has complications
from the tx and sues the 1st psychiatrist for malpractice. Which element of malpractice
is missing in this case? - ANSWER-DUTY
"A preventative program for patients who exhibit attenuated psychotic symptoms and
recent decline in functioning is what type of prevention program?" - ANSWER-
INDICATED PRIMARY
"A preventative program for patients who exhibit attenuated psychotic symptoms and
recent decline in functioning is what type of prevention program?" - ANSWER-
INDICATED PRIMARY
"A resident performs a research study utilizing all of the outpatients with any psychiatric
disorder, who were treated during the first 2 months of the resident's outpatient
experience. The resident discovers that of the 47 patients diagnosed with any
psychiatric disorder, six meet the criteria for OCD. Which of the following statistic best
defines this info?" - ANSWER-THE POINT PREVALENCE OF OCD IS 6/47
"According to Thomas Θ Chess' categories of temperament, the difficult child shows
what characteristics?" - ANSWER-INTENSE EXPRESSIONS OF MOOD
"According to Winnicott, if mother can't provide ͞holding͟ environment for infant, infant will
develop what defensive process?" - ANSWER-FALSE SELF
"APA addressed ethics of sexual relationships between psychiatrists & pts by stating" -
ANSWER-NOT PERMISSIBLE TO HAVE A SEXUAL RELATIONSHIP WITH A
CURRENT OR FORMER PATIENT
"Assessment instrument used in epidemiology study that relies solely on subjects'
report" - ANSWER-GENERAL HEALTH QUESTIONNAIRE
,"Calculate number needed to treat with lithium to prevent 1 suicide: 1000 subjects
recruited in study, 500 receive placebo, 500 randomized to lithium. After 1 year, 50 from
placebo commit suicide, 25 from lithium group suicide." - ANSWER-20
"Compulsions & obsessions are related to development disturbance during which of
Erikson's psychosocial stages?" - ANSWER-AUTONOMY VS SHAME AND DOUBT
"Consultant evaluates patient for capacity. Patient is refusing meds, procedures, yells at
nurses, orders take out into hospital, threatens lawsuits if demands are not met. Patient
accuses doctor of being abusive, screams at doctor, when asked for explanation of
behavior ͞you're just another person here to abuse me!͟ Best response and advice for the
medical team is?" - ANSWER-͞THE PATIENT IS A DIFFICULT PATIENT TO WORK
WITH. LET'S TALK ABOUT WAYS TO MANAGE THE PATIENT'S BEHAVIOR.͟
"Erickson's psychosocial stage in which a person invests energy into establishing,
caring for, and guiding in the next generation? (2x)" - ANSWER-GENERATIVITY VS
STAGNATION
"Famous entertainer comments publicly about having problems cutting down on ETOH
use despite knowing negative effects on family members. Well-known psychiatrist,
never met the entertainer, goes on a news program and says that the entertainer is
most likely experiencing ETOH abuse. What explains the ethics of the MD? (2x)" -
ANSWER-UNETHICAL BECAUSE THE PSYCHIATRIST HAS NOT EXAMINED THE
ENTERTAINER
"First do no harm" refers to what ethics principle ;ϰx Ϳ - ANSWER-NONMALEFICENCE
"Guardian of a pt with intellectual disability with medication-refractory epilepsy insists
that the pt should have epilepsy surgery. Neurosurgeon believes the seizure focus can
be resected, but there's a >50% chance of RUE paralysis which outweighs potential
benefit from freedom from seizures. Guardian insists on surgery. Which describes
physician responsibility in this case?" - ANSWER-SHOULD PERFORM THE SURGERY
ONLY UNDER COURT ORDER
"HIPAA limits disclosure of patient health information without patient's consent except
for what" - ANSWER-PAYMENT
"In forensic psychiatry, the term "standard of care" refers to the use of treatments that
are (2x)" - ANSWER-USED BY AVERAGE REASONABLE PRACTITIONERS
"In terms of the normal functioning of the personality, Anna Freud's contributions were
in the realm of" - ANSWER-DEFENSE MECHANISMS
"In Vaillant's model of lifespan development, what is classified as a mature defense
mechanism" - ANSWER-HUMOR
, "In which stage of Piaget's theory of cognitive development do children first understand
conservation of volume?" - ANSWER-CONCRETE OPERATIONAL
"Legal responsibility to reach out to potential victim of pt's homicidal urges is called" -
ANSWER-DUTY TO PROTECT
"Medication can be administered without a patient's consent under which of the
following circumstances? (2x)" - ANSWER-AN EMERGENCY SITUATION EXISTS
AND CAN BE DOCUMENTED
"Most common allegation in malpractice suits against psychiatrist (3x)" - ANSWER-
INCORRECT TREATMENT
"Most common complaint in Southeast Asians who are diagnosed w/ mental disorder" -
ANSWER-MULTIPLE SOMATIC SYMPTOMS
"Naturalistic investigations of a treatment's effects look at which factor?" - ANSWER-
EFFECTIVENESS
"Piaget's contribution to development was a theory explaining what phenomenon (2x)" -
ANSWER-HOW INDIVIDUALS LEARN AND UNDERSTAND THE WORLD
"Psych eval requested on management of 32 yo pt admitted by internal medicine for tx
of severe gastrointestinal viral infectionͶ dehydration, nausea, vomiting, fever. Pt has
hx of schizoaffective disorder, controlled w stable doses of clozapine over the past year.
Staff concerned that pt might be delusional/hallucinating, as pt has appeared somewhat
confused/inattentive. On exam, pt is oriented to person, place but not time. Pt
somewhat slow, appears visibly ill/tired. Pt complains of stiffness, there is some rigidity
to movements. Psych recommendation?" - ANSWER-DISCONTINUE CLOZAPINE
"Psych MD sees 62 yo pt who has been hospitalized after an acute MI because staff
report that ͞the pt is driving us crazy.͟ Nurses complain that pt is constantly requesting
info about his condition and treatment, and will refuse tests and medications if he feels
the explanations are not sufficient. On interview pt admits, ͞I am a perfectionist͟ but is
proud of this fact, saying that it is ͞the secret of my success.͟ Pt is aware of the staff's
frustration, but feels his requests for information are reasonable. The best advice to the
team?" - ANSWER-"ANSWER THE PT'S QUESTIONS AND ACTIVELY INVOLVE THE
PT IN ALL PORTIONS OF HIS TREATMENT"
"Pt called ED complaining of hallucinations that command the pt to kill others.
Psychiatrist's first action?" - ANSWER-OBTAIN PHONE NUMBER, ADDRESS OF
PATIENT
"Pt qualifies for ECT, but does not want his doc to tell him the risks. He is a ͞chronic
worrier͟ and fears hearing the risks will make him anxious, perhaps to the point of