NUR631 Exam 3 neuro,musculoskeletal,
mental health Questions And Answers.
A 19-year-old college student, Todd, is brought to your clinic by his mother. She is concerned that there is
something seriously wrong with him. She states for the past 6 months his behavior has become peculiar
and he has flunked out of college. Todd denies any recent illness or injuries. His past medical history is
remarkable only for a broken foot. His parents are both healthy. He has a paternal uncle who had similar
symptoms in college. The patient admits to smoking cigarettes and drinking alcohol. He also admits to
marijuana use but none in the last week. He denies using any other substances. He denies any feelings of
depression or anxiety. While speaking with Todd and his mother you do a complete physical
examination, which is essentially normal. When you question him on how he is feeling, he says that he is
very worried that Microsoft has stolen his software for creating a better browser. He tells you he has se -
Answer D) Schizophrenia
A 24-year-old secretary comes to your clinic, complaining of difficulty sleeping, severe nightmares, and
irritability. She states it all began 6 months ago when she went to a fast food restaurant at midnight.
While she was waiting in her car a man entered through the passenger door and put a gun to her head.
He had her drive to a remote area, where he took her money and threatened to kill her. When the gun
jammed he panicked and ran off. Ever since this occurred the patient has been having these symptoms.
She states she jumps at every noise and refuses to drive at night. She states her anxiety has had such a
marked influence on her job performance she is afraid she will be fired. She denies any recent illnesses
or injuries. Her past medical history is unremarkable. On examination you find a nervous woman
appearing her stated age. Her physical examination is unremarkable. You recommend medication and
counseling.
What - Answer C) Post-traumatic stress disorder
A 75-year-old homemaker brings her 76-year-old husband to your clinic. She states that 4 months ago he
had a stroke and ever since she has been frustrated with his problems with communication. They were
at a restaurant after church one Sunday when he suddenly became quiet. When she realized something
was wrong he was taken to the hospital by EMS. He spent 2 weeks in the hospital with right-sided
weakness and difficulty speaking. After hospitalization he was in a rehab center, where he regained the
ability to walk and most of the use of his right hand. He also began to speak more, but she says that
much of the time "he doesn't make any sense." She gives an example that when she reminded him the
car needed to be serviced he told her "I will change the Kool-Aid out of the sink myself with the ludrip."
She says that these sayings are becoming frustrating. She wants you to tell her what is wrong and what
you can do about - Answer A) Wernicke's aphasia
,A 32-year-old white female comes to your clinic, complaining of overwhelming sadness. She says for the
past 2 months she has had crying episodes, difficulty sleeping, and problems with overeating. She says
she used to go out with her friends from work but now she just wants to go home and be by herself. She
also thinks that her work productivity has been dropping because she just is too tired to care or
concentrate. She denies any feelings of guilt or any suicidal ideation. She states that she has never felt
this way in the past. She denies any recent illness or injuries. Her past medical history consists of an
appendectomy when she was a teenager; otherwise, she has been healthy. She is single and works as a
clerk in a medical office. She denies tobacco, alcohol, or illegal drug use. Her mother has high blood
pressure and her father has had a history of mental illness. On examination you see a woman appearing
her st - Answer C) Major depressive episode
A 27-year-old woman is brought to your office by her mother. The mother tells you that her daughter has
been schizophrenic for the last 8 years and is starting to decompensate despite medication. The patient
states that she has been taking her antipsychotic and she is doing just fine. Her mother retorts that her
daughter has become quite paranoid. When asked why, the mother gives an example about the
mailman. She says that her daughter goes and gets the mail every day and then microwaves the letters.
The patient agrees that she does this but only because she sees the mailman flipping through the
envelopes and she knows he's putting anthrax on the letters. Her mother turns to her and says, "He's
only sorting the mail!"
Which best describes the patient's abnormality of perception?
A) Illusion
B) Hallucination
C) Fugue state - Answer A) Illusion
A 22-year-old man is brought to your office by his father to discuss his son's mental health disorder. The
patient was diagnosed with schizophrenia 6 months ago and has been taking medication since. The
father states that his son's dose isn't high enough and you need to raise it. He states that his son has
been hearing things that don't exist. You ask the young man what is going on and he tells you that his
father is just jealous because his sister talks only to him. His father turns to him and says, "Son, you know
your sister died 2 years ago!" His son replies "Well, she still talks to me in my head all the time!"
Which best describes this patient's abnormality of perception?
A) Illusion
B) Hallucination
C) Fugue state - Answer B) Hallucination
A 26-year-old violinist comes to your clinic, complaining of anxiety. He is a first chair violinist in the local
symphony orchestra and has started having symptoms during performances, such as sweating, shaking,
, and hyperventilating. It has gotten so bad that he has thought about giving up his first chair status so he
does not have to play the solo during one of the movements. He says that he never has these symptoms
during rehearsals or when he is practicing. He denies having any of these symptoms at any other time.
His past medical history is unremarkable. He denies any tobacco use, drug use, or alcohol abuse. His
parents are both healthy. On examination you see a young man who appears worried. His vital signs and
physical examination are unremarkable.
What type of anxiety disorder best describes his situation?
A) Panic disorder
B) Specific phobia
C) Social phobia
D) Generalized anxiety disorder - Answer C) Social phobia
A 23-year-old ticket agent is brought in by her husband because he is concerned about her recent
behavior. He states that for the last 2 weeks she has been completely out of control. He says that she
hasn't showered in days, stays awake most of the night cleaning their apartment, and has run up over
$1,000 on their credit cards. While he is talking, the patient interrupts him frequently and declares this is
all untrue and she has never been so happy and fulfilled in her whole life. She speaks very quickly,
changing the subject often. After a longer than normal interview you find out she has had no recent
illnesses or injuries. Her past medical history is unremarkable. Both her parents are healthy but the
husband has heard rumors about an aunt with similar symptoms. She and her husband have no children.
She smokes one pack of cigarettes a day (although she has been chain-smoking in the last 2 weeks),
drinks four to si - Answer B) Manic episode
A 72-year-old African-American male is brought to your clinic by his daughter for a follow-up visit after
his recent hospitalization. He had been admitted to the local hospital for speech problems and weakness
in his right arm and leg. On admission his MRI showed a small stroke. The patient was in rehab for 1
month following his initial presentation. He is now walking with a walker and has good use of his arm.
His daughter complains, however, that everyone is still having trouble communicating with the patient.
You ask the patient how he thinks he is doing. Although it is hard for you to make out his words you
believe his answer is "well . . . fine . . . doing . . . okay." His prior medical history involved high blood
pressure and coronary artery disease. He is a widower and retired handyman. He has three children who
are healthy. He denies tobacco, alcohol, or drug use. He has no other current symptoms. On examinati -
Answer B) Broca's aphasia
A 35-year-old stockbroker comes to your office, complaining of feeling tired and irritable. She also says
she feels like nothing ever goes her way and that nothing good ever happens. When you ask her how
long she has felt this way she laughs and says, "Since when have I not?" She relates that she has felt
pessimistic about life in general since she was in high school. She denies any problems with sleep,
