NUR631 Exam 3 -Neuro,
Musculoskeletal, Mental Health Latest
Update
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 - ANS -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 - ANS -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 - ANS -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 - ANS -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
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