Psychology and Psychiatric Nursing MCQ Quiz - Objective Question with Answer for Psychology and Psychiatric Nursing - Download Free PDF

• The Narcotic Drugs and Psychotropic Substances Act (NDPSA) was enacted by the Indian Parliament in the year 1985. This legislation was introduced to control and regulate the operations related to narcotic drugs and psychotropic substances, including their production, consumption, and trafficking.
• It aimed to strengthen the legal framework to combat drug abuse and illicit drug trafficking, which had become a growing concern globally and within India during the 1980s.
• The Act provides stringent provisions for penalties for offenses related to the illegal possession, trade, and manufacture of narcotic drugs and psychotropic substances.
• Another important feature of the Act is its focus on rehabilitation of drug addicts and provisions for the treatment of addiction as a medical condition.

• Rationale: The year 1982 is incorrect because, during this time, discussions regarding drug-related issues were ongoing globally, but India had not yet enacted the NDPSA. The Act was still in the drafting and planning stages.

• Rationale: The year 1995 is also incorrect as the NDPS Act had already been in effect for a decade by this time. However, during this period, amendments to the Act were made to address emerging concerns related to drug abuse and trafficking.

• Rationale: The year 2000 is incorrect because this was long after the NDPSA had been enacted. However, like in 1995, the Act underwent further amendments in subsequent years, including changes to make its provisions more effective and balanced.

• The Narcotic Drugs and Psychotropic Substances Act (NDPSA) was passed in 1985 to address the growing problem of drug abuse and trafficking in India. It remains a critical piece of legislation, with periodic amendments to ensure its relevance in combating drug-related issues effectively.

• Mental illness encompasses a range of mental health conditions that affect mood, thinking, and behavior. Identifying warning signs is crucial for early intervention and effective management. The correct answer includes all the provided options because each represents a significant warning sign of mental illness.
• Mental health conditions vary in severity and presentation, and these symptoms often overlap. Early recognition of these warning signs can help prevent worsening symptoms and support timely treatment.

• Marked changes in eating or sleeping patterns: Sudden or extreme changes in appetite (eating too much or too little) and sleep disturbances (insomnia or hypersomnia) can indicate mental health issues such as depression, anxiety, or eating disorders.
• Thinking or talking about suicide or harming oneself: Suicidal thoughts or self-harming behaviors are critical warning signs of severe mental health conditions, such as major depressive disorder or borderline personality disorder. These require immediate attention and intervention.
• Extreme mood swings (high or low): Drastic emotional shifts, such as periods of intense happiness (mania) followed by severe sadness (depression), may indicate bipolar disorder or other mood disorders.
• All of the given options: These symptoms collectively represent significant warning signs of potential mental health issues. Addressing these symptoms holistically is essential for accurate diagnosis and treatment.

• Rationale: While this is a key symptom of mental illness, such changes alone may not always indicate a mental health condition. They could also result from medical conditions, lifestyle changes, or stress. However, when combined with other symptoms, they often point to underlying mental health issues.

• Rationale: This is a significant and immediate warning sign of mental illness, often associated with depression, anxiety, or trauma-related disorders. While this is a critical indicator on its own, it is not the only warning sign of mental illness, which is why all options are correct together.

• Rationale: Extreme mood swings can suggest conditions like bipolar disorder or borderline personality disorder. However, relying solely on mood swings without considering other symptoms may not provide a full picture of mental health status.

• All the listed options are important warning signs of mental illness. Mental health issues are complex, and recognizing these symptoms early can lead to better outcomes. If these signs are observed in oneself or others, professional help from a mental health provider should be sought immediately to ensure proper care and support.

• Spending consistent time with a depressed client demonstrates that they are valued and worthy of attention. People experiencing depression often struggle with feelings of low self-esteem and worthlessness. Through consistent interaction, you can help communicate that their emotions and presence matter to you, which can have a positive impact on their mental health.
• This approach fosters trust and rapport between the client and the caregiver or therapist. It helps create a safe environment where the client feels comfortable expressing their feelings and discussing their struggles without fear of judgment.
• By dedicating time to the client, you are providing emotional support, which is a critical component in the management and recovery process for individuals experiencing depression.

• Rationale: Obedience refers to compliance with authority or rules. Spending time with a depressed client is not about enforcing rules or requiring compliance, but rather about building a supportive relationship. This option does not align with the therapeutic goals of addressing depression.

• Rationale: While maintaining a routine can be beneficial for individuals with depression, spending time with a client is not merely about establishing a routine. It involves active listening, empathy, and showing genuine care, which go beyond the idea of simply following a set schedule.

• Rationale: Monitoring for medication side effects is an important aspect of care for clients on antidepressants or other medications, but it is a separate task from spending consistent time with the client. Monitoring focuses on observing physical and emotional responses to medication, whereas spending time with the client emphasizes emotional support and connection.

• Rationale: Since no fifth option is provided, it does not factor into the question or answer.

• Spending consistent time with a depressed client communicates that they are valued and worthy. This is essential in building a therapeutic relationship and fostering a sense of self-worth, which is often diminished in depression. The incorrect options fail to address the emotional and psychological support that is central to this practice.

• Schizophrenia is a mental disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness, and social interactions. Patients with schizophrenia often experience symptoms such as hallucinations, delusions, and difficulty managing emotions, which can sometimes lead to disruptive behaviors.
• In a group therapy setting, a client shouting or behaving disruptively can escalate the situation for both the individual and the group. The best approach is to remove the client from the group to reduce sensory stimulation and provide a quieter, more controlled environment where the client can de-escalate.
• Reducing stimulation helps minimize triggers that may exacerbate the client’s emotional or behavioral response, offering an opportunity for the healthcare professional to address the client’s needs calmly and individually.
• This action not only ensures the safety and well-being of the client but also maintains the therapeutic environment for the rest of the group members.

• Rationale: Shouting back at the client is counterproductive and unprofessional. It may escalate the situation further, increase the client’s agitation, and undermine trust between the client and the nurse. Therapeutic communication emphasizes calm, empathetic, and supportive interactions to de-escalate challenging behaviors.

• Rationale: While calling security may be necessary in cases of physical aggression or danger to others, it is not the first-line response to shouting. Security involvement can further escalate the client’s distress and should only be considered after other de-escalation techniques have been attempted and proven ineffective.

• Rationale: Physical restraint is a last resort and should only be used when there is an immediate risk of harm to the client or others. Restraining a client for shouting is inappropriate, may violate ethical guidelines, and can cause further emotional trauma or harm to the client.

• The best nursing action in this scenario is to remove the client from the group to reduce stimulation. This approach allows the client to calm down in a safe environment while preserving the integrity of the group therapy session. Other options, such as shouting back, calling security, or using restraints, are inappropriate or excessive unless the situation involves a direct risk of harm.

• Schizophrenia is a complex mental health disorder characterized by symptoms such as hallucinations, delusions, disorganized thinking, and impaired social functioning. Ensuring a safe environment for a client with schizophrenia is critical to their well-being and recovery.
• Reducing excessive environmental stimuli is essential because individuals with schizophrenia often have difficulty filtering sensory inputs. Overwhelming stimuli such as loud noises, crowded spaces, or bright lights can exacerbate symptoms, cause distress, and increase the risk of agitation or behavioral disturbances.
• A calm, structured, and low-stimulation environment promotes emotional stability and reduces the likelihood of triggering psychotic episodes. It provides the client with a sense of safety and aids in their ability to focus on therapeutic interventions and coping strategies.
• This intervention aligns with the principles of therapeutic care, allowing the client to feel secure while minimizing external stressors that could worsen their condition.

• Rationale: Allowing the client to wander freely may pose a safety risk, especially if they are experiencing hallucinations or delusions. They may accidentally harm themselves or others due to impaired judgment or perception. This option does not provide the necessary structure or supervision to ensure their safety.

• Rationale: Total isolation can exacerbate feelings of loneliness, paranoia, or depression in a schizophrenic client. Social interaction and therapeutic communication are important components of care for individuals with schizophrenia. Isolation may also hinder their ability to develop coping mechanisms and trust in caregivers.

• Rationale: Locking the client in a room is not only unethical but can also increase their fear, agitation, and paranoia. This approach violates basic principles of patient dignity and autonomy and may lead to further deterioration in their mental health.

• The most appropriate nursing intervention to ensure a safe environment for a schizophrenic client is reducing excessive environmental stimuli. This approach minimizes stressors, promotes emotional stability, and provides a therapeutic space conducive to recovery.
• Other options, such as allowing the client to wander freely, total isolation, or locking them in a room, fail to address safety concerns and may worsen the client’s condition or violate ethical standards in patient care.

Explanation:

• A phobia is an exaggerated usually inexplicable and illogical fear of a particular object, class of objects, or situation
• The term ‘phobia’ is often used to refer to a fear of one particular trigger.
• There are three types of phobia recognized by the American Psychiatric Association (APA).

1. Specific phobia:
   • This is an intense, irrational fear of a specific trigger.
2. Social phobia, or social anxiety:
   • This is a profound fear of public humiliation and being singled out or judged by others in a social situation.
   • These kinds of people avoid large gatherings because of social anxiety.
   • It is different than shyness.
3. Agoraphobia:
   • This is a fear of situations from which it would be difficult to escape if a person were to experience extreme panic, such as being in a lift or being outside of the home.

The correct answer is mood.

Key Points

• Depression is a mood disorder.
• Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act.
• It is treatable.
• It causes feelings of sadness and a loss of interest in activities you once enjoyed.
•  It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home.​

Additional Information

The Psychosocial crisis ‘Trust vs Mistrust’ is linked with the stage infancy (0 – 18 months) of Erikson’s theory. There are 8 stages in Erikson’s theory.

Concept:-

• The concepts of id, ego and superego are proposed by 'Sigmund Freud' in his 'Psychoanalytic Theory of Personality. Freud used these three concepts to describe the three parts of the human personality and to explain the way a human mind works.  

According to Freud, the human personality is made up of three major systems: the id, ego, and superego. 

Important Points

Another concept introduced by Freud was the “unconscious”. He conceived of the mind like an Iceberg, the tip of which is called the conscious, a small portion as subconscious and the remaining large portion as the Unconscious.

Let's Understand in Brief:

• The ID:
  • It is the unconscious part of the human personality that works to fulfil basic desires.
  • It is based on the pleasure principle which aspires for the satisfaction of antisocial desires.
• The Ego:
  • It looks for rules and morals and resides in the unconscious mind. 
  • The Ego always postpones the desire and discharge the tension until it gets the desired object. 
• The Super-Ego:
  • It is the moral part of the personality, which is known as conscience too. It stands for perfection, rather than pleasure.
  • It acts as a balance between id and super-ego, it tries to figure the solution which does not hurt either id or super-ego.
• Unconscious:
  • A reservoir of feelings, thoughts, urges, and memories that are outside of our conscious awareness.
  • Most of the contents of the unconscious are unacceptable or unpleasant, such as feelings of pain, anxiety, or conflict.
  • According to Freud, the unconscious continues to influence the conscious behaviours of the individual.

Key Points

• The deep-seated unconscious mind is the storehouse of all our memories and experiences. It is the centre for emotions and feelings and for all our behaviour and habits.
• Freud proved that through various psychoanalytical techniques which are also partly therapeutic like the free association technique or the dream analysis technique, changes can be brought in the unconscious mind.

Erikson covered human personality development in a series of eight stages that take place from the time of birth and continue throughout an individual’s complete life. Erik Erikson’s Psycho-social Theory focused on the adaptive function of the ego and the development of ego strength. There are some reasons due to which his theory is considered as stage theory:

• Personality develops in stages in a pre-determined order, from infancy to adulthood.
• Each stage has a psychological crisis, which could be positive or negative.
• Each crisis comes with its psychological needs which conflicts with the need of society.
• On completing the stage, a healthy personality comes out along with basic virtues.

Hence, there are four reasons behind Erikson’s theory being a stage theory.

Concept:

Mania

• Mania is a psychological condition that causes a person to experience unreasonable euphoria, very intense moods, hyperactivity, and delusions.
• Mania (or manic episodes) is a common symptom of bipolar disorder.
• A doctor will also likely prescribe a mood stabilizer, also called an “antimanic” medication.
• These help control mood swings and prevent them, and may help to make someone less likely to attempt suicide.
• Patients may need to take medicine for a long time, sometimes indefinitely.
• The doctor may prescribe lithium (Eskalith, Lithobid) and certain anti-seizure drugs like carbamazepine (Tegretol) or valproate (Depakote).
• Patients may need very close medical supervision and blood tests while you take these.

Additional Information

• Glutamate is an excitatory neurotransmitter that is elevated during mania. Lithium acutely stimulates the NMDA receptor, increasing glutamate availability in the postsynaptic neuron.
• It takes about 1 to 3 weeks for lithium to show the effects of symptoms.
• Therapeutic lithium level is somewhere between 0.6 to 1.2 mEq/L

Concept:-

In psychoanalytic theory, given by Sigmund Freud says that the defense mechanism is an unconscious psychological action that functions to protect a person from anxiety-producing thoughts and feelings related to internal conflicts and outer stressors. There are many defense mechanisms enlist which a person uses in his day to day life:

• Sublimation: It is similar to displacement, but takes place when a person manages to displace his unacceptable emotions into behaviors that are constructive and socially acceptable, rather than destructive activities.
• Sublimation is one of Freud's original defense mechanisms in which his deep sexual desires were turned into socially acceptable behavior by his writings and paintings.

Additional Information   1. Regression

• Regression is a defense mechanism proposed by Anna Freud whereby the ego reverts to an earlier stage of development usually in response to stressful situations. Regressions enable a person to psychologically go back in time to a period when the person felt safer.
• Example: When a person is troubled, he behaves most often childish or primitively to cope with the undesirable situation.

    2. Identification: 

• also known as Introjection. Is a defense mechanism when a person not only takes on a belief or voice of another person but also begins to identify with that individual. For example, a father tells his son that women do the household work and the son keeps this thought in his mind and acts in the same manner as his father does.

Concept:

• Anorexia nervosa: it is an eating disorder occurs most often in adolescent girls.
• The problem is found as refusal of food to maintain normal body weight by reducing food intake, especially fats and carbohydrates.
• Sign and symptoms:
  • Extreme weight loss or not making expected developmental weight gains.
  • Thin appearance.
  • Abnormal blood counts.
  • Fatigue.
  • Insomnia.
  • Dizziness or fainting.
  • Bluish discoloration of the fingers.

Explanation:

• Complication in anorexia nervosa:

Osteoporosis: A condition in which bones become weak and brittle.

• The body constantly absorbs and replaces bone tissue. With osteoporosis, new bone creation doesn't keep up with old bone removal.
• Many people have no symptoms until they have a bone fracture.

Myocardial hypertrophy:

• Myocardial hypertrophy is defined as an increase in ventricular myocardial mass.
• In clinical practice and in animal studies, left ventricular (LV) hypertrophy (LVH) is often assessed by measurement of end-diastolic thickness of septal and LV posterior wall and may be associated with normal or dilated LV cavity.

Electrolyte imbalance:

• It occurs when you have too much or not enough of certain minerals in your body.
• This imbalance may be a sign of a problem like kidney disease.

Additional Information 

• Bulimia nervosa: Eating disorder where the person will have binge eating
• Pica: Eating disorder where the child eats non nutritive substances
• Geophagia : Eating mud
• Trichophagia : Eating hair

Obsessive-compulsive disorder (OCD) is characterized by the occurrence of unwanted, intrusive obsessive thoughts and distressing images which are usually accompanied by compulsive behaviors. Compulsive behaviors are carried out either to undo or neutralize the obsessions or to prevent the occurrence of some dreadful event.

Key Points

• Anxiety disorders are disorders that decrease the performance or social functioning of an individual due to hyper-anxiety. Anxiety disorder can be of many types such as generalized anxiety disorder, obsessive-compulsive disorder, somatoform disorder, etc.
• Obsessive behavior is the inability to stop thinking about a particular idea or topic. The person involved, often finds these thoughts to be unpleasant and shameful.
• Compulsive behavior is the need to perform certain behaviors over and over again. Many compulsions deal with counting, ordering, checking, touching, and washing.  
• People affected by the obsessive-compulsive disorder are unable to control their preoccupation with specific ideas or are unable to prevent themselves from repeatedly carrying out a particular act or series of acts that affect their ability to carry out normal activities.

Thus, it is concluded that Obsessive-compulsive disorder is an anxiety disorder.

Hint

• Somatoform disorders refer to physical problems which have no organic basis, for example, fatigue, headaches, vague body pains, etc. The persons suffering from this disease remain preoccupied with symptoms.
• Dissociative disorders describe a persistent mental state that is marked by feelings of being detached from reality, being outside of one’s own body, or experiencing memory loss.
• Adjustment disorders are a group of conditions that can occur when you have difficulty in coping with a stressful life event. Example"the death of a loved one, relationship issues, or being fired from work. 

Concept:-

Erickson's Theory

• Erickson's theory for adolescent- Identity vs confusion.
• Erikson described eight stages of development. Each stage is characterized by a psychosocial crisis, representing a conflict between the individual and society.
• The progression to the next stage depends on the resolution of these conflicts.
• Out of eight stages,​ only five are relating to childhood.

Additional Information