Psychology and Psychiatric Nursing MCQ Quiz in मल्याळम - Objective Question with Answer for Psychology and Psychiatric Nursing - സൗജന്യ PDF ഡൗൺലോഡ് ചെയ്യുക

Concept:-

Schizophrenia:

• A group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and behaviors.
• Those with paranoid tendencies are particularly prone to delusions of persecution.
• Disorganized thinking may result from a breakdown in selective attention.
• Hallucinations are sensory experiences without sensory stimulation, most often auditory.
• They expressed emotions of schizophrenia are often utterly inappropriate, split off from reality.

Explanation:

• Bleuler's ideas on schizophrenia have often been summarized under the rubric 4 AS —representing affect (flat or inappropriate), associations, autism, and ambivalence, as though these characteristics were fundamental to his concept of schizophrenia.

Additional InformationParanoid Schizophrenia 

• Preoccupation with 1 or more delusions or frequent auditory hallucinations; cognitive function & effect remain mainly preserved.

​Disorganized Schizophrenia

• Characterized by disorganized behavior & speech.

​Catatonic Schizophrenia

• Has at least 2 of the following features: immobility, excessive or purposeless motor activity, extreme negativism, peculiarities of voluntary movement.

​Undifferentiated Schizophrenia

• Doesn’t have any of the characteristics of paranoid, disorganized, or catatonic schizophrenia.

Residual Schizophrenia

• A continued presence of negative symptoms. More commonly known as Pronounced symptoms.

• Parkinsonism is a slow, progressive, chronic neurologic disease that affects the substantia nigra, which is a part of the basal ganglia.
• These cells normally produce dopamine when there is Impairment of dopamine producing cells in the brain leads to Parkinson's disease.
• Parkinson's disease is primarily caused by low and falling dopamine levels.
• A person with Parkinson's has abnormally low dopamine levels.
• Dopamine is a neurotransmitter that transmits signals between brain and nerve cells.

4 cardinal signs

• Resting tremors-Rhythmic movements in one or more parts of the body.
• Rigidity
• Akinesia Loss of ability to move muscles voluntarily.
• Postural instability.

Additional Information

Other signs and Symptoms

• Cog-wheeling
• Micrographia
• Sleep disturbance 
• Cognitive and psychiatric disturbance
• Dysautonomia

Traits are relatively permanent characteristics of personality which compel an individual to behave consistently across different situations. People can be compared by measuring these traits. We call these traits relatively permanent because they change over time. A trait refers to any characteristic that differs from person to person in a relatively permanent and consistent way.” The trait approach got maximum impetus from the work of Allport, Cattell and Eysenck.

Important Points

• H.J. Eysenck proposed that personality could be reduced into two broad dimensions. These dimensions are Neuroticism and Extraversion-Introversion dimensions. According to Eysenck, these are biologically and genetically based and each dimension subsumes under it a number of specific traits. He drew a scale with one end having a normal dimension and at another extreme having the Neuroticism dimension. In between the person could have in varying degrees many traits which are part of these dimensions.

Key Points

• Neuroticism is the name Eysenck gave to a dimension that had persons who tend to be quite “nervous.” These people tend to suffer more frequently from a variety of “nervous disorders”, hence the name of the dimension. But it does not mean that people who score high on the neuroticism scale are necessarily suffering from neurotic disorders, but it only shows that such persons are relatively more susceptible to develop neurotic problems as compared to normal persons.
• Introversion-extroversion:
  • It is a bipolar trait. People with a predominance of introversion are self-centred. Such people are idealistic, imaginative, shy and secluded. The predominance of thoughtfulness steers them in the world of brooding, fantasy and daydreaming. These people take considerable time in reaching a decision and are worried about the future.
  • Extroverts are more inclined to social activities. They are gregarious and social by nature. Such people are realistic, practical, talkative, and active. They show more interest in leadership

Thus from the above-mentioned points, it is clear that the neuroticism trait of personality is given by Eysenck.

Additional Information

• Allport’s Trait Theory- Allport mentioned three types of traits; cardinal traits, central traits, and secondary traits.
• Cattell’s Trait Theory- He divided traits into two categories, viz., surface traits, and source traits.
• Carl Gustav Jung- A Swiss psychologist, has proposed the concepts of "introvert" and "extrovert" in his 'theory of personality'.

Concept-

• One of the most discussed topics in psychology is that intelligence is a single, general ability. Other theories of intelligence hold that intelligence includes a variety of abilities, skills, and talents.

Different theories of intelligence

• Over time, researchers have developed several contrasting theories of intelligence in psychology.
• Although these theories of intelligence attempt to explain the nature of intelligence, disagreement remains among psychologists.

One Factor Theory:

• It reduces all abilities to a single capacity of common sense.
• This would mean that they are all perfectly correlated, and would allow no disparity of people i.e. abilities along different lines.
• As this goes against the general observation that a person has different levels of different abilities and does not shine equally in all directions.

Thurston's Theory:

• As Thorndike claimed, intelligent activities are not the expression of a myriad of highly specialized factors. Nor is it primarily an expression of a common factor that pervades all mental activity. This is the essence of intelligence, as Spearman said.

Model Theory:

• Thomson propounded this theory. According to his opinion, a person has many abilities, but when he is unable to perform a task,
• If he does, then by taking a little sample or sample from all the abilities in the execution of that work, he makes a new ability for that particular work. That is, every work is a model of certain abilities.
• In performing a particular task, we select some abilities from a large set of mental abilities to represent them and their correlation is due to the representational mixture of all the independent factors.

Key Points

• David Wechsler defines intelligence as the global capacity to act purposefully, think rationally, and deal effectively with the environment.
• But Wechler's theory is not a theory of intelligence, Wechler is the main individual intelligence test. Hence Option 2 Wechler's theory is wrong

Concept:

• CAGE stands for Cut, Annoyed, Guilty, and Eye.
• It includes four questions.
• It is used for the assessment of alcohol abuse.
• CAGE assessment scoring 0 for 'no' 1 for 'yes'

Explanation:

• CAGE Questionnaire:
  • Have you ever felt you should Cut down on drinking/drug use? 
  • Have people Annoyed you by criticizing your drinking/ drug use?
  • Have you ever felt Guilty about your drinking/or drug use? 
  • Have you ever taken a drink and/or used drugs even in the morning to steady your nerves or get rid of a hangover (“Eye-opener”)?
• 2 or more yes answers indicate strong alcohol dependency.

Additional Information

• The brief psychiatric rating scale is used to identify anxiety, depression, or psychosis.
• A manic-state rating scale is a tool for trained nurses. It helps to assess manic symptoms. It consists of 26 questions.
• The Global assessment of functions determines the severity of mental illness. It has 10 sections.

Concept:

• Organic brain disorders are those which occur because of the damage in the brain
• Delirium causes disturbances in the mental abilities, confused thinking and lack of awareness
• Alcohol, dementia, organic brain disorders, metabolic disorders, dehydration can cause this delirium
• Based on the underlying cause treatment can be given like stopping use of any medication or treating the underlying metabolic diseases

Explanation:

• Hyperactive, Hypoactive and Mixed are the 3 most common forms of delirium
• Hyperactive -> Patients will be agitated disoriented and will get delusions and hallucinations
• Hypoactive -> depressed and isolated
• Mixed -> combination of both
• Because of all these psychiatric symptoms people can confuse this with schizophrenia

Additional Information

• Schizophrenia -> Psychiatric condition characterized by delusions and hallucinations
• Paranoid is the most common type, apart from that hebephrenic, catatonic, undifferentiated are the other forms of schizophrenia
• Mania is a condition where the patient will experience extreme happiness and high mood elations
• OCD -> Where the person will have repeated actions followed by obsessed thoughts

Concept:

• Bleuler's four A's of schizophrenia are:
  1. Associations
  2. Autism
  3. Ambivalence
  4. Affective disturbance
• Schizophrenia affects the thought process of an individual.
• It is characterized by:
  • Hallucinations
  • Delusions
  • Disorganized speech
  • Catatonia
• The negative symptoms may include social withdrawal.

Explanation:

• Associations refer to the ord salad/ flight of ideas/ thought disorder.
• Autism or autistic thinking is social withdrawal.
• Ambivalence is the presence of conflicting thoughts and emotions towards people and the self.
• The affective disturbance is the flattened affect or emotionless.

• While many side effects are associated with antidepressant drugs, an increase in heartbeat (tachycardia) is not typically considered one of the more common side effects. Some other medications might have this effect, but it's less commonly seen with antidepressants.
• Key points related to the side effects of antidepressant drugs:
  • Diarrhea: Gastrointestinal issues like diarrhea can occur, especially with certain types of antidepressants such as selective serotonin reuptake inhibitors (SSRIs).
  • Tremor: Tremors or shakiness can be a side effect, particularly with SSRIs and tricyclic antidepressants (TCAs).
  • Increase in weight: Weight gain is a common side effect, especially with medications like SSRIs and TCAs.
• Additional Information:
  • Although antidepressants generally have a range of side effects, it's essential to tailor the treatment to individual patient needs and monitor for any adverse reactions.
  • Tachycardia might be a side effect associated more with other psychiatric medications, such as stimulants used for ADHD or certain antipsychotic medications.

• Brief Overview: Diarrhea is a known side effect of some antidepressant medications, especially SSRIs.
• Key Points:
  • SSRIs can increase serotonergic activity in the gastrointestinal tract, leading to symptoms like diarrhea.
• Additional Information:
  • Management may involve adjusting the dosage or switching to a different medication if diarrhea becomes problematic.

• Brief Overview: Tremors can occur as a side effect of several types of antidepressants, including SSRIs and TCAs.
• Key Points:
  • Tremors are often mild but can be bothersome and affect functional ability in severe cases.
• Additional Information:
  • Tremors may subside with continued use or may require medication adjustment.

• Brief Overview: Weight gain is a common side effect of many antidepressants, particularly SSRIs and TCAs.
• Key Points:
  • Weight gain may be due to changes in metabolism, increased appetite, or other factors related to medication.
• Additional Information:
  • Regular monitoring and lifestyle modifications can help manage this side effect.

• Among the listed options, an increase in heart rate is not typically considered a common side effect of antidepressant drugs. Common side effects of antidepressants include diarrhea, tremors, and weight gain. Therefore, the correct answer is the increase in heart beat.

Concept:

• Anorexia nervosa is mental health disorder.
• It comes under eating disorders.
• Anorexia nervosa is characterized by an intense fear of gaining weight.

Explanation:

• People with anorexia follow a strict diet or starve.
• Nutritional deficiencies are common in anorexia.
• Bulimia nervosa is another eating disorder characterized by binge eating and induced vomiting.

Concept:-

• ECT (Electroconvulsive Therapy): also known as electroshock. It is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect.
• Conducted: in 1938 by Ugo Cerletti and Bini.
• Voltage: 70-120 volts
• Duration: 0.7-1.5 seconds

Indication for ECT:

• Sever depressive disorders with suicidal risk. It is the most common indication for ECT.
• Psychosis
• Schizophrenia
• When medications are not tolerated
• The medical condition that does not allow for conventional treatment. 

Pre-nursing care protocol for ECT:

• Ascertain if the client and the family have received a full explanation, including the option to withdraw the consent at any time.

• Hold food and fluids for 6 to 8 hours.
• Give preoperative medications as ordered.
• Loosen tight clothing
• Remove all cosmetic and metallic substances like glasses, contact lenses, hearing aids, rings, bracelets, hairpins, etc.

Types of ECT: