DIRE DAWA UNIVERSITY

COLLEGE OF MEDICINE AND HEALTH SCIENCE

DEPARTMENT OF PSYCHIATRY
Model Exam for 4th year psychiatry students
Time allowed: 120 minutes
Exam weight: 100%
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Please check as the exam contains 17 pages including cover page
The exam contains MCQ. Please try to cover all questions
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Any form of cheating makes your result zero
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GOOD LUCK

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1. A 56-year-old woman came to a health facility with complain of hopelessness,
worthlessness, feeling of loneliness and feeling of helplessness. On further examination, the
patient has suicidal thoughts and unable to recognize the faces of his two children which may be
associated with organic brain diseases. The most likely type of agnosia observed in this patient
is:-
A. Anosognosia
B. Topognosia
C. Visual agnosia
D. Prosopagnosia
2. During mental status examination of a 55-year-old woman on follow up ,a clinician
witnesses involuntary movements of her mouth and protrusion of her tongue. What is the most
likely reason for her motor disturbances?
A. Part of the disease process
B. Side effects of mood stabilizer medications
C. Side effects of first generation anti-psychotics
D. Side effects of second generation anti-psychotics
3. A psychiatric resident wants to know the thought disturbances of his patient after taking
detail psychiatric history. Which of the following terms are less concerned for the clinician to
detect the patients thought content?
A. Phobias
B. Obsessions
C. Blocking
D. Somatic preoccupations
4. An old man examined in X hospital has difficulties in identifying his own name ,to name the
professionals treating him as ‘nurses’ and ‘doctors’ and didn’t know the place where he is treated
now and month of the current year. The clinician understood as the patient is dis-oriented to
time, place and person and may have cognitive impairments associated with underlined mental
disorders. The sequence in significance from the most to the least for the psychiatrist to diagnose
and manage this patient is:-
A. Person...place…time
B. Time…place…person
C. Place…person…time
D. Place…time…person
5. An old man who was a teacher visits a health facility complaining memory loss which
increased from time to time and confusion, inability to learn new things and face difficulty with
language and problems with reading, writing, and working with numbers. On neuron-
pathological examination, the patient has neurotic plaques and neurofibrillary tangles in his
brain. What is the most likely diagnosis of this patient?
A. Huntington's diseases
B. Alzheimer disease
C. Wilson’s disease
D. Parkinson’s disease

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 6. A 63-year- old widowed, hypertensive woman retired recently has a claim on her mental
health condition after her energy and concentration has been reduced, face sleep problems,
decreased appetite, losses weight, and develops frequent somatic symptoms. After performing
mental status examination and laboratory investigations, the psychiatrist diagnosed her as she
had major depressive disorders. Which factor/s has less contribution for her mental health
problem?
A. Her age
B. Being widowed
C. Being hypertensive
D. Being retired
7. An old woman who seeks treatment at Amanuel mental specialized hospital has been
diagnosed as late onset schizophrenia by her psychiatrist. Which symptoms are rare to occur in
this patient?
A. Delusions and hallucinations
B. Social withdrawal
C. Aggressive towards people
D. Illogical thinking
8. A 55-year-old client has been admitted in a psychiatric unit at Dil Chora referral hospital
because of fearing of ordinary situations ,feeling threaten without reason and extreme distress.
The clinician who admitted the patient told to his students as he has paraphernaia. This patient is
most likely affected by which type of delusion?
A. Somatic delusion
B. Persecutory delusion
C. Delusion of infidelity
D. Delusion of jealousy
9. A psychiatrist wants to prepare a treatment plan for his 70 year-old-man with schizophrenia.
The least accepted goal of treatment that should be omitted for this patient is:-
A. To improve the quality of life of the patient
B. To maintain the patient in the community
C. To avoid his placement in his home
D. To delay his placement in nursing homes
10. Among the alternatives given below, which option/s is/are not taken as the difference of
depression in older patients as compared to younger patients?
A. Older patients had more somatic symptoms
B. Older patients had more thoughts about death
C. Older patients report more severe memory problems.
D. Older patients had more pre- occupation with a wish to die

11. Among persons who successfully commit suicide, the two most frequent diagnoses are
major depression and:
A. Alcoholism C. Dementia
B. Borderline personality disorder D. Schizophrenic
12. A 29-year-old woman with a history of schizophrenia presents to your office for a refill of
her prescriptions. She is convinced her mother hid her bottle of olanzapine (Zyprexa). The patient
states that she feels betrayed and is having auditory hallucinations commanding her to kill her mother.
However, when questioned further, the patient denies having any specific plans to harm her mother.
Which of the following is the most important next step in management?

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 A. Refill the patient's prescription with a more potent dosage of olanzapine.
B. Immediately contact the patient's mother.
C. Admit the patient.
D. Refill the prescription and then contact the patient's mother.
13. While you are working at emergency psychiatry clinic, a patient receiving clozapine whose
CBC shows white blood count (WBC) of 2,000 per cc presented to you; what will be your next step to
manage the condition?
A. Stop the administration of clozapine at once.
B. Increase the dosage of clozapine at once.
C. Monitor the patient's WBC every 10 days.
D. Institute weekly complete blood count (CBC) tests with differential
14. Which of the following is correct regarding psychiatry interview in emergency settings?
A. the psychiatrist must not ask depressed patients if they have suicidal thoughts
B. the psychiatrist should have a seat higher than the patient's seat
C. the psychiatrist may have to medicate a violent patient before taking a history
D. A violent patient should be interviewed alone to establish a patient-doctor
15. Delirium tremens is
A. opiate withdrawal delirium
B. alcohol withdrawal delirium
C. alcohol intoxication delirium
D. amphetamine intoxication delirium
16. Mrs. B had a horrific car accident at the street of Harar Town. She has absolutely no desire
to go back on that street and takes back roads to keep away from it. A clinician can conclude that Mrs.
B is experiencing____.
A. Flashbacks C. Negative alteration of emotion
B. Recurrent negative memories D. Avoidance behaviors
17. A 31-year-old man narrowly escapes (without injury) from a house fire caused when he
dropped the lighter while trying to light his crack pipe. Six weeks later, while smoking crack, he thinks
he smells smoke and runs from the building in a panic, shouting, “It’s on fire!” Which of the following
symptoms or circumstances would rule out a diagnosis of posttraumatic stress disorder (PTSD) for this
patient?
A. Having difficulty falling asleep.
B. Being uninterested in going back to work.
C. Inappropriately getting angry at family members.
D. Experiencing symptoms only when smoking crack cocaine.
18. A psychiatry professional concluded that a 28 year old man suffering from PTSD is
experiencing troubling intrusive symptoms. Which of the following symptom did NOT contribute an
input for this clinician’s conclusion?
A. The patient reports having flashbacks
B. The patient claims that he is unable to keep negative memories from occurring
C. The patients reports that he is repeatedly having depressed mood
D. The patient has prolonged distressing reaction to a trigger of the traumatic event

19. A 5-year-old child was present when her babysitter was sexually assaulted. Which of the
following symptoms would be most suggestive of posttraumatic stress disorder (PTSD) in this child?
A. Having dreams about princesses and castles.

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 B. Taking the clothing off her dolls while playing.
C. Expressing no fear when talking about the event.
D. Talking about the event with her parents
20. Mr. A was walking his dog while it was hit by a car and died immediately. He has been
living with this dog for the last 5 years and considers it as his only friend. After the accident he has
vivid memories that play back in his head over and over about the accident. He thinks that it was his
fault that his dog was hit. He felt sad and become completely homebound. After evaluation he was
diagnosed with PTSD. Which of the following is not an evident reason that Mr. A may be
experiencing depression with his PTSD?
A. Blame C. Shame
B. Loss of trust in others D. loss of a loved one
21. The most common comorbid condition with Body dysmorphic disorder is.
A. Major depressive Disorder
B. Panic Disorder
C. Generalized anxiety Disorder
D. Schizophreniform Disorder
22. Obsessive compulsive disorder is among differential diagnosis of Body Dysmorphic
Disorder? Which of the following is correct about the two disorders?
A. Both engage in compulsive behaviors
B. Both have obsessive preoccupations
C. Both spend excessive amounts of time of their obsessions
D. All of the above.
23. Ms. L feels that she must pray for 2 hours everyday day before she leaves for work or else
someone she loves will get hurt. Which of the following best describes her disturbance?
A. Fear C. Overvalued ideas
B. Obsession D. Compulsion
24. Which of the following is not a common feature of patients with hoarding disorder?
A. Perfectionism C. Indecisiveness
B. Distractibility D. Recklessness
25. A 38-year-old woman presented to your clinic telling you that she has had disturbing,
recurrent thoughts about harming her 7-month-old infant. She imagines using a knife to stab her child.
Since having these distressing thoughts, she has removed all sharp objects from her kitchen. Because
of this, she has not been able to prepare meals at home and has chosen to buy fast food or take-out food
for the family meals. She has not shared these thoughts with her husband. The most possible diagnosis
for this condition is which of the following?
A. Unspecified schizophrenia spectrum and other psychotic disorder
B. impulse control disorder not otherwise specified
C. obsessive-compulsive personality disorder
D. Obsessive Compulsive Disorder
26. Mentally healthy person shows growth and maturity in the following areas; except.
A. Social interaction C. Emotional well being
B. Physical combat D. Cognitive processes
27. __________is the cognitive distortion of the fact to make an event or an impulse less
threatening by supplying a logical reasons as opposed to the real reason
A. Reaction formation C. Rationalization
B. Intellectualization D. Sublimation

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 28. All are causes of mental distress according to psychological model, Except;
A. Faulty thinking C. unresolved issues from
childhood
B. introjected values D. work and working conditions
29. Ms. A is referred to psychiatry clinic after complaining that she is unable to see anything.
Examinations show that she has no defect. When asked, her attendants report that her complaint started
immediately after she witnessed her boyfriend dating another woman while she has been waiting for
their wedding to be happened next month. Which defense mechanism is she experiencing?
A. Intellectualization C. Reaction formation
B. Denial D. Conversion reaction
30. _________is false presentation of some fact with the intention that it will be acted up on by
another person.
A. False imprisonment C. Fraud
B. Negligence D. Informed consent
31. While collaborating on a presentation to their customers, the members of a sales team
become increasingly frustrated with their team leader. The leader insists that the members of the team
adhere to his strict rules for developing the project. This involves approaching the task in sequential
manner such that no new task can be begun until the prior one is perfected. When other members
suggest alternative approaches, the leader becomes frustrated and insists that the team stick to his
approach. Although the results are inarguably of high quality, the team is convinced that they will not
finish in time for the scheduled presentation. When voicing these concerns to the leader, he suggests
that the real problem is that the other members of the team simply don’t share his high standards.
Which of the following disorders would best explain the behavior of this team leader?
A. Narcissistic personality disorder.
B. Obsessive-compulsive disorder (OCD).
C. Avoidant personality disorder.
D. Obsessive-compulsive personality disorder (OCPD).
32. A30-year-old woman with a history of unstable interpersonal relationships, suicidal gestures,
and marked impulsivity is referred to you for dialectical behavioral therapy (DBT). Which of the
following disorders is this patient likely to be suffering from?
A. avoidant personality disorder
B. bipolar disorder
C. passive-aggressive personality disorder
D. borderline personality disorder
33. Individuals with obsessive-compulsive personality disorder are primarily motivated by a
need for which of the following?
A. Autonomy. C. Control.
B. Admiration. D. Intimacy.
34. Which of the following cognitive or perceptual disturbance is associated with borderline
personality disorder?
A. Odd thinking and speech.
B. Ideas of reference.
C. Transient, stress-related paranoid ideation.
D. Superstitiousness.
35. A 36-year-old woman is approached by her new boss, who has noticed that despite working
for her employer for many years, she has not advanced beyond an entry level position. The boss hears

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that she is a good employee who works long hours. The woman explains that she has not asked for a
promotion because she knows she’s not as good as other employees and doesn’t think she deserves it.
She explains her long hours by saying that she is not very smart and has to check over all her work,
because she’s afraid that people will laugh at her if she makes any mistakes. On reviewing her past
evaluations, her boss notes that there are only minor critiques and her overall evaluations have been
very positive. Which of the following personality disorders would best explain this woman’s lack of
job advancement?
A. Avoidant personality disorder.
B. Obsessive-compulsive personality disorder.
C. Schizoid personality disorder.
D. Borderline personality disorder.
36. Mr X pinches his skin during the interview in the examination room. When the clinician
asked him why he did this, the patient says as insects are crawling on his body. What is the psycho-
pathological term for this sensation?
A. Visual hallucination
B. Tactile hallucination
C. Taste hallucination
D. Smell hallucination
37. My sister was suddenly shout and pull me back while walking with me because of
perceiving threatening faces. After a minute, she awareness as there was nothing there and
laughs by her own action.What is the most likely psycho-pathological term for her actions?
A. Illusion
B. Delusion
C. Hallucinations
D. Pseudo hallucination
38. As a clinician, what do you think the possible etiological theories about hallucination?
A. Over stimulation affecting different levels of information processing
B. failure of inhibition of mental functions
C. Distortion of the processing of sensory information at the interpretive level.
D. All
39. In which of the following presentation of patients the mood/affect and the mental disorder
correctly matched?
A. Euphoric in mania
B. Blunted in MDD patient
C. Flat affect in schizophrenia
D. All
40. A depressed person feels worthlessness and develops a firmed idea of inadequacy. After
staying in this manner for the last 9 months, he hears a voice left him to assign roles because of
his worthlessness and inadequacy. What can you say about his delusional theme?
A. Primary delusion
B. Secondary delusion
C. Tertiary delusion
D. Overvalued idea
41. Which one of the following elements of the brain cells are not involved in the hypothesis of
delayed nerve impulse conduction if your patient showed poor impulse conduction?
A. The axon of the neuron cell

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B. The Microglia of the nerve cell
C. The schwann cells
D. The astrocytes cells
42. One of the following is not classified under the central nervous system
A. Spinal cord
B. Deep cerebral structures
C. Spinal nerves
D. Endocrine glands
43. Abebe was diagnosed with TB but he was not showing any signs like sweating, or fever. If
we associate this with the problem of the central nervous system, which one of the following is
most involved with the modulation of the internal and external environment?
A. Spinal cord
B. Cranial nerves
C. Cerebellum
D. Frontal lobe
44. W/ro Zeritu is a 32 years old woman who came to a clinic last month. She came with deep
burn injury at her right hand while handling hot pot at home. When she was asked how she got
this burn, she reported that she was not feeling the hotness and she was not sensing anything with
her both two hands on physical examination. Which group of nerve fibers is likely to be found
diseased?
A. Cervical plexus
B. Lumbar plexus
C. Sacral plexus
D. Brachial plexus
45. One of the following fiber is different based on the type of the information it carries
A. Cortico-spinal tract
B. Spinocerebellar system
C. Corticobulbar tract
D. Vestibulospinal tract
46. Which one of the following is not true to say it is possibly hallucinatory disturbance
A. I see things near to the door but I know that it is my imagination
B. I see animals moving close to my door and my family confirmed
C. I smell bad things and I could not confirm it
D. Insects are moving over my head ideally
47. The following statements show the definitions for delusion except
A. It is thought held strongly despite of the situation
B. The feelings and fixed thoughts not easy to persuade
C. Thought of being persecuted as confirmed by his close friend
D. Thought of achievement considered as fantasy by his friends
48. In a clinical senario, patients may report their confusion as, except,
A. They have difficulty of controlling their thought
B. They are feeling fuzzy
C. They are feeling clouded thoughts
D. They are attending the interview
49. Select the true statement regarding memory

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A. immediate memory loss may show dementia
B. Long term memory loss is the only to tell you about delirium
C. Both short term and long term memory loss may show problem of amnesia
D. Alcohol use induces short term memory loss only
50. Select false statement about Calculation ability
A. Can be tested with serial seven
B. Deficits show delirium and dementia
C. Can be tested with serial three
D. Usually not used for neuropsychiatric assessment
51. Which one of the following is not true to say it is possibly hallucinatory disturbance
A. I see things near to the door but I know that it is my imagination
B. I see animals moving close to my door and my family confirmed
C. I smell bad things and I could not confirm it
D. Insects are moving over my head ideally
52. The following statements show the definitions for delusion except
A. It is thought held strongly despite of the situation
B. The feelings and fixed thoughts not easy to persuade
C. Thought of being persecuted as confirmed by his close friend
D. Thought of achievement considered as fantasy by his friends
53. In a clinical senario, patients may report their confusion as, except,
A. They have difficulty of controlling their thought
B. They are feeling fuzzy
C. They are feeling clouded thoughts
54. They are attending the interview
4. Select the true statement regarding memory
A. immediate memory loss may show dementia
B. Long term memory loss is the only to tell you about delirium
C. Both short term and long term memory loss may show problem of amnesia
D. Alcohol use induces short term memory loss only
55. Select false statement about Calculation ability
A. Can be tested with serial seven
B. Deficits show delirium and dementia
C. Can be tested with serial three
D. Usually not used for neuropsychiatric assessment
56. Once a medication is ingested, the effect that produces on the body but not
A. Stimulator of the specific biological activity of a Receptor
B. Producing cells in the body
C. Inhibitor of biological activity of specific receptor
D. Facilitator of biological activity of receptor cells if added with other stimulators
57. Different types of drugs are classified and distinguished based on their
A. Molecular structure that gives colour for the drug
B. Type of interaction with the neurotransmitter system
C. the presence of inactive metabolites
D. None of the above are essential for classification

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58. Once your patient comes to your clinic for treatment, you could consider one of the following
conditions to select a specific medication
A. Frequency of the time for medication
B. taste of the medication preparation
C. The pharmaceutical belonging
D. The generation
59. Which one of the following medication could have drug- drug interaction with TCAs?
A. Olanzapine
B. Risperidone
C. Fluoxetine
D. Imipramine
60. Which one of the following is not the way medications produce their effect on our body?
A. Replacing presynaptic terminal
B. Inhibiting re uptake of neurotransmitters
C. Blocking the binding to their site
D. Enhancing neurotransmitter release
61. People start substances of abuse for many different reasons but one of the following is not.
A. They think they could do things better with substance than without
B. Some people use substance just to look like others
C. Some people use substance because their family were using
D. They start using to get healthier
62. A common description for harmful drinking can include the following except
A. A drinking pattern resulting physical or mental damage
B. A drinking pattern with a unit of 50 or more for men within a week time
C. If a women drink alcohol of more than 35 units a week
D. A woman drinking an average of 2 bottles of beer with 4.5%
63. Which one of the following is the most widely used psychoactive substance?
A. Cannabis
B. Caffeine
C. Marijuana
D. Khat
64. Which one of the following is not among the patterns of risky drug use?
A. Intoxication
B. Withdrawal
C. Dependence
D. Regular use
65. Select the wrong statement among the following
A. Women and men with higher education level are likely to drink more
B. Jews are more likely to drink but less dependent than others
C. The most common causes for death of alcoholic include suicide
D. Alcohol abuse decreases life expectancy by less than 5 years
66. While clerking a patient, which of the following information may make us less certain to put
a diagnosis of schizophrenia
A. A history of long lasting social withdrawal before active symptoms
B. A history of many symptom free periods with restored functionality
C. Unable to initiate a communication with others

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 D. Aggression which is secondary to delusional thoughts
67. True about the epidemiology of schizophrenia
A. It is more common in women
B. The outcome is better for men
C. It is common before the age of 10 years
D. If the onset is early the course tends to be chronic
68. Which medical condition should we suspect from the patient with brief psychotic symptoms
A. Cerebral malaria
B. Hypothyroidism
C. Pneumonia
D. DM
69. Delusions in clear consciousness are seen in
A. Delirium B. Dementia C. GAD D. Schizophrenia
70. A 35 year’s old male comes with a history of aggression, highly suspiciousness, and insulting
others which started immediately after losing his son and lasts for about 3 days, the most likely
diagnosis is
A. Bipolar 1 disorder
B. Delusional disorder
C. Brief psychotic disorder
D. Bereavement
71. From the following symptoms one has the most debilitating effect on schizophrenia patients
A. Hallucination B. Delusion C. Shouting D. Anhedonia
72. True about delusional disorder
A. More common than schizophrenia
B. Delusional patients rarely seek psychiatric treatment
C. Most patients exhibit bizarre behavior
D. Functional impairment is needed as diagnostic criteria
73. In psychotic illness when a patient believes he/she is in danger, this is referred to as
A. Persecutory delusion B. Delusion of grandeur C. Somatic delusion D. Delusion of control
74. the most common type of hallucination in schizophrenia is
A. Visual B. Auditory C. Tactile D. Olfactory
75. Which of the following comes under the term disorganized speech?
A. Talking alone B. Talkativeness C. Shouting D. Word salad
76. Which of the following drug enhances a neurotransmitter by stimulating its release?
A. Serotonin B. Methylphenidate C. Haloperidol D. Mirtazapine
77. A 25 years old female patient reports having a depressed mood, and decreased energy, she
was not able to maintain her attention during an interview, as her husband reported she had
an attempt to hurt herself. Which medication is most preferred to treat her in outpatient
setting?
A. Sertraline B. Amitriptyline C. Carbamazepine D. Imipramine
78. Which antidepressant is used for childhood enuresis?
A. Fluoxetine C. Sertraline C. Imipramine D. Mirtazapine
79. A patient with MDD had a severe headache and persistent nausea. He was also
complaining being unable to fall sleep. Which antidepressant is the most preferable?
A. Fluoxetine B.Paroxitine C. Isoniazid D. Amitriptyline

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 80. A Patient was on antipsychotic and reported a feeling of restlessness, she was agitating
during MSE. One is not true
A. She is suffering from akathesia
B. The Side effect is mostly associated with second generation antipsychotics
C. Nigrostriatal path way is responsible pathway for this side effect
D. Minimizing the dosage of antipsychotics could help control the side effect
81. One is true about psychotherapy
A. Psychotherapy alone may be helpful for disorders with mild severity
B. It is also called talk therapy because a therapists talks a lot to relieve patient symptoms
C. The nature of the problem may not affect certain type of psychotherapy
D. It is mostly a second line option if pharmacotherapies are not working
82. The following are the benefits of psychotherapy, except
A. Helps the patients to gain an insight regarding their problems
B. Makes someone to repress un desired thoughts
C. Helps in Finding of coping mechanisms
D. Makes someone to think in more rational way
83. When should therapist break confidentiality?
A. When the coworkers are eager to hear about client’s history
B. When families want to know about clients secret
C. If a therapist thinks disclosing the secret may not offend the client
D. If there are safety issues, so that the third person should be aware of
84. The main area of interest for psychodynamic approach is
A. Overt behavior
B. Interpersonal relation ships
C. Unconscious mind
D. Cognitive aspect of behaviors
85. According to psychoanalysis theory some once mal adaptive behavior may be secondary
to
A. Repressed memories
B. Learned from the society
C. Distorted thinking about others
D. Inherited from parents
86. Hana was presented with GI complains like abdominal bloating and constipation, despite
the negative findings on Lab work ups she is always worried if she got a serious illness.
The most likely dx is

A. Factitious disorder B .MDD C. Hypochondriasis D. Malingering

87. From birth to adulthood the amount of sleep we need

A. Increases B. Decreases C. Stays the same D. Decreases then increases

88. Which of the following is not parasomnia?

A. Narcolepsy B. Sleepwalking C. Sleep terror D. Nightmare

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 89. Which group of drug is commonly indicated for primary insomnia?

A. Antidepressants .Antipschotics C. Psychostimulants D. Benzodiazepines

90. One is true about suicide in medical illness

A. The prevalence of suicide among medically ills is equal to general population

B. Severe pain associated with the illness may increase suicidal risk
C. Being female is a high risk of suicide

Case study

While a mental health professional is working in Dil chora referral hospital, a 25-year-old female
patient comes to hospital for treatment of depression. She has been cutting her wrist regularly.
She seems to suffer from borderline personality disorder. Recently, she has broken up with her
boyfriend. She feels very lonely and empty. She feels abandoned. She does not like to take
antidepressant. She needs a professional who can listen to her and keeps her occupied. Answer
question 91 and 92 based on the above case given for you
91. If you are the treating mental health professional for this patient and you have been
seeing her for a few times. During one consultation, she invites you to go for a coffee in
Triangle hotel. She says that she will be very upset if you reject her offer and she will
hate you forever. What will be your rational response for her?
A. You will communicate with hospital medical director and go for coffee if hospital
medical director allowed for you
B. You will go for a coffee with her if you are interested and if you have free time
C. You have to report to the hospital medical director because the patient is violating her
boundary
D. You will go for coffee with this patient because the patient will be very upset if you
reject her offer
E. None
92. She is also asking for your hand phone number. She needs your personal hand-phone
number because she wants to call you if she needs urgent help. She promises that she
only calls you if she is in an emergency and she will not call you for any reason. What
will be your rational response for her?
A. You will give her your hand phone number because the patient is promised not to call
you unless emergency situation
B. You will give her your hand phone number because patient is mentally intact
C. You will give her your hand phone number because giving hand phone number is not
boundary violation
D. None of the above is rational response for her
93. An unconscious client is admitted to the emergency department with a self-inflicted
gunshot wound to the head. Family members state that they know of the existence of a
living will in which the client insists that life support not be implemented. What is the
legal obligation of the health-care team?
A. Follow the family’s wishes because of the family’s knowledge of the living will
B. Follow the directions given in the living will because of mandates by state law

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 C. Follow the ethical concept of non-maleficence, and place the client on life support
D. Follow the ethical concept of beneficence by implementing life-saving interventions
94. The phone rings at the nurse’s station of an in-patient psychiatric ward. The caller asks
to speak with Mr. Abebe, a client in ward 20. Which nursing response protects this
client’s right to autonomy and confidentiality?
A. I am sorry you cannot talk to Mr. Abebe
B. I cannot confirm or deny that Mr. Abebe is a client admitted here.
C. I’ll see if Mr. Abebe wants to talk with you.
D. I’m sorry; Mr. Abebe is not taking any calls
Case study: While you are working in mental hospital as mental health professional, Mr. Tola
comes to the hospital you are working in with behavioral disturbance suggestive of Major
depressive disorder with psychotic feature. Answer question 95 based on this case study
95. Family of Mr. Tola needs to know about his illness and other related condition but, Mr.
Tola told you as you have to kept his information confidentially. What you should be to
tell to Mr. Tola’s family
A. You will tell them as protecting patient’s confidentiality is the responsibility of
you/mental health professional
B. You will tell them about his condition even without patient allowed for you
C. You have to ignore the patient because he is mental ill and protecting the
confidentiality of mental ill patient is not needed
D. All of the above
Answer question 96 and 97 based on the following case study
A -23- year old male brought to the hospital with complain of decreased needs of sleep of 2
weeks duration and reporting as he is the leader of football international federation, he also took
as he is the one who found illuminate religion. The patient also reports flight of ideas. His family
also report as the patient is very aggressive, gives his clothes and money to the person he didn’t
know. During the interview the clinician understand as the patient has suspiciousness that
characterized by suspecting as the persons to magic on him. The finding of physical examination,
laboratory is negative for other medical condition. From history the patient has no uses of
substance and no report of physical condition that shows about medical condition.
96. Based on the above case study what is the most possible diagnosis?
A. MDD with severe psychotic feature
B. Bipolar II disorder, with psychotic feature
C. Hypomania with psychotic features
D. Bipolar I disorder, current manic episode, with severe psychotic feature
97. Based on the above case study which the following type of medication is preferable for
this patient?
A. Antidepressant and antipsychotic
B. Selective serotonin reuptake inhibitors
C. Mood stabilizers only
D. Mood stabilizers and antipsychotic
Answer question 98 and 99 based on the following case study
Mr. Abebe, a 32-year-old man, reports feeling sadness and having difficulties falling asleep for
the past three weeks. During the course of his history, he also stated that he has lost his appetite

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and that his sexual relationship with his wife has decreased to the extent where he has separated
his sleeping place from her. His wife witnessed her spouse attempting to take his own life by
ingesting poison. His wife also reported as her spouse has suspecting of food that characterized
by suspecting food as food has poison that harms his life. From the patient's history, he has no
prior history of mental illness, and from laboratory evaluation, he has no other medical
condition, and both the physical examination and the patient's history reveal no signs and
symptoms. Mr. Abebe had to miss two weeks of work as a result of this.
98. Which of the following medication is preferable for this patient?
A. Mood stabilizers and antidepressants
B. Mood stabilizers and antipsychotics
C. Antidepressant and antipsychotic
D. Antidepressant
99. If you are considered to give maintenance treatment for this patient which medication
you will continue?
A. Antipsychotic
B. Mood stabilizers
C. Antidepressant
D. Antidepressant and antipsychotic
100. Mr. Chala was diagnosed as Bipolar I disorder; severe with psychotic features,
and he was prescribed mood stabilizer (sodium valproate) and antipsychotics
(Haloperidol). He is symptom-free from both psychosis and manic symptoms after three
months of the treatment, and the patient is currently engaged in his everyday activities.
What is your next treatment strategy/plan for this patient, if you are the treating
clinician?
A. continue both medication for next one year
B. stop antipsychotic an continue mood stabilizers
C. stop both medication
D. stop mood stabilizer and continue antipsychotic
101. Mr. Bortola came to the hospital where you work with a complaint of depression
and a loss of interest that lasted a month. During the examination, you got signs and
symptoms that met the full criteria for Major depressive disorder, and because the
patient had a headache and fever for three days, a laboratory investigation was ordered,
and the laboratory result revealed that the patient had Typhoid fever. Following further
evaluation, the patient informed you that he has no prior history of such medical
conditions and that this three-day attack of typhoid fever is his first. What is the best
diagnosis for this patient based on the history
A. major depressive disorder severe with psychotic features
B. Major depressive disorder
C. Depressive disorder due to Typhoid fever
D. Major depressive disorder plus Typhoid fever
102. Which of the following symptoms must be present for a woman to meet criteria
for premenstrual dysphoric disorder?
A. Marked affective liability
B. Decreased interest in usual activities
C. Physical symptoms such as breast tenderness
D. Marked change in appetite

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 E. A sense of feeling overwhelmed or out of control
103. The Specify in full remission for MDD is used when
A. During the past 2 months, no significant signs or symptoms of the disturbance were
present.
B. During the past 2 months, significant signs or symptoms of the disturbance were
present.
C. During the past 2 year, no significant signs or symptoms of the disturbance were
present.
D. During the past 2 year, significant signs or symptoms of the disturbance were present.
104. As soon as she returns home from the hospital, three days after delivering a
healthy baby girl, a 23- year-old woman becomes increasingly irritable and tearful. She
constantly worries about the baby, fearing she won’t be an adequate mother. What is the
most likely diagnosis?
A. Postpartum depression
B. Postpartum psychosis
C. Postpartum blues
D. Major depressive episode
105. 27-year-old woman seeks evaluation for her “depression” in an outpatient clinic.
She reports episodic feelings of sadness since adolescence. Occasionally she feels good,
but these periods seldom last more than two weeks. She is able to work but thinks she is
not doing as well as she should. In describing her problems, she seems to focus more on
repeated disappointments in her life and her low opinion of herself than on discrete
depressive symptoms. In a differential diagnosis at this point, the most likely diagnosis
is
A. Dysthymia
B. Major depression with melancholia
C. Cyclothymia
D. Childhood depression
106. A17-year-old boy with a history of major depressive disorder (MDD) comes to
your office for a routine visit. When you walk into the examining room, you notice that
the boy is sitting slumped forward with his head bent down. He does not make eye
contact and says nothing. You suspect that he is having a recurrence of depressive
symptoms and are concerned about his risk for suicide. Which of the following
statements regarding depression and suicide in adolescents is true?
A. Rates of suicidal behavior are similar in Adolescent girls and boys.
B. More girls than boys commit suicide
C. Suicide is a considerable risk in depressed adolescents and should be specifically
addressed during an interview
D. A prior suicide attempt does not increase an adolescent’s risk of a subsequent one.
107. A 15-year-old boy has a long history of nonverbal communication deficits. As an
infant he was unable to follow someone else directing his attention by pointing. As a
toddler he was not interested in sharing events, feelings, or games with his parents. From
school age into adolescence, his speech was odd in tonality and phrasing, and his body
language was awkward. What do these symptoms represent?
A. Stereotypies.
B. Restricted range of interests

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 C. Developmental regression
D. Deficits in nonverbal communicative behaviors
108. A 9-year-old girl presents with a history of intellectual impairment, structural
language impairment, nonverbal communication deficits, disinterest in peers, and
inability to use language in a social manner. She has extreme food and tactile
sensitivities. She is obsessed with one particular computer game that she plays for hours
each day, and she scripts and imitates the characters in this game. She is clumsy, has an
odd gait, and walks on her tiptoes. In the past year she has developed a seizure disorder
and has begun to bang her wrists against the wall repetitively, causing bruising. On the
other hand, she plays several musical instruments in an extremely precocious manner.
Which feature of this child’s clinical presentation fulfills a criterion symptom for DSM-
5 autism spectrum disorder?
A. Motor abnormalities.
B. Seizures
C. Structural language impairment
D. Intellectual impairment
E. Nonverbal communicative deficits
109. Which of the following characteristics is generally NOT associated with autism
spectrum disorder?
A. Anxiety, depression, and isolation as an adult.
B. Catatonia.
C. Poor psychosocial functioning.
D. Insistence on routines and aversion to change.
E. Successful adaptation in regular school settings.
110. Which of the following disorders is generally NOT comorbid with autism
spectrum disorder (ASD)?
A. Attention-deficit/hyperactivity disorder (ADHD).
B. Rett syndrome.
C. Selective mutism
D. Intellectual disability (intellectual developmental disorder)
E. Stereotypic movement disorder.

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