BH_E1_Initial_Eval_Doc

During a psychiatric interview, which of the following should be assessed to understand a patient's perspective on treatment?

A patient undergoing a mental status examination exhibits a persistent false belief that they are being followed by government agents, despite evidence to the contrary. This is an example of what?

Which of the following observations during an interview might suggest a patient is experiencing anxiety, even if they deny feeling anxious?

In the context of a psychiatric evaluation, what is the MAIN purpose of using brief standardized screening questionnaires?

How does a general medical condition potentially impact a patient's psychiatric state?

A patient reports experiencing overwhelming urges to repeatedly check if the door is locked, causing significant distress and impairment in daily functioning. This is MOST consistent with:

During a mental status exam, a patient exhibits pressured speech, flight of ideas, and inflated self-esteem. Which domain of mental function is MOST likely impaired?

During a Mental Status Examination, you observe a patient who is diagnosed with a chronic cardiac condition. Although, denying feelings of sadness, you notice the patient consistently avoids eye contact, speaks in a monotonous tone, and exhibits slouched posture. Assuming the patient is being truthful, what is the MOST appropriate conclusion?

During a mental status examination, which aspect of a patient's appearance might suggest an inability to care for themselves?

A patient is speaking very softly and slowly during an interview. According to the text, this could be indicative of:

What is the difference between 'mood' and 'affect' in the context of a mental status examination?

In emergency situations, what should a clinician prioritize when assessing a patient with psychiatric symptoms?

A patient is smiling while recounting a traumatic experience. This observation primarily concerns which aspect of the mental status examination?

What is the primary goal of using open-ended questions during a psychiatric interview?

Which of the following best describes 'ideas of reference'?

When is it most appropriate for a clinician to seek information from collateral sources such as family or caregivers during a psychiatric assessment?

Why is it important to review previous psychiatric treatments and the patient's adherence to them?

A patient abruptly jumps from discussing their pet cat to quantum physics, then to their favorite sandwich, with no apparent connection between these topics. Which of the following is the most likely to be documented?

During a mental status exam, a patient claims to be the King of France. When questioned, they provide elaborate details about royal duties and historical events, all unsubstantiated. This is an example of:

All of the following are components of a routine psychiatric assessment EXCEPT:

An experienced clinician is conducting a psychiatric interview. Which approach would MOST effectively elicit relevant information from the patient?

A patient consistently trivializes severe physical injuries and expresses an unwarranted sense of optimism about their recovery, despite medical evidence to the contrary. Further, they exhibit pressured speech and inflated self-esteem. Which condition is most suggested by these signs?

A patient presents with new psychiatric symptoms of unknown etiology. After initial assessment, the clinician suspects that the symptoms may be related to an underlying general medical condition. According to best practice, what is the MOST appropriate next step?

During a psychiatric evaluation, a patient exhibits subtle cognitive deficits that do not significantly impair their ability to provide a coherent history. However, the clinician suspects that these deficits may be impacting the reliability of the information provided. Which of the following strategies would be the MOST ethically sound and clinically prudent approach?

Which of the following is the MOST important initial step for a clinician to take when a patient presents with psychiatric symptoms?

In which scenario is it MOST appropriate for a clinician to prioritize gathering information from collateral sources such as family or caregivers during a psychiatric assessment?

What is the primary reason for using open-ended questions during a psychiatric interview?

You're treating a patient with a long history of bipolar disorder who has been generally stable on their medication. However, they report that they stopped taking their medication a few weeks ago and endorse feeling 'on top of the world' and have increased energy and racing thoughts. According to the information, what would be the MOST important next step?

A seasoned clinician is conducting a psychiatric evaluation of a new adult patient. The clinician begins by asking the patient 'Tell me about what brought you in today.' What is the MOST likely reason for this approach?

A patient in an outpatient psychiatric clinic presents with symptoms suggestive of major depressive disorder. The patient has a complex medical history, including hypertension, hyperlipidemia, and type 2 diabetes, all of which are currently well-managed with medications. The patient also reports experiencing a recent stressful life event. Considering the information provided, what is the MOST important next step in the assessment?

Which element of the psychiatric history is MOST crucial in guiding immediate treatment decisions for a patient presenting with acute psychosis?

A patient consistently attributes failures to external factors and is unduly upset by minor setbacks. This behavior is MOST relevant to assessing which aspect of the patient's profile?

When evaluating a patient with a history of intravenous drug use, which aspect of the general medical history is of MOST immediate concern?

In assessing 'response to the usual vicissitudes of life,' which of the following examples would be MOST indicative of a potential underlying psychiatric disorder?

A patient presents with symptoms suggestive of both a mood disorder and a substance use disorder. According to best practices, what is the MOST appropriate initial step?

Which of the following historical details would be MOST important to ascertain when assessing a young adult with newly onset anxiety?

A patient with a long-standing history of bipolar disorder is currently stable on medication. However, they report a recent job loss. Which area of the initial psychiatric assessment should be MOST carefully re-evaluated?

During an initial psychiatric assessment, a patient mentions a distant relative with schizophrenia. How should the clinician proceed in gathering useful information about the potential relevance of this information?

A clinician is conducting a psychiatric evaluation of a patient with a complex medical history, and they are unsure if recent symptoms are psychiatric in nature or caused by a medication they are taking. Which course of action is MOST appropriate?

A patient reports a history of 'always' feeling inadequate despite objective evidence of success in various aspects of life including a loving family, a good education, and a promising career. Which area of the psychiatric assessment will MOST likely yield additional information to explain this discrepancy?

A patient presents with repetitive hand-washing that they recognize as excessive but feel unable to control, alongside persistent intrusive thoughts about contamination. Which of the following best describes these findings?

When conducting an initial psychiatric assessment, which of the following is the MOST critical aspect to explore beyond the presenting symptoms?

During an initial psychiatric evaluation, a patient discloses a history of poorly managed diabetes. According to best practice, which of the following would be MOST appropriate?

A clinician is conducting a psychiatric assessment and focuses primarily on the patient's current depressive symptoms, neglecting to inquire about past manic episodes. What is the MOST significant risk associated with this approach?

A patient consistently breaks eye contact, fidgets, and speaks rapidly while reporting feeling 'completely fine' and denying any anxiety or distress. Which of the following actions is MOST appropriate, given the conflicting information?

Which of the following is the MOST appropriate application of a standardized screening questionnaire during a psychiatric assessment?

During a psychiatric evaluation, a patient reports symptoms of anxiety. What additional information from the patient's history would be MOST helpful in determining if a general medical condition is contributing to their psychiatric presentation?

A patient presents with new-onset psychosis. The clinician obtains a thorough personal and social history that is unremarkable. What should the clinician do NEXT?

A clinician is treating a patient with comorbid depression and generalized anxiety disorder (GAD). The clinician wants to choose an antidepressant medication that will address symptoms of both disorders, but the patient has a history of insomnia and weight gain with prior antidepressant trials. Which of the following choices of medication is MOST appropriate in this scenario?

A patient with a known history of schizophrenia is brought to the emergency department exhibiting increased agitation, disorganized speech, and paranoid ideation. The patient has been prescribed oral haloperidol for several years but admits to inconsistent adherence. A urine drug screen is negative. After initial assessment, the treatment team considers several options for rapid tranquilization. Which of the following treatment approaches is LEAST appropriate in this clinical scenario?

Why is it essential to inquire about past medications during a psychiatric assessment?

During a psychiatric evaluation, a patient describes symptoms indicative of a mood disorder. To differentiate between major depressive disorder and bipolar disorder, which of the following questions is MOST critical for the clinician to ask?

A 30-year-old patient presents with symptoms of depression, including low mood, anhedonia, and fatigue. They deny any past episodes of mania or hypomania. After a thorough assessment, the clinician diagnoses major depressive disorder and initiates treatment with a selective serotonin reuptake inhibitor (SSRI). Several weeks later, the patient presents to the emergency department with symptoms of increased energy, racing thoughts, impulsivity, and decreased need for sleep. What is the MOST likely explanation for the patient's change in presentation?

A patient presents with symptoms of anxiety, but also reports unexplained weight loss, heat intolerance, and palpitations. Recognizing the potential overlap between psychiatric and medical symptoms, the clinician orders laboratory tests, including thyroid function tests. The results reveal elevated levels of triiodothyronine (T3) and thyroxine (T4), and suppressed thyroid-stimulating hormone (TSH). Considering the patient's symptoms and laboratory findings, which of the following is the MOST appropriate next step?