Multiple Choice Questions MCQ

Question 13# Print Question

Closed questions are best avoided in which of the following scenarios?

A. A patient with suspected malingering

B. A guarded patient not answering spontaneously

C. A suggestible patient with learning difficulty

D. A psychotic patient who is actively hallucinating

E. All of the above

Question 11# A patient with schizophrenia vividly describes how Martians are ‘reverse freezing’ earth to produce global warming. He stops to ask what you think about this. Choose the best response.
A. This is a fantastic theory. But I want to know more about this. Tell me, have you ever seen these Martians?
B. This seems possible but there is no proof for all this. Tell me, have you ever seen these Martians?
C. This cannot be true. Martians do not exist. Tell me, have you ever seen these Martians?
D. Tell me, have you ever seen these Martians?
E. What I think is not so important. I want to know more about what you think of this. Tell me, have you ever seen these Martians?
E. Option A and B indicate collusion with the patient’s belief. Option C is a direct confrontation while D is evasion from the topic which can reduce engagement. Reference: Semple DM et al., eds. Oxford Handbook of Psychiatry, 1st edn. Oxford University Press, 2005, p. 56.

Question 12# Which one of the following is NOT an advisable fi rst response when a patient discloses past sexual abuse at a clinical encounter?
A. Postpone discussing the issue
B. Ask if she wants to say anything more about this now
C. Ask if she has ever disclosed this to anyone
D. Ask if she sees a link between this and her current difficulties
E. None of the above
A. Childhood physical, sexual abuse, and neglect are extremely common experiences among those who develop serious mental health problems. But victims are typically reluctant to disclose their histories of abuse and psychiatrists are often reluctant to seek this important information. Though clinicians are not comfortable exploring sexual abuse in the first interview, postponing the discussion once it is disclosed is not an advisable strategy. Reference: Read J, et al. Why, when and how to ask about childhood abuse. Advances in Psychiatric Treatment 2007; 13: 101–110.

Question 14# Which of the following is the single best question to discern premorbid personality of a patient?
A. How would you describe yourself?
B. How would your friends describe you?
C. What were you like before you became unwell?
D. If we had met 10 years ago, what sort of person would I be talking to?
E. None of the above
E. There is no single question that can reliably elicit premorbid personality traits. A detailed discourse that includes enquiry about hobbies, leisure, predominant mood state, character, and descriptions – both self and by friends – is necessary to understand one’s premorbid personality. Reference: Sadock BJ and Sadock VA. Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 10th edn. Lippincott Williams & Wilkins, 2007, p. 228.

Question 15# Which of the following is not a discriminating question to screen for harmful use of alcohol?
A. Have you ever attempted to cut down your drinking?
B. Do you get annoyed when people talk about your drinking?
C. Have you ever felt guilty for drinking excessively?
D. Do you drink every evening?
E. Do you need a drink as soon as you wake up?
D. The CAGE questionnaire includes questions on ‘Cut down’, ‘Annoyed’, ‘Guilty’, and ‘Eye opener’. Early morning drinking (not evening as indicated in the question) indicates a problem use of alcohol. Reference: Semple DM et al., eds. Oxford Handbook of Psychiatry, 1st edn. Oxford University Press, 2005, p. 509

Question 13# Closed questions are best avoided in which of the following scenarios?
A. A patient with suspected malingering
B. A guarded patient not answering spontaneously
C. A suggestible patient with learning difficulty
D. A psychotic patient who is actively hallucinating
E. All of the above
C. While interviewing people with limited intelligence, questions should be brief and worded in a simple way. Closed and leading questions are best avoided as suggestibility is prominent in this population. Suggestibility in patients with limited intelligence can be assessed using the Gudjonnson Suggestibility Scale. Closed questions are a good way of eliciting information from a disturbed psychotic patient who is guarded or distracted by hallucinations. Confrontation through closed questions may be useful in malingerers. Reference: Gudjonsson GH and Henry L. Child and adult witnesses with intellectual disability: The importance of suggestibility. Legal and Criminological Psychology 2003; 8: 241–252.