BEH. SCIENCES
Two young boys are playing at a daycare center. One holds a ball on top of some blocks that the other child has
placed on the floor. The cond child helps steady the blocks, then the first child lets go of the ball, knocking the blocks down to the floor. They both watch and then repeat the process. The children are most likely
A. 10 months old
B. 16 months old
C. 18 months old
D. 24 months old
E. 48 months old
Explanation:
The correct answer is E. The capacity for cooperative play generally does not begin much before the age of 4. Prior to this time (24-30 months), children may play in a parallel fashion, but without real interaction.
A 23-year-old woman visits a primary care physician complaining of recurrent naua and generalized abdominal
kidding是什么意思pain, which has distresd her and compromid her functioning for the past veral months. Thorough
evaluations by a gynecologist and gastroenterologist have revealed no abnormalities. She was referred to a
neurologist for headaches and has been taking acetaminophen for her "joint pains." The primary care doctor
completes a thorough physical exam; the results are normal. Which of the following is the most likely diagnosis?
A. Body dysmorphic disorder
B. Conversion disorder
C. Factitious disorder
D. Malingering
E. Somatization disorder
Explanation:
The correct answer is E. Patients with somatization disorder have many medically unexplained symptoms in
multiple body systems, causing work limitation, incread visits to the physician, needless surgery, or
unnecessary medical treatments. Somatization disorder is distinguished by its ego dystonic symptoms; that is,range
the patient's functioning is compromid becau of the unpleasantness of symptoms. It usually begins before
age 30.
Body dysmorphic disorder (choice A) refers to the patient who is preoccupied with the belief that some part of the body is marred in looks. It usually begins in adolescence and is equally common in males and females.
Conversion disorder (choice B) refers to patients with neurological complaints that are not consistent with
prent-day knowledge about the nervous system (e.g., anesthesia that does not run along a nerve
distribution). A classic clue to this diagnosis is that the patient reveals a relative lack of concern about the
symptoms, known as "la belle indifference."
There are three types of factitious disorder (FD; choice C): FD with psychological symptoms, FD with medical symptoms, and chronic FD. FD with medical symptoms is different from somatization disorder becau in FD
symptoms are completely fabricated, patients often insist on hospitalization and submit to invasive procedures, and may produce symptoms through specific acts (e.g., taking drugs). The patients differ from somatizationkmt
disorder in that they are consciously trying to assume a sick role.
Malingering (choice D) refers to the situation in which a patient reports psychological or general medical
symptoms in order to achieve some easily recognizable condary gain. The question implied no condary
gain for the patient, therefore malingering is not the best diagnosis in this ca.
An 88-year-old male complaining of abdominal pain enters the emergency room with his wife. A mini-mental
status exam reveals pronounced forgetfulness and confusion. The patient is discovered to have acute
appendicitis requiring immediate surgery. He is unable to understand the situation and cannot provide informed connt. Which of the following further actions must the physician take?
A. Do not perform surgery
B. Have another doctor confirm the necessity of surgery
C. Obtain a court order to perform surgery
D. Obtain connt from his wife to perform surgery
E. Try to persuade the patient to connt to surgery
Explanation:
The correct answer is D. In cas in which an emergency exists, the patient is incompetent to give connt, and the withholding of treatment would be potentially life-threatening, the physician must ek out clo relatives of the patient to supply connt. The physician should proceed with treatment, assuming the patient would want
the treatment had he or she understood the situation.
Not performing surgery (choice A) could cost the patient's life.
Having another doctor confirm the necessity of surgery (choice B) is favorable (if done immediately) but not
mandatory and does not change the patient's connt status.
Obtaining a court order (choice C) is not necessary with the patient's wife immediately accessible.
Trying to persuade the patient to connt to surgery (choice E) would not only waste time and prove futile but
might agitate the patient as well.
国庆节英文怎么说A 50-year-old physician is recovering from aptic meningitis that began two weeks ago. He appears to have lost
considerable cognitive function, and he says he will not go on living if his cognitive ability remains compromid. To demonstrate to him that recovery is occurring, rial evaluations with which of the following psychological
asssments is indicated?
A. Halstead-Reitan Battery
B. Stanford Binet Intelligence Test
C. Vineland Adaptive Behavior Scale
D. Wechsler Adult Intelligence Scale
E. Wide Range Achievement Test
Explanation:
The correct answer is A. The Halstead-Reitan Battery is a group of tests that reflects the basic and higher level cognitive and neuro-nsory functioning of the entire brain, and can be ud in a rial fashion with little
learning effect being prent. Since there is recovery of function for up to 2 years post CNS-trauma, test results can demonstrate that the prent loss the patient is experiencing is not permanent.
The Stanford Binet Intelligence Test (choice B), ud in the adult, mainly reflects verbal skills and conquently would miss large portions of this man's situation.
The Vineland Adaptive Behavior Scale (choice C) asss developmental and social functioning, not cognitive and neuro-nsory abilities.
The Wechsler Adult Intelligence Scale (choice D) confines its results to intelligence asssment and does not
asss more basic issues like aphasia and neuro-nsory skills.
The Wide Range Achievement Test (choice E) asss academic achievement only.
Geraldine Jones, M.D., is to e a 32-year-old patient, John Smith, whom she has never talked with before. Upon
entering the patient's room, which of the following is the most appropriate introduction the physician can make?
水平面A. "Hello, I'm Dr. Jones."
B. "Hello, John."
C. "John, I'm Dr. Jones."
D. "Mr. Smith, I'm Dr. Jones."
E. "Mr. Smith, I'm Geraldine."
Explanation:
The correct answer is D. Communication with patients should be leveling. That is, if the physician expects to be addresd using a title, then the patient should also be addresd with a title.
Choice A is not correct becau the patient is not addresd by name; and, the physician may be in the wrong
room and about to treat the wrong person.
Choices B, C, and E are not correct becau there is no leveling. In choice B, the physician is not identified. In choice C, the patient is called by his first name while the physician maintains a distance through the title of "Dr."
Choice E is incorrect becau the patient is given a title and the physician goes by her first name.
A 19-year-old female, who recently moved from her family's home in another state, is hospitalized for attempting
suicide by taking an overdo of antidepressant medications. On the third day of her hospital stay, she insists,
under threat of a lawsuit, that her medications be stopped and that she be discharged from the hospital so she
"can go home and finish the job." Her nsorium is clear. Her physician should
A. discharge her against medical advice (AMA)
B. honor her request and relea her immediately
C. obtain an emergency order of detention
D. relea her to go back to her parents' home
E. date her
Explanation:
The correct answer is C. The physician should obtain an emergency order of detention, regardless of her
threats of a lawsuit. The woman clearly still has suicidal intent, demonstrated by her expresd verbalizations,
and is therefore a danger to herlf.
Choices A, B, and D clearly place her in a position where she can carry out her plans to terminate her life.
Sedating her (choice E) is the cond best choice since it will prevent her from taking her life; however,
success作文dation does not give therapists the opportunity to address the underlying motivations for her suicidal
ideation.
Eight rearch scientists are brought into the hospital by the paramedics. They are suffering from diaphoresis,
blurred vision, palpitations, and hallucinations with brilliant colors. Police suspect that the coffee at their lab
meeting was laced with a psychoactive substance. Which of the following substances is most likely to be found in the coffee pot?
A. Lyrgic acid diethylamide (LSD)
B. Methadone
C. Phencyclidine (PCP)
D. Phenobarbital
E. Tetrahydrocannabinol (THC)
九月 英文Explanation:
The correct answer is A. The eight rearchers are probably under the influence of LSD, which caus
hallucinations notable for their brilliant colors. LSD also shows activity at rotonin receptors, and can activate the sympathetic nervous system, resulting in symptoms such as diaphoresis, blurred vision (due to pupil
dilation), and palpitations.
Methadone (choice B) is a synthetic opiate ud to treat heroin addiction. It has analgesic properties, but does not ordinarily induce hallucinations.
PCP (choice C) can cau hallucinations marked by alterations of body image and distortions of space and time. PCP can also cau a dissociative anesthesia and analgesia. Common side effects of PCP u include
hypersalivation, muscular rigidity, hypertension, and nystagmus. Highly colored visual hallucinations are not as commonly en with PCP intoxication as with intoxication by LSD.
Phenobarbital (choice D) is a long-acting barbiturate that acts as a CNS depressant. It is ud in the long-term management of izure disorders.
对不起英文THC (choice E) is found in marijuana, and produces a euphoric high followed by subquent relaxation and
sleepiness. Marijuana u can result in visual hallucinations, delusions, and a toxic psychosis, but generally only at extremely high dos.
Medical students at a major teaching hospital are routinely assigned to obrve obstetric patients and to assist
during delivery. When a male medical student introduces himlf to an obstetric patient, the patient becomes
agitated and requests that no students be prent during her delivery. The patient had been informed, prior to
admission, that this was a teaching hospital and that a student would be assigned to her ca. When informed of the patient's refusal, the attending physician in charge should
A. ask the patient's husband for his connt
B. assign a female medical student to obrve
C. not allow any medical students to obrve this patient
D. have the patient's nur ek permission
E. have the student approach the patient again and explain the necessity for student obrvation
F. have the student obrve in the background as a part of the health care team.
G. meet with the patient and discuss the value of obrvation in medical training
ozzyExplanation:
The correct answer is C. The patient has the right to decide who will or will not be prent during her care. This includes the right to refu to be a part of a student's educational experience. The desires of the patient, not
android是什么意思the physician or training facility, come first. If the patient does not want a medical student prent dur
ing the
delivery, respect the patient's wishes.
Choice A is incorrect becau the patient's connt, not her husband's, is required. The husband cannot give
connt for an alert, competent patient.
Choice B is incorrect becau the patient is not rejecting male students, but all students.
Choice D is incorrect becau the patient has already refud. Sending the nur to get permission suggests
that the physician is not respecting her expresd wishes.
