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After hearing that he has a serious heart condition, a man talks calmly and in great technical detail about the statistics of heart disease, showing no emotion. Which defence mechanism is this?

1. AIntellectualisation
2. BReaction formation
3. CDisplacement
4. DRegression

What is anticipatory grief?

1. AGrief that appears for the first time many years after a loss
2. BGrief that never ends and stops the person from functioning
3. CGrief that is hidden from others because the loss is not openly recognised or socially accepted
4. DGrief that begins before an expected loss, such as during a terminal illness

A depressed patient moves and speaks very slowly and takes a long time to answer questions. What is this called?

1. ACatatonic excitement
2. BAkathisia
3. CPsychomotor agitation
4. DPsychomotor retardation

An agitated patient has not responded to verbal de-escalation. A PRN medicine is prescribed. What is the most appropriate step?

1. AOffer the oral medicine first, before considering an injection
2. BPlace him in seclusion and then decide about medicine later
3. CHide the medicine in his drink without telling him
4. DGive an intramuscular injection at once without offering any choice

A patient in a manic episode makes repeated sexual comments to a nurse. What is the most appropriate response?

1. ALaugh at the comments so he does not feel rejected
2. BRespond with similar comments to build rapport
3. CCalmly say that the comments are not acceptable and redirect him
4. DAvoid the patient for the rest of the shift

A patient who has taken lithium for 3 years reports tiredness, weight gain, feeling cold and constipation. Which problem should be checked?

1. AHypothyroidism
2. BSerotonin syndrome
3. CHyperthyroidism
4. DAgranulocytosis

A patient with long-standing schizophrenia is often seen drinking from the taps. Today he is confused, has a headache and his serum sodium is 124 mmol/L (124 mEq/L). What is the most likely problem?

1. ADehydration caused by anticholinergic side effects
2. BNeuroleptic malignant syndrome from his antipsychotic medicine
3. CWater intoxication from psychogenic polydipsia
4. DA worsening of his psychosis that needs a higher dose of antipsychotic

A resident with Alzheimer's disease becomes very agitated and hits out when staff try to help him bathe. What is the best approach?

1. AGet more staff to hold him so the bath can be finished quickly
2. BSkip bathing for the rest of his stay
3. CAsk the doctor for a sedative to be given before every bath so that he stays calm and cooperative
4. DStop, try again later or in a different way, and explain each step calmly