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A patient says she feels as if she is watching herself from outside her body, as if in a film. What is this called?

1. AA visual hallucination
2. BDerealisation
3. CA delusion of control
4. DDepersonalisation

Which level of anxiety involves disorganised thinking, an inability to communicate clearly and possible loss of contact with reality?

1. APanic
2. BModerate anxiety
3. CMild anxiety
4. DNormal everyday anxiety

A withdrawn patient comes to the day room for the first time. The nurse says, "Good morning, Mr Ahmed. I see you've joined us today." Which technique is this?

1. AGiving approval
2. BPresenting reality
3. CVoicing doubt
4. DGiving recognition

In families of people with schizophrenia, which pattern of "high expressed emotion" is linked to a higher rate of relapse?

1. AFrequent criticism, hostility and emotional over-involvement
2. BEncouraging the patient to take part in activities
3. CCalm, supportive and warm communication
4. DRegular contact with the care team and other families

A patient who has started chlorpromazine feels dizzy when she gets out of bed. What should the nurse teach her?

1. AStop the medicine if the dizziness happens more than once
2. BSit on the edge of the bed for a moment and then stand up slowly
3. CGet up quickly to get the blood flowing to the brain
4. DDrink a cup of strong coffee before getting out of bed each morning

An 84-year-old asks for an over-the-counter sleep aid containing diphenhydramine. What is the main concern?

1. AIts anticholinergic effects can cause confusion, urine retention and falls
2. BIt raises blood pressure to dangerous levels in older adults
3. CIt is a strong opioid that causes severe dependence
4. DIt has no effects at all in people over 80, so it will not help her sleep

A patient with borderline personality disorder says, "If you don't make Anna my nurse again tomorrow, I'll cut myself." What is the most appropriate response?

1. AIgnore the threat, because she is only trying to manipulate staff
2. BTake the statement seriously, assess her risk and explain that nursing assignments are decided by the team
3. CAgree to assign Anna to her every day so that she stays safe
4. DTell her that if she cuts herself again, she will be discharged from the ward at once without any follow-up

A patient in DBT feels a strong urge to self-harm after a distressing phone call. Which DBT skill module is designed to help her get through this moment without making things worse?

1. ASystematic desensitisation
2. BDistress tolerance
3. CCognitive restructuring of core beliefs
4. DInterpersonal effectiveness