Disorder of stream of thought

(I’ve split up these into disorder of thought form and stream, but several could be argued both
ways)

Flight of ideas is when the content of speech moves quickly from one idea to another so that
one train of thought is not carried to completion before another takes its place. The normal logical
sequence of ideas is generally preserved although ideas may be linked by distracting cues in the
surroundings and from distractions from the words that have been spoken. These verbal distractions
may be of three kinds: clang associations, puns and rhymes.

Retardation of thinking is often seen in depression, the train of thought is slowed down,
although still goal directed. The opposite is pressure of speech and this is often seen in
mania.

Peseveration is the persistent and inappropriate repetition of the same thoughts. In reply to a
question a person may give the correct answer to the first but ue to give the same answer
inappropriately to subsequent questions. This is especially seen in ‘orcontinganic’ brain disorders like
dementia.

Disorders of thought form:

Overinclusion refers to a widening of the boundaries of concepts such that things are grouped
together that are not often closely connected.

Loosening of associations denotes a loss of the normal structure of thinking. The

patient’s discourse seems muddled and illogical and does not become clearer with further questioning;
there is a lack of general clarity, and the interviewer has the experience that the more he/she tries to
clarify the patient’s thinking the less it is understood. Loosening of associations occurs
mostly in schizophrenia

Three kinds of loosening of association have been described:

Knight’s move thinking or derailment where there are odd tangential associations between ideas.

Tensentiality Talking past the point (= vorbeireden) where the patient seems to get close to the
point of discussion, but skirts around it and never actually reac7hes it

Verbigeration (= word salad = schizophasia = paraphrasia) where speech is reduced to a

senseless repetition of sounds and phrases (this is more of a disorder of thought form)
Circumstantiality is where thinking proceeds slowly with many unnecessary details and
digressions, before returning to the point. This is seen in epilepsy, learning difficulties and obsessional
personalities

Neologisms are words and phrases invented by the patient or a new meaning to a known word

Metonyms are word approximations e.g. paperskate for pen

Derailment (aka entgleisen) is where there is a change in the track of thoughts. There is
perserved, but misdirected determining of tendency/goal of thought)

With drivelling there is a disordered intermixture of the constituent parts of one complex thought

Fusion is where various thoughts are fused together, leading to a loss of goal direction.

Omission is where a thought or part of a thought it is senselessly omitted

Substitution is where one thought fills the gap for another appropriate more ‘fitting-in’ thought.

Concrete thinking is seen as a literalness of expression and understanding, with failed

abstraction. Can be tested by the use of proverbs.

Thought block refers to the sudden arrest in the flow of thoughts. The previous idea may then
be taken up again or replaced by another thought.

Some important point

Ect discovered by carlet and vini

Anurosis means repeatative urin voiding in anappropriat place after 5 ege of 5 year
Falding is the vehavior therapy which is use to treat phobia
In schizophernia audatory hallucination is most accure
Ocd is neuratic disorder
Lithium level is the 0.6 to 1.2 meq
Insest is the sexual activity in which same family member
Imiramine is antidepressent medicine
Pedophelia is involmet of sexual relation adult to children
Gastrative hallucination is the hallusination of test
Retrograde amnisia is the side effect of ect
Voltage of the ect is 70 to 110 volt
.1 Resperidone is a :-

(A) Benzodiazipine

(B) Atypical Antidepressant

(C) Atypical Antipsychotic

(D) Mood Stabilizer

Q. 2 Nurse Must Observe on of the following side effects in a patient who is on Antipsychotic :-

(A) Extra Pyramidal symptom

(B) Arrythmia

(C) Anorexia

(D) Hypertension

Q. 3 Electro Convulsive Therapy is most commonly given in the following condition :-

(A) Neurosis

(B) Depression

(C) Obession

(D) Substance Abuse

Q. 4 All of the Following are types of Delusion EXCEPT :-

(A) Grandisoity

(B) Wrong Perception

(C) Ideas of Reference

(D) Persecution

Q.5 All of following are neurotic disorder EXCEPT;

A. Mania

B. Conversion disorder
C. Neurotic depression

D. Phobia

Q.6. Repetitive behavior pattern performed in a stereotype manners?

A. Compulsion

B. Obsession

C. Repression

D. Replication

Q.7. When thought are so quick without association it is called?

A. Flight of ideas

B. Catalepsy

C. Mannerism

D. Clung association

Q. 8. Morphine belong to following group of drugs?

A. Belldona alkaloids

B. Opioid

C. Barbiturates

D. Anticholinergics

Q.9. Fear of going outside to open space

A. Algophobia

B. Agrophobia

C. Acrophobia

D. Ampjiphobia

Q.10. Patient with mania having all of the following symptoms EXCEPT.;
A. Elated with unstable mood

B. Increase Pressure of speech

C. Sluggish & Fatigue www.prncfet.com

D. Increased Motor Activity

Q.11 Which of the following is not the example of emotion :-

A. Fear

B. Love

C. Hunger

D. None of these

Q.12 Which of the following will influence an individual’s perception ?

A. Sensory limitations

B. Previous Experiences

C. Individual Needs

D. All of the above

Q.13 An idea or a thought that is silly, abused or appartly Meaningless. Yet a person can’t get rid of is
known as :-

A. Agoraphobia

B. Obsession

C. Both of the Above

D. None of the above

Q.14 Irrational Fear from public places is known as :-

A. Agoraphobia

B. Specific phobia
C. Social phobia

D. None of the above

Q. 15 Another Name of conversion Disorder :-

A. Epilepsy

B. Hysteria

C. Hypochondriasis

D. None of these

Q. 16 Clomipramine is a :-

A. Antidepresant Drug

B. Antipsychotic Drug

C. Antianxiety Drug

D. None of these

Q.17 “Flight of Body “ is known as :-

A. Amensia

B. Depersonalization

C. Fugue

D. None of these

Q. 18 Which of the following is not included in psychosomatic disorder :-

A. Epilepsy

B. Anorexia Nervosa

C. Essential Hypertension

D. None of these
Q.19 Revised Name of the Multiple Personality is :-

A. MDP

B. OCD

C. DID

D. None of these

Q.20 Increased Dopamine Neurotransmitter receptors in brain could be responsible for the onset of :-

A. Schizophernia

B. Depression

C. Narcissism

D. MDP

Q.21 Hebephrenic Schizophrenia is known as :-

A. Residual schizophrenia

B. Undifferentiated schizophrenia

C. Disorganized schizophrenia

D. None of the above

Q.22 Which of the following is not a symptom of schizophrenia ?

A. Delusion

B. Excessive Anxiety

C. Hallucination

D. None of these

Q. 23 In ECT, The intensity of Electric Current is Between :-

A. 70-130 volts

B. 130-220 volts

C. 220-440 volts
D. 440-540 volts

Q.24 Causes of Delirium are :-

A. Metabolic Disorder

B. Head Trauma

C. Infection

D. All

Q. 25 The Cause of Sucide is :-

A. Hopelessness

B. Helplessness

C. Worthlessness

D. All of the Above

Q. 26 In which defence Mechanism the person transfers his anger on others v;-

A. Delusion

B. Conversion

C. Repression

D. Projection

Q. 27 The therapy in which Harmony between husband and wife may achieved or established by efforts
of experts :-

A. Cognitive therapy

B. Family therapy

C. Group therapy

D. Marital therapy

Q.28 The Factor which is Responsible to cause schizophrenia :_-

A. Sociocultural Factor

B. Psychosocial Factor

C. Genetic Factor

D. All of the above

Q.29 After Ingestion of Alcohol by person who is on disulfiram Ethanol Reaction Occurs within :-

A. 10 min.

B. 30 min.

C. 60 min.

D. 2 hours

Q.30 Confabulation is commonly observed in patients with :-

A. Delusional Disorders

B. OCD Disorders

C. Amnestic Syndrome

D. Personality Disorders

Q.31 Dissociation is present in All, EXCEPT :-

A. Delirium

B. Multiple personality

C. Fugue

D. Somnabulism

Q.32 The person with generalised Anxiety Disorder :-

A. Is carefree and settled in mood

B. Does not worry about everyday routine events

C. Has no routine everyday events to worry about

D. Worries about everyday routine events

Q. 33 Agitated Depression is NOT characterized by ?

A. Elevated mood

B. Increased motor Activity

C. Depressed mood

D. Restless and purposeless movements

Q.34 The Essential features of obsessional thoughts in OCD are All EXCEPT –

A. A Resistance to subjective compulsion

B. A feeling of subjective compulsion

C. Presence of primary delusions

D. Preservation of Insight

Q.35 Which is NOT a positive sign seen in Schizophrenia :-

A. Delusions

B. Flat Affect

C. Thought disorder

D. Hallucinations

Q.36 At what age can medical treatment be withdrawn :-

A. 70

B. 90

C. 110

D. No Age

Q. 37 Mutism is NOT Associated with –

A. Depressive stupor
B. Hysteria

C. Catatonic stupor

D. Korsakoff’s psychosis

Q. 38 In following which is not included in the 4’´A s of Schizophrenia :-

A. Autism

B. Anxiety

C. Association Disorder

D. Ambivalence

Q. 39 In ICD – 10 Classification the disease that are classified in group F70-79 are-

A. Mood Affective disorder

B. Neurotic stress Related and somatoform disorder

C. Mental Retardation

D. Disorder of adult personality

. 40 Nursing care for improving sleep pattern of schizophrenic patient include all Except –

A. Switch off main light

B. Provide calm and cool environment

C. Give a glass of hot milk before sleeping

D. Avoid day time activities

Q. 41 Tertiary prevention of mental retardation includes:-

A. Autism

B. Immunization of children with DPT,BCG,OPV and MMR

C. Increase Educational level

D. Early detection of presence of mental retardation

Q. 42 A Neurotic disorder in which person has two more personalities or which only one is being
manifest at a time :-

A. Dissociative Identity Disorder

B. Hysterical fits

C. Dissociative fugue

D. Dissociative Amnesia

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Q. 43 The Most important dependence producing opoid Derivates are –

A. Codeine and Papaverine

B. Heroine and Methadone

C. Morphine and Heroine

D. Pethidine and Nolaptrine

Q. 44 In Following which is not a characteristic of Disulfiram ethanol reaction :-

A. Tachycardia

B. Hypertension

C. Hypotension

D. Headache

Q. 45 The drug which is used for managing withdrawal symptoms of opoid ?

A. Clonidine

B. Methadone

C. Naltrxone
D. All of the Above

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Q. 46 A Disorder in which Attempt is Made to counteract the effects of overeating by self induced
vomiting , after period of starvation etc.:-

A. Hypermnesia

B. Anorexia Nervosa

C. Bulimia Nervosa

D. Anorexia

Q. 47 The Nurse employed in a psychiatric unit is as signed to care for a patient admitted to the unit 2
days ago. On review of the patient’s record . The Nurses notes that the admission was an informal
voluntary admission. Based on this type of admission, the Nurse expects which of the following ?

A. The patient will participate in the treatment plan

B. The patient will be angry and will refuse care

C. The patient will be very resistant to treatment measures.

D. The patient’s family will be very resistant to treatment measures.

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Q.48 Disulfiram is prescribed for a patient with a problem related to alcohol. The nurse understand that
this medication works on the principle of which of the following therapies?

A. Self control Therapy

B. Milieu therapy

C. Aversion therapy

D. Desensitization

Q.49 A Client was admitted to a medical unit with acute blindness .Many tests Are performed and three
seems to be no organic reason why this patient cannot see. The nurse later learns that the patient
become blind after witnessing a hit and run car accident . when a family of three was killed. The nurse
suspects that the patient may be experiencing a :-

A. Repression

B. Psychosis

C. Dissociative Disorder

D. Conversion Disorder

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Q.50 Which of the following is not typical Anti-psychotic and does not have marked extra pyramidal side
effects?

A. Clozapine

B. Haloperidol

C. Chlorpromazine

D. Fluphenazine