The Renal Problem
Psychosocial Issues
Pretest
1. In studying the interaction of psychological stress and DNA repair, suppressed DNA repair was found in persons with
C
A. chronic stress more often than those with acute stress
B. low distress over an extended period of time
C. a diagnosis of major depression
D. increased anxiety and depression from bereavement
E. recently diagnosed cancer
2. Immunocompetence can be suppressed by all the following EXCEPT
B
A. the endocrine system
B. chronic stress of long duration
C. the central nervous system
D. the autonomic nervous system
E. psychosocial factors
3. Hyperventilation from anxiety, threat, or fear results in all the following EXCEPT
E
A. reduced CO2 in the blood
B. reduced acid level in the blood
C. increased sympathetic activity
D. increased risk of cardiac arrhythmia
E. increased oxygen supplied to brain tissue
4. When one faces stressors for which there is no apparent coping strategy, one manifests vigilant inaction, which results in all the following EXCEPT
E
A. decreased skeletal movement
B. increased blood pressure
C. vagus nerve-mediated bradycardia
D. increased levels of corticotropin (ACTH) and cortisol
E. increased levels of brain norepinephrine
5. When one has NO sense of control over a stressful situation, all the following physiologic reactions will occur EXCEPT
A
A. weaker corticosteroid elevations will develop
B. an endogenous opioid peptide will be released
C. a brief endogenous opiate analgesia will be produced
D. greater suppression of the cytotoxicity of natural killer cells will occur than in controllable
stress
E. a weaker immune response to mitogen stimulation will develop than in controllable stress
6. Patients who have somatization disorder are diagnosed on the basis of their
D
A. having unexplained symptoms that persist after treatment
B. experiencing symptoms in multiple organ systems
C. having a history of past and present illnesses that have not responded to self-treatment
D. having a specific number of medically unexplained symptoms
E. demonstrating positive test results for several chronic illnesses at the same time
7. Contrary to coping mechanisms, defense mechanisms
C
A. confront a problem directly and continue to generate possible solutions
B. get help when one is unable to handle the problem
C. work to remove awareness of the conflict
D. consciously drop certain habits or form new ones
E. gather information
8. True statements about personality traits and aging include all the following EXCEPT
C
A. a person’s personality traits after age 30 tend to be less variable
B. the personalities of adolescents show lower levels of stability than those of adults
C. most people redefine and make alterations in their personalities during the period of midlife
crisis
D. the neuroticism trait in personality has a high correlation with lower levels of stability
E. personality traits are relatively stable over one’s life span
9. Hypochondriacal patients tend to exhibit each of the following EXCEPT
A
A. quick improvement with treatment
B. dependent personalities
C. depression
D. anxiety
E. chronic reaction to stress as a “way of life”
10. All the following statements about anxiety are true EXCEPT
D
A. intense, manifest anxiety reactions usually involve cardiovascular, respiratory, and
gastrointestinal changes
B. anxiety as subjectively experienced bears no consistent relationship to physiologic responses
commonly associated with it
C. anticipation of a stressful event usually reduces the actual level of anxiety the event evokes
D. performance levels rise and fall with anxiety levels in a linear fashion
E. avoidance behavior is reinforced when it reduces an anxiety
11. A behavior pattern that increases in frequency when followed by a reward is an example of
D
A. classical conditioning
B. shaping
C. respondent conditioning
D. operant conditioning
E. generalization
12. In operant conditioning, the rate of extinction is most effectively slowed when the response or learning has been maintained on a reinforcement schedule of
B
A. fixed ratio
B. variable ratio
C. fixed interval reinforcement
D. continuous reinforcement
E. piecework reinforcement
13. Learned helplessness is associated with depression in that both are characterized by each of the following EXCEPT
A
A. continued failure from lack of ability
B. passive behavior
C. negative expectations
D. hopelessness
E. feelings of no control over events
14. Of the following methods of behavior treatment to reduce blood pressure, which has NOT been found effective?
C
A. biofeedback
B. meditation
C. contingency conditioning
D. relaxation
E. weight loss
15. A social learning approach to attitude change includes all the following methods EXCEPT
E
A. modeling
B. desensitization
C. extinction
D. direct reinforcement
E. integration of nature (vs. nurture)
16. Accurate statements regarding our knowledge of intervention and skills in changing health behavior include all the following EXCEPT
C
A. we know a lot about how to help people change initially, but are not as successful at helping
them sustain the new behavior
B. we are not well informed about preparing and motivating people to undertake change
C. we know more about health promotion than about risk reduction
D. we know very little about how people successfully change their own behavior without
assistance
E. we know very little about how to assure patient compliance
17. Which of the following statements of intervention would be LEAST effective in changing a person’s type A pattern of behavior?
D
A. changing environmental demands
B. changing the patient’s response to the environment
C. changing the physiological concomitants of type A behavior
D. changing the expectation of the social group or society
E. progressive relaxation training
18. The highest patient adherence (compliance) can be achieved by
B
A. communication that is technical and authoritative
B. the patient’s belief that his or her health is influenced by internal control
C. the patient’s belief that his or her health is influenced by external control
D. explanations of need for prophylactic medicine
E. patients being treated for chronic disease
19. In informing a patient or a patient’s relative of the patient’s serious illness, it is LEAST important to
A
A. establish clearly that you would prefer to talk about it only after you have all the facts, tests
and other relevant information
B. find out what the person thinks or knows about the illness
C. find out what the person wants to know about the illness
D. give honest answers in such a way as to leave the person with some realistic hope
E. determine the person’s understanding of what you have discussed
20. Statements about patient’s or physician’s perceptions of symptoms that are generally true include all the following EXCEPT
B
A. physicians tend to focus on symptoms that have serious implications for future health
B. physicians usually focus on symptoms according to visibility or recognizability
C. patients often focus on symptoms that interfere with usual activities or routines
D. patients tend to focus on the degree of discomfort rather than the amount or degree
of tissue damage
E. patients tend to deny symptoms they fear may be related to severe illness
21. A person becomes more vulnerable to conditions of psychological and physical distress if he or she is
D
A. aware of results of diagnostic tests
B. receiving medical information
C. denying the illness
D. introspective
E. receiving counselling
22. Sickness is best defined as the
A
A. patient’s experience of not being well
B. clinical diagnosis of disease
C. laboratory diagnosis of disease
D. medical labeling of a disease
E. physician’s perception of a disease
23. Among spiritual healers, the most common theory disease is that
B
A. disease is a spiritual malaise resulting from sinful acts
B. disease results from psychological stress
C. disease is caused by parapsychological phenomenon
D. disease is caused by germ-mechanical factors
E. disease is caused by invasion of the body by evil spirits
24. Rights and obligations of the sick role include all the following EXCEPT
B
A. attempt to secure professional help
B. ability to pay for treatment
C. compliance with the prescribed regimen
D. release from certain normal role obligations
E. freedom from blame for being ill
25. Changes in life-style had caused a decline in each of the following diseases before the application of modern medicine and technology EXCEPT
B
A. tuberculosis
B. prostatic carcinoma
C. rheumatic heart disease
D. coronary artery disease
E. stroke
ROJ@17nov6