COMLEX-USA Behavioral Sciences and Psychiatry 1 — Questions and Answers
Question 1: In Kübler-Ross's stages of grief, which stage is characterized by the patient seeking to delay the inevitable through promises?
- Denial
- Anger
- Bargaining (Correct answer)
- Depression
Correct answer: Bargaining
The bargaining stage involves attempts to negotiate with a higher power or fate to delay or prevent death, often including 'if only' statements.
Question 2: A patient repeatedly arrives late to appointments despite genuine attempts to be on time. Which defense mechanism best explains this behavior?
- Rationalization
- Passive aggression (Correct answer)
- Intellectualization
- Projection
Correct answer: Passive aggression
Passive aggression involves indirect expression of hostility through behaviors like tardiness, forgetfulness, or inefficiency.
Question 3: Which neurotransmitter is most implicated in the pathophysiology of schizophrenia, based on the dopamine hypothesis?
- Serotonin
- GABA
- Dopamine (Correct answer)
- Norepinephrine
Correct answer: Dopamine
The dopamine hypothesis proposes that mesolimbic dopamine hyperactivity causes positive symptoms while mesocortical hypoactivity causes negative symptoms of schizophrenia.
Question 4: The Wisconsin Card Sorting Test is used to assess dysfunction in which brain region?
- Temporal lobe
- Parietal lobe
- Prefrontal cortex (Correct answer)
- Cerebellum
Correct answer: Prefrontal cortex
The Wisconsin Card Sorting Test assesses cognitive flexibility and set-shifting, which are executive functions dependent on the prefrontal cortex.
Question 5: A patient refuses a blood transfusion on religious grounds despite life-threatening blood loss. The ethical principle guiding the physician to respect this decision is:
- Beneficence
- Non-maleficence
- Autonomy (Correct answer)
- Justice
Correct answer: Autonomy
Autonomy requires respecting a competent patient's right to make their own medical decisions, even when the physician disagrees with the choice.
Question 6: Which sleep stage is characterized by sleep spindles and K-complexes on EEG?
- Stage N1 (NREM 1)
- Stage N2 (NREM 2) (Correct answer)
- Stage N3 (NREM 3)
- REM sleep
Correct answer: Stage N2 (NREM 2)
Stage N2 NREM sleep features sleep spindles (12–14 Hz bursts) and K-complexes (large biphasic waves) and constitutes the largest portion of total sleep.
COMLEX-USA Behavioral Sciences and Psychiatry 1
In Kübler-Ross's stages of grief, which stage is characterized by the patient seeking to delay the inevitable through promises?