NBOME Behavioral Health & Psychiatry 3

Question 1

A patient experiences sudden-onset auditory hallucinations and grossly disorganized behavior for 10 days following a severe interpersonal stressor, then returns fully to baseline functioning. Which diagnosis is most appropriate?

Accepted Answer

Brief psychotic disorder

Answer

Brief psychotic disorder involves sudden onset of ≥1 positive psychotic symptom lasting ≥1 day but <1 month, often following a marked stressor, with full return to premorbid function.

Question 2

Which feature most reliably distinguishes delirium from dementia?

Accepted Answer

Acute onset with fluctuating levels of consciousness and attention

Answer

Delirium is defined by acute onset and fluctuating disturbance in attention and awareness; dementia typically has an insidious onset with stable (though declining) consciousness.

Question 3

Which of the following is the MOST significant independent risk factor for completed suicide?

Accepted Answer

Previous suicide attempt

Answer

A prior suicide attempt is the single strongest predictor of completed suicide, increasing the risk approximately 30–40 times compared to the general population.

Question 4

A 35-year-old man has intrusive thoughts about contamination that he recognizes as irrational, and he washes his hands more than 50 times daily to reduce distress. Which is the first-line treatment for OCD?

Accepted Answer

Exposure and response prevention (ERP) with or without an SSRI

Answer

First-line treatment for OCD is exposure and response prevention (a CBT technique), often combined with an SSRI (e.g., fluoxetine, fluvoxamine, sertraline), which has the strongest evidence base.

Question 5

Which FDA-approved medication for opioid use disorder works exclusively as an opioid receptor antagonist, preventing euphoric effects without any agonist activity?

Accepted Answer

Naltrexone

Answer

Naltrexone is a pure opioid receptor antagonist with no agonist activity; it blocks opioid receptors to prevent euphoria and is approved for both opioid and alcohol use disorder.

NBOME - National Board of Osteopathic Medical Examiners Practice Test

NBOME - National Board of Osteopathic Medical Examiners Practice Test

NBOME Behavioral Health & Psychiatry 3