1. Choose the correct statements:
a) Communication as a messaging process includes the following steps: encoding, message, decoding.*
b) In medical interviews, open questions are preferably used in the second part of the talk.
c) Multiple and leading questions should be avoided when interviewing patients.*
d) Spatial behaviour is a form of nonverbal communication.*

2. Choose the correct statements:
a) We can increase patient’s understanding of the medical information conveyed to them by asking them to put in their own words what has been discussed*
b) Patient’s usually forget most of the information they get by doctors because it is important and beneficial for their health.*
c) The most popular doctor patient relationship/communication models are the Paternalistic” (aka Educational) model and the “Shared decision making” model*
d) There are no gender differences in doctor patient communication.

3. Choose the correct statements:
a) Patient centered questioning and emphatic responses to patients are elements of optimal nonverbal doctor’s communication behavior.
b) Longer consultations and friendliness on the part of doctor tend to produce better patient outcomes.*
c) The way doctors communicate their own view of the disease risk influences the patient choice and adherence to treatment.*
d) A common phenomenon among patients is unrealistic optimism a belief that they are less likely than other people to experience negative outcomes and more likely than others to experience positive outcomes.*

4. Choose the correct statements:
a) The most popular medical interview models are “Doctor patient” model, Calgary Cambridge” model and “Shared decision making” model
b) The doctor’s agenda in “Doctor patient” medical interview model focuses on disease, i.e. its symptoms, signs, necessary examinations and underlying pathology.*
c) Consideration of patients concerns typical for “Doctor patient” medical interview model is associated with greater readiness of patients to discuss difficult issues.*
d) The “Calgary Cambridge” medical interview includes a summary of what has been discussed in the end of conversation.*

5. When confronted with angry patients, doctor may typically:
a) Try to ignore the anger and keep going with the interview*
b) Might get angry back*
c) Call colleagues and auxiliary staff for reassurance
d) Try to pacify the patient*

6. The following approaches help diffusion of patient’s anger during a medical interview:
a) Checking doctor ‘s own emotional response and trying to cope with feelings of anxiety, upset or anger.*
b) Giving short acting sedative drugs
c) Finding the source of anger*
d) “Disarming” verbal responses such as: „I am sorry if that upsets you”*

7. In dealing with an anxious patient the following may help:
a) Giving loud verbal commands e.g. „Calm down!”
b) Acknowledgment of patient’s anxiety and trying to find its source*
c) Empathizing*
d) Increasing patient ‘s feeling of safety*

8. In communicating bad news to patients:
a) They appreciate doctor’s kind, sensitive and caring attitude*
b) Doctors should avoid presenting the information clearly and instead try to „dampen” it by using complex medical terms
c) People prefer quiet and private setting*
d) A six-step approach known as SPIKES is recommended*

9. Choose the correct statements:
a) Medical iatrogenesis has four levels: clinical, social, cultural and accidental 
b) Social iatrogenesis’s refers to the vested interest of certain parties (e.g. pharmaceutical companies) in promoting sickness.*
c) Clinical iatrogenesis includes (but is not limited to): adverse side effects of drugs or drug interactions, medical errors, negligence, nosocomial infections, adverse psychological reactions (e.g. making the patient extremely frightened or anxious by exaggeration of the implications of their illness)*
d) 2% of patient deaths are with iatrogenic cause.*

10. Choose the correct statements:
a) Elements of valid informed consent are disclosure, capacity and voluntariness.*
b) According to most legislations’ parents or legal guardians of a child are authorized to give consent on his/her behalf.*
c) Adequate reasoning faculties of the patient and possession of all relevant facts are essential prerequisites for a valid informed consent.*
d) Patients with severe mental illness are generally considered not capable of providing informed consent even when their reasoning and judgement are intact (e.g. patient with paranoid schizophrenia in remission with no or only minimal thought disorder and psychotic symptoms)

11. Choose the correct statements:
a) For the majority of physical symptoms or complaints, underlying physiological basis cannot be found*
b) The WHO definition of health as a state of “complete physical, mental and social wellbeing” refers to a commonly seen condition
c) According to the multidimensional model of health, the latter is seen as a continuum where health promotion interventions operate on the wellness side, while medical treatment focuses on the illness side*
d) Health is not easy to define and is very individual*

12. Choose the correct statements:
a) In the western world, dominating view is that individuals are responsible for their health by adopting healthy and unhealthy lifestyles*
b) The traditional biomedical model in medicine focuses on disease and not person and considers mind and body as functioning independently*
c) Biopsychosocial model in medicine takes into account biological, psychological and social factors in each particular case of disease*
d) Biopsychosocial approach is easier to apply and less time consuming than the traditional biomedical one

13. Choose the correct statements:
a) Psychosomatic medicine emerges in the 1980-es as a sequence to the development of biopsychosocial model in medicine
b) Patient physician relationship is a key element of the biopsychosocial model*
c) Behavioral medicine includes elements from psychology, sociology and healthcare and deals with maintenance of health and prevention of illness*
d) Health psychology studies the role of psychological factors in all areas of health and illness*

14. Choose the correct statements:
a) Clinical psychology primarily deals with development and implementation of tools for psychological assessment (questionnaires, tests, rating scales etc.)*
b) The first department of medical psychology was established in the University of Basel in the beginning of the 20th century*
c) Currently, the scope of medical psychology has been devoured by the psychological sub disciplines of health and clinical psychology*
d) Medical psychology aims to help patients only and is not interested in their relatives and caregivers

15. Choose the correct statement:
a) Methods of assessment in psychology/medical psychology may be subdivided into type based and information eliciting based*
b) Each psychological tool (test, interview etc.) is characterized by reliability and validity*
c) Reliability refers to the extent in which a psychological tool for assessment predicts treatment outcome
d) Validity is expressed to the extent to which a certain psychological tool measures what is designed to measure*

16. Choose the correct statement:
a) Psychological assessment interviews are subdivided into non structured, semi structured and structured*
b) Observation as a psychological method refers to external objects only and may not be self-directed
c) Observation is a descriptive and naturalistic method of method of assessment*
d) Experiment is defined as a goal directed intervention in some variable characteristic with subsequent registration and measurement of the resulting change in another characteristic*

17. Choose the correct statements:
a) Spoken language cannot exist without written language, i.e. all cultures have developed both forms
b) Language may be defined as a set of symbols which permit transmission and understanding of infinite variety of messages*
c) The rule system of language is called grammar*
d) The process of acquisition and development of speech sounds continues throughout the first several years of life*

18. Choose the correct statements:
a) Semantics is the study of meaning*
b) Language development is individual process and does not follow universal timetable
c) The three major stages of language development are prelinguistic stage, one-word stage and stage of two world sentences*
d) Phoneme contraction occurs around 10 months of age and refers to the restriction of the phonemes to only those used in baby’s natural language*

19. Choose the correct statements:
a) Around the age of two, children begin to learn about 20 new words per day*
b) Stage of two-word sentences is sub divided into stage 1 grammar (18 30 months) and stage 2 grammar (30 months to 4 5 years)*
c) In stage 1 grammar grammatical terms, plurals and possessives begin to be correctly used
d) By 30 months of age the longest sentences reach 8 10 words*

20. Choose the correct statements:
a) At 4 5 years of age basic grammatical rules have already been acquired*
b) By age of 20, most English-speaking youth use 50 000 words*
c) B. Skinner applied operant condition principles to explain language development*
d) Operant conditioning may explain the culturally universal and invariant sequence in the stages of language development

21. Choose the correct statements:
a) Development of object permanence is not a prerequisite for understanding that words can represent things
b) N. Chomsky hypothesized the existence of innate language acquisition device, i.e. an innate program enabling children to understand all types of sentences*
c) Integrated view of language development maintains that children cannot acquire language unless a certain maturational level has been achieved*
d) There are four major categories considering the relationship between language and thought*

22. Choose the correct statements:
a) According the behaviorist view proposed by Watson (1913) language and thought are basically the same thing*
b) According to the social constructionist’s theories our thoughts are not based on language
c) According to the linguistic relativity hypothesis peoples who speak different languages have different world views*
d) According to J. Piaget (1950) cognitive and thought development are obligatory prerequisite if language is to be used properly*

23. Choose the correct statements:
a) According to Vygotsky (1962) around 7 yrs. age overt language is restricted to communication, while the thought function of language becomes internalized verbal thought*
b) Any theory of language development which does not take into account culture is inadequate*
c) The right hemisphere has central role in language
d) Broca’s area is associated with spoken language*

24. Choose the correct statements:
a) Contemporary imaging studies have revealed that besides classical language areas (Broca’s and Wernicke’s) other parts of the cortex are also involved in this process*
b) It is more likely that brain has units specialized in phonology, symtacs and semantics rather than speaking, repeating and listening*
c) The term “aphasia” is commonly used for all types of language loss*
d) In deep type of dyslexia patients substitute a word with another that sounds similarly, i.e. “March” is substituted for “Marsh”

25. Choose the correct statements about perception:
a) Perception is equal to attention
b) Available theories of perception may be subdivided as considering perception as a top down (perceptually driven) or bottom up (data driven) process*
c) Size and shape constancy and depth perception are examples of top down perception*
d) Research shows that we are very selective and biased on what we perceive*

26. A perceptual set is driven by the following factors:
a) Past experience*
b) Intelligence
c) Current drive state*
d) Emotions*

27. The basic dimensions of attention are
a) Width*
b) Direction*
c) Span
d) Volitional control*

28. According to neuropsychiatric studies attention is mostly associated with the function of
a) Certain thalamic nuclei (e.g. pulvinar thalami)*
b) Occipital cortex
c) Frontal areas and anterior cingular cortex in particular*
d) Parietal lobe*

29. Key learning processes are:
a) Classical conditioning*
b) Repetition
c) Operant conditioning*
d) Imitation*

30. Classical conditioning may be involved in:
a) Development of phobias*
b) Anticipatory nausea and vomiting in chemotherapy*
c) Placebo effects*
d) Development of mania

31. Memory includes the following processes
a) Retrieval (reproduction)*
b) Storage (retention)*
c) Forgetting
d) Registration (encoding)*

32. Anatomical substrates of memory are thought to be:
a) Frontal cortex*
b) Occipital cortex*
c) Limbic structures (amygdala, hippocampus and mammillary bodies
d) Temporal cortex*

33. Which statements about intelligence are correct:
a) Intelligence is not a psychological construct
b) Different theories about intelligence may be subdivided into biological (focusing on its qualitative aspects) and psychometric (focusing on its quantitative aspects)*
c) Binet Simon and Wechsler are names of authors of popular intelligence tests*
d) According to Horn & Cattel (1967, 1982) theory general intelligence (g) may be subdivided into fluid and performance intelligence*

34. Which of the following are components of Gardener’s (1998) multiple intelligences model:
a) Spatial*
b) Linguistic*
c) Inductive reasoning
d) Interpersonal*

35. Choose the correct statements:
a) Erikson’s theory of psychological development (1950) through the lifespan includes eight stages*
b) Illnesses and disabilities do not influence the extent to which people are able to resolve psychological challenges associated with each developmental stage.
c) Identity vs role confusion is a psychological conflict typical for the adolescence*
d) Generativity vs stagnation is a psychological conflict typical of middle adulthood*

36. Choose the correct statements:
a) According to Bowlby, for a proper attachment process to occur, infant mother relationship should start no later than the first 2 and ½ years of the infant’s life*
b) There are four distinct attachment styles determined by corresponding parenting style of the mother*
c) Attachment does not seriously influence child’s development.
d) Most children are able to recover at least to some extent from earlier neglect or abuse*

37. Choose the correct statements:
a) Theories about language development may be subdivided into behaviorist, nativist and interactionalist*
b) The process of language development includes four major stages
c) By age of 13, most English-speaking children use 20 000 words*
d) Typically, a child produces its first word around the age of 1 year*

38. Choose the correct statements:
a) According to Piaget’s theory of cognitive development in children in the concrete operations stage (7 12 years) still cannot understand the perspectives of others.
b) In his theory of children’s social and cognitive development Vygotsky (1978) sees culture as important factor for learning*
c) Medical consultations with young children need to take into account the issues of egocentrism and the absence of theory of mind*
d) Explanation of illnesses by internalization is typical for 9 11 years old children*

39. The major psychological challenges of adolescence include:
a) Adjusting to a changing body size and shape*
b) Arising sexuality*
c) Adjusting to new social demands
d) Striving for emotional maturity and economic independence*

40. Choose the correct statement:
a) The term compression of morbidity refers to the tendency observed in the past several decades for greater occurrence of illnesses in the final stage of life*
b) In the elderly (65 years +) both fluid and crystalloid intelligence has declined
c) The prevalence of depression tends to increase with age*
d) Dementia affects about 3% of people in the age group 70 74 years*

41. Choose the correct statements:
a) The term stress originates is a purely psychological one, i.e. it is not used in other scientific branches (like physics)
b) Stress occurs when environmental/situational demands are apprised as exceeding a person’s resources to cope*
c) The most important distinction when studying stress is between a stressor and a stress response*
d) Based on their origin, stressors are sub divided into external and internal*

42. Choose the correct statements:
a) Base on their type and duration stressors are subdivided into acute, chronic, traumatic, daily hassles, and role strain*
b) Stress responses are subdivided into two categories affective and physiological
c) Physiological responses to stress are primarily mediated through the hypothalamic pituitary adrenal (HPA) axis*
d) The adrenal medulla produces stress hormones adrenaline (epinephrine) and noradrenaline (nor epinephrine)*

43. Choose the correct statements:
a) Cortisol, produced by adrenal cortex is a critical stress response hormone*
b) Cortisol increases blood sugar level and metabolic rate*
c) The levels of cortisol do not influence and control the activity of HPA axis
d) If stress response continues for too long, the HPA axis can become dysregulated resulting in chronically elevated levels of cortisol*

44. Choose the correct statements:
a) The general adaptation syndrome proposed by H. Selye (1956) includes three stages*
b) It is the alarm stage of the general adaptation syndrome that the fight or flight physiological reaction occurs in*
c) The physiological response to stress is strongest in situations characterized as new (i.e. never occurred in the past) and unpredictable*
d) It is important to encourage patients to have as much control as possible even in essentially uncontrollable situations

45. Choose the correct statements:
a) Stress responsivity is not at all genetically determined
b) Individuals vary in their pattern of physical responses to stress*
c) Babies of mothers with high levels of stress and anxiety during pregnancy are more responsive to stress*
d) Animal studies show that offspring of more nurturing mothers have reduced HPA axis responses*

46. Choose the correct statements:
a) Evidence suggests that “fight or flight” stress response may be more relevant to males, while females rather show “tend be friend” response*
b) Physiological responses to stress are determined by individual differences only
c) The sympathetic nervous system increases immune system activity while HPA axis suppresses it*
d) Short acting stressors increase the immune system activity thorough increase in cytokine production*

47. Choose the correct statements:
a) Tools like the Perceived Stress Scale try to measure the stressful effect of major life events*
b) Appraisal processes may explain the large variation that people show in responding to stressful circumstances*
c) Stress may be conceptualized as a static and linear process including appraisal and subsequent coping
d) Stress increases the morbidity of infectious illnesses, cardiovascular disease and slower wound healing*

48. Choose the correct statements:
a) Stress worsens auto immune conditions (e.g. rheumatoid arthritis)*
b) Acute and severe as well as chronic stress are associated with mental disorders such as PTSD, anxiety and depression*
c) In vulnerability stress model stress contributes to development of disease in interaction with individual ‘s physical and psychosocial vulnerability, environment, coping responses, etc.*
d) Available social support does not moderate the effect of stress on health

49. Choose the correct statements:
a) People with the psychological trait of neuroticism generally report less pain and symptoms and fewer health problems
b) The variety of coping strategies may be sub divided into two categories: emotion focused and problem focused*
c) For medical purposes, coping strategies may be divided into approach strategies and avoidant strategies (i.e. denial, repression)*
d) Avoidant coping strategies are very good for reducing distress and anxiety and distress in the short term* 

50. Choose the correct statements:
a) Children with disturbed attachment (e.g. abandoned or abused) are more likely to develop insecure or chaotic responses to stress*
b) Patients and children exposed to the same stressor show profoundly distinct responses
c) Social support has a direct effect on health slower disease progression, reduces mortality and increases recovery*
d) Exercise intervention programs have been used successfully in a range of medical conditions*

51. Choose the correct statements:
a) Stress burnout is experienced roughly by 20% of adults*
b) The main symptoms of burnout are emotional exhaustion, depersonalization and reduced personal accomplishment*
c)Burnout does not have contribute to with staff turnover which is dependent on payment only
d) Nearly 30% of hospital consultants in the UK report symptoms of burnout and psychological problems*

52. Choose the correct statements:
a) Areas such as intensive or palliative care tend to have higher rates of staff burnout*
b) Medical students with poorer time management and feeling unsure of the demands of different tasks are more likely to report more stress*
c) Relaxation, physical fitness and cognitive restructuring are among the main approaches to stress management*
d) Stress inoculation interventions are an example for cognitive restructuring approach to stress management