Psychiatric Nursing: OCD, Substance Abuse, Personality Disorders, and Lithium Toxicity, Exams of Nursing

Download Psychiatric Nursing: OCD, Substance Abuse, Personality Disorders, and Lithium Toxicity and more Exams Nursing in PDF only on Docsity! NRNP 6675-15 Week 6 Exam Questions With Answers 1. Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply Age Rapid dose escalation Parental route of administration Higher potency typical antipsychotics 2. Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects? Reduces negative symptoms Increases extra pyramidal symptoms (EPS) Causes prolactinemia Reduces positive symptoms 3. Phencyclidine (PCP) and Ketamine exert their unique behavioral effects by blocking which of the following receptors? GABA type receptors Serotonin receptors Dopamine receptors NMDA type receptors 4. The diagnosis used to describe a syndrome characterized by specific signs and symptoms resulting from recent ingestion or exposure to a substance is known as which of the following? Substance intoxication Substance withdrawal Substance use disorder Any of the above 5. Abnormal involuntary movements in a rhythmic pattern affecting face, mouth, tongue, jaw is known as which of the following? Akathisia Dystonia Tardive dyskinesia Extrapyramidal side effects 6. A deeply held belief despite evidence to the contrary, lasting at least one month, without prominent hallucinations, with functional impairment that relates to the delusional syste..... Schizophrenia Delusional disorder Brief psychotic disorder Schizophreniform disorder HIPPA B. DSM-5 CPT DRG A federal program administered nationally and locally which covers enrolled individuals 65 years and older who pay premiums and disabled individuals.... Medicare Medicaid Both A and B None of the above Having an adequate legal description of nurse practitioner (NP) scope of practice according to state law is important for which of the following reasons? To avoid any charges of practicing medicine without a license To place accountability for both benefits and harm to patients squarely on the NP To get reimbursement for physician services when provided by an NP All of the above Which of the following is the most widely consumed psychoactive substance? Alcohol Caffeine Heroine Cannabis Which of the following is used to treat Tardive Dyskinesia? Cogentin (benztropine) Artane (trihexyphenidyl) Catapress (Clonidine) None of the above The APRN consensus model did which of the following? Merged adult, gerontology and pediatric foci so that all NPs could truly work across the.... Adult and gerontology were merged and identified as primary care or acute care Psychiatric mental health foci were stipulated as across the lifespan B and C Which of the following behaviors are associated with an alcohol blood level of 0.05 percent? Voluntary motor actions usually become perceptibly clumsy Thought judgment, and restraint are impaired Confusion, stupor None of the above According to HIPPA, which of the following must the NP share their NPI with? Check all that apply. Health plans Other providers Any entity that may need it for billing purpose A and C only A patient presents with delusions, disorganized thoughts, and speech with poor self care all of which have persisted for the past 7 months. The APRN this presentation is. with which of the following diagnosis? Schizophrenia Schizophreniform disorder Brief psychotic disorder Delusional disorder Major neurotransmitters possibly involved in developing substance abuse and substance dependence..... which of the following? Dopamine GABA Serotonin A and B only The Dopamine hypothesis of schizophrenia...which of the following? Schizophrenia results from too much dopaminergic activity Neurochemical or neurophysiologic changes in the body that result from the repeated administration of a drug is known as which of the following? Cross-tolerance Neurotransformation Neuroadaptation Neurocognitive adjustment The recurrent and intense sexual arousal from the physical and psychological suffering of another person is known as which of the following? Frotteurism Voyeurism Sexual sadism Sexual masochism Which of the following is not consistent with the onset of OCD? More than half of patients with OCD have a sudden onset of symptoms The onset of symptoms for about 50-70 percent of patients occurs after a stressful event. Most patients keep their symptoms secret initially. The onset of OCD is typically preceded by OCD personality traits. The recurrent urge to expose one's genitals to a stranger is known as which of the following? Fetishism Voyeurism Exhibitionism Paraphilic disorder Which of the following patients would be appropriate for hospitalization for substance use disorder? Select all that apply. Patients who have a substance overdose who cannot be safely treated in an outpatient setting Patients who are at risk for severe or medically complicated withdrawal syndromes Patients who have a history of not benefiting from treatment in a less intensive setting A and B only The nursing practice model recommended for NPs by the National Academy of Medicine and the National Council of State Boards of Nursing is which of the following? Full practice Reduced practice Restricted practice Arbitrary practice Which of the following groups does Medicare cover? Select all that apply. Individuals 65 years and older who have enrolled and pay premiums Disabled individuals who qualify for Social Security Disability payments and benefits Adults who are disabled for one year or less and who qualify on the basis of poverty Mothers and children who qualify on the basis of poverty. Which of the following neurotransmitters increases libido? GABA Serotonin Oxytocin Dopamine Which of the following factors are associated with poor prognosis for patients with OCD? Childhood onset The presence of a precipitating event Co-existing major depressive disorder A and C Which of the following is inconsistent with current knowledge about schizophrenia? Schizophrenia is one of the most common of the serious mental disorders. A diagnosis of schizophrenia is based entirely on the psychiatric history and mental status examination. Dopamine level is a laboratory test that assists in the diagnosis of schizophrenia. Schizophrenia likely comprises a group pf disorders with heterogeneous etiologies and variable presentations. A Chronic disorder characterized by repetitive hair pulling leading to variable hair loss that may be. .to others is known as which of the following? Health disparities Health vulnerabilities Social determinants of health All the following is consistent with ANCC rules regarding recertification EXCEPT: You are required to have a maximum of 25 credit hours during each certification period You can start the recertification process 1 year before your expiration date, but no later than 3 months before. You must have 1000 clinical practice hours in the clinical specialty within the preceding 5 years. You must have at least 25 contact hours in pharmacotherapy. Risk factors for school violence include which of the following? Select all that apply. Bullying Being bullied Isolation...... Involvement in school organizations. Persons who subordinate their own needs to those of others, get other to assume responsibility for major areas of the lives, lack of self-confidence, and may experience intense discomfort when alone for more than a brief period of time are demonstrating characteristics consistent with which of the following personality disorders? Avoidant personality disorder Passive personality disorder Dependent personality disorder Antisocial personality disorder Generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following lithium levels? 0.8-1.5 mEq/L 1.5-2.0 mEq/L 2.0-2.5 mEq/L >2.5 mEq/L .....form of child abuse in which a patient or character repeatedly fabricates or actually inflicts injury or illness in a child for whom medical intervention is then sought in an emergency setting is known as which of the following? Korsakoff's syndrome Snyder's syndrome Munchausen syndrome Munchausen syndrome by proxy Self-care strategies for the ARNP in preparing for the certification exam include all of the following EXCEPT? Study in a distraction free environment Six to eight hours of sleep is recommended Drink lot of caffeine and eat high concentrated sugars Plan to study for short periods of time over a longer time period. A patient presents with a formal, tense manner. He reluctantly reports a longstanding (since early adulthood) pervasive suspiciousness of others, preoccupied with...trustworthiness of friends, unjustified concerns about others deceiving him, angry about perceived insults and slights, reluctant to confide in the ARNP. The ARNP suspects that the patient likely has which of the following personality disorders? Schizoid personality disorder Paranoid personality disorder Borderline personality disorder Antisocial personality disorder Generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following lithium levels? 0.8-1.5 mEq/L 1.5-2.0 mEq/L 2.0-2.5 mEq/L > 2.5 mEq/L A patient with a history of alcohol use presents to the emergency department with oculomotor disturbances, cerebellar ataxia, and confusion....Symptoms as consistent with which of the following psychiatric emergencies? Akathisia Korsakoff's syndrome Wernicke's encephalopathy Idiosyncratic alcohol intoxication Cultural Dimensions Therapy is a framework for cross-cultural communication that describes the effects of a society's culture on the values of its members. by which of the following theorists? Hofstede Leininger Purcell Campinha-Bacote The treatment of choice for patients with paranoid personality disorder includes which of the following? Group therapy Behavioral therapy Psychotherapy B and C The differences in the quality of healthcare across individuals or groups in regard to access, treatment options, and p following? Racism Health disparities Vulnerable populations Social determinants of health The incidence of suicide is highest for which of the following populations? Older Latino men Older Caucasian men Older Caucasian women Older African American men A patient on lithium with a history of alcohol use disorder presents with dry mouth, ataxia, dizziness, abdominal pain, and slurred speech. The ARNP should do which of the following? The ARNP recognizes this is likely a relapse on alcohol so sends the patient home to sleep it off. The ARNP recognizes these are symptoms of mild to moderate lithium toxicity, decreases the lithium by half, and encourage the patient to drink more fluids The ARNP recognizes these are symptoms of mild to moderate lithium toxicity, discontinues the lithium immediately, orders lithium level, serum electrolytes, and renal function tests The ARNP recognizes these are symptoms of moderate to severe lithium toxicity, discontinues the lithium and tells the patient hemodialysis will most probably be needed. An ARNP takes a position in which a specific amount is paid according to a set job description. This type of pay structure is known as which of the following? Straight salary Average percentage of net receipts Base salary plus percentage Hourly rate A personality disorder characterized by emotional constriction, orderliness, perseverance, stubbornness, indecisiveness, a inflexibility as which of the following? Depressive personality disorder Borderline personality disorder Dependent personality disorder Obsessive-compulsive personality disorder Which of the following is consistent with what is known about the epidemiology of anxiety? Men have a higher lifetime prevalence of anxiety than women. Women have a higher lifetime prevalence of anxiety than men Men and women have equal lifetime prevalence. The lifetime prevalence of anxiety is not gender specific Which of the following is consistent with NP practice parameters when prescribing buprenorphine? NPs with full practice authority can prescribe and administer buprenorphine under their state NP license. As a qualified practitioner the NP simply needs to notify SAMHSA prior to prescribing or administering buprenorphine The NP can provide buprenorphine to 300 patients per month The NP is required to complete specific training to prescribe and dispense buprenorphine Which of the following are consistent with current data related to the prevalence of drinking alcohol? Men and women with higher education and income are less likely to drink alcohol. Men and women with higher education and income are more likely to drink alcohol Men and women with lower education and higher income are more likely to drink alcohol. Education and income are not a factor in prevalence of drinking alcohol. A patient with history of hypoglycemia reports feelings of fear, worry, and restlessness that has persisted over the past 6 months. The patient states these feelings are worse when glucose is low. The ARNP suspects the patient has which of the following diagnoses? Generalized anxiety disorder attributable to another medical condition The three major neurotransmitters associated with anxiety, based on animal studies and response to drug treatment include which of the following? Glutamate, Norepinephrine, Serotonin GABA, Norepinephrine, Serotonin GABA, Dopamine, Glutamate Dopamine, Norepinephrine, Serotonin Which of the following is consistent with the epidemiology of schizophrenia in the United States? The lifetime prevalence of schizophrenia is about 50 percent Schizophrenia is more prevalent in children than in adolescents. Peak age of onset in men is 10 to 25 years of age Onset of schizophrenia before the age of 25 is extremely rare. Clinical findings that may indicate abuse include which of the following? Select all that apply. Delay between onset of injury and seeking treatment Explanation by the patient which is inconsistent with the type of injury Psychological distress such as depression, anxiety, suicidal ideations and/or sleep disorder Explanation by the patient which is inconsistent with the type of injury According to the American Psychiatric Association (APA) which of the following is consistent with the evidence base practice for telepsychiatry? There are few studies exploring the evidence for telepsychiatry. In populations with severe anxiety, telepsychiatry is preferred. The effectiveness is comparable to in-person care in terms of therapeutic engagement, quality of care, validity and reliability of assessment, and clinical outcomes The evidence base for children and adolescents is very weak. Which of the following is consistent with literature regarding the term psychosexual? Psychosexual is used to describe personality development and functioning Psychosexual is synonymous with libido in the Freudian sense Psychosexual basically refers only to sexual feelings and behavior None of the above Bleuler identified four fundamental symptoms of schizophrenia known as the 4 As, which include which of the following symptoms? Associations, affect, autism and ambivalence Associations, alogia, abstraction, anxiety. Affect, apraxia, anhedonia, audible thoughts. Autism, apperception, amotivation, automatism. The fear of or anxiety regarding places from which escape might be difficult is known as which of the following? Depression Panic disorder Agoraphobia Generalized anxiety disorder All of the following are one of the five major categories of third-party payers EXCEPT: Medicare/Medicaid Managed-care organizations (MCOs) Indemnity insurance companies Only A and B Discrepancy between anatomical sex and gender identity is known as which of the following? Gender role behavior Gender discordance Gender nonconformity Internalized sexual prejudice Which of the following is not a common physical effect of cannabis? Mild tachycardia Mild bradycardia Orthostatic hypotension Dilation of the conjunctival blood vessels A conscious standardized recurrent behavior such as counting, checking, avoiding that interferes significantly with the person's normal routine and functioning is known as which of the following? A compulsion