NURS 6670 Midterm Exam Latest update 2021/2022 Questions & Verified Answers (Already Grade, Exams of Nursing

Download NURS 6670 Midterm Exam Latest update 2021/2022 Questions & Verified Answers (Already Grade and more Exams Nursing in PDF only on Docsity! NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Question 1 Lorazepam Venlafaxine Propranolol Buspirone The PMHNP is considering pharmacotherapeutic options for Ana, a 28-year-old female with generalized anxiety because there are a lot of things going on in her life and she worries all the time. Her husband is deployed overseas, she has just started a new job, and her only child has just started kindergarten. Ana denies any panic-type symptoms; her primary concern is that she is worried about everything and it is making it hard to sleep and concentrate on learning the skills for her new job. Ana may best benefit from: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 2 Sally is a 54-year-old female who presents for care at the urging of her employer. She says that she doesn’t think she needs to be there, but the manager of her division at work strongly suggested that she make an appointment. She is the evening shift manager in the accounting department of a major online sales organization. Her role requires meticulous accountability of a complex system of production statistics, and she has done this exceedingly well for years. She has been a valued employee, and her work is above reproach. A few months ago, the company adopted a new software program that required a complete revamping of Sally’s department. She has not adapted well, and her resulting anxiety is almost prohibitive of functioning in her role. During her interview, Sally is very somber and serious, and is clearly having difficulty with this change. She is distraught over the potential of not being able to do NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Systematic desensitization Relaxation and cognitive techniques Question 4 Clothing Speech pattern The PMHNP is conducting an initial interview with a patient whose history is consistent with avoidant personality disorder. The PMHNP understands that one of the most striking features of this interview is likely to be centered upon the patient’s: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Ange r Anxi ety Question 5 A 27-year-old female with a 1-month history of social withdrawal, anorexia, hypersomnia, unprovoked outbursts of anger, and a strong family history of endogenous depression A 41-year-old male with a history of childhood sexual abuse, loss of interest in both his professional and personal life, an unplanned 10 lb. weight loss in the last 3 months, and perceptual disturbances A PMHNP student is reviewing his notes from his clinical experience over the past week to prepare his first required case presentation on a patient suffering a major depressive episode. Which of the following patients best represents the DSM-5 criteria for major depressive episode? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University A 65-year-old male whose wife died 2 months ago and he reports a 3-week history of generally depressed mood, guilt about his wife’s death, insomnia, difficulty focusing on daily tasks, with increasing thoughts of dying A 72-year-old female who just relocated across country to live with her adult son and daughter-in-law who is despondent about leaving her home and reports forgetfulness, loss of appetite, new onset bowel problems, and extreme loss of energy NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University ke Confused Question 8 Fletcher is a 29-year-old male referred for court-ordered counseling. He has a long history of repeated offenses including DUI, domestic violence, battery, and other violent acts that fortunately have not yet caused any serious injury or death to the recipients. An interview with his wife reveals that he has lied about almost everything for the NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University History and symptoms are most consistent with antisocial personality disorder Fletcher needs a neurological workup to include an EEG and assessment for neurological soft signs Consistent with his symptoms, Fletcher will likely respond well to a stress interview It is likely that substance abuse is the underlying cause of symptoms and should be explored further last few years; he is able to get hired for jobs because he is very engaging and likeable, and then invariably he gets fired because he misses work and doesn’t do his job properly when he is there. According to the wife, they have known each other since high school, where Fletcher was very happy and well-adjusted. He was on the soccer team, liked by teachers, and never demonstrated the tendencies he does now. Apparently in college he got involved with a fraternity that was notorious for alcohol and drug abuse, and he started drinking heavily; it was ―all downhill from there.‖ The PMHNP considers that: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 9 Which among the following neurotransmitters is decreased in depression and increased in mania? Dopamine Norepinep hrine Serotonin Glutamate NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 11 A history of schizophrenia of a first-degree relative Sustained psychosis predating his mother’s death Comorbid Asperger’s syndrome Apparent frank thought disorder Mr. Kendall is a 47-year old male who is presented to care by his younger sister, Megan. Mr. Kendall has spent his entire adult life living in an apartment that was attached to his parents’ home. His mother died a few weeks ago, and the property is listed for sale. Mr. Kendall will have to move, and while discussing this with him, Megan became very concerned. He has apparently been considered odd all his life, has never married or even dated as far as Megan knows, but she had no idea how odd he was. When his mother died, he seemed disconnected from reality and had episodes of talking to people who weren’t present. Megan says that sometimes she does not even understand what he is talking about. He seems to think he has psychic powers, and that he doesn’t need to move because he knows the house will not be sold. When considering a diagnosis of schizotypal disorder, the PMHNP expects which of the following to be present in the history? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 12 Which of the following is a true statement with respect to the treatment of narcissistic personality disorder? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Psychoanalytic psychotherapy has strong empiric support Both serotonergic drugs and lithium are useful Group therapy is rarely helpful Immobilized patients (hospitalized or incarcerated) have the best outcomes Question 13 NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 15 Hugo’s wife meets diagnostic criteria for this disorder Hugo is a 39-year-old male who has encouraged his wife to come to counseling because he is worried about her wine drinking. Hugo says that he and his wife have shared a bottle of wine with dinner most nights for the last couple of years, but in the last few months he has become worried that she drinks too much. They both agree that she never really becomes intoxicated, but he does not like the fact that evening wine has become the most important part of her meal. If he wants to go out, she will only go to a place that has a wine she likes. Last month they went on a week-long vacation, and she insisted on packing enough of her wine to last the whole time. If they go to a restaurant that does not have a wine she likes, she will take her own in a disposable coffee cup. It seems like for the last few months, she has been drinking more and more, occasionally finishing the bottle alone when he doesn’t want any. Both partners agree that there is no interference with work or any activities or responsibilities, but it is causing some tension in their marriage. When considering a diagnosis of substance use disorder, the PMHNP considers that: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University A trial period with no wine ingestion is necessary to assess for withdrawal symptoms The family history should be assessed for genetic tendency Hugo may have unreasonable expectations Question 16 When developing a pharmacologic treatment plan for the management of major depressive disorder, the PMHNP counsels the patient that the medication will be titrated up to the appropriate dose and then continued for a minimum of 3 months; medication must not be stopped abruptly or without provider supervision. This is because the physiologic consequence of abrupt cessation is likely to result in: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Antidepressant discontinuation syndrome Rebound depressive symptoms A manic or hypomanic episode Unresponsiveness to medication with future episodes NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Unrestrained flow of ideas Question 19 An important part of the history will come from the caregiver The patient must also be interviewed alone to preserve privacy of the relationship A sexual history is not necessary in patients who are not sexually active All of the above. When performing a psychiatric assessment of an elderly patient with Alzheimer’s dementia, the PMHNP recognizes that: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 20 Dependence Abuse Adaptation Addiction Jeffrey T. is a 27-year-old man who has presented for care after being required to do so by the county court. He was involved in a car accident, and while he was not at fault for the accident, routine blood alcohol screening revealed that he was driving while intoxicated. He is a bit resentful at being required to attend therapy; he is very vocal that his driving was not impaired and that he is able to function normally even after drinking what others might consider excess amounts of alcohol. His wife confirms this; they both admit that what began as one or two beers after work a few years ago has evolved to where he now drinks at least a 12 pack of beer nightly. Regardless, they both confirm that he never ―seems drunk,‖ and this does not interfere with his job or fulfilling his family functions. Jeffrey’s ability to function normally despite high blood alcohol is likely a result of: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 21 Danielle is a 31-year-old female who is having a psychiatric evaluation at the insistence of her husband. They have been married for 4 years, and her husband has finally become so frustrated by her jealous behavior that he threatened to leave her if she didn’t ―get help.‖ Her husband insists that he has never been unfaithful, but Danielle repeatedly accuses him of having an affair. If he is even a few minutes late getting home from work, she demands an explanation and then does not believe anything he says. She does not have any real friends—her sister is her closest social contact, but Danielle has been angry with her for several weeks and won’t answer phone calls. Reportedly she does this often, and according to her husband can ―hold a grudge forever.‖ During the interview, Danielle is calm, responsive, but distant. She says she really doesn’t understand why she is there—there is not a problem. The PMHNP considers the most likely diagnosis and discusses with Danielle that the treatment of choice is: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Women rarely experience DTs Question 23 Venlafaxine and clozapine Fluoxetine and olanzapine Amitriptyline and haloperidol Anthony is a 41-year-old male patient who presents for evaluation. His wife made the appointment because she is worried about him and he would not seek care on his own. Anthony has become progressively withdrawn over the last few months and is in danger of losing his job because he misses so many days. He has been evaluated by his primary care provider and has no apparent medical conditions. His wife reports that he has been diagnosed with depression in the past, and has even taken medication that seemed to help. This time he just refused to pursue care. After a comprehensive assessment, the PMHNP diagnoses the patient with major depressive episode with psychotic features. Consistent with the Texas Algorithm Medication Project (TAMP), the appropriate choice of initial medication therapy would be: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Paroxetine and buspirone Question 24 NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Sense of self-importance Defense mechanisms Self-esteem Interpersonal relationships Question 25 Marlene is a 35-year-old female who is in therapy primarily to develop coping mechanisms for living with her husband, who has narcissistic personality disorder. She is committed to the marriage and loves her husband, but finds his inflated sense of self-importance and complete lack of empathy to be especially difficult. She believes he has a good side, but most of her friends have only ever seen extreme arrogance, and she is embarrassed by that. While counseling Marlene, the PMHNP advises her that patients with narcissistic personality disorder have extremely fragile: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University HAM-D Question 27 Clare’s history of personal relationships is characterized by complete intolerance of being alone. Whether it is an NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University intimate-partner relationship or a close friend, Clare appears to always need someone in her life. She had a live- in boyfriend of 3 years, and while they were together, he took care of everything. The PMHNP expects all of the following to be additional features of Clare’s history except: Has disproportionate anger toward an abusive spouse Question 28 When symptoms are preceded by antidepressant therapy, a diagnosis of bipolar A 22-year-old male patient is started on sertraline 50 mg p.o. daily after presenting with a major depressive episode. After tolerating without difficulty for 2 weeks, his dose is increased to 100 mg p.o. daily. Approximately 4 weeks later he reports an unusual set of new symptoms for the last week and a half. He says he feels ―amped up‖ and just very generally agitated and nervous. He was short-tempered at work and home and was snapping at people for no good reason. He also reports difficulty concentrating at work. Last week he expressed disproportionate anger at his work and his boss told him that he was bipolar and should be put on medication. The PMHNP discusses with the patient that: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University does not apply His symptoms may be consistent with bipolar disorder if they persist for at least 2 weeks A formal assessment of the social and occupational implications of his symptoms should be performed The symptoms are most likely a physiologic adaptation to the sertraline and most often normalize NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 31 Cannabis intoxication delirium is characterized by all of the following except: Impaired memory Perception NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Psychosis Motor coordination Question 32 Avoidant personalities have a strong desire for personal relationships Tim is a 20-year-old male who has been referred for care by his college counselor. The counselor has noted that Tim engages in virtually no social activities in college, and for that matter avoids day-to-day activities that require social interaction. By his own admission, Tim never participates in class discussions, even in online discussion boards. Tim is so afraid of rejection that he confines himself to his room and his studies. When differentiating NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Avoidant personalities may have an active fantasy life Schizoid personalities are perceived as distant and aloof Schizoid personalities may be very attached to animals Question 33 Affect Cory J. is a 23-year-old male being seen by the PMHNP today for an initial evaluation. He says that he does not think anything is wrong, but his family, including his mother, grandmother, and aunt, have all told him that he must be ―mentally ill.‖ He has been unable to hold a job and has worked as a cook at more than five chain restaurants in the last 6 months. He has no real friends—he says his ―friends‖ only call him when they need something but never help him. He is currently staying with his grandmother but reportedly will soon be homeless ―unless things change.‖ While he is telling his story, the PMHNP appreciates that Cory repeatedly includes details that make it hard to understand his point. When asked why he thinks he will be homeless, he responds by talking about how many hours he has worked and how everything was going well but then his car broke down and he couldn’t afford to fix it because his tax return was held by the IRS. The PMHNP recognizes that this represents an abnormal: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Come from smaller nuclear families Question 35 An acute change in mental status Angry verbal outbursts that seem unwarranted Mrs. Maxwell is a 75-year-old patient with moderate Alzheimer’s dementia. She lives with her son and his wife and generally does very well with her day to day activities. The family understands the importance of routine and Mrs. Maxwell maintains a regular schedule of activities including her meals, timed toileting, and recreational activities. Which of the following behaviors should prompt and immediate depression screening for Mrs. Maxwell? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Death of her best friend An unplanned weight loss despite consistent oral intake Question 36 NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Psychoanalytic Behavioral Existential Cognitive Question 37 The psychological sciences have contributed theoretical foundations to the etiology and management of anxiety disorders from both conceptual and practical perspectives. The concept that anxiety develops in persons who feel as though they are living in a world devoid of meaning is an example of which theoretical foundation? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University This disorder tends to be more common in men Question 39 The physiologic stress accompanying her first episode of depression may have produced changes in brain biology that makes her susceptible to subsequent episodes without an external trigger M.T. is a 39-year-old female being seen by the PMHNP for a major depressive episode. She is being managed with SNRI therapy in combination with cognitive behavioral therapy. She is having difficulty achieving remission, and her husband comes with her to this office visit because he is becoming very frustrated. He wants to be supportive, but he is finding it very difficult to understand why she is so depressed. M.T. had an episode of depression approximately 2 years ago, but that was when her sister died in an accident. After 6 months of treatment, she seemed to return to normal. This time, her husband points out that she ―has nothing to be depressed about,‖ but she has become so depressed that she has essentially withdrawn from the family. In trying to help M.T.’s husband understand the disease process, the PMHNP discusses with him that: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University The pharmacotherapy required to achieve remission with her first episode resulted in neuroplastic changes that increased her likelihood of experiencing additional depressive episodes The scientific literature suggests that the loss of a sibling is the life event most closely associated with recurrent episodes of major depressive disorder throughout adulthood Response to pharmacotherapy often takes a minimum of 8 weeks and that M.T. is much more likely to achieve remission if he can continue to provide the necessary support throughout her remission period. NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 40 A thorough physical examination A family history of mental health disease A urine drug screen Becci is a 31-year-old female who presents to the PMHNP for evaluation after being referred by her friend who is a patient of the practice. She describes a relatively acute, recent onset of panic attacks. Becci says that ―out of the blue‖ her heart starts to race, her mouth gets dry, she gets shaky, and feels like she cannot get her breath. She is afraid because her friend has panic disorder and Becci knows that before her friend got treatment, she basically would not leave the house in case an attack happened. The PMHNP recognizes that the immediate priority in assessment for Becci is: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Transference-focused psychotherapy A stress interview Question 43 NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Urinary tract infection Mild cognitive impairment Normal pressure hydrocephalus Depression The PMHNP is asked to evaluate the parent of one of her existing patients, a 49-year-old woman named Sheri. Sheri reports that her father, a 78-year-old man who lives alone, has always been in good health. However, when Sheri went to have breakfast with him this past Sunday, she found her father overtly confused and he did not even seem to recognize her at first. Sheri is concerned that he has Alzheimer’s disease, and she is amazed because two days prior he was ―completely fine.‖ The PMHNP knows that the most likely cause of this presentation is: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Low-grade chronicity for at least 2 years Insidious onset, usually in childhood or adolescence Strong family history of depression and bipolar disorder Long asymptomatic periods between episodes Question 46 Which of the following personality disorders is associated with females with fragile X syndrome? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Borderline Narcissistic Dependent Schizotypal Question 47 NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Borderline personality disorder Structural brain damage Substance abuse disorder Cognitive impairment The PMHNP is evaluating Jared, a 47-year-old male who is brought to care by his wife because ―he’s not the man I married 20 years ago.‖ According to his wife, she and Jared have been married for 20 years, have two children, and have lived a ―normal‖ life. Jared owns a local construction company and their marriage has been a solid one, characterized by the typical day-to-day issues that occur in most marriages, but otherwise happy. For the last 2–3 months, she says Jared has completely changed. He will get angry for no apparent reason and even broke a lamp once. He tells stupid and offensive jokes that no one else thinks are funny, and even had someone call the police when he continued to make inappropriate remarks to a woman in a restaurant. Jared seems unsure what to say, but his wife is adamant that this is a totally different man from the one she has known. The PMHNP knows that Jared should be evaluated for: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University He should maintain this dose for 4 weeks and reassess He should change his therapy to an SNRI Addition of cognitive behavioral therapy would likely improve response NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 50 Pharmacologic treatment is not indicated The etiology is different Perfectionism is common Depressive personality disorder exists along the spectrum of dysthymia and major depressive disorder, but it is different from these two in that: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Physical symptoms are lacking Question 51 Intrusion symptoms Avoiding stimuli Karen is a 19-year-old female who has been referred to care after being seen in the emergency department following a violent sexual assault. She was working late one evening at the shopping mall and walked alone to her car after dark. She was assaulted, beaten, and thankfully a passerby saw her lying in some bushes and called 911. Initially she was resistant to mental health care, but now, 2 months later, she feels as though she needs help because she is experiencing a collection of symptoms including flashbacks, dreams of the assault, palpitations, anxiety, and a sense that she is watching the assault happen to her This sense of watching the assault as if she was an observer is characteristic of which diagnostic domain of PTSD? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 53 Patients who require long-term benzodiazepine management should be maintained on long-acting agents The use of benzodiazepines long term for anxiety does not pose a high risk of dependence and abuse The panel supports increased federal and/or state restrictions on benzodiazepine prescribing When detoxifying from therapeutic dosages, daily intake should be decreased by 10–25% The International Study of Expert Judgment on Therapeutic Use of Benzodiazepines and Other Psychotherapeutic Medications was designed to gather systematic data on the opinions of leading clinicians concerning the benefits and risks of benzodiazepines and alternative anxiety treatments. Which of the following best characterizes the majority opinion of this group? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 54 The time course of symptoms Presence of physiologic arousal Reexperiencing the event Differentiating post-traumatic stress disorder (PTSD) from panic disorder and generalized anxiety disorder can be challenging. Which of the following provides the strongest support for PTSD vs the other two differential diagnoses? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Response to pharmacotherapy Question 55 Urine drug screen Hepatic function test John is a 41-year-old male who presents for management of heroin addiction. He has a long history of opiate abuse spanning decades and has had several unsuccessful attempts at recovery. Because of his lifestyle, he has developed a variety of chronic health problems, including cardiomyopathy and stage 2 chronic kidney disease. He currently takes several psychiatric medications for mood disorder. When considering methadone maintenance as a mechanism of treating his opiate addiction, the PMHNP knows that if he requires more than 100 mg of methadone at the start of therapy he should have a baseline: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 57 Macrocytosis Transaminitis Uremia Hypertriglyceridemia When evaluating the laboratory assessment of a patient with alcohol use disorder, the PMHNP may reasonably expect to find all of the following abnormalities due to chronic alcohol use except: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 58 Fluoxetine Paroxetine Escitalopram Sertraline Mr. Henderson is a 69-year-old man who presents for evaluation and care for depression. His wife died 6 months ago following a difficult 2 years with breast cancer. His primary complaint is that he just does not look forward to anything anymore. He cannot get interested in his children and grandchildren, he no longer enjoys any of his hobbies because he and his wife used to do them together. He does not sleep well, and wakes up frequently during the night. He also admits to thinking more and more about dying himself, although he expressly denies suicidal ideation. His medical history is significant for coronary artery disease, osteoarthritis, hypothyroidism, hypertension, and dyslipidemia. He also has atrial fibrillation and is on warfarin for emboli prophylaxis, but he does not remember the names of all of his other medications. When considering pharmacotherapy for Mr. Henderson, the PMHNP considers that which of the following SSRIs is safest with respect for potential drug interactions? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 59 The PMHNP is called to the acute care unit to evaluate a patient who is admitted after being brought in by his friends. They were at a party where there were numerous drugs of abuse as well as alcohol. The patient cannot provide a history, and his friends are unclear as to which drugs he used. Physical examination reveals a patient who is diaphoretic, tremulous, has a pulse of 130 bpm, dilated pupils, and cannot perform fine motor tasks. These physical findings are most consistent with which type of intoxication? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 61 From a biological perspective, all of the following neurotransmitters are implicit in the anxiety response except: Gamma-aminobutyric acid Norepinephrine NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Serotonin Dopamine Question 62 NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University BPRS Toxicology screen Head imaging Family history Laura T. is a 27-year-old female who has been referred for psychiatric evaluation. She has no significant psychiatric or medical history and denies any history of substance abuse, but she is here because she is persistently having olfactory hallucinations. For the last 3 months, she has been having this progressive sense of smelling particularly foul odors—feces, rotting food, trash— with no obvious cause. She made the appointment because she had an uncle who had schizophrenia and he used to have hallucinations too, although he was mostly hearing voices. The PMHNP knows that a priority of assessment includes a: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 64 Any history of suicidal attempts or serious ideation History and current patterns of substance abuse Chantel is a 19-year-old female who presents for care because she thinks she is bipolar. During her initial interview, she admits that she has a long history of feeling like she was the person in the family of whom there were always high expectations, and she was never able to express concerns or feelings of inadequacy. When asked why she thinks she is bipolar, she says she gets very moody. She was at the grocery store last week and slipped and fell. While waiting for help, she could not control her anger and reached up to swipe all the food off of the shelves. She has been fired from jobs because of her uncontrollable temper; she sometimes ―just can’t be around certain people.‖ Chantel also reports that at times she will go two full days and nights being unable to sleep, and that her mind keeps racing and she can’t ―shut it down.‖ When this happens, she just gets up and does things around the house. Finally, Chantel reports that she cannot hold onto money at all. Whenever she gets a paycheck, she immediately spends it on things that she acknowledges she doesn’t even need. When considering a diagnosis of bipolar disorder, the PMHNP specifically assesses for: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Concomitant psychotic features such as hallucination or delusion Manic symptoms that are sustained most of the day for at least 2 weeks Question 65 Lithium carbonate is the drug of choice for Joe Joe would be best managed with injectable antipsychotics Joe W. is a 28-year-old male who is currently having an acute manic episode. He has not slept for 3 days, is extremely irritable, and is prone to violent outbursts of anger. He reports what is clearly a sustained episode of racing thoughts and has experienced psychotic episodes. According to his history, Joe has been on mood stabilizing medication in the past, but he is very unreliable when it comes to follow-up. When considering medication therapy for Joe, the PMHNP knows that: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Risperidone is an appropriate choice when mania is characterized by anger and violence Symbyax (olanzapine/fluoxetine) is the safest choice for Joe given his psychosis NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University CBC and BMP TSH and serum Na+ CMP and ECG LFTs and EEG NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 68 Depression presents with more somatic symptoms as compared to younger age groups Ageism may cause primary care clinicians to accept depressive symptoms in the elderly as normal Risk factors include loss of spouse, physical illness, and social isolation Incidence of geriatric depression is estimated at 60–75% of the population The PMHNP is preparing a presentation for a primary care conference on geriatric health care. The topic is geriatric depression, and this presentation is designed to increase recognition of community-dwelling elders at risk. An important talking point in this presentation will include all of the following about geriatric depression except: NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 69 When differentiating a major depressive episode from dysthymic disorder, the PMHNP considers that: The cognitive theory of depression does not apply to dysthymia Hospitalization is typically indicated early in the course of dysthymia Dysthymia is more subjective in its presentation than depression Insight-oriented therapy is the most effective treatment for dysthymia NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Parallel form reliability Construct validity Face validity Question 72 The presence of fixed delusional thought The PMHNP is considering a diagnosis of paranoid personality disorder in a new patient. When reviewing the history and physical examination, which of the following findings would be most consistent with this diagnosis? NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Disdain for weak or sickly people A history of antisocial behavior Extreme ―drama‖ in most personal relationships NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University NURS 6670 Midterm Exam Latest update 2021/2022 Questions and Verified Answers (Already Graded A+) Walden University Question 73 The major defensive mechanisms employed by patients with histrionic personality disorder include: Repression and dissociation Projective identification Fantasy and isolation Splitting