Case Studies on Personality Disorders: Diagnosing Cluster A Disorders in PMHNP Students, Exams of Nursing

Download Case Studies on Personality Disorders: Diagnosing Cluster A Disorders in PMHNP Students and more Exams Nursing in PDF only on Docsity! NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass NURS 6670 Midterm Exam Question 1 Schizoid personality disorder Schizotypal personality disorder Paranoid personality disorder Delusional disorder Question 2 While preparing a class on personality disorders for a class of PMHNP students, the instructor is presenting case studies of patients with cluster A personalities. One of these cases is Clark M., a 41-year-old man who is described Currently described as a brilliant computer programmer, he clearly prefers solitary pursuits and the company of his cat over people. He knows he is socially isolated, but he is just more comfortable this way. This description is most consistent with: 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Sense of self-importance Defense mechanisms Self-esteem Interpersonal relationships Pharmacotherapy Psychoanalytic psychotherapy Transference-focused psychotherapy A stress interview Question 4 Janel is a 37-year-old woman who is being interviewed as part of a family assessment. Her 10-year-old son is having some behavioral issues in school and has been referred for evaluation. While interviewing Janel, the PMHNP appreciates that she appears very emotional. She expresses extreme distress at her son’s behavior and says she will unhappy when she is not the center of attention during the evaluation process. She repeatedly talks about her own medical problems, such as recurrent headache and abdominal pain, which her doctors cannot diagnose. Her appearance is very flamboyant, and her dress is more appropriate to a nightclub than a family assessment. In addition to managing her son’s needs, Janel would likely benefit from: Sarah is a 23-year-old patient who presents for a follow-up of her major depressive episode. She was titrated up to maximal dose fluoxetine 6 weeks ago after demonstrating tolerance without side effects at lower doses. Today in follow-up, she reports that she still has no sides effects but no therapeutic effect either. There does not appear to be any measurable improvement of her initial presenting symptoms. The PMHNP knows that the most appropriate approach at this point is to: Question 3 NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 6 SSRIs TCAs Antiadrene rgics Antipsycho tics Question 7 A variety of pharmacologic agents have demonstrated effectiveness in the treatment of post-traumatic stress disorder. Which of the following does not have any evidenced-based support in the literature? NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Stuttered Increa sed Childli ke Confused Question 8 The PMHNP is on call at the local county correctional facility. He is asked to evaluate M.S., a 21-year-old male who was just arrested following an altercation at a local bar. M.S. has never been incarcerated before and apparently has no psychiatric or medical history available. His toxicology screen was negative for alcohol or any drugs of abuse. His mother says that he has in the past had some occasions when he got kind of agitated, but this is the first time it’s been a problem. Reportedly some people from his office were at the bar celebrating a birthday, and before anyone punched a coworker and started breaking bottles. When considering a manic or hypomanic episode, the PMHNP expects that his speech would most likely be: 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass 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 Question 9 Which among the following neurotransmitters is decreased in depression and increased 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 there.‖ The PMHNP considers that: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Both serotonergic drugs and lithium are useful Group therapy is rarely helpful Immobilized patients (hospitalized or incarcerated) have the best outcomes Question 13 Histrionic Narcissistic Borderl ine Schizoi d Alexa is a 27-year-old female who has come to group therapy while she is in the city jail. She was arrested for vagrancy because she was sleeping in her car in a parking lot at a local shopping center. She could not post bail, so she is sentenced to 14 days in jail. During group, she contributes that none of this is her fault. Her mother is totally evil because she would not let Alexa stay in the family home. She has some other family. but they are all jerks because they won’t help her. Alexa’s friend Melanie is the absolute best person in the world, but she can’t help because her boss fired her for no reason. Alexa has a history of arrests for buying illegal drugs and prostitution. The last time she was in jail, her sentence was extended for 30 days because she got into a fight with another inmate and beat her up so badly she had to be admitted to the hospital for 6 days. The PMHNP considers which of the following personality disorders? NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 14 A history of racing thoughts Difficulty interacting with others Extremely high expectations of self Significant impairment at work Question 15 Darius is a 26-year-old male who presents for care as part of couple therapy with his wife, who is being seen for dependency issues. Darius himself seems very anxious to ―do the right thing‖ and appears to want to please the therapist. During the evaluation, Darius is impeccably dressed, very formal in his presentation and interaction, and is watchful of time because he has an appointment after the interview and states several times that he cannot be late. The PMHNP considers that Darius may have obsessive compulsive personality disorder (OCPD). In differentiating this from obsessive compulsive disorder (OCD), she explores his history further for: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Hugo’s wife meets diagnostic criteria for this disorder 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 Antidepressant discontinuation syndrome Rebound depressive symptoms A manic or hypomanic episode 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: 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Addiction Question 21 Diazepam Pimozide Psychotherapy Group therapy Question 22 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: Margo is a 47-year-old female who admits to a history of fairly heavy alcohol use over many years. She admits that she has had periods in the past where she stopped drinking for a brief time, but she has always gone back to it. At this point she says she has been drinking a fifth of bourbon every 2–3 days for over a year. She has a new boyfriend and really wants to stop drinking, but she is afraid she will ―go into the DTs.‖ She has been reading about it on the Internet, and she knows it can be fatal. Other than her drinking, Margo is amazingly healthy. She had a complete physical exam with blood work through her primary doctor, and he says that her drinking does not appear to have affected her physical health at all. While counseling Margo about alcohol withdrawal delirium (delirium tremens), the PMHNP advises Margo that: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass She should be admitted for inpatient detoxification People in good physical health rarely have DTs A beta adrenergic antagonist medication can minimize her risk of DTs Women rarely experience DTs Question 23 Venlafaxine and clozapine Fluoxetine and olanzapine Amitriptyline and haloperidol Paroxetine and buspirone 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 24 The physiologic symptoms of withdrawal may require a short-term hospitalization Unlike other substances of abuse, there are no medications to help reduce the intensity of withdrawal She will need to be monitored for depression Overcoming the intense craving for cocaine is the biggest issue Question 25 Discontinuing medication presents a marked risk of return to alcohol Anne is a 32-year-old female who presented to care after a random drug screening at work was positive for cocaine. She was initially resistant to therapy, maintaining that her use is not a problem and she could stop at any time. Upon further discussion in session, it appears that she uses cocaine every day at work, sometimes 2–3 times, other days more. She also uses it occasionally at home and most weekends. During her third session, she admitted that it is a financial burden, and she basically cannot afford any other form of recreation. She understands that if she uses again she will lose her job, and she admits that she loves her job and that cocaine is not worth losing it. When counseling her about cessation strategies, the PMHNP advises all the following except: Marie is a 30-year-old woman who presents for follow-up after starting treatment for bipolar disorder. She had been treated on and off for depression for years and had a history of alcohol abuse. After her marriage, she decided to stop drinking and was successful in eliminating alcohol from her life; unfortunately, she then went on to have a manic episode and was finally started on a mood stabilizer 1 month ago. She tolerated medication very well, and within 2 weeks symptoms were much improved. Now, 4 weeks later, she feels much better and wants to come off medication. The PMHNP tells her that: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass When symptoms are preceded by antidepressant therapy, a diagnosis of bipolar 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 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 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 29 Lamotrigine Valproic acid Lithium Amitriptyline Question 30 The PMHNP is seeing a patient who has been referred by primary care. The patient was diagnosed with major depressive disorder and trialed on both an SSRI and SNRI by the primary care provider. The patient appears refractory to therapy and has not had any appreciable clinical response. A more detailed psychiatric history is significant for indicators of bipolar disease, as well as a family history of bipolar disease in both the patient’s father and paternal aunt. This patient will most likely benefit from: Mariel is a middle-aged woman who is referred by her primary care provider for management of agoraphobia. Mariel has had this fear as long as she can remember, but now that her children have moved away from home she will need to be more independent and is very committed to trying to manage her fear. The PMHNP counsels Mariel that the most successful therapy for phobic disorders is: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Insight-oriented psychotherapy Behavior therapy Virtual therapy Pharmacotherapy Question 31 Cannabis intoxication delirium is characterized by all of the following except: Impaired memory Perception NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 34 Have a family history of the same disorder Respond well to dialectical behavioral therapy Have impaired emotional defense mechanisms Come from smaller nuclear families Cory is a 23-year-old male recently incarcerated in the county correction facility for a 9-month sentence following his third conviction for battery. As part of an early release program, he is required to participate in the therapy program. During his initial interview, he is very pleasant and engaged, expressing no anxiety or distress with his current circumstances. His psychiatric history is significant for numerous adolescent episodes of running away, truancy, and substance abuse. As a young adult, he reportedly has not held a steady job but rather is constantly coming up with money-making schemes. According to family reports is a personality disorder are very likely to: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 35 An acute change in mental status Angry verbal outbursts that seem unwarranted Death of her best friend An unplanned weight loss despite consistent oral intake Question 36 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Psychoanalytic Behavioral Existential Cognitive Question 37 An SNRI will likely be the most appropriate choice if pharmacotherapy is indicated for this episode This may be an inaccurate characterization, as depressed patients tend to overemphasize negatives 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? Mrs. Bowen is a 33-year-old female who presents as a new patient requesting medication for depression. She reports a long history of mood disorders on and off going back to adolescence. She is very articulate in describing her how long she took the medication. With respect to considering Mrs. Bowen’s medication history, the PMHNP knows that: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass support throughout her remission period. 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 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass An assessment for phobic disorder Question 41 The difference between a manic and hypomanic episode is best characterized by all the following except: The duration of symptoms is shorter for hypomanic episodes Hypomanic episodes do not cause marked impairment in function There are no psychotic features with hypomanic episodes Hypomanic episodes may occur as a response to antidepressants NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 42 Clare’s history of personal relationships is characterized by complete intolerance of being alone. Whether it is an 1 NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Urinary tract infection Mild cognitive impairment Normal pressure hydrocephalus Depression Question 44 Appearanc e Motor 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 presentation is: In documenting a mental status exam (MSE) for Janet, a 54-year-old female, the PMHNP notes that she is bradykinesic, has poverty of speech, is depressed, and appears flat. This includes all the following elements of physical examination except: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass activity Mood Affect Question 45 Jen is a 31-year-old female who presents for care complaining of depressed mood. During the interview, it becomes apparent that she has a long history of depressive symptoms, as well as a long history of being socially isolated and feeling generally inadequate. When considering a diagnosis of dysthymia, the PMHNP considers that the core concept of dysthymia refers to sub-affective or subclinical depressive disorder with all of the following except: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass 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? Borderline Narcissistic Dependent Schizotypal NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 49 He needs to be increased to 200 mg today and follow up in 4 weeks 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 Maurice is a 22-year-old male who is being treated for major depressive episode. He presents today for a follow up visit. He was started on sertraline 50 mg daily 4 weeks ago, and 2 weeks ago, his dose was increased to 150 mg daily. Today he is concerned because he doesn’t really feel much symptom improvement, and he thinks he needs something else. The best response to Maurice is to tell him that: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 50 Pharmacologic treatment is not indicated The etiology is different Perfectionism is common Physical symptoms are lacking 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 51 Intrusion symptoms Avoiding stimuli Autonomic arousal Clinical significance 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Response to pharmacotherapy Question 55 Urine drug screen Hepatic function test Pulmonary function test 12-lead ECG 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 56 Reinforcement Reassurance Encouragement Acknowledgement During the interview of Kevin, a 42-year-old male who presents for treatment because of marital problems, the PMHNP responds to his tears by gently moving a box of tissues toward him. This is a facilitating intervention of interview known as: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 57 Macrocytosis Transaminitis Uremia Hypertriglyceridemia Question 58 Fluoxetine 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: 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 61 From a biological perspective, all of the following neurotransmitters are implicit in the anxiety response except: Gamma-aminobutyric acid Norepinephrine Serotonin Dopamine Question 62 BPRS 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Toxicology screen Head imaging Family history Question 63 Schizophrenia Social anxiety Schizoid personality Marcus is an 18-year-old male presented for care by his parents. It is time for Marcus to begin exploring colleges and he flat out refuses to do so. Both Marcus and his parents admit that he has had a rather solitary lifestyle. He has been home-schooled since the eighth grade. According to his parents, he is extremely intelligent and in junior high it became very difficult for him to be in school. He was very uncomfortable in the school setting and it was counterproductive to learning, so the parents were amenable to home schooling. However, now they want him to go to college, but he will not discuss it. When considering differential diagnosis, the PMHNP considers all of the following except: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Agoraphobia NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 66 Reveal a very strong desire for an intimate relationship Become very engaged in group therapy Describe an active fantasy life with imaginary friends Demonstrate psychotic or delusional features The professional relationship between therapist and patient with schizoid personality disorder is a challenge because these patients do not typically seek care independently. However, once a trusting relationship develops, this type of patient may: NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 67 Patients on lithium carbonate for management of bipolar disorder should be subject to routine assessment of: CBC and BMP TSH and serum Na+ CMP and ECG LFTs and EEG NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass 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 Question 69 When differentiating a major depressive episode from dysthymic disorder, the PMHNP considers that: 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass The presence of fixed delusional thought Disdain for weak or sickly people A history of antisocial behavior Extreme ―drama‖ in most personal relationships NURS 6670 Midterm Exam Latest Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Question 73 The major defensive mechanisms employed by patients with histrionic personality disorder include: Repression and dissociation Projective identification Fantasy and isolation Splitting Question 74 Lorazepam 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 Version 2024 100% Verified Questions And Answers (Already Graded A+) Guaranteed Pass Venlafaxine Propranolol Buspirone Question 75 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