Mental Health Nursing Midterm Exam Questions and Answers, Exams of Nursing

Download Mental Health Nursing Midterm Exam Questions and Answers and more Exams Nursing in PDF only on Docsity! NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. ● Question 1 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: Selected Answer: Appear anc e Answers: Appear anc e Motor activi ty Mood Affec t NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Resp onse Feed back : (a) is the correct answer. Appearance and behavior refer to a general description, such as apparent age, style of dress, jewelry, grooming and hygiene. None of these are noted here. Janet’s motor activity is bradykinesia, her mood is depressed, and her affect is flat. ● Question 2 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 1 out of 1 points NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Answers: 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 In some circumstances patients will purposefully mischaracterize the efficacy of medications they feel were ineffective Some forms of recurrent depression are best managed with nonpharmacologic strategies Resp ons e Feed back : (a) is the correct answer. A common mistake among clinicians is to accept the depressed patient’s self-report of medication accuracy. Depressed patients frequently overemphasize the negative and minimize the positive and may genuinely have a misimpression of their medications effectiveness; similarly, unrealistic expectations may skew their NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. im pr es sio n of m ed ic ati on re sponse. An SNRI may ultimately be the most appropriate choice, but the PMHNP should not base this primarily on the patient’s self-report of SSRI response. This should not be perceived as a purposeful mischaracterization – the patients are not usually trying to misrepresent thing; they are reporting their genuine impression. Finally, recurrent depressions spanning decades will most likely require pharmacotherapy along with some form of nonpharmacologic intervention for best outcomes. ● Questi on 4 1 out of 1 points NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 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 Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 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: Selected Answer: When symptoms are preceded by antidepressant therapy, a diagnosis of bipolar does not apply Answers: When symptoms are preceded by antidepressant therapy, a NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 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 Resp onse Feed back : (a) is the correct answer. Consistent with DSM-5 criteria, a manic episode that emerges in response to an antidepressant does not constitute bipolar disorder. If these symptoms occur beyond the natural washout period of the sertraline, then bipolar may be appropriate. Symptoms have occurred long enough, as diagnostic criteria require 1 week of symptoms most of the day. An assessment of social and occupation impact will be helpful, but as his boss has already commented, this appears possible. While NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. th er e is a physiologic adaptation to sertraline, that does not include symptoms described here. ● Question 6 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 1 out of 1 points 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: Selected NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. include (a) through (c). ● Question 7 1 out of 1 points 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 2 out of 1 points 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 NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. with this change. She is distraught over the potential of not being able to do her job well and meet her immediate supervisor’s expectations. Recognizing the likely diagnosis, the PMHNP knows that Sally is likely to respond best to: Sele cted Answ er: [None Given] Answers: Pharmacotherapy with clonazepam Free-association, nondirective therapy Interpersonal therapy Serotonergic agents Resp onse Feedback NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. : (b) is the correct answer. These patients often recognize that there is a problem and will do well with this form of therapy, although it is a long and complex process. Clonazepam and serotonergic agents are effective with obsessive-compulsive disorder, but their utility with obsessive-compulsive personality disorder is less clear. Interpersonal therapy is not among the therapeutic modalities with any demonstrated success with this personality disorder. ● Question 8 When performing a psychiatric assessment of an elderly patient with Alzheimer’s dementia, the PMHNP recognizes that: 1 out of 1 points Selected Answer: All of the above. Answers: An important part of the history will come from the caregiver NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 1 out of 1 points Resp ons e Feed back : (c) is the correct answer. While dysthymia overlaps with depression, it is different in that symptoms tend to be more prevalent than physical findings; disturbances in appetite, libido, and psychomotor function rarely occur. The cognitive theory of depression also applies to dysthymia; hospitalization is rarely indicated in dysthymia, and while insight-oriented therapy has been historically utilized, objective evidence supports cognitive, behavioral, or pharmacotherapy. ● Question 10 During the interview of Kevin, a 42-year-old male who presents for treatment 1 out of 1 points 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 Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Selected Answer: Acknowle dgem ent Answers: Reinforce ment Reassura nce Encourag emen t Acknowle dgem ent Resp ons e Feed back : NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. (d) i s th e co rr ec t an s w er . Th is is a fo r m of no nv er bal acknowledgement of emotion and often leads the patient to sharing more feelings. Reinforcements are those brief phrases that urge the patient to continue, such as “I see” or “go on.” Reassurance is a technique by NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. ● Question 12 Which of the following is a true statement with respect to the treatment of narcissistic personality disorder? Selected Answer: Both serotonergic drugs and lithium are useful Answers: 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 1 out of 1 points Resp onse Feed back : NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. (b) is th e co rre ct an sw er. Tr ea tm en t of thi s dis or de r is ve ry difficult as patients must acknowledge and eschew their narcissism before any real therapeutic progress can be made; however, these patients are prone to both depression and mood swings for which both serotonergic drugs and lithium have been successful. Psychoanalytic therapy has been advocated, but there is no validating research. Group therapy has NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. been advocated for by some clinicians, although more research is needed. There is no evidence that immobilized patients do better—this concept is true of antisocial personality disorder. ● Question 13 0 out of 1 points 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 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 NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 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 NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 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: Selected Answer: The physiologic symptoms of withdrawal may require a short-term hospitalization Answ ers: 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 Resp onse Feed back : NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. (a) is th e co rre ct an sw er. Un lik e op iat es , alc ohol, or sedative-hypnotics, cocaine withdrawal does not produce physiologic symptoms that require inpatient withdrawal; occasionally a patient may need to be placed in a residential or inpatient setting just to keep them away from social settings where they can obtain the drug. There are no medications to help with withdrawal. The patient does need to understand that fatigue, dysphoria, and depression may occur. The depression can be severe, and patients should be followed for its development. The primary barrier to withdrawal is the intense cravings that patients experience, particularly as there are no other drugs to help with these symptoms and the patients know that even a small dose of cocaine will attenuate the symptoms they are having. ● Questio n 15 1 out of 1 points NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 0 out of 1 points 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 Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Selected Answer: Narcissis tic Answers: Histri oni c Narci ssis tic Borde rlin e Schiz oid Resp onse Feed back : NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. ( c ) T h e s e b e haviors are most consistent with borderline personality disorder. Histrionic personalities are often extreme, flamboyant, and sexually aggressive, but do not typically have this pattern of law breaking or incarceration. Narcissistic personalities are not characterized by splitting behaviors— the grandiose sense of self- importance is the dominant feature. Schizoid personalities are much more aloof and withdrawn, not prone to these extremes of emotion. ● Question 17 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: Selected Answer: Describe an active fantasy life with imaginary friends Answers: R e v e a l a v e NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Repressi on and dissociati on Answers: Repression and dissociation Projective identification Fantasy and isolation Splitting Resp onse Feedb ack: (a) is the correct answer. These are most commonly used by histrionic personalities. Projective identification and splitting are more commonly used by borderline personalities, whereas fantasy and isolation. ● Questio n 19 0 out of 1 NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. points 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: Selected Answer: Strong family history of depression and bipolar disorder Answers: Low-grade chronicity for at least 2 years Insidious onset, usually in childhood or adolescence Strong family history of NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. depression and bipolar disorder Long asymptomatic periods between episodes Response (d) is the correct answer. Dysthymia is characterized by its chronicity, NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. bo rd erl in e pe rs on ality disorder, not antisocial. Patients with personality disorders tend to have heightened defense mechanisms; this is what is responsible for symptoms and behaviors, and the inability to penetrate those defenses presents a challenge to successful therapy. Boys with antisocial personality disorder tend to come from larger families. ● Questio n 21 1 out of 1 points Assessment of the manic state in a patient with bipolar disorder is likely to include all the following except: Selected Answer: Suicidal or homicidal ideation Answers: Mood-congruent delusions of grandeur NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Suicidal or homicidal ideation NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Impaired judgment with no insight Unrestrained flow of ideas Resp onse Feedb ack: (b) is the correct answer. While most manic patients are assaultive or threatening, the incidence of suicidal and homicidal ideation is unknown. Conversely, the other answer choices are all classic in the manic patient and are present most of the time. ● Questio n 22 1 out of 1 points From a biological perspective, all of the following neurotransmitters are implicit in the anxiety response except: Selected Answer: Dopamine NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. (b) is the cor rec t an sw er. Mo st of the pa nel me mb ers opi ne tha t the be nefit of benzodiazepines in long-term anxiety management NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Feed back : outweighs risk and that therapeutic use does not pose high risk of dependence or abuse. This group does not support increased federal or state prescribing restrictions. There is no suggestion that short- vs. long-acting agents are superior with respect to abuse potential. Detoxification from therapeutic doses should begin with a 10–25% reduction, but that is not the purview of this panel and it is not their recommendation. ● Questio n 24 1 out of 1 points Which of the following is a true statement with regard to the etiology of substance abuse? Selected Answer: Neurotransmitters or receptors have been identified with most substances of abuse except for alcohol Answ ers: NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. N e u r o t r a n s m itters or receptors have been identified with most substances of abuse except for alcohol Twin and sibling studies do not support a genetic component with respect to the etiology of substance abuse Substances of abuse decrease activity in the amygdala and anterior cingulate The WHO schematic of drug use and dependence identifies immediate antecedents as the central element of abuse Resp onse Feed back : (a) is the correct answer. No receptor or transmitter has been identified for alcohol; most other substances of abuse have these identified. Studies of twins, adoptees, and sibling raised separately support a genetic component to substance abuse. Substances of abuse stimulate or increase activity in the limbic regions. The WHO schematic identifies the drug-using behavior itself as the central element. NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Self-esteem Interpersonal relationships Resp onse Feed back : (c) is the correct answer. Patients with narcissistic personality disorder have an extremely fragile sense of self-esteem, which makes them vulnerable to depression when it is assaulted. They have an inflated sense of self-importance, a central feature of this disorder. Their defense mechanisms are intact; this is part of the pathophysiology of this disorder. They do have difficulties with interpersonal relationships because of their self-aggrandizing nature—not due to fragility. ● Question 26 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 1 out of 1 points “mentally ill.” He has been unable to hold a job and NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 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: Selected Answer: Thought process NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Answers: Affect Cogni tion Thou ght proce ss Abstr act reaso ning Resp ons e Feed back : (c) is the correct answer. Overinclusion of trivial or irrelevant details that make it difficult to get to the point is indicative of circumstantiality, which is an abnormal thought process. Affect is an expression of mood and may be described as happy, irritable, tearful, etc. Cognition describes the patient’s level of consciousness, orientation, memory, and attention..Abstract reasoning is the ability to expand a concrete or specific NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. choti cs Resp onse Feed back : (d) is the correct answer. There are no data to support the efficacy of antipsychotics, and these are only indicated acutely for severe agitation or aggression. Conversely, SSRIs; TCAs; antiadrenergics, such as clonidine propranolol; as well as MAOIs and mood stabilizers all have demonstrated utility. ● Question 28 The PMHNP is on call at the local county correctional facility. He is asked to 1 out of 1 points 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 NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. bar celebrating a birthday, and before anyone knew what happened an argument escalated into M.S. getting very loud, yelling, and acting “crazy” before he punched a coworker and started breaking bottles. When considering a manic or hypomanic episode, the PMHNP expects that his speech would most likely be: Selected Answer: Increas ed Answers: Stut ter ed Incr eas ed NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Child lik e Conf us ed Resp onse Feed back : (b) is the correct answer. Speech is described in terms of fluency, amount, speed, tone, and volume. Patients who are experiencing a manic or hypomanic episode most often (although not always) will NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. ol Buspi ron e Resp onse Feed back : (d) is the correct answer. Buspirone is not physically addictive, and it is particularly useful for the cognitive (vs. physiologic) manifestations of anxiety, which seems to be Ana’s primary concern. While benzodiazepines do have a role in generalized anxiety disorder, they must be used very judiciously, and Ana’s circumstances—along with her concerns— make them not a good first choice. Venlafaxine is an alternative, but its action on the physiologic symptoms makes buspirone a better choice. Propranolol does not impact the cognitive symptoms at all and is more useful for physiologic symptoms such as performance anxiety. ● Question 30 The PMH NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. NP is evaluating Jared, a 47-year-old male who is brought to care by his 0 out of 1 points 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 NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 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: Selected Answer: Substance abuse disorder Answers: Borderline personality disorder Structural brain damage Substance abuse disorder Cognitive impairment Resp onse Feedback NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. (a) i s th e co rr ec t answer. Avoidant personalities do have a desire for interpersonal relationships; schizoid personalities do not. Both types of personalities may have an active fantasy life, be perceived as distant and aloof, and be attached to animals; none of these things differentiate one type from the other. ● Questio n 32 0 out of 1 points NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Clare’s history of personal relationships is characterized by complete intolerance of being alone. Whether it is an 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: Selected Answer: Has difficulty disagreeing with others Answers: Has difficulty disagreeing with others Needs reassurance to support even mundane decisions Volunteers to do unpleasant tasks to obtain nurturance Has disproportionate anger toward an abusive spouse NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Resp onse Feed back : (d) is the correct answer. Not only do these patients not express anger, they are more likely to tolerate abusive behavior as preferable to being alone. Conversely, dependent personalities do have difficulty disagreeing with others, need constant support and affirmation for even routine daily decision making, and will often put themselves in unpleasant situations or volunteer for undesirable tasks to be liked. ● Question 33 The PMHNP is conducting an initial interview with a patient whose history is 0 out of 1 points 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: Selected Answer: NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Patients on lithium carbonate for management of bipolar disorder should be subject to routine assessment of: Selected Answer: TSH and serum Na+ Answers: CBC and BMP TSH and serum Na+ CMP and ECG LFTs and EEG Resp onse Feed back : NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. (b) c or re ct a n s w er. Lithium, as an iodine-containing medication, presents a risk of both hypothyroidism and hyponatremia. Patients on lithium should have routine monitoring of these labs as well as lithium levels. CBC is not routinely indicated; this is appropriate for drugs that can cause pancytopenia, such as valproic acid. ECG, LFT, and EEG are not routinely indicated. ● Question 35 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 0 out of 1 points 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, NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 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? Selected Answer: Fluoxetine Answers: Fluoxe tine Parox etine Escita lopr NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Normal pressure hydrocephalus Depression Resp onse Feed back : (a) is the correct answer. The acute nature of this mental status change without any preexisting conditions or deficits is consistent with infection, most likely of the urinary tract. This is not mild cognitive impairment as his current symptoms clearly interfere with ADLs. Normal pressure hydrocephalus is remotely possible but much less likely. Depression may mimic dementia, but the acute and global nature of this presentation is more consistent with delirium. ● Question 37 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? Sel ect ed An NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. swer: Reexperiencing the event Answers: The time course of symptoms Presence of physiologic arousal Reexperiencing the event Response to pharmacotherap y 1 out of 1 points Resp onse Feed back : (c) is the correct answer. PTSD, unlike generalized anxiety disorder or panic disorder, is characterized by reexperiencing of the traumatic event. The time course of symptoms is not specific; while PTSD does occur after a traumatic event, symptoms may occur 1 week or 30 years after the event. All of these conditions are characterized by NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. physiologic arousal, and SSRIs are indicated for all of them as well. ● Question 38 0 out of 1 points 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: Selected Answer: Lithium NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. function test 12-lead ECG NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Resp onse Feed back : (d) is the correct answer. In patients who are at high risk, such as those with cardiomyopathy, a 12-lead ECG should be assessed prior to starting methadone at doses > 100 mg daily as it may prolong the QT interval predisposing to ventricular dysrhythmia. A urine drug screen is typically performed prior to treatment, but this is not related to the dose of methadone. Hepatic function profile is appropriate only if there is concern about liver disease, and pulmonary function test does not have any routine indication. ● Question 40 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 0 out of 1 points late one evening at the shopping mall and walked alone to her car after dark. She was assaulted, NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. 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? Selected Answer: Intrusion symptoms Answers: Intrusi on sympt oms NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. BPRS PA NS S HA M- D Resp onse Feed back : (c) is the correct answer. This tool was designed in the late 1980s to improve upon deficits in the BPRS. The BPRS was developed in the 1960s and was widely used for assessing schizophrenia symptoms but has been essentially replaced by the PANSS. The SCID is a lengthy diagnostic tool that is used in research but, due to its length, is not practical for clinical practice. The HAM-D is a depression tool. ● Question 42 The PMHNP is working on a graduate program in which he is hoping to develop a new personality ass ess me nt NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. tool. After an exhaustive review of the literature and 1 out of 1 points many months of work, he developed a tool to use in a research study and needs to establish its psychometric properties. He distributes the tool to four different professionals in the field and asks that they assess whether the questions appear to measure what they are purported to measure. This is an assessment of: Selected Answer: Face validity Answers: Internal consistency reliability Parallel form reliability Construct validity Face validity NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. Resp onse Feedb ack: (d) is the correct answer. Assessing whether the items measure what they appear to measure is face validity. Construct validity uses data outside of the test to measure validity. Reliability evaluates whether the tests measure what it is supposed to measure consistently. ● Question 43 The difference between a manic and hypomanic episode is best characterized by all the following except: Selected Answer: Hypomanic episodes do not cause marked impairment in function Answers: The duration of symptoms is shorter for hypomanic episodes Hypomanic episodes do not cause marked impairment in function There are no psychotic features with hypom anic episod es NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. among the following neurotransmitters is decreased in depression and increased in mania? Selected Answer: Serotonin Answers: 0 out of 1 points Dopami ne Norepin ephri ne Seroto nin Gluta mate Resp onse Feed back : (a) is the correct answer. Norepinephrine and serotonin are clearly implicit in depression, but their relationship or concentration in mania is not established. Although glutamate is being explored as a NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. n e u rotransmitter implicit in mood disorders, its role is emerging and not well articulated now. ● Question 45 Dependence is a common feature of many psychiatric disorders. One of the 1 out of 1 points primary distinguishing features that differentiates dependent personality disorder from histrionic and borderline personalities is that: Selected Answer: Dependent personalities tend to have long-term relationships with one person Answers: The treatment of dependent personality is rarely successful Occupational dysfunction is rarely impaired Dependent personalities tend to have long-term relationships with one person NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2024Answers 100%Correct/Verified With Explanations. This disorder tends to be more common in men Response (c) is the correct answer. Unlike other personality disorders, dependent NURS 6670 Midterm Exam Questions And Answers Attained Grade A+ Guaranteed Success Latest2023 Answers 100%Correct/Verified With Explanations