NU664C 2022 May All Quizzies Latest

NU664C Primary Care of the Psychiatric Mental Health Client I

Week 2 Quiz   

Question 1Actions judged based on their inherent value regardless of their consequences is based on which ethical decision-making approach?

 a.Teleological theory

 b.Virtue ethics

 c.Deontological theory

! Deontological theory considers the inherent value regardless of consequences.

 d.Justice principal

Question 2?Brain plasticity, which refers to the brain's capacity to change in response to an event, ________.

 a.is the same for all individuals

 b.involves physical changes in the brain

 c.is absent in older adults

 d.is independent of genetic influence

 e.is a concept not well received by scientists

Question 3 ?Current Procedural Terminology (CPT) is a code set by the American Medical Association.  What is Its function?

  a.Describe medical, surgical, and diagnostic services

 b.Communicate uniform information about medical services

 c.Describe services for billing purposes

 d.All of the answers

Question 4

?Symptoms of anxiety and panic are associated with a low level of which neurotransmitter?

  a.ortisol

 b.Dopamine

 c.Norepinephrine

 d.Gamma-aminobutyric acid

 e.Glutamate

Question 5?The brain structure that is believed to have a gating/filtering function and is the area of the brain through which all sensory information passes en route to various cortical areas is which of the following?

 a.Brainstem

 b.Reticular activating system

 c.Thalamus

 d.Hypothalamus

 e.Cerebellum

Question 6?The range of personal, social, economic, and environmental factors that influence health status are known as which of the following?

 a.Tertiary action items

 b.Epidemiological patterns and prevalence

 c.Determinants of health

 d.IHI's Triple Aim

Question 7The role of neurotransmitters in the central nervous system is to function as ________.

 a.a communication medium

 b.a gatekeeper for transmissions

 c.a building block for amino acids

 d.an agent to break down enzymes

Question 8?This portion of the brain is implicated in addiction medicine.  The rewards pathway lights up in this area of the brain when substances are abused.  It is believed that long-term damage from methamphetamine abuse can cause chronic feelings of loss of interest, flat affect, and social isolation.

 a.Hippocampus

 b.ucleus accumbens

 c.Corpus callosum

 d.Basal ganglia

 e.Hypothalamus

 f.Reticular information system

Question 9What is the most effective strategy for a PMHNP to act as a change agent in mental health policy?

 a.Serve on a legislative committee

 b.Write the media about mental health issues

 c.Advocate for patients in the hospital

 d.Notify the patient of their rights

Question 10?What is the principle excitatory neurotransmitter in the central nervous system?

 a.

Gamma-aminobutyric acid

 b.Serotonin

 c.Dopamine

 d.Glutamate

 e.Acetylcholine

Question 11?What is the purpose of the American Nurses Association's Scope and Standards of Psychiatric-Mental Health Clinical Nursing Practice?

  a.Define the role and action for the NP

 b.Establish the legal authority for the prescription of psychotropic medications

 c.Define the legal authority of the PMHNP

 d.Define the differences between the physician role and the NP role

Question 12Which of the following definitions of statutory law is ?

 a.Statutory law outlines the rules and regulations for each state and may provide restrictions in practice unique to a specific state.

 b.Statutory law is a process by which an agency of state government grants permission to individuals accountable for the practice of a profession.

 c.Statutory law protects the public by ensuring a minimal level of professional competence.

 d.Statutory law is a process that provides title protection.

Question 13?Which of the following bestdescribes population health?

 a.Delivering the same health care to all people

 b.Stratifying risk within populations

 c.The quality of medical health care

 d.Linking outcomes to patterns of health determinants

Question 14Which of these brain structures puts emotional meaning on a stimulus, forms emotional memories, and is involved with rage and fear?

  a.Hippocampus

 b.Basal ganglia

 c.Amygdala

 d.Midbrain

Question 15Which structure in the brain is responsible for temperature regulation, thirst, appetite, endocrine control, and sleep and wakefulness?

  a.Basal ganglia

 b.Amygdala

 c.Thalamus

 d.Hypothalamus

 e.Hippocampus 

Question 16Each state has its own Board of tration for Nursing, but the federal agency NONPF regulates the practice of PMHNPs.

  True

 False

 

NU664C Primary Care of the Psychiatric Mental Health Client I

Week 3 Quiz   

Question 1A PMHNP is using a cognitive-behavioral approach to help an adolescent client change self-defeating behaviors. Which of the following would the PMHNP highlight when using CBT?

 a.Feelings

 b.Introjection

 c.Beliefs

 d.Transference

Question 2Bowlby's Attachment Theory is a developmental perspective about anxiety that consists of three essential concepts. Which of the following is not included?

 a.Attachment

 b.Impotence

 c.Separation

 d.Loss

Question 3Which of the following are psychotherapeutic modalities that can be effective for anxiety disorders?

 a.Cognitive behavioral therapy (CBT)

 b.Relaxation with bio

 c.Mindfulness

 d.All of the answers

Question 4Which of the following is the most important initial step when a patient is in crisis?

 a.Identify whether or not the patient has a home to live in.

 b.Identify the patient's current level of cognitive functioning.

 c.Identify other staff that have more training in diagnosing mental health disorders.

 d.Identify whether the patient is reporting intent to harm himself or others.

Question 5Which of the following PMHNP activities may contribute to successfully accomplishing the Healthy People 2020 goals?

 a.Teach educators about suicide screening and prevention at the local high school.

 b.Use the Beck Depression Inventory (BDI) in private practice.

 c.Provide mental health care to children and adolescents.

 d.Provide education to high school students and their parents about eating disorder behaviors.

 e.Write a local senator about current NP practice restrictions.

Question 6Assessing resiliency is a part of the overall mental health evaluation process and could be defined as which of the following?

 a.Adaptability

 b.Resourcefulness

 c.Self-efficacy

d.The ability to bounce back from negative life experiences

 .All of the answers

Question 7One of the targets of Healthy People 2020 focuses the United States on which mental health promotion issue?

 a.Decreasing polypharmacy in mental health care

 b.Reducing child and adolescent suicide

 c.Promoting deinstitutionalization

 d.Increasing social supports for the indigent

Question 8Systematic desensitization involves all of the following except which one?

 a.Relaxation techniques

 b.Gradual exposure to a feared object

 c.Resolution of childhood conflicts

 d.Mindfulness

Question 9Which of the following are psychotherapeutic modalities that can be effective for anxiety disorders?

 a.Cognitive behavioral therapy (CBT)

 b.Relaxation with bio

 c.Mindfulness

 d.All of the answers

Question 10Which of the following statements about anxiety is not true?

 a.Anxiety disorders are more likely in those with a first-degree relative who has an anxiety disorder.

 b.People with untreated anxiety disorders may self-medicate with EtOH or other substances.

 c.Anxiety disorders are more common in people of lower socioeconomic status.

 d.Anxiety disorders are generally more prevalent in females than in males.

 

NU664C Primary Care of the Psychiatric Mental Health Client I

Week 4 Quiz   

Question 1A client seeks treatment from a solution-focused therapist for somatic complaints. What would the therapist's question to the client most likely be?

 a.Can you tell me what happened in your childhood?

 b.Tell me about the surgeries you have had.

 c.When you aren't in terrible pain or visiting your doctor, what are you doing instead?

 d.What was going on in your life when the pain started?

Question 2Communication Accommodation Theory (CAT) provides a useful framework for examining the dynamics of patient-practitioner communication and has a particular relevance for comparing language-discrepant and language congruent communication. In theoretical terms, what does CAT proposes?

 a.Speakers attempt to diverge their manner of speaking, to accomplish important social goals around attaining social approval, identity, and so on.

b.The extent to which speakers over-talk reflects the need for communication efficiency.

 c.Convergence is viewed as positive and normative.

 d.Convergence in manner of speaking reflects a specific intention to do so, and is normally perceived negatively.

Question 3The learned beliefs and behaviors common among all members of a group defines as which of the following?

 a.Complex delusions

 b.Follie a deux

 c.Culture

d.Follie a familia

Question 4The most important thing to learn as a beginning psychotherapist is how to develop a therapeutic alliance.

 

 a.True

 b.False

 Question 5The Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) helps providers integrate suicide prevention strategies into their practice including which of the following?

 a.Assessment of risk factors

 b.Protective factors that can be enhanced

 c.A scale to determine the level of risk and possible interventions

 d.All of the answers

Question 6What are the CLAS standards in healthcare?

 a.Intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and healthcare organizations to implement culturally and linguistically appropriate services.

 b.Barriers to effective and equitable healthcare that can result from linguistic differences between patients and clinicians.

 c.Unclear about how health-related risk is appropriately and accurately conveyed to a patient when their first language is discordant with that of the practitioner and the wider community.

 d.Failures to communicate properly the seriousness of risk.

Question 7What is one way the therapist can competently deal with a patient’s resistance?

 a.Avoiding identified problems

 b.Recognizing defenses

 c.Giving a lot of advice

 d.Ignoring disruptive behaviors

Question 8What is the definition that best articulates the spirit of empathy?

 a.A process of understanding whereby the nurse enters the patient’s perceptual world, the patient feels understood, and confirmation of self occurs as a part of the process.

b.Deflecting as a form of empathic validation which separates the facts from the individual.

 c.Talking too much and giving good advice are important clinical skills.

 d.A way of rejecting and resisting the patient’s narrative that allows the therapist to confront cognitive distortions successfully.

Question 9Which of the following are signs of an APRN’s countertransference?

 a.Always remembering to attend the session, being on time, and looking forward to the session

 b.Denying pathology for the person’s best interest, allowing free sessions, ignoring the outcome of therapeutic errors

 c.Listening attentively, not thinking about the person outside of the session, being late

 d.Staying awake during the session, being on time, rescue fantasies

Question 10Which of the following statements is an example of focusing?

  a.Yes, your relationship with your mother is important, and it may help you understand better what goes on for you in other relationships by discussing this further.

 b.Perhaps you are feeling that I am not giving you what you need here.

 c.Some people feel journaling their thoughts is helpful.

 d.I recommend that you take this medication at bedtime because it may make you drowsy.

 

NU664C Primary Care of the Psychiatric Mental Health Client I

Week 6 Quiz   

Question 1A biopsychosocial evaluation includes several steps and categories of information gathered during the patient interview. It also includes the assessment of which category(ies)?

 a.Ego functioning

 b.Affective development

 c.Interpersonal relationships

 d.Adult attachments

 e.All of the answers

Question 2Assessing ego strength is a part of the overall mental health evaluation process. What could Ego strength be defined as?

 a.Adaptability

 b.Resourcefulness

 c.Self-efficacy

 d.Life satisfaction

 e.All of the answers

Question 3Assessing resiliency is a part of the overall mental health evaluation process and could be defined as which of the following?

 a.Adaptability

 b.Resourcefulness

 c.Self-efficacy

 d.The ability to bounce back from negative life experiences

 

e.All of the answers

Question 4Current Procedural Terminology (CPT) is a code set by the American Medical Association. What is its function?

 a.Describe medical, surgical, and diagnostic services

 b.Communicate uniform information about medical services

 c.Describe services for billing purposes

 d.All of the answers

Question 5Of the following which one best describes population health?

 a.Delivering the same health care to all people

 b.Stratifying risk within populations

 c.The quality of medical health care

 d.Linking outcomes to patterns of health determinants

Question 6The PMHNP is assessing a patient's ego functioning in the initial assessment. What does an assessment of ego functions include?

 a.Socratic questioning

 b.Assessment of patient strengths

 c.ompleting a genogram

 .Assessing for presence of delusions and hallucinations

Question 7The range of personal, social, economic, and environmental factors that influence health status are known as which of the following?

 a.Tertiary action items

 b.Epidemiological patterns and prevalence

 c.Determinants of health

 d.IHI's Triple Aim

Question 8There are several approaches for developing a case formulation. Which of the following best describes this process?

 a.It consists of interviewing the patient and completing a screening tool.

 b.It is a skill set that is easily learned.

 .It is primarily used by physicians and not really necessary for PMHNPs.

 d.It is a descriptive process that organizes, explains, and makes sense out of the information collected.

Question 9What are defense mechanisms best viewed as?

 a.A function of the ego to alert us to harm and danger

 b.A function of the ego to alert us to problems

 c.A function of the ego used to resolve a conflict

 d.A function of the ego used to protect the id

Reduces anxiety arising from an unacceptable or potentially harmful stimuli or when our id or superego becomes too

Question 10Which of the following is the most important initial step when a patient is in crisis?

 a.Identify whether or not the patient has a home to live in.

 b.Identify the patient's current level of cognitive functioning.

 c.Identify other staff that have more training in diagnosing mental health disorders.

 d.Identify whether the patient is reporting intent to harm himself or others.

 

NU664C Primary Care of the Psychiatric Mental Health Client I

Week 9 Quiz   

Question 1A 34-year-old secretary climbs 12 flights of stairs every day to reach her office because she is terrified by the thought of being trapped in the elevator. She has never had any traumatic event occur in an elevator; nevertheless, she has been terrified of them since childhood. Which of the following is the most likely diagnosis?

 a.Social phobia

 b.Generalized anxiety disorder

 c.Specific phobia

 d.Agorophobia

 e.Adjustment disorder

Question 2A 42-year-old woman is referred to you for psychiatric evaluation and therapy. She believes there’s something “really bad with my heart, a missed diagnosis” and angry medical providers do not believe her. She does not meet diagnosis of delusional disorder; all laboratory values and physical examination are normal. In the psychiatric treatment of this patient, which of the following would be effective?

 a.Short term and brief psychotherapy have been used to treat psychosomatic disorders with efficacy

 b.Bluntly tell her that her claims are unfounded

 c.Try to disprove her claims

 d.Always agree with all her claims

Question 3A 45-year-old male is seen for a follow up visit after starting on an SSRI 2 weeks ago. Which assessment tool would be the best indicator of progress?

 

 

a.Geriatric Depression Scale

 b.The Young Mania Rating Scale

 c.Yale-Brown Obsessive Compulsive Scale

 d.Quick Inventory of Depressive Symptomology

Question 4A patient is demonstrating efficacy to clozapine 600 mg/day. This week's granulocyte count is less than 500 mm3. What is the most appropriate initial recommendation?

 a.Substitute haloperidol for clozapine.

 b.Discontinue clozapine and do not restart.

 c.Reduce dosage.

 d.Start dyphenhydramine 25 mg po bid.

 e.Restart clozapine in 4 weeks.

Question 5A PMHNP uses cognitive therapy strategies with a patient who has an anxiety disorder. The patient's homework is to keep a diary of symptoms of anxiety and events that transpired just before the onset of symptoms. What is the rationale for this strategy?

 a.Keep the patient intellectually occupied to prevent dwelling on physiological phenomena

 b.Link symptoms with precipitating events, which provides a basis for discussion and reframing

 c.That anxiety gives rise to automatic, negative, obsessive thoughts that must be analyzed

 d.That antecedent events have less to do with the anxiety onset than internal events

Question 6A tool for suicide assessment called Suicide Safe App include key features such as patient and provider education materials, SAMHSA's behavioral health treatment services locator, interactive sample cases, and conversation starters. Suicide Safe App is based on SAMHSA’s ________.

 a.SAFE-T Card

 b.Suicide-C App

 c.U.S. Prevention and Safety Tool

 d.Samaritan’s Link

Question 7All of the following are common baseline labs and history that you would obtain before any atypical antipsychotic is initiated except which of the following?

 a.CPK

 b.Family medical history

 c.Fasting blood sugar (FBS)

 d.Fasting lipids

Question 8All of the following are brain structures critical to memory except which one?

 a.Hippocampus

 b.Amygdala

 c.Medial temporal lobe

 d.Substantia nigra

Question 9An 18-year-old young woman was involved in a car accident 2 weeks ago with her family. Since then, she has had flashbacks, difficulty sleeping, and is afraid to drive. What is the most appropriate diagnosis?

 a.PTSD

 b.GAD

 c.Adjustment disorder

 d.Acute stress disorder

Question 10Any court of law that evaluates the standard of care provided by a PMHNP ________.

 a.compares the action to the standard of care provided by a psychiatrist

 b.considers what a reasonably prudent healthcare provider would do

 c.evaluates patient satisfaction data

 d.reviews the nurse practitioner's charts for similar patients

 e.All of the answers

Question 11Common disadvantages of antihistamines such as diphenhydramine include which of the following?

 a.NMS

 b.EPS

 c.Anticholinergic side effects

 d.Postural hypotension

Question 12Commonly cited predictors of dangerousness to others include which of the following?

 a.Chronic anger or hostility

 b.Making specific verbal threats

 c.Prior acts of violence

 d.All of the answers

Question 13Good adult adjustment despite the experience of adverse childhood experiences (ACEs) is associated with which of the following?

 a.Social support

b.Resilience

c.Structured upbringing

d.All of the answers

Question 14Important issues to consider when using psychological testing or screening tools include which of the following?

 a.Reliability, validity, cultural bias, confidentiality

 b.Maleficence, goodness of fit, scale standards

 c.The Beck inventory, Cage, Safe-T, Tarasoff warnings

 d.Confidentiality, HIPPA, goodness of fit, scale standards

Question 15Increased rates of suicide attempts occur in patients diagnosed with which of the following?

 a.Panic disorder

 b.Personality disorders

c.Substance use disorders

d.All of the answers

Question 16Serotonin is ________.

 a.primarily located in the CNS

b.able to cross the blood brain barrier

c.unaffected by tryptophan ratios

 d.synthesized from the amino acid tryptophan

Question 17Some defense mechanisms employed by the average 50-year-old include all the following except

which one?

a.Repression

 b.Sublimation

 c.Altruism

d.Splitting

Question 18The Conners Rating Scales-Revised (CRS-R) is used to qualify symptoms of alcohol use disorder.

 a.True

 b.False

 Question 19The Mental Status Exam (MSE) includes all of the following except which one?

 a.Appearance and behavior

 b.Insight and judgement

 c.Mood and affect

 d.Cranial nerves and reflexes

Question 20The technique that lets clients know they are heard and understood beyond the level of words requires which of the following?

 a.Active listening

 b.Restating

d) Empathizing

*e) Reflecting feelings

Question 21What can normal adolescence include?

 a.Episodes of depression

 b.Occasional delinquent acts

 c.Vulnerability to crisis

 d.Dissolution of intense ties to parents

 e.All of the answers

Question 22What does the basal ganglia include?

 a.Substantia nigra

 b.Subthalamic nucleus

 c.Caudate nucleus

 d.All of the answers

Question 23When completing the history of present illness (HPI), the PMHNP ________.

 a.attempts to gain a clear understanding of the full history of the person’s problems, such as when they started, what they entail, worsening or associated symptoms to begin formulating a diagnosis

 b.collects basic details about the patient such as name, address, gender, and educational attainment

 c.documents the reason for the person’s presentation in the person’s words

 d.explores surgical, medical diagnoses, and medication history

Question 24When completing the history of present illness (HPI), the PMHNP ________.

 a.attempts to gain a clear understanding of the full history of the person’s problems, such as when they started, what they entail, worsening or associated symptoms to begin formulating a diagnosis

 b.collects basic details about the patient such as name, address, gender, and educational attainment

 c.documents the reason for the person’s presentation in the person’s words

 d.explores surgical, medical diagnoses, and medication history

Question 25Which of the following ethical principles would conflict if the treatment team wished to implement an intervention designed to deceive a patient?

 a.Justice

 b.Beneficence

 c.Nonmaleficence

 d.Veracity

 

NU664C Primary Care of the Psychiatric Mental Health Client I

Week 10 Quiz    

Question 1A 45-year-old man with severe major depression is on a high dose of an antidepressants but develops increased blood pressure. Which of the following medications is most likely the culprit?

 a.Citalopram

 b.Fluoxetine

 c.Mirtazapine

 d.Venlafaxine

 e.Nefazodone

Question 2Compared with unipolar depression, the depressed phase of bipolar disorder ________.

 a.has a later onset

 b.has a more gradual onset

 c.carries a higher risk of suicide

d.is less frequently accompanied by psychotic symptoms in younger patients

Question 3Nikki is a 22-year-old female diagnosed with borderline personality disorder. Her symptoms are self-harm by cutting, binge-purge eating, and alcohol and prescription pill abuse. Which of the following therapies would be the bestmatch for this type of client?

 a.Exposure therapy because behaviors are acquired through conditioning

b.Psychodynamic psychotherapy since knowing the self is the basis for practice

c.Solution-focused therapy because people have the capacity to solve their problems

d.Dialectical Behavior Therapy because its goal is to increase self-awareness

Question 4One of the targets of Healthy People 2020 focuses the United States on which mental health promotion issue?

 a.Decreasing polypharmacy in mental health care

 b.Reducing child and adolescent suicide

 c.Promoting deinstitutionalization

 d.Increasing social supports for the indigent

Question 5The primary function of a biopsychosocial case formulation is to ________.

 a.generate an understanding of the person as a whole

 b.identify comorbid medical illnesses

 c.assess the maturity of the patient's defense mechanisms

 d.determine the patient's level of social support

Question 6Which of the following characteristics are critical factors to evaluate in light of a client's potential for suicide?

 a.Frustration and impatience

 b.Anger and resentment

 c.Anxiety and loneliness

 d.Hopelessness and helplessness

Question 7Which of the following is a protective factor for the risk of suicide?

 a.Having a sense of responsibility for one's spouse or children

 b.Having good social standing in the community

 c.Having an IQ over 120

 d.A childhood physical illness that has now resolved

Question 8Which of the following PMHNP activities may contribute to successfully accomplishing the Healthy People 2020 goals?

 a.Teach educators about suicide screening and prevention at the local high school.

 b.Use the Beck Depression Inventory (BDI) in private practice.

 c.Provide mental health care to children and adolescents.

 d.Provide education to high school students and their parents about eating disorder behaviors.

 e.Write a local senator about current NP practice restrictions.

Question 9Which one of the following is a self-administered rating scale in psychiatry?

 a.Hamilton Rating Scale for Depression (HAM-D)

 b.Hamilton Rating Scale for Anxiety

 c.Beck Depression Inventory (BDI)

 d.Clinical Global Impression of Change (CGI)

Question 10Women are twice as likely to become depressed but men are more at risk for suicide.

  True

 False

 

NU664C Primary Care of the Psychiatric Mental Health Client I

Week 15 Final Exam    

Question 1A 16 y/o girl is brought to your office for an initial consultation. Since her parent's divorce three months ago, she has been irritable and has had problems keeping up her grades in school. She spends most of the time at home and does not want to engage in social activities. She denies any change in her appetite or weight, reports being able to sleep well, and denies any feelings of helplessness or hopelessness. What would be the best initial treatment of this patient?

 a.A trial of citalopram

 b.Supportive psychotherapy

c.Long-term psychodynamic psychotherapy

 d.Inpatient admission to an inpatient adolescent unit

Question 2A 22 y/o woman is referred to your office by her family physician for an evaluation of her "depression." Her PCP is unsure whether she is suffering from depression or something else. Which of the following characteristics is more consistent with a persistent depressive disorder (dysthymia) versus major depression?

 a.pisodic course

 b.Numerous neurovegetative symptoms

 c.Presence of psychotic symptoms

 d.Symptoms that are lower in intensity and chronic in nature

 e.Severe impairment in functioning

Question 3A 40 y/o woman with bipolar disorder presents to your office after starting a new medication. She reports that she was doing "well" until she got a viral gastroenteritis and was unable to eat for several days. While the viral symptoms have resolved, she now complains of nausea and vomiting, ataxia, and tremor. Which of the following studies would you order?

 a.Carbamazepine level

 b.Depakote level

 c.Head CT

 d.Lithium level

e.Urine toxicology screen

Question 4A 46 y/o man presents with a long-standing belief that his thoughts are being taken from his head and used to create a blockbuster movie. He is certain that the government is involved because they often communicate with him through a microchip they have implanted in his brain. What would this most likely diagnosis be for this gentleman?

 a.Major depression with psychotic features

 b.Schizoaffective disorder

 c.Schizophrenia

d.Psychosis secondary to a general medical condition

 e.Bipolar disorder I with psychotic features

The  answer is: Schizophrenia

Question 5A 70 y/o woman presents to her PCP complaining of fatigue for the past seven weeks. She admits to difficulty falling asleep, a poor appetite with a 10-lb. weight loss, and thoughts of wanting to die. She admits to having had symptoms similar to these on several occasions in the past, but "never this bad." Her medical problems include asthma and HTN. She uses an albuterol inhaler only as needed. Which of the following symptoms is additionally necessary in order to make a diagnosis of major depressive disorder?

 a.Depressed mood

b.Decreased appetite

 c.Excessive guilt

 d.Fatigue

 e.Homicidal ideation

Question 6A child who is indifferent toward its caregiver and is just as easily comforted by a stranger as by a parent may be assessed as having which attachment style?

 a.Secure

b.Avoidant

 c.Disorganized

 d.Ambivalent

Question 7A client says to the PMHNP, "Some days life is just not worth it. All I do is argue with my boss, fight with my wife, and yell at my kids. Things would be a lot calmer and simpler if I just wasn't around anymore." The most therapeutic response for the PMHNP to make is ________.

 a."Do you mean you want to kill yourself?"

 b."Are you thinking about leaving your wife and quitting your job?"

 c.to remain silent and let the client continue

 d."Tell me what you mean when you say it would be simpler if you weren't around."

Question 8A new client has the following symptoms: Has had insomnia for five days, sees "devils" walking across the room, cannot recall when she last ate, carries a large notebook with numerous unusual drawings and lists of project that are "in the works," and has drawn abstract pictures in ink on her forearms and clothing. The client is most likely diagnosed with ________.

 a.Cyclothymia

 b.Substance-induced anxiety disorder

 c.Dysthymia

 d.Schizoaffective disorder, depressive subtype

 e.Bipolar I with psychotic features

Question 9A PMHNP is using a cognitive-behavioral approach to help an adolescent client change self-defeating behaviors. Which of the following would a PMHNP highlight when using CBT?

 a.Feelings

b.Introjection

 c.Beliefs

 d.Transference

Question 10According to American Diabetes Association recommendations, how frequently should fasting plasma glucose/HbA1C and fasting lipid profile be monitored in patients treated with antipsychotic agents?

 a.Every 6 weeks

b.Annually

 c.Baseline, 12 weeks, then annually

 d.Every 2 years

Question 11According to the DSM, which of the following would you find when doing a history on a client with a diagnosis of bipolar disorder type II who is currently in a depressive episode?

 a.History of prior manic episodes

b.Far more manic episodes than depressive episodes

 c.No known history of hypomanic or manic episodes

 d.Prior hypomanic episodes without prior manic episodes

Question 12Among the different types of temperament, which one is associated with more impairment of brain functioning, and in the absence of positive nurturing parenting, is a risk factor for later development of psychiatric disorders?

a.Easy

 b.Slow to warm up/inhibited

 c.Mixed

 d.Difficult

Question 13Antonio is an 18 y/o single male who recently dropped out of his first semester of college. He says he could not continue in his courses because he was feeling uncomfortable in class and was receiving failing grades. Prior to this, he relays symptoms including anxiety, excessive worrying, trouble relaxing, irritability, and difficulty sleeping. He says he worries about "everything," especially his health, finances, his future, and the health of his family. The PMHNP diagnoses Antonio with ________.

 a.generalized anxiety disorder

b.somatic symptom disorder

 c.attention deficit hyperactivity disorder

 d.illness anxiety disorder

Question 14Assessing resiliency is a part of the overall mental health evaluation process. Resiliency could be defined as ________. "

 a.adaptability

 b.resourcefulness

 c.self-efficacy

 d.the ability to bounce back from negative life experiences

 e.All these answers are .

Question 15Current Procedural Terminology (CPT) is a code set by the American Medical Association. Its function is to ________.

 a.describe medical, surgical, and diagnostic services

 b.communicate uniform information about medical services

 c.describe services for billing purposes

d.All of these answers

Question 16Cyclothymia is different from Bipolar I and II in that the patient needs to experience symptoms for at least ________ with numerous hypomanic and depressive episodes that do not meet criteria for hypomania or depression.

 a.one year

 b.two years

 c.three years

 d.6 months

e.18 months

Question 17In the biopsychosocial theory of the development of psychiatric disorders, it is proposed that psychiatric disorders are due to a combination of ________.

 a.exposure to adverse experiences and a large social support network

 b.compromised brain development and adverse experiences

c.small family size and challenging learning experiences

 d.democratic parenting style and limited financial resources

Question 18Leonard avoids going out to eat with his family at restaurants. He is concerned that others may watch him and criticize his table manners. He also has difficulty going to grocery stores and public swimming pools. Which of the following is his most likely diagnosis?

 

 a.Agoraphobia

 b.Specific situational phobia

 c.Social anxiety disorder

d.Generalized anxiety disorder

Question 19Part of the diagnostic criteria for bipolar disorder must include which of the following?

 a.A persistently elevated, expansive, or irritable mood lasting for at least 1 month

b .A persistently elevated, expansive, or irritable mood lasting for at least 1 week

 c.A persistently elevated, expansive, or irritable mood lasting for at least 2 weeks

 d.A persistently elevated, expansive, or irritable mood lasting for at least 6 months

Question 20A term used to explain a confused or unintelligible mixture of seemingly random words and phrases is ________.

 a.flight of ideas

 b.word salad

c.tangentiality

 d.circumstantiality

 e.looseness of association

Question 21People with recurrent panic disorder usually present with ________.

 a.a low level of general anxiety

 b.cardiac/respiratory symptoms of distress

c.la belle indifference

 d.clear precipitants

Question 22People whose affect development has proceeded optimally are more aware and less emotionally reactive. Which statement about people who have problems with affective regulation is true?

 a.They have a great deal of trouble describing their feelings.

 b.They lack self-awareness.

 c.They have poor body awareness of emotional arousal.

 d.All of these answers

Question 23Pharmacotherapy for manic episodes or mixed episodes in the acute phase includes ________.

 a.mood stabilizers

 b.antipsychotics

 c.benzodiazepines

 d.All these answers are .

Question 36Who is generally credited with developing dialectical behavioral therapy?

 a.Melanie Klein

 b.Aaron Beck

 c.B.F. Skinner

 d.Marsha Linehan

e.Harry Stack Sullivan

Question 37Each state has its own Board of tration for Nursing, but the federal agency NONPF regulates the practice of PMHNPs.

  True

 False

Question 38A 32 y/o woman is brought to the ED by police after she was found standing in the middle of a busy highway, naked, commanding the traffic to stop. In the ED, she is agitated and restless, with pressured speech and an affect that alternates between euphoric and irritable. Her father is contacted and states that this kind of behavior runs in the family. Which of the following is the most likely diagnosis?

 a.Dementia

 b.Hypothyroidism

 c.Bipolar disorder type I, manic

 d.Cyclothymia with psychosis

 e.Schizophrenia

Question 39During group therapy, a client asks the PMHNP group leader for advice on how to handle the stress of her new job. The best approach for the leader is to ________.

 a.answer her question directly

 b.enlist the other group members to respond

c.encourage the client to speak to her after the group

 d.use silence

Question 40A 17 y/o girl with a history of asthma presents to her FNP for a physical exam prior to going to college. Upon questioning, the FNP learns that she has felt irritable for the past six months since breaking up with her boyfriend of two years. She says she feels tired all the time and comes home from school every day, lies on the couch, and watches TV. Her grades have dropped because she cannot concentrate. Despite her fatigue, she complains of difficulty sleeping. She has lost 12 lbs. over the past six months. She no longer hangs out with her friends, has dropped some of her after-school activities and is considering not even going to college since she can't imagine things will ever get better. Her H&P is normal. Which of the following symptoms of depression in this patient differs from that of an adult?

 a.Anhedonia

 b.Decreased concentration

 c.Insomnia

d.Irritable mood

Question 41A 32 y/o woman presents to her PCP with the chief complaint that she is anxious about the way she looks. She notes that for as long as she can remember, she has felt there is something wrong with her face. She thinks her eyes are too far apart and that her nose is misshapen. She states that this concern is ruining her life because she spends all her time isolated from others so that they cannot see her face. There does not seem to be anything unusual about her appearance. Even when her PCP gives her positive

, she is not convinced it is true. Which of the following is the most likely diagnosis?

 a.Delusional disorder

 b.Obsessive-compulsive disorder

 c.Body dysmorphic disorder

 d.Somatization disorder

 e.Anxiety disorder

Question 42A 37 y/o man with a diagnosis of schizoaffective disorder develops an alteration in his level of consciousness, marked muscle rigidity, mild fever, hypertension, leukocytosis, and an elevated CPK. He has been transferred to the ICU and is being treated for acute renal failure. A recent change in which medication is most likely responsible for this presentation?

 a.Lithium

b.Citalopram

 c.Fluphenazine (Prolixin)

 d.Clonazepam

 e.Benztropine

Question 43A 44 y/o man comes to see you complaining of insomnia and poor concentration since he was fired from his job a few weeks ago. He reports being hopeful that he will find a new job soon and has sought out the support of his family and friends. However, he has found it difficult to pursue some of his regular daily activities, such as going to the gym. He has also noticed that he feels very tired during the day, which he attributes to poor sleep. Given this history, what is this patient's most likely diagnosis?

 a.Acute stress disorder

b.Major depressive disorder

 c.Dysthymia

 d.Cyclothymia

 e.Adjustment disorder

Question 44A patient who has been taking venlafaxine for major depressive disorder says that recently he has not be able to sleep and he spends increasing amounts of time writing letters to his congressman about ways to reduce the national debt. The PMHNP is concerned about this change and feels the most likely explanation for the change in this man's clinical picture is ________.

 a.non-compliance with medication

 b.worsening depression with psychotic features

c.emergence of hypomania

 d.probable substance-use issues

Question 45A PMHNP screens his client by asking questions on the CAGE questionnaire. This is an example of ________ prevention.

 a.primary

 b.secondary

c.tertiary

 d.None of these answers

Question 46A subtype of OCD that begins before puberty and is characterized by an episodic course with severe exacerbations has been linked to infections caused by ________.

 a.C. difficile

 b.Group A beta-hemolytic strep infection

c.Group B beta-hemolytic strep infection

 d.enterovirus

Question 47Brain plasticity, which refers to the brain's capacity to change in response to an event, ________.

 a.is the same for all individuals

 b.involves physical changes in the brain

c.is absent in older adults

 d.is independent of genetic influence

 e.is a concept not well received by scientists

Question 48Developing differentials is an essential part of the assessment and diagnostic process. A stepwise approach is especially important when you are looking at organic "rule-outs." Which statement best describes why this process is so difficult?

 a.Symptoms of a psychiatric and medical disorder are rarely identical.

 b.Some presenting symptoms of medical illnesses are psychiatric in nature.

 c.Medical providers rarely dismiss the medical concerns of a known psychiatric client.

 d.None of these answers