Question 1
The PMHNP is conducting an initial interview with a patient whose history is consistent with avoidant personality
disorder. The PMHNP understands that one of the most striking features of this interview is likely to be centered
upon the patient’s:
Clothing
Speech pattern
Anger
Anxiety
Question 3
A PMHNP student is reviewing his notes from his clinical experience over the past week to prepare his first required
case presentation on a patient suffering a major depressive episode. Which of the following patients best represents
the DSM-5 criteria for major depressive episode?
A 27-year-old female with a 1-month history of social withdrawal, anorexia, hypersomnia,
unprovoked outbursts of anger, and a strong family history of endogenous depression
A 41-year-old male with a history of childhood sexual abuse, loss of interest in both his
professional and personal life, an unplanned 10 lb. weight loss in the last 3 months, and
perceptual disturbances
, A 65-year-old male whose wife died 2 months ago and he reports a 3-week history of generally depressed
mood, guilt about his wife’s death, insomnia, difficulty focusing on daily tasks, with increasing
thoughts of
dying
A 72-year-old female who just relocated across country to live with her adult son and daughter-in-
law who is despondent about leaving her home and reports forgetfulness, loss of appetite, new onset
bowel problems, and extreme loss of energy
Question 4
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?
SSRIs
TCAs
Antiadrenergi
cs
Antipsychotics
Question 5
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 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:
Stuttered
Increase
d
Childlike
Confused
, 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 teachers, and never demonstrated the tendencies he does now. Apparently in college he got involved with a
fraternity that was notorious for alcohol and drug abuse, and he started drinking heavily; it was ―all downhill from
there.‖ The PMHNP considers that:
Question 6
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 7
Which among the following neurotransmitters is decreased in depression and increased in mania?
Dopamine
Norepinephrin
e
Serotonin
Glutamate
Question 8
Among the various types of therapeutic intervention for patients with borderline personality disorder, which of the
following is characterized as polymodal, including group skills training, individual therapy, telephone consultation,
and a consultation team with a goal of improving interpersonal skills and decreasing self-destructive behavior?
Question
, Mentalization-based treatment (MBT)
Transference-focused psychotherapy (TFP)
Countertransference-focused psychotherapy (CTFP)
Dialectical behavioral therapy (DBT)
9
Mr. Kendall is a 47-year old male who is presented to care by his younger sister, Megan. Mr. Kendall has spent his
entire adult life living in an apartment that was attached to his parents’ home. His mother died a few weeks ago, and
the property is listed for sale. Mr. Kendall will have to move, and while discussing this with him, Megan became
very concerned. He has apparently been considered odd all his life, has never married or even dated as far as Megan
knows, but she had no idea how odd he was. When his mother died, he seemed disconnected from reality and had
episodes of talking to people who weren’t present. Megan says that sometimes she does not even understand what he
is talking about. He seems to think he has psychic powers, and that he doesn’t need to move because he knows the
house will not be sold. When considering a diagnosis of schizotypal disorder, the PMHNP expects which of the
following to be present in the history?
A history of schizophrenia of a first-degree relative
Sustained psychosis predating his mother’s death
Comorbid Asperger’s syndrome
Apparent frank thought disorder
Question 12
Which of the following is a true statement with respect to the treatment of narcissistic personality disorder?
Psychoanalytic psychotherapy has strong empiric support
Both serotonergic drugs and lithium are useful
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