NURS 6670 / NURS6670 FINAL EXAM. QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Question1.
Collette is a 23-year-old female who presented for emergency care with her mother because her behavior has become increasingly erratic and caused her to lose her job. Her mother reports that she had never done ...
nurs 6670 nurs6670 final exam questions and answers with explanations question1 collette is a 23 year old female who presented for emergency care with her mother because her behavior has become
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NURS 6670 / NURS6670 FINAL EXAM.
QUESTIONS AND ANSWERS WITH
EXPLANATIONS.
Question1.
Collette is a 23-year-old female who presented for emergency
care with her mother because her behavior has become
increasingly erratic and caused her to lose her job. Her
mother reports that she had never done anything like this in
the past, but about 3 months ago, her boyfriend of 3 years
broke up with her, and Collette began to express unrealistic
beliefs that her boyfriend wanted to drive her crazy and hurt
her. A gentleman trying to hail a taxi accidentally bumped into
her this morning, and she started screaming that her ex-
boyfriend had hired the man to throw her into the street
under a car.
Collette is on a 2-week suspension from her job as a
restaurant server because she was combative to a customer—
she accused him of colluding with her ex-boyfriend to get her
fired. After this morning's incident, her mother was so
worried she brought her to the emergency room. Her
appearance is disheveled, she is clearly hyperalert and is
crying that
her boyfriend must have converted her mother to work against
her. Head imaging, screening lab, and a toxicology screen are
negative. A leading differential for Collette is:
Acute psychotic episode
Rationale:
Collette's differential diagnosis is an acute psychotic episode,
this disorder causes abnormal ideas and perceptions. Two of
the main symptoms are delusions and hallucinations.
Delusions are false beliefs, such as that someone is against
them and hallucinations are false perceptions, such as
listening, or feeling something that does not exist.
Question 2.
Jake and Laurie are a young married couple who have been
referred to mental health counseling because Jake is having
disturbing sleep events. Laurie reports that on more than one
occasion she has awakened to find Jake having what appears
to be a panic attack, but he doesn't seem to realize it. When
he finally wakes up, he is confused and doesn't really
understand what happened, although he does have a sense of
intense fear. This has happened twice in the last 2 weeks, and
,the last time Laurie heard him screaming. Jake is now a bit
,afraid to go to sleep and as a result does not feel well the
next day. The PMHNP recognizes that sleep terrors in adults:
Are often associated with trauma or psychiatric problems
Question 3.
Jack is a 27-year-old male who has a history of paranoid
schizophrenia that first became apparent approximately 10
years ago. He developed paranoid delusions and eventually
decompensated to the point that he required inpatient
stabilization. At the time, he was started on conventional
antipsychotics, but due to intolerable adverse effects he was
switched to haloperidol. It worked well, but whenever he
stopped taking it, symptoms would recur. After several
hospitalizations, he was stabilized. The neurophysiologic
theory of schizophrenia suggests that Jack's symptoms were a
result of:
Increased dopamine activity in the mesolimbic pathway
Question 4.
Johanne is a 22-year-old female who is being treated for
narcolepsy. She is attempting to implement a regimen of
forced daytime naps in an effort to manage her condition
without pharmacotherapy as she is generally averse to taking
medications. While following Johanne, the PMHNP should be
alert to signs and symptoms of
Depression
Question 5.
Narcolepsy
A sleep disorder characterized by uncontrollable sleep
attacks. The sufferer may lapse directly into REM sleep, often
at inopportune times.
Question 6.
The PMHNP is asked to prepare a presentation for non-
nursing health care workers in a local long-term care
facility on the various causes of cognitive impairment in
the elderly. A case presentation approach is used to
reinforce principles of identifying delirium, which needs to
be reported to the patient's
, attending provider right away. The case should emphasize
which of the following features as being closely correlated
with delirium?
Rapid onset
Question 7.
Valerie is a 27-year-old woman who has been referred by her
primary care provider. She was initially diagnosed with major
depressive episode following a breakup with her boyfriend of
7 years. They moved into a house together 1 year ago, but
within a few months the boyfriend moved out. Valerie was
unresponsive to medication for depression and was referred
to the mental health clinic. During this initial psychiatric
evaluation, the PMHNP learns that a primary reason for the
breakup was that Valerie had an extensive routine every night
of repeatedly checking every door and window in the home to
ensure that they were locked.
Valerie's nighttime routine is exhaustive and involves
checking every door and window at least four times. She has
a remote history of being attacked in her home while alone
and states that she is unable to go to bed until she is certain
that every door and window is locked. When considering
diagnostic criteria for OCD, the PMHNP needs further
assessment to ascertain which diagnostic criteria?
The patient has good or fair insight with respect to the
appropriateness of her behaviors
Question 8.
Michael is an 18-year-old male who is presented to care at the
urging of his parents. He has never had any significant
medical or psychiatric problems in the past, but during his
first semester at college he has developed a very alarming
pattern of excess sleep. He is missing classes and is in danger
of losing a scholarship. He is sleeping normally at night but
apparently is having these very long episodes of napping and
sleeping during the day. When he is awake, he tends to be
rather withdrawn. His parents have taken him to their family
practitioner as they thought he might be using drugs. A full
exam, laboratory assessment, and toxicology screen are all
normal, and there is no apparent cause for this sleepiness.
While very rare, the PMHNP considers Kleine-Levin syndrome
and further assesses for coincident onset of:
Hypersexuality
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