10/19/23, 11:44 AM NRNP6670 Midterm Exam - latest nursing exam
Q#1
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?
o Histrionic
o Narcissistic
o Borderline
o Schizoid
Q#2
Anne is a 32-year-old female who presented to care after a random drug screening at work was positive
for cocaine. She was initially resistant to therapy, maintaining that her use is not a problem and she
could stop at any time. Upon further discussion in session, it appears that she uses cocaine every day at
work, sometimes 2–3 times, other days more. She also uses it occasionally at home and most
weekends. During her third session, she admitted that it is a financial burden, and she basically cannot
afford any other form of recreation. She understands that if she uses again she will lose her job, and she
admits that she loves her job and that cocaine is not worth losing it. When counseling her about
cessation strategies, the PMHNP advises all the following except:
o The physiologic symptoms of withdrawal may require a short-term hospitalization
o Unlike other substances of abuse, there are no medications to help reduce the intensity
of withdrawal
o She will need to be monitored for depression
o Overcoming the intense craving for cocaine is the biggest issue
Q #3
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:
o Has difficulty disagreeing with others
o Needs reassurance to support even mundane decisions
o Volunteers to do unpleasant tasks to obtain nurturance
o Has disproportionate anger toward an abusive spouse
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,10/19/23, 11:44 AM NRNP6670 Midterm Exam - latest nursing exam
Q#4
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:
o Clothing
o Speech pattern
o Anger
o
Anxiety Q # 5
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?
o 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
o 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
o 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
o 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
Q#6
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?
o SSRIs
o TCAs
o Antiadrenergics
o Antipsychotics
Q#7
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
P a g e 2 | 25
about:blank 2/26
, 10/19/23, 11:44 AM NRNP6670 Midterm Exam - latest nursing exam
escalated into M.S. getting very loud, yelling, and acting ―crazy‖ before he punched a coworker and
started
P a g e 3 | 25
about:blank 3/26
Q#1
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?
o Histrionic
o Narcissistic
o Borderline
o Schizoid
Q#2
Anne is a 32-year-old female who presented to care after a random drug screening at work was positive
for cocaine. She was initially resistant to therapy, maintaining that her use is not a problem and she
could stop at any time. Upon further discussion in session, it appears that she uses cocaine every day at
work, sometimes 2–3 times, other days more. She also uses it occasionally at home and most
weekends. During her third session, she admitted that it is a financial burden, and she basically cannot
afford any other form of recreation. She understands that if she uses again she will lose her job, and she
admits that she loves her job and that cocaine is not worth losing it. When counseling her about
cessation strategies, the PMHNP advises all the following except:
o The physiologic symptoms of withdrawal may require a short-term hospitalization
o Unlike other substances of abuse, there are no medications to help reduce the intensity
of withdrawal
o She will need to be monitored for depression
o Overcoming the intense craving for cocaine is the biggest issue
Q #3
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:
o Has difficulty disagreeing with others
o Needs reassurance to support even mundane decisions
o Volunteers to do unpleasant tasks to obtain nurturance
o Has disproportionate anger toward an abusive spouse
P a g e 1 | 25
about:blank 1/26
,10/19/23, 11:44 AM NRNP6670 Midterm Exam - latest nursing exam
Q#4
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:
o Clothing
o Speech pattern
o Anger
o
Anxiety Q # 5
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?
o 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
o 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
o 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
o 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
Q#6
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?
o SSRIs
o TCAs
o Antiadrenergics
o Antipsychotics
Q#7
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
P a g e 2 | 25
about:blank 2/26
, 10/19/23, 11:44 AM NRNP6670 Midterm Exam - latest nursing exam
escalated into M.S. getting very loud, yelling, and acting ―crazy‖ before he punched a coworker and
started
P a g e 3 | 25
about:blank 3/26
