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NR 547 MIDTERM EXAM 2024 ACTUAL EXAM TEST BANK 250+ QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)|A GRADE $22.99
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NR 547 MIDTERM EXAM 2024 ACTUAL EXAM TEST BANK 250+ QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)|A GRADE

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NR 547 MIDTERM EXAM 2024 ACTUAL EXAM TEST BANK 250+ QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)|A GRADE

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  • June 16, 2024
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  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

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NR 547 MIDTERM EXAM 2024 ACTUAL EXAM TEST
BANK 250+ QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS)|A GRADE

A 52-year-old client presents to the emergency department
following a car accident. The emergency department (ED)
physician is concerned that the client may have intentionally
crashed her car and requests a stat PMHNP consult. In
speaking with the PMHNP, the client describes persistent
feelings of sadness and hopelessness. She states that she
often wonders if her husband would be happier if she wasn't
around anymore since she's never happy and sometimes
thinks about what it would be like to just take a handful of
sleeping pills and go to sleep forever. The client reports a
previous suicide attempt when she was 16 but denies that
she is considering killing herself right now.
Based on the client's ASQ score, what is the most
appropriate response?

No action is necessary as the client is not currently
considering suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST
Provide a brief suicide safety assessment.

Rationale: While the client's responses do not indicate a need for
a stat full safety and mental health evaluation, the client requires
a brief suicide safety assessment to determine whether a full
mental health evaluation in necessary. It is also important to notify
the client's physician or the clinician responsible for the client's
care.
Diagnostic Testing when diagnosing mental health disorders

,-Diagnostic tests and labs are most used to rule out physical
conditions that may cause psychiatric symptoms and to evaluate
the effects of treatment
Basic Laboratory Interpretation
Complete Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
Basic Laboratory Interpretation: Complete Blood Count
-measures RBCs, WBCs, hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental health, the CBC is used to rule out medical conditions
that may present with symptoms that can be attributed to both
medical and psychiatric diagnoses
• Ex: rule out anemia as a cause for depressive symptoms and
fatigue
• Ex: rule out infection as a cause of acute mental status changes

RBCs: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
Reticulocytes: 0%-1.5%
WBCs (total): 5000-10,000/microliter
Neutrophils: 55%-70%
Eosinophils: 1%-3%
Basophils: 0.5%-1%
Lymphocytes: 20%-35%
Monocytes: 3%-8%
Platelets: 150,000-300,000/microliter
Basic Laboratory Interpretation: Comprehensive Metabolic
Panel (CMP)

,common blood test used to determine general health status
-fluid and electrolyte balance, status of the body's metabolism,
liver function, and kidney function
-used to monitor the effects of medications, such as
antipsychotics, on liver function and glucose levels
-rule out medical conditions that could cause symptoms
• Ex: changes in mood or cognition

Sodium (Na+): 136-145 mEq/L
Postassium (K+): 3.5-5.0 mEq/L
Chloride (Cl-): 95-105 mEq/L
Bicarbonate (HCO3-): 22-28 mEq/L
Calcium, serum (Ca 2+) 8.4-10.2 mg/dl
Glucose, serum Fasting: 70-110 mg/dl; 2-h postprandial:
<120mg/dl
Cholesterol, serum: REC<200 mg/dl
Total Protein 6.0-7.8 g/dl
Albumin 3.5-5.5 g/dl
-Kidney Tests
• Creatinine, serum 0.6-1.2mg/dl
• Urea nitrogen, serum (BUN) 7-18mg/dl
-Liver Tests
• Alanine aminotransferase (ALT), serum: 8-20 U/L
• Aspartate aminotransferase (AST), serum: 8-20 U/L
• Bilirubin, serum (adult) Total//Direct: 0.1-1.0 mg/dl // 0.0-0.3
mg/dl
• Phosphatase (alkaline), serum: 20-70 U/L
Basic Laboratory Interpretation: Thyroid Function Tests
(TFTs)
used to rule out thyroid disorders as a cause for symptoms
• symptoms related to thyroid disorders include anxiety,
restlessness, depression, mood swings, sleeping difficulties,
difficulties with concentration, short-term memory lapses, and lack
of mental alertness

, Normal TFT levels
TSH: 0.4-4.5 mIU/L
T3: 100-200 ng/dL
T4: 5-11 ug/dL
Basic Laboratory Interpretation: Vitamin B12 Level
Deficiency of vitamin B12 can affect mood and other brain
functions
-psychiatric symptoms associated with B12 deficiency include
depression, mania, psychotic symptoms, and cognitive
impairment

normal: 190-950 picograms/mL
• 200-300/mL indicates a borderline level with a possible need for
additional testing
Basic Laboratory Interpretation: Vitamin D Level
affects functions such as neurotransmission, neuroprotection, &
neuroimmunomodulation
-high prevalence of vitamin D deficiency in clients with psychiatric
disorders such as schizophrenia, depression, seasonal affective
disorder, and cognitive impairment
-Symptoms of vitamin D deficiency include depression, irritability,
anxiety, psychosis, and poor brain development

25-hydroxy vitamin D blood test: normal 20-50 ng/mL, less than
12 ng/mL indicates a deficiency
Basic Laboratory Interpretation: Toxicology Screen
-rule out substance use as a cause for symptoms
-used before starting therapy involving controlled substances
-used to monitor medication adherence
-used in the diagnosis of substance use disorder
Basic Laboratory Interpretation: Urinalysis (UA)
Urinary tract infections are associated with a variety of
neuropsychiatric symptoms
-acute mental status changes
• UA may be used to rule out a UTI as the cause.

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