A psychiatric mental health nurse practitioner working in an outpatient clinic is evaluating Tom, a 45-year-old man, who has been prescribed oxycodone (OxyContin, 10 mg q12h) for chronic lower back pain for the past five years. Tom reports that he used to feel relief with one pill, but now he requi...
A psychiatric mental health nurse practitioner working in an outpatient clinic is evaluating Tom, a
45-year-old man, who has been prescribed oxycodone (OxyContin, 10 mg q12h) for chronic
lower back pain for the past five years. Tom reports that he used to feel relief with one pill, but
now he requires three pills to achieve the same level of pain relief. This is possibly an example
of which process?
1. Kindling
2. Addiction
3. Tolerance
4. Potency - ANS 3
A psychiatric mental health nurse practitioner (PMHNP) is conducting an evaluation on a
7-year-old child, Emma, who has been referred to an outpatient clinic due to concerns about her
behavior and attention span. Her parents report that she frequently loses her belongings, has
difficulty staying seated in class, struggles to complete schoolwork, and often interrupts others
during conversations. They have also noticed that these symptoms have been present for at
least six months. What is the next action of the PMHNP?
1. Initiate ADHD diagnosis based on parent reports and school observations.
2. Conduct a thorough psychiatric evaluation to rule out other possible causes of her symptoms.
3. Prescribe a low-dose stimulant medication to see if there is a positive response.
4. Refer Emma for psychotherapy without further assessment. - ANS 2
A PMHNP is working in an outpatient pediatric clinic. Sarah's parents have brought her for an
evaluation due to concerns about her behavior. She is an 8-year-old girl who frequently exhibits
symptoms such as difficulty paying attention, forgetfulness, impulsivity, and frequent
restlessness. What is her most likely diagnosis?
1. Attention-Deficit/Hyperactivity Disorder (ADHD)
2. Conduct Disorder
3. Generalized Anxiety Disorder (GAD)
4. Autism Spectrum Disorder (ASD) - ANS 1
A psychiatric mental health nurse practitioner (PMHNP) working in a pediatric clinic is assessing
a 9-year-old boy, Liam, who has recently been diagnosed with Attention-Deficit/Hyperactivity
Disorder (ADHD). Liam's parents are concerned about his frequent motor and vocal tics. Which
medication is the most appropriate to prescribe?
1. Methylphenidate (Ritalin)
2. Atomoxetine (Strattera)
3. Guanfacine (Intuniv)
4. Bupropion (Wellbutrin) - ANS 3
,A PMHNP working in an outpatient mental health clinic is conducting an assessment of a
40-year-old patient, Sarah, who presents with a long history of emotional detachment, a
preference for solitary activities, and limited interest in close relationships, including with her
own family. Sarah rarely experiences pleasure from activities and appears indifferent to both
criticism and praise. Which of the following is the most likely diagnosis?
1. Major Depressive Disorder (MDD).
2. Schizotypal Personality Disorder (STPD).
3. Generalized Anxiety Disorder (GAD).
4. Schizoid Personality Disorder (SPD). - ANS 4
A 5-year-old boy shows no interest in playing with other children and ignores adults other than
his parents. He spends hours lining up his toy cars or spinning their wheels. He rarely uses
speech to communicate, and his parents state that he has never done so. Physical examination
indicates that his head is of normal circumference and his gait is normal. Which of the following
is the most likely diagnosis for this boy?
1. Obsessive-compulsive disorder
2. Fragile X syndrome
3. Fetal alcohol syndrome (FAS)
4. Autism Spectrum Disorder - ANS 4
Which of the following medications has a unique mechanism that is both a serotonin and
norepinephrine reuptake inhibitor?
1. Bupropion (Wellbutrin).
2. Sertraline (Zoloft)
3. Clomipramine (Anafranil)
4. Duloxetine (Cymbalta) - ANS 4
A PMHNP is evaluating a 10-year-old child, Sarah, referred for assessment due to frequent
severe temper outbursts, irritability, anger, and mood dysregulation. Sarah's parents report that
these episodes occur in various settings and are often disproportionate to the situation. Which
of the following is the most likely diagnosis?
1. Post-Traumatic Stress Disorder (PTSD)
2. Major Depressive Disorder (MDD)
3. Conduct Disorder (CD)
4. Disruptive Mood Dysregulation Disorder (DMDD) - ANS 4
Which characteristic of Fluoxetine (Prozac) provides the greatest degree of safety for patients
who have severe depression?
1. Greater efficacy than tricyclic antidepressants
2. Less potential for drug interaction
3. Less potential for injury with intentional overdose
4. Less potential for suicidal thinking - ANS 3
, During patient education about sertraline (Zoloft), an adult psychiatric and mental health nurse
practitioner focuses upon the potential side effect of:
1. Agranulocytosis.
2. Hypernatremia.
3. Sexual dysfunction.
4. Weight loss. - ANS 3
A 72-year-old female is brought in by her husband with increasing forgetfulness, insomnia,
decreased activity, and decreased appetite for 2 months. She has a history of hypertension and
is being treated with lisinopril. The exam is normal, and the mini-mental status exam provides a
score of 24 but she declines to answer some questions and needs to be urged to participate in
the assessment. What is the most likely diagnosis?
1. Alzheimer disease
2. Vascular dementia
3. Depression
4. Delirium - ANS 3
A 23-year-old woman is brought into the ER after attempting suicide by cutting her wrists.
Which nursing action by the PMHNP would be of highest priority initially?
1. Assess her coping behaviors.
2. Assess her current level of suicidality.
3. Take her vital signs.
4. Assess her health history. - ANS 3
A 35-year-old male patient with a history of bipolar disorder presents to your psychiatric clinic in
a highly agitated state. He reports feeling extremely elated, racing thoughts, and a decreased
need for sleep for the past week. He also mentions experiencing auditory hallucinations
commanding him to "take action." Which nursing action by the PMHNP would be of highest
priority initially?
1. Assess his coping behaviors.
2. Assess his current level of suicidality.
3. Take his vital signs.
4. Assess his health history. - ANS 2
A male patient informs an adult psychiatric and mental health nurse practitioner that he has not
slept in three days, has poor concentration, and denies fatigue. The patient presents with rapid
speech, irritability, self-inflated esteem, and is uncooperative during assessment. What is the
patient's most likely diagnosis:
1. Antisocial personality disorder
2. Bipolar disorder
3. Panic disorder
4. Attention deficit hyperactivity disorder - ANS 2
The neuroprotective treatment of choice for bipolar disorder is:
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