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NR547 Midterm Exam questions and answers rated A+ 2025/2026
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NR547 Midterm Exam questions and answers rated A+ 2025/2026
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NR547 Midterm Exam5Ps to collect a client's sexual history: - ANS-Partners
Practices
Protection from STDs
Past History of STDs
Prevention of Pregnancy
*may consider adding another P for pleasure
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 - ANS-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.
A client has been on clozapine for 9 months. Absolute neutrophil counts (ANC) have
consistently been less than 1500/microliter? At what frequency should a CBC be drawn?
daily
weekly
every 2 weeks
monthly - ANS-every 2 weeks
Rationale: With a normal baseline ANC, the CBC should be monitored weekly for 6 months;
every 2 weeks for months 6-12; and monthly thereafter
Adjustment Disorder with Anxiety - ANS-DSM-5 classifies adjustment disorder as a trauma- and
stressor-related disorder
-presents with nervousness, worry, or jitteriness
,-Adjustment disorder occurs in the presence of a specific and identifiable stressor
• common stressors include loss of employment, getting married, a new disability, or a natural
disaster
• Symptoms begin within three months of the stressor and typically last no more than six months
Agoraphobia - ANS-intense fear, anxiety, or panic out of proportion to the situation that occurs in
two or more of the following specific scenarios:
-public transportation (bus)
-open spaces (parking lot or bridge)
-enclosed spaces (store, theater)
-standing in a crowd or line (crowd)
-being outside of their home
alogia - ANS--decrease in speech or speech content
-symptom of schizophrenia.
-AKA poverty of speech.
American Geriatric Society (AGS) Beers Criteria - ANS-Avoid the use of haloperidol,
ziprasidone, and olanzapine due to an increased risk of CVA, cognitive decline, and death in
persons with dementia and with dementia-related psychosis.
anhedonia - ANS-inability to experience pleasure
anosognosia - ANS-inability to realize that he or she is ill, which is caused by the illness itself.
Antipsychotics: Potency low to high - ANS-Chlorpromazine - Low
Mesoridazine - Low
Thioridazine - Low
Thiothixene - Medium
Fluphenazine - Medium
Haloperidol - High
Anxiety Disorders - ANS-Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder
Panic
Phobias
Agoraphobia
Adjustment Disorder with Anxiety
Anxiety is often comorbid with _________________ as well as medical conditions such as
____________, ___________, and ___________ - ANS-major depression, COPD, asthma,
diabetes
Anxiety rating scale: GAD-7 - ANS-General Anxiety Disorder-7
-answer question with several days (+1), more than half days (+2), nearly every day (+3)
• Feeling nervous, anxious, or on edge
• Not being able to stop or control worrying
• Worrying too much about different things
• Trouble relaxing
• Being so restless that it's hard to sit still
• Becoming easily annoyed or irritable
• Feeling afraid as if something awful might happen
,0-4: No anxiety disorder
5-9: Mild anxiety disorder
10-14: Moderate anxiety disorder
15-21: Severe anxiety disorder
Anxiety rating scale: HAM-A - ANS-Hamilton Anxiety Scale
-mild (+1), moderate (+2), severe (+3), very severe (+4)
• Anxious mood
• Tension
• Fears
• Insomnia
• Intellectual
• Depressed mood
• Somatic (muscular)
• Somatic (sensory)
• Cardiovascular symptoms
• Respiratory symptoms
• Gastrointestinal symptoms
• Genitourinary symptoms
• Autonomic symptoms
• Behavior at interview
0-17: Mild anxiety
18-24: Mild to moderate anxiety
25-30: Moderate to severe anxiety
31-56: Severe anxiety
armodafinil (Nuvigil) - ANS-FDA Indications:
-excessive sleepiness (OSA, narcolepsy, shift-work)
RX Status: Schedule IV
Normal Dosage: 150-250 mg/daily
avolition - ANS-lack of motivation
Basic Laboratory Interpretation - ANS-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 - ANS--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) - ANS-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) - ANS-used to rule out thyroid
disorders as a cause for symptoms
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