NRNP 6670 Midterm Exam Questions With Verified Answers Latest Updated | Graded A+

NRNP 6670 Midterm Exam Questions With Verified Answers Latest Updated | Graded A+. 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 livein 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: a) Has disproportionate anger toward an abusive spouse QUIZ# 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: b) Clothing c) Speech pattern d) Anger e) Anxiety QUIZ# 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? a) 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. b) 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. c) 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. lOMoAR cPSD| d) 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. QUIZ# 6 A variety of pharmacologic agents have demonstrated effectiveness in the treatment of posttraumatic stress disorder. Which of the following does not have any evidenced-based support in the literature? a) SSRIs b) TCAs c) Antiadrenergic d) Antipsychotics QUIZ# 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 escalated into M.S. getting very loud, yelling, and acting ―crazy‖ before he punched a coworker and started breaking bottles. When considering a manic or hypomanic episode, the PMHNP expects that his speech would most likely be: a) Stuttered b) Increased c) Childlike d) Confused QUIZ# 8 Fletcher is a 29-year-old male referred for court-ordered counseling. He has a long history of repeated offenses including DUI, domestic violence, battery, and other violent acts that lOMoAR cPSD| fortunately have not yet caused any serious injury or death to the recipients. An interview with his wife reveals that he has lied about almost everything for the last few years; he is able to get hired for jobs because he is very engaging and likeable, and then invariably he gets fired because he misses work and doesn’t do his job properly when he is there. According to the wife, they have known each other since high school, where Fletcher was very happy and well-adjusted. He was on the soccer team, liked by teachers, and never demonstrated the tendencies he does now. Apparently in college he got involved with a fraternity that was notorious for alcohol and drug abuse, and he started drinking heavily; it was ―all downhill from there. ‖ The PMHNP considers that: a) History and symptoms are most consistent with antisocial personality disorder b) Fletcher needs a neurological workup to include an EEG and assessment for neurological soft signs c) Consistent with his symptoms, Fletcher will likely respond well to a stress interview d) It is likely that substance abuse is the underlying cause of symptoms and should be explored further QUIZ# 9 Which among the following neurotransmitters is decreased in depression and increased in mania? a) Dopamine b) Norepinephrine c) Serotonin d) Glutamate QUIZ# 10 Among the various types of therapeutic intervention for patients with borderline personality disorder, which of the following is characterized as polymodal, including group skills training, individual therapy, telephone consultation, and a consultation team with a goal of improving interpersonal skills and decreasing self-destructive behavior? a) Mentalization-based treatment (MBT) b) Transference-focused psychotherapy (TFP) lOMoAR cPSD| c) Countertransference-focused psychotherapy (CTFP) d) Dialectical behavioral therapy (DBT) QUIZ# 11 Mr. Kendall is a 47-year old male who is presented to care by his younger sister, Megan. Mr. Kendall has spent his entire adult life living in an apartment that was attached to his parents’ home. His mother died a few weeks ago, and the property is listed for sale. Mr. Kendall will have to move, and while discussing this with him, Megan became very concerned. He has apparently been considered odd all his life, has never married or even dated as far as Megan knows, but she had no idea how odd he was. When his mother died, he seemed disconnected from reality and had episodes of talking to people who weren’t present. Megan says that sometimes she does not even understand what he is talking about. He seems to think he has psychic powers, and that he doesn’t need to move because he knows the house will not be sold. When considering a diagnosis of schizotypal disorder, the PMHNP expects which of the following to be present in the history? a) A history of schizophrenia of a first-degree relative b) Sustained psychosis predating his mother’s death c) Comorbid Asperger’s syndrome d) Apparent frank thought disorder QUIZ# 12 Which of the following is a true statement with respect to the treatment of narcissistic personality disorder? a) Psychoanalytic psychotherapy has strong empiric support b) Both serotonergic drugs and lithium are useful c) Group therapy is rarely helpful d) Immobilized patients (hospitalized or incarcerated) have the best outcomes lOMoAR cPSD| QUIZ# 13 While preparing a class on personality disorders for a class of PMHNP students, the instructor is presenting case studies of patients with cluster A personalities. One of these cases is Clark M., a 41-year-old man who is described as a life-long ―loner.‖ In high school and college, he kept to himself, excelling in his studies in the sciences. Currently described as a brilliant computer programmer, he clearly prefers solitary pursuits and the company of his cat over people. He knows he is socially isolated, but he is just more comfortable this way. This description is most consistent with: a) Schizoid personality disorder b) Schizotypal personality disorder c) Paranoid personality disorder d) Delusional disorder QUIZ# 14 Darius is a 26-year-old male who presents for care as part of couple therapy with his wife, who is being seen for dependency issues. Darius himself seems very anxious to ―do the right thing ‖ and appears to want to please the therapist. During the evaluation, Darius is impeccably dressed, very formal in his presentation and interaction, and is watchful of time because he has an appointment after the interview and states several times that he cannot be late. The PMHNP considers that Darius may have obsessive compulsive personality disorder (OCPD). In differentiating this from obsessive compulsive disorder (OCD), she explores his history further for: a) A history of racing thoughts b) Difficulty interacting with others c) Extremely high expectations of self d) Significant impairment at work 7 QUIZ# 15 lOMoAR cPSD| Hugo is a 39-year-old male who has encouraged his wife to come to counseling because he is worried about her wine drinking. Hugo says that he and his wife have shared a bottle of wine with dinner most nights for the last couple of years, but in the last few months he has become worried that she drinks too much. They both agree that she never really becomes intoxicated, but he does not like the fact that evening wine has become the most important part of her meal. If he wants to go out, she will only go to a place that has a wine she likes. Last month they went on a week-long vacation, and she insisted on packing enough of her wine to last the whole time. If they go to a restaurant that does not have a wine she likes, she will take her own in a disposable coffee cup. It seems like for the last few months, she has been drinking more and more, occasionally finishing the bottle alone when he doesn’t want any. Both partners agree that there is no interference with work or any activities or responsibilities, but it is causing some tension in their marriage. When considering a diagnosis of substance use disorder, the PMHNP considers that: a) Hugo’s wife meets diagnostic criteria for this disorder b) A trial period with no wine ingestion is necessary to assess for withdrawal symptoms c) The family history should be assessed for genetic tendency d) Hugo may have unreasonable expectations QUIZ# 16 When developing a pharmacologic treatment plan for the management of major depressive disorder, the PMHNP counsels the patient that the medication will be titrated up to the appropriate dose and then continued for a minimum of 3 months; medication must not be stopped abruptly or without provider supervision. This is because the physiologic consequence of abrupt cessation is likely to result in: a) Antidepressant discontinuation syndrome b) Rebound depressive symptoms c) A manic or hypomanic episode d) Unresponsiveness to medication with future episodes lOMoAR cPSD| QUIZ# 17 Which of the following is a true statement with regard to the etiology of substance abuse? a) Neurotransmitters or receptors have been identified with most substances of abuse except for alcohol b) Twin and sibling studies do not support a genetic component with respect to the etiology of substance abuse c) Substances of abuse decrease activity in the amygdala and anterior cingulate d) The WHO schematic of drug use and dependence identifies immediate antecedents as the central element of abuse QUIZ# 18 Assessment of the manic state in a patient with bipolar disorder is likely to include all the following except: a) Mood-congruent delusions of grandeur b) Suicidal or homicidal ideation c) Impaired judgment with no insight d) Unrestrained flow of ideas QUIZ# 19 When performing a psychiatric assessment of an elderly patient with Alzheimer’s dementia, the PMHNP recognizes that: a) An important part of the history will come from the caregiver lOMoAR cPSD| b) The patient must also be interviewed alone to preserve privacy of the relationship c) A sexual history is not necessary in patients who are not sexually active d) All of the above.