Georgette PMHNP
A 16-year off boy presents with a long head, large ears, and hyper extensible joints, is
very shy, and starts rocking and flapping his hands when he is upset. Which of the
following is your most likely diagnosis?
A. Tourette disorder
B. Autism
C. Fragile X
D. Rett disorder ...
Georgette PMHNP
A 16-year off boy presents with a long head, large ears, and hyper extensible joints, is
very shy, and starts rocking and flapping his hands when he is upset. Which of the
following is your most likely diagnosis?
A. Tourette disorder
B. Autism
C. Fragile X
D. Rett disorder - correct answersFragile X
a 17 year old arrives at the emergency department with nonspecific complaints The
patient's temperature is 100.8, pulse rate and blood pressure are elevated, and pupils
are dilated with decreased reaction to light. Two days ago, the patient began taking
sertraline for the treatment of depression. the patient has a history of substance use and
smoked marijuana one week ago. The diagnosis is - correct answersserotonin
syndrome
A 23 year old woman is Brought in to to the ER after attempting to commit suicide by
cutting her wrists. Which action by the PMHNP would be of highest priority initially?
A. Assess her coping behaviors
B. Assess her current level of suicidality
C. Take her vital signs
D. Asess her health history - correct answerstake her vital signs
A 24 year olf female attempts suicide by overdose on an MAOI phenelzine. She is
stabilized in the hospital. Ten days later she is started on venlafaxine and becomes
tachycardia and diaphoretic, and develops myoclonic jerks. What condition is this?
A. NMS
B. Opisthotonos
C. Akathisia
D. Serotonin syndrome - correct answersserotonin syndrome
a 48 year off Caucasian male presents for his therapy appointment. He is sad about
losing his wife recently to covid 19. He reports feeling thoughts of hurting himself. He
has a past history of overdosing on propranolol several years ago. Which of the
following places him at higher risk of suicide?
A. Previous attempt
B. Age
C. Gender
D. Marital Status - correct answersA previous attempt
A 64 year old caucasian male referred for treatment of refractory depression by his PCP
reports continued lack of purpose, insomnia, decreased energy, reduced interest in
pleasurable activities since losing his wife hit by a drunk driver 3 months ago. Which of
the following is an assessment priority?
,A. Prior and current meds, dose, clinical response, side effects.
B. Thoughts of self-harm, plan, intent, access
C. Extent of alcohol use, and motivation to reduce to safe levels
D. Sleep patterns and hygiene - correct answersthoughts of self-harm, plan, intent,
access
A 69 year old man with diagnosis of delirium has symptoms of psychosis which include
frightening auditory and visual hallucinations and paranoid delusions. Which of the
following medications should be chosen first for this man's symptoms?
A. Haloperidol
B. Quetiapine
C. Valium
D. Olanzapine - correct answershaloperidol.
A 72 year old is brought in by her husband with increasing forgetfulness, 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?
A. Alzheimers disease
B. Vascular dementia
C. Depression
D. Delirium - correct answersdepression
A client experiencing difficulties with working memory, planning, and prioritizing, insight
into his problems, and impulse control presents for assessment. In planning his care,
the PMHNP should apply his knowledge that these symptoms represent problems with
the
A. frontal lobe
B. Temporal lobe
C. Parietal lobe
D. Occipital lobe - correct answersfrontal lobe
A client presents with complaints of changes in appetite, feeling fatigued, problems with
sleep-rest cycle, and changes in libido. What is the neuroanatomical areas off the brain
that is responsible for the regulation of these functions? - correct answersHypothalamus
A client says to the PMHNP, Some days life is just not worth it. All my wife and I do is
fight and scream. Things at home were be calmer and simpler if I just wasn't there
anymore." The most therapeutic response is:
A. Do you mean yo are thinking about leaving your wife to moving out?"
B. Tell me what you mean by "it would be simpler if you weren't there anymore."
C. So you are thinking suicide might be an option for you?
D. Remain silent. - correct answersB. Tell me what you mean by "it would be simpler if
you weren't there anymore"
,A male patient informs as adult PMHNP that he has not slept in three days, has poor
concentration, and denies fatigue. The patient's diagnosis is:
A. ADHD
B. Bipolar disorder
C. Panic disorder
D. Primary insomnia - correct answersbipolar disorder
A married female patient has been in therapy with an adult psychiatric and mental
health nurse practitioner for 3 months. The patient's husband abuses alcohol and
refuses treatment. The night before the next scheduled appointment, the patient
telephones the clinical nurse specialist stating that her husband is drunk, violent, and
threatening to kill her. The PMHNPs priority intervention is
A. To arrange for an emergency psychiatric intervention
B. Arrange for the woman's safety
C. Request a restraining order
D. Request to speak to the husband - correct answersArrange for the woman's safety.
A patient has been treated for the past several years with fluphenazine (Prolixin). You
tonic that he is drooling and has a slight pill rolling movement of the fingers. These are
EPS symptoms known as
A. pseudo parkinsonism
b. anticholinergic effects
C. Tardive dyskinesia
D. Acute dystonia - correct answersA. Pseudoparkinsonism
A patient is diagnosed with schizophrenia. Which of the following would be the
appropriate question for the PMHNP to ask when assessing side effects produced by
dopamine antagonism in the nigrostriatal pathway?
A. Are you experiencing constipation?
B. Are you experiencing pill rolling tremors, shuffling gait, and mask like facial
expression?
C. Are you experiencing increased thirst?
D. Are you experiencing breast discharge? - correct answersAre you experiencing pill
rolling tremors, shuffling gait, and mask like facial expression
A patient with a known diagnosis of bipolar I disorder presents to your clinic complaining
of manic symptoms and insomnia. Your patient has been stable on lithium for the past
six months To determine if a medication change or increase is warranted, it is important
to gather more information. You suspect a possible medication-induced manic episode
when the patient endorses what?
A. She was recently placed on a beta blocker for anxiety.
B. She was recently prescribed a benzo
C. She recently had a flare up of her rheumatoid arthritis and received treatment for one
week (aka a steroid)
D. She recently began a new retroviral agent for hepatitis - correct answersrecently
treated for RA
, A week after raising the dose of clomipramine, a patient treated for depression presents
to the clinic with reports of change in mental status, fever, and hyperreflexxia. As the
treating PMHNP, you know these symptoms are consistent with which of the following?
A. NMS
B. EPS
C. Hypertensive crisis
D. Serotonin syndrome - correct answersserotonin syndrome
Absence of movement or difficulty initiating movement - correct answersakinesia
Treatment: cogentin
According to the current clinical guidelines for treating a patient with bipolar I disorder
mania with psychotic features, an adult psychiatric and mental health nurse practitioner
prescribes:
A.) Lithium
B. Citalopram
C. Lamotrigine
D. Quetiapine - correct answersquetiapine
Acetylcholine is made - correct answersbasal nucleus of Meynert
action in contemplation - correct answershelp the person find a change strategy that is
realistic, acceptable, accessible, and effective.
action in precontemplation - correct answersgive information to raise awareness of the
problem, but do not try to tell the person what to do.
action step in action - correct answerssupport and advocate
help accomplish steps for change.
action step in maintenance - correct answershelp the person identify the possibility of a
relapse
identify strategies to prevent relapse.
action step in preparation - correct answershelp the person find the change strategy that
is realistic, acceptable, appropriate, and effective.
Acute onset
altered level of consciousness
inattenion
poor prognosis--1 year mortality rate of is up to 40% - correct answersdelirium
ADHD causes DNS - correct answersdopamine
noreip
serotonin
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