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6640 final exam Q & AS ALL ANSWERS NRNP 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RA, Exams of Nursing

6640 final exam Q & AS ALL ANSWERS NRNP 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+

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Download 6640 final exam Q & AS ALL ANSWERS NRNP 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RA and more Exams Nursing in PDF only on Docsity! • Question 1 1 out of 1 points The PMHNP is assessing a 30-year-old client who reports feeling stressed out due to his current employment situation. When asked about how he manages this work- related stress, the patient says that exercise helps him feel less anxious, so he often spends 2 or more hours at the gym each night. After completing the patient assessment, the PMHNP has determined that an existential psychotherapy approach may best benefit this client. What is the PMHNP’s goal in employing this treatment approach? Selected Answer: • Question 2 1 out of 1 points • Question 3 1 out of 1 points • Question 4 1 out of 1 points B. Help the patient be aware of his anxiety and embrace it A PMHNP is assessing a 60-year-old patient named Carlos. He has severe PTSD and mild substance abuse issues. The most appropriate setting to treat Carlos would be a . Selected Answer: D. mental health system of care A PMHNP is using motivational interviewing (MI) with a 50- year-old patient named Dave to commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP hopes to help the patient build self-esteem and hope. True or false: If Dave is resisting change, the PMHNP should challenge his resistance in order for MI to be successful. Selected Answer: Tru e • Question 9 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ Select ed Answ er: A. “Focus on your anger, take a deep breath, and allow an image to emerge.” The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas tearfully states, “I have driven my family and friends away with this terrible habit. I have no one left. I had more than enough chances and now my children won’t even talk to me.” Which of the following statements demonstrate a simple reflection? Select ed Answ er: NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 10 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ D. All the above. The PMHNP is caring for a geriatric patient who expresses symptoms of gastrointestinal problems, aches and pains, and loss of appetite. The patient reports feeling lonely, as more of his friends have been passing away over the recent months and years. The PMHNP focuses on which therapeutic approach for this patient? Select ed Answe r: D. All of the above NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ A 19-year-old female patient named Anna, who was the victim of child abuse and neglect, is also in treatment for substance abuse. At her most recent appointment, Anna confesses to the PMHNP that she is having romantic fantasies about him, and explains the he is one of the few people she trusts. She believes that he is interested in her as well. What is the most appropriate response by the PMHNP in this situation? Selec ted Answ er: C. Guide the patient to examine her feelings and explore the underlying meaning The PMHNP is assessing a patient who requires cognitive NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 11 1 out of 1 points • Question 12 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ D. “You seem upset. Tell me what seems to be bothering you.” The PMHNP is caring for an older patient with major depressive disorder, seasonal pattern. The patient has been resolute about not taking medication to manage the depression brought on by his illness, stating that it is against his yogic lifestyle. In addition to psychotherapy, what can the PMHNP suggest to this patient? Selec ted Answ er: A. “You may want to look into therapeutic oils and aromatherapy as an alternative to medication.” NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 15 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ The PMHNP is assessing a new geriatric patient who reports symptoms of depression. The PMHNP wants to identify the patient’s symptom severity over time. Which assessment tool will the PMHNP use to collect this data on the patient? Select ed Answ er: B. Montgomery- Asberg Depression Rating Scale The PMHNP uses therapeutic communication skills while ensuring that the patient NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 16 1 out of 1 points • Question 17 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ understands that he has choices. The PMHNP comprehends and practices motivational interviewing. This is best understood as which of the following? Selec ted Answ er: B. A statement that both challenges the patient’s resistance and offers an opportunity to discuss the issues allows the patient to argue with him/herself to help produce a desired change. NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 18 NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ Question 21 The PMHNP assesses a 27-year-old patient named Jeff, who was a victim of child abuse and neglect. Jeff says that he remembers a traumatic situation that he wants to share, but is having trouble talking about it. Which statement made by the PMHNP demonstrates the use of emotion-focused therapy? Selec ted Answ er: A. “Let’s see if we can come up with some ideas for you to feel safe telling your story.” NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 22 1 out of 1 points • Question 23 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ The PMHNP is interviewing a patient who is in the process of successfully completing a substance abuse program. During the interview, the patient states, “I wish I was strong enough to keep the same friends I had before I came here for treatment. I’m really afraid of being discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex reflection when she states the following: Selec ted Answ er: C. “You’d like to keep your old friends but know being around them may lead you to abuse substances again.” The PMHNP continues to meet with Gerald, who is the patient with depression and NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 27 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ B. “The type of treatment depends on the stage of dementia and safety considerations.” The PMHNP meets with a 31-year-old woman who reports feeling as though she is “at her breaking point” with work. The PMHNP learns that the woman works 12-hour days, including one day on the weekend, because she is nervous about company layoffs. “I feel like I need to work myself to death in order to prove that I am valuable to the organization,” the woman says. Using the supportive psychodynamic therapy approach, how does the PMHNP respond? Selec ted Answ er: D. “That must be a very tiring work schedule. How do you feel about working so much?” NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 28 1 out of 1 points • Question 29 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ A 38-year-old patient tells the PMHNP that her father went to jail for selling drugs when she was a child. The patient is visibly upset when discussing what happened. Using a humanistic- existential approach to psychotherapy, which of the following is the most appropriate response by the PMHNP? Select ed Answ er: B. “What are you experiencing now as you share this story?” The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 30 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ following? Selec ted Answ er: D. There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes. A PMHNP has been treating a 14-year-old patient using interpersonal psychotherapy. The patient has been depressed since the death of his grandmother. To help the patient recover, the PMHNP has told the parents: Select ed Answ er: B. “Modify your expectations at home and school until the depression lifts.” NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 33 1 out of 1 points • Question 34 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ Answer: Encourage the patient to continue treatment by using alternative strategies A PMHNP is assessing a 40-year-old patient named Sarah who has a severe cocaine addiction and mild depression. Using the four-quadrant model, what would be the most appropriate setting to help the patient? Select ed Answ er: C. Substance abuse treatment system The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP? NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 35 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ Select ed Answ er: D. A and C The PMHNP has been providing interpersonal psychotherapy (IPT) for a patient who the PMHNP observes implementing new ways of being, such as interacting more with peers and being less isolated in social scenarios. The PMHNP understands that the patient is approaching termination. How does the PMHNP address termination with this patient? Select ed Answ er: C. Embed the termination into the work of the therapeutic phase NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 36 1 out of 1 points • Question 37 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ A 21-year-old patient has been having trouble adjusting to college life. She tells the PMHNP that she had five alcoholic drinks at a party this past weekend. She also acknowledges that she drank the same amount of alcohol at a party the previous month. Based on this information, what would the PMHNP most likely recommend? Select ed Answ er: D. None of the above The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is having trouble adjusting to her new job and NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 40 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ stays out too late at the casino on Sunday nights. In addition, he once was an avid runner, and has given up running to spend more time gambling. True or false: According to the PMHNP, the desired goal after treatment is not complete abstinence from gambling, but reaching a healthy level of the behavior. Select ed Answ er: Tr u e A 35-year-old male patient is being treated for alcohol addiction. He asks for the PMHNP’s cell phone number to use in case of an emergency. When the PMHNP responds that giving her number would be against therapeutic rules, the patient threatens an act of violence to the therapist. What would NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 41 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ be the most appropriate response by the PMHNP? Select ed Answ er: A. Immediately report the threat to the local police department As part of the PMHNP’s role in the clinic, the PMHNP oversees students that gain clinical experience at the agency. The student is instructed to use the supportive psychodynamic therapy approach with the patient. Which action made by the student causes the PMHNP to intervene, after observing the student interacting with the patient? Select ed Answ er: A. Focusing too heavily on defenses NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 42 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ The PMHNP is caring for a patient who is histrionic. Using the supportive psychodynamic therapy model, what is the best statement made by the PMHNP? Selec ted Answ er: B. “Let’s not think too much about emotion right now. Let’s focus on what NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 46 1 out of 1 points • Question 47 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ The PMHNP is communicating with a middle-aged male patient who has a history of addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell them.” The PMHNP understands that there are phases of change and can best demonstrate “focusing” by responding with: Selec ted Answ er: D. “I am wondering if your use of pain medication has ever prompted you to seek medical attention.” The PMHNP has been providing supportive psychodynamic psychotherapy to a NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ patient and is nearing the termination stage. The PMHNP will use which criteria for determining that the patient is ready for termination? Select ed Answ er: B. Symptoms have improved. NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 48 • Question 49 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ A 21-year-old patient is worried about starting a new job. She talks about her fears of failure and not making friends at the office. Using a person-centered approach, an appropriate response by the PMHNP is to . Select ed Answ er: C. ask the patient to reflect on and explore what she is experiencing While assessing a patient using a humanistic-existential approach, a patient tells the PMHNP, “For the past few weeks, I’ve felt anxious almost every single day.” What would be an appropriate next step by the PMHNP? Select ed Answer: NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ 1 out of 1 points • Question 52 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment? Selec ted Answ er: B. Reviews the patient’s file to identify issues and important themes that were highlighted throughout treatment NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 53 1 out of 1 points • Question 54 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ A 25-year-old female states, “I really need to lose weight. I know I’m the cause of our problems, if I could just lose weight he might be more attracted to me. Then we could start a family and we would be happy. I’m sure of it, right, we would definitely be happy!” Which statement shows the PMHNP’s ability to apply “summarizing”? Selec ted Answ er: C. “You have identified your weight as a problem in your marriage and but believe that losing weight will gain happiness.” How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ Select ed Answ er: D. A and C A PMHNP is treating a 10-year-old boy who is exhibiting signs of aggression and attention problems. What type of intervention will the PMHNP consider using a common elements approach? Select ed Answ er: D. All of the above A PMHNP is treating a 12-year-old girl who witnessed NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 55 1 out of 1 points • Question 56 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ Select ed Answ er: D. All of the above. A 38-year-old patient has been having trouble communicating with his teenage daughter. Using a solution-focused therapy approach, the PMHNP responds by saying, “When was a time that a communication problem could have occurred, but did not?” In this case, what type of question is the PMHNP asking? Select ed Answ er: C. Exception question NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 59 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ The PMHNP is treating an older adult patient who reports experiencing nightmares associated with an automobile accident he was in 20 years ago. As the PMHNP formulates the case using the dynamic supportive therapy model, what questions will the PMHNP use during the session? Select ed Answ er: C. “Let’s talk about what kinds of things are triggering you now.” NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 60 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ The PMHNP is caring for an adult male patient whose wife left him several months ago. He recently learned that his ex-wife is dating someone much younger. The man feels belittled, sad, and lonely. He talks about trying to meet other women, but says, “I can’t compete with the younger guys these days, with the cool clothes and the vegan diets. I’m bald and overweight, and what woman is going to want to be with me?” How does the PMHNP help raise the man’s self-esteem? Select ed Answe r: D. All of the above NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 61 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ schizophrenia. Which therapeutic model will the PMHNP employ with this patient? Select ed Answe r: D. None of the above The PMHNP uses the cognitive behavioral therapy model with Gerald, an older adult patient who is being treated for depression and mood disorder. What will the PMHNP do with the patient during the first three sessions? Select ed Answe r: A. Build a therapeutic alliance NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 64 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ A PMHNP has been treating a 9-year-old patient who was referred by her school. Students are asked to raise their hands before speaking during group discussion, but the patient seems to blurt out what she wants to say without being called on. She also interrupts other children while they are talking instead of waiting her turn. When the patient gets frustrated, she has trouble controlling her emotions and cries often. Based on the initial information provided, the first focus by PMHNP is the child’s . Select ed Answe r: B. self- regulat6on NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 65 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ The PMHNP is working with a patient who describes having a painful and traumatic childhood experience, which causes her to have anxiety as an adult. When asked how she manages her anxiety, the patient dismisses it and denies that it is a problem. Using the supportive psychotherapy approach, the PMHNP will do which of the following when assessing the patient’s ego strength? Select ed Answe r: A. Identify the primary defenses the patient uses to ward off anxiety NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 16 1 out of 1 points • Question 67 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ The PMHNP is assessing an older adult male patient with depression and comorbidities. According to the medical chart, the patient takes medication to manage joint and bone pain. The patient reports feeling “forgetful” and complains that he has a hard time remembering where he puts things. What is the primary action by the PMHNP? Select ed Answe r: C. Determining if the patient’s medications can be causing memory problems NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 70 1 out of 1 points • Question 71 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ The PMHNP is caring for a patient who experiences depression caused by the traumatic experience of her dog passing away. She reports not being able to eat or sleep, and sometimes doesn’t want to leave the house at all. Which statement is most appropriate for the PMHNP to maximize the patient’s adaptive coping mechanisms? Selec ted Answ er: C. “It’s important to be mindful of how you feel and then to determine what causes those feelings.” NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ • Question 72 1 out of 1 points • Question 73 1 out of 1 points NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+ A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? Select ed Answ er: D. All of the above. A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the 10 guiding principles of recovery, an appropriate step by the PMHNP is to . Select ed Answer: NRNP 6640 final exam Q & AS ALL ANSWERS 100% CORRECTLY VERIFIED LATEST UPDATE 2022/2023 RATED A+