ENPC EXAM QUESTIONS AND ANSWERS/ ENPC 2023 UPDATED VERSION OF THE EXAM/ ENPC EXAM, Exams of Nursing

Download ENPC EXAM QUESTIONS AND ANSWERS/ ENPC 2023 UPDATED VERSION OF THE EXAM/ ENPC EXAM and more Exams Nursing in PDF only on Docsity! Barkley DRT #2 ENPC EXAM QUESTIONS AND ANSWERS/ ENPC 2023 UPDATED VERSION OF THE EXAM / ENPC EXAM 1. During a suicide intervention with your 28yo male patient, to which agreement should you ask for his consent, verbally or in writing? a. -“No Harm” contract- health care professionals are obligated to ask suicidal patients to agree to a no harm contract, verbally or in writing, detailing specifically that the patient will restrain from harming themselves b. “No Suicide” contract- typical contraajeminatincts used in the prevention of suicide c. “Prevention” Contract- typical contracts used in the prevention of suicide d. “Affirming Life” contract- typical contracts used in the prevention of suicide 2. Courtney 35 is a rape victim. You note that she has an expressed style of coping in her acute rape trauma syndrome. Which of the following would most lead you to this conclusion? a. Patients Masked face b. Patients Distractibiity c. Patient Smiling d. Patient having difficulty making decisions 3. Which of the following patients would not require hospitalization? a. A 29yo self-admitted bulimic male with bradycardia b. A 27yo female with repeated use of laxatives and diuretics at least two times a week for 3 months c. A 20yo male suffering from persistent hypothermia P a g e 1 | 20 d. A 18yo young woman who is 5’4” and weighs 92 pounds 4. Terry, 35yo, visits your office with the assumption that he is experiencing depression. Terry explains that he has a history of substance abuse and a family history of mood disorders. He claims that he has recently been incredibly fatigued, possessing no energy to even perform day to day activities. Even with the sudden onset of fatigue. Terry explains that he is still experiencing insomnia. He also complains about recurring confusion and loss of weight, and confesses that he has been experiencing more recurrent suicidal thoughts. Of the following which is the best medication to prescribe Terry for his situation? a. Sympathomimetics- thought to be most effective pharmacological treatment for depression, however they have a potential for abuse b. Bupropion- better choice due to history of substance abuse c. Olanzapine- mood stabilizer more effective for bipolar d. Risperidone- for mania 5. You are attending to a 30yo male after he was shot at and almost killed. By showing empathy, confrontation, and immediacy, you are exhibiting which of the following? a. Identifying the hazard and precipitating event- involves differentiating the precipitating event from long term psychological problems. Three of the counseling keystones relevant to assessment of a crisis are empathy, confrontation, and immediacy. c. Identifying coping mechanisms- does not involve wide-ranging keystones such as empathy, but rather specific actions such as questioning and increasing adaptive coping by recommending the patient seek information. d. Situational support 6. A patient with which of the following findings should be referred to primary care for cardiovascular problems? a. A patient with a blood pressure of 130/85- considered prehypertension and should be referred to primary care. b. Systole c. Diastole d. Low density lipoprotein level (LDL) of 69 mg/dl- is the desired LDL for patients, anything over 100 mg/dl should warrant a referral to primary care for evaluation of cholesterol. 7. Patients with severe and persistent mental illness (SPMI) exhibit symptoms which interfere with occupational, academic, and social functioning. Which of the following illnesses eventually touches 100% of patients affected with SPMI? a. Unipolar depression- affects 20-30% of SPMI patients b. Schizophrenia- affects 90% of SPMI patients c. Dementia- 100% of patients with SPMI are eventually affected by varying degrees of dementia which interfere with occupational, academic and social functioning d. Bipolar Depression- affects 40-50% of SPMI patients 8. Before patients enter a hospice they are advised of their right to refuse care, but only if they have which of the following? a. Decisional capability b. A living will c. A healthcare directive d. Informed consent 9. Which of the following statements is not a correct association with the Bronfenbrenner’s ecological P a g e 2 | 20 b. Counseling keystones relevant to assessment of a crisis- d. Depression- major characteristics of premorbid phase 20. A physical therapist helps Chris who was paralyzed below his waist after falling off a horse. He is now post spinal cord surgery and he is able to feel his legs and feet again. What level of prevention is occurring here? a. Secondary Prevention b. Tertiary Prevention c. Primary Prevention d. Quaternary prevention 21. The following choices represent the predisposing factors for enuresis except: a. African American b. Male c. Small bladder capacity d. Poor nutrition 22. You are meeting Ginger, a 10yo, who was brought to you by a social worker. You notice that Ginger is wary of adult contact, withdrawn and responds to your questions in monosyllabic answers. You also gather that she is frightened of her parents, yet she makes constant efforts to please them. The patient’s behavior is most indicative of which of the following? a. Neglect y caretakers b. Emotional abuse by caretakers c. Sexual abuse by caretakers d. Physical abuse by caretakers 23. Despite the fact that she claims she “forgot” to pay for the items. Cynthia was recently arrested for shoplifting at a clothing store. Looking at this 32yo, female’s history, you realize she has a history of shoplifting often by herself and with no apparent need or want for the items. Which of the following would you expect to see in Cynthia’s family history? a. Her sister was addicted to pain killers b. Her mother has OCD c. Her father was an alcoholic d. Her aunt suffered from panic attacks 24. You are performing a comprehensive health history of 20yo Ricky. He has been in and out of juvenile detention centers because of his violent history over the last 3 years. You are trying to delineate whether his propensity for violence is associated with internal or external factors. Yu should pay special attention to the following possible issues except: a. GI problems b. History of substance abuse c. High fevers d. Head injury 25. Jameson, 47, is a self-described “neurotic overachiever” who is obsessed with growing his small business. During your interview, you note that he appears arrogant and grandiose. He is convinced that his largest business competitor is intent on sabotaging his company. He appears unable to empathize with the feelings and P a g e 5 | 20 needs of others and has few friends or interests outside of work as a result. Which of the following personality disorders best explains Jameson’s behavior? a. Obsessive-Compulsive b. Histrionic c. Borderline d. Narcissistic 26. You see an Alzheimer’s patient you treat regularly, 77yo Jane. In your last checkup you have noticed bruises on her, and Jane is in no state to recall what occurred. In most states, which of the following would you be legally required to report to social services? a. Neither incident b. The incident of domestic abuse c. Both incidents d. The incident of elder abuse 27. When treating a patient with hyperactive delirium, you must help the patient in managing his or her symptoms until the delirium has resolved. Which of the following would be least appropriate for this type of patient? a. Schedule treatments and medications at times that will not interrupt nighttime sleep b. Clearly identify staff and their function c. Allow the patient to sit up partially d. Provide the patient with a semi-darkened room 28. Even though many types of dementia are permanent and become progressively worse, there is a potentially eversible form of dementia. This type of dementia impairs the return of cerebral spinal fluid to brain from the spinal column because of enlarged ventricles. Which of the following matches this description? a. Dementia due to Picks disease b. Dementia due to normal-pressure hydrocephalus c. Dementia due to HIV d. Dementia due to Creutzfeld-Jacob disease 29. Which of the following are two risk factors for the recurrence of major depressive disorder? a. Prior history of multiple major depressive episode and a later age of onset—earlier age of onset not later b. Negative Cognitive style and persistent sleep disturbance- along with a prior history of major depressive episodes, ongoing psychosocial stress, negative cognitive style, and earlier age of onset, and persistent sleep disturbances are some of the risk factors for the recurrence of major depressive disorder. c. Sociopathic behavior and paranoid behavior- suggests less of a risk for mood disorders. d. Ongoing psychosocial stress and family history of major depressive disorder- family history of MDD not a risk factor for its recurrence 30. Which of the following statements about elder abuse is false? a. Elderly women are at higher risk of being abused than elderly men- elderly men at higher risk of being abused than women, especially if the elderly men were abusive in the past. b. About one in ten elders in the community are mistreated- true c. Elder abuse increases with increase in “caretaker burden”- true d. More than half of abused dependent elders are abused by their spouse- true P a g e 6 | 20 31. Abnormalities in neurotransmitters such as serotonin and dopamine may be a neurological predisposing factor for bipolar disorders. An abnormality of which of the following may also be a neurological predisposing factor? Neurological predisposing factors for bipolar disorders include, but are not limited to, abnormalities of cortisol, norepinephrine, glutamate, and acetylcholine. a. Somatostatin b. Epinephrine c. Cortisol d. dimethyltryptamine 32. Which of the following findings is not among the list of necessary symptoms for a diagnosis of dementia? a. Agnosia b. Aphasia c. Anosognosia d. Apraxia 33. Samuel is under your care for depression. Your medication of choice in his case is a prescription for a serotonin norepinephrine reuptake inhibitor (SNRI). This type of medication blocks the reuptake of neurotransmitters after their release from the presynaptic terminal. Which of the following medications did you prescribe? a. Venlafaxine b. Thioridazine c. Perphenazine d. Chlorpromazine 34. Of the following, which is not a goal of the “Healthy People 2020” program? a. Help Americans attain lives free of preventable conditions b. Promote accessibility to health care c. Provide healthcare for the uninsured- goal to promote not provide d. Provide measurable data and goals to guide policy decisions- the program collects and provides information to help healthcare providers, consumers, and policy makers make better informed decisions concerning healthcare. 35. A 47yo male presents with slurred speech, an unsteady gait, and overall drowsiness, as well as a sense of “wellbeing”. Which of the following substances is he most likely abusing? a. Alcohol- blackouts and headaches b. Amphetamines- autonomic hyperactivity and pupil changes c. Opioids- indicated by constricted pupils, and diarrhea d. Benzodiazepines 36. A 19yo female comes to your office with her parents. She recently finished her first year of college, and her parents mention she has lost a significant amount of weight, even though she was not heavy when she began college. When discussing the issue with you, the patient clarifies that she is not preoccupied with losing weight, rather she has increased her workouts to avoid the unhealthy behavior of many other freshmen around her. Upon further delving into the issue, she mentions that she is not sexually active and that exercise and her weight help her feel better about herself. If the patient’s signs and symptoms are indicative of an eating disorder, which of the following would be most expected in this patient? a. Broken fingernails b. Amenorrhea c. Pale skin tone d. Binging followed by purging P a g e 7 | 20 b. Plan and previous c. Abuse of substances d. Access 46. Of the following, which is not a special population to be considered by the nurse practitioner in the context of a cultural assessment? Special populations to be considered by the NP within the context of a cultural assessment include the homeless population, migrant workers, people who are fearful of discrimination based on gender and sexual identity differences, the correctional population, and the forensic population a. Forensic population b. LGBT population c. Physically handicapped population- not considered a special population within the context of a cultural assessment d. Correctional population 47. Sani, 83 was diagnosed with mild to moderate stage Alzheimer’s 18 months ago. Since his diagnosis, he has experienced progressively worsening depression. You wish to alleviate his depression, sparring his cognitive facilities as much as possible, but do not want significantly increase his risk for seizures. Which of the following medications should you not prescribe? a. Bupropion b. Venlafaxine c. Ducxetine d. Fluoxetine 48. A patient throws a vase across the room, smashing it. You are treating him for violent outbursts. Of the following, which is the best way to deal with him at this moment? a. The NP should leave the room until the patient has calmed b. Speak only to give short directions c. Process the patient’s problems d. Attempt to give the patient a solution to problems. 49. A 34yo man comes to your office saying that he may be suffering from depression. When taking a Zung depression inventory, which of the following scores indicates an increased risk of depression? The Zung Depression Inventory is made up of 20 items, a patient who scores above 50 may have increased risk of depression. A normal score would be 34 or less. The other 3 choices are all too low to indicate an increased risk for depression a. Scores of 31 b. Score of 53 c. Score of 44 d. Score of 39 50. Which of the following is known as “double depression”? a. Dysthymia and melancholic depression b. Dysthymia and cyclothymia c. Major depressive disorder d. Major depressive disorder and dysthymia P a g e 10 | 20 51. Of the following which population’s manic episodes are often misdiagnosed as Schizophrenic, attention-deficit hyperactivity disorder, or a personality disorder? a. Elder population b. African Population c. Female Population d. Adolescent Population 52. Which of the following disorders is inherited, typically develops symptoms between the ages of 30 and 50, causes dementia, and stems from a defect on chromosome 4? a. Early onset familial Alzheimer’s disease- mostly caused by single-gene mutations on chromosomes 21, 14, or 1 b. Huntington’s disease- caused by a genetic defect on chromosome 4 c. Parkinson’s disease- classified as idiopathic, many experts think the disease is caused by a combination of genetic and environmental factors, which may vary from person to person, rather than a mutation in chromosome 4. Additionally most cases develop after age 50 d. Creutzfeldt-Jacob disease- 5-10% are inherited, these cases arise from a mutation in the gene that controls formation of the normal prion protein, and typically chromosome 20 is involved 53. According to the Centers for Disease Control, which of the following is not true about self-directed violence? a. Suicidal ideation includes thinking about suicide b. A suicide attempt may or may not result in injury c. Suicide is defined only as the act of killing one’s self- The CDC defies suicide as “death caused by self- directed injurious behavior with any intent to die as a result of the behavior”. Hence the implication is not only the act, but the intent is necessary for this definition. All the other statements are true regarding suicide or suicidal ideation d. Suicidal ideation includes planning for suicide 54. Josh, a 9yo patient is experiencing a chronic motor tic disorder, which does not respond successfully to psychotherapy. After prescribing haloperidol and failing to observe a considerable improvement in the patient’s symptoms, the NP decides to use Pimozide in the course of Josh’s treatment. What diagnostic procedure should the NP consider before prescribing this drug? a. Urinalysis- used to diagnose enuuresis b. Electroencephalogram- use with ADHD if seizures are suspected c. Electrocardiogram- recommended prior to using pimozide because of the risk of QT prolongation. d. Metabolic screening for liver function enzymes- although widely recommended diagnostic procedure for patients diagnosed with tic disorder, it is not performed as a precautionary measure prior to the use of pimozide 55. Vivian, 26 has volunteered to go to Mumbai with her fellow Christian missionaries. She will be working and living with the poor and destitute. She has received all her vaccines as a child but was advised to check with her healthcare provider. Because Vivian will be staying in a crowded part of the city with poor sanitation, which vaccination is most warranted? a. Hepatitis B vaccine- blood and body fluid b. Hepatitis A vaccine P a g e 11 | 20 c. Pneumococcal vaccine- 65 or older, or children 2 and older and are immunocompromised d. Mumps vaccine- 56. You have been treating Elizabeth, a 56yo, for her anxiety. She was driving, against your recommendation, and had a car accident. She is on Medicare, and asks if her health insurance covers inpatient hospitalization. What version of Medicare covers inpatient hospitalization? Medicare A & C cover inpatient hospitalization a. Neither Medicare A nor B b. Medicare A- intended for hospitalization and other forms of inpatient services, such as skilled nursing facility services and hospice c. Both Medicare A and B d. Medicare B- covers outpatient hospitalization but no overnight stay, provides coverage aimed at medical tests and treatments, such as laboratory and diagnostic procedures, as well as the use of medical equipment during tests and treatment 57. At 11years of age, Lorena reports an intense dislike of school, especially since her English class has been broken into groups to write and perform their own version of A Midsummer Night’s Dream. Because she has gotten into trouble for her lack of follow-through with various past projects, the teacher has assigned her a small role. Lorena thinks she is being singled out and ridiculed. She tells you that she hates the idea of having to come up with her own version of the play. She also states that she is afraid of dealing with her English group because they act “all cliquey” and that she has no friends in the group. Lorena is in which of the following Eriksonian stages of development? a. Generativity vs stagnation- occurs later in life (40-59yo), and concerns attempts to contribute to the world via a career and/or family life b. Identity vs role confusion- adolescence 12-20yo c. Intimacy vs isolation- early adulthood 20-39yo and is concerned with developing close, committed relationships with other people rather than mastering tasks and group relationships d. Industry vs inferiority- a period of development in which a child’s productivity is associated with his or her self-esteem 58. A 55yo patient has battled alcoholism in the past, but he has been sober for several years. However, his recent work-related stress, recent late nights out, and the smell of his breath have all caused his wife to believe he has recently relapsed. Which of the following could detect whether the patient has been drinking? a. Aspartate aminotransferase of 34 IU/L- normal 10-34IU/L if elevated may have signs of liver damage due to alcoholism b. Carbohydrate deficient transferrin of 5%- Carbohydrate-deficient transferrin levels higher than 2.6% indicate than an individual is consuming at least 5 drinks a day for the past two weeks. c. Gamma glutamyl transferase of 45 IU/L- normal is between 0-51IU/L if elevated may have signs of liver damage due to alcoholism d. Mean corpuscular volume of 90 fL- normal 80-100fL 59. Your clinically depressed patient has attempted suicide twice in the last five years. He recently told you that he has been having overwhelming suicidal thoughts over the last week. Which of the following is the best way to proceed? a. Contact the police to have the patient arrested b. Refer the patient for a psychiatrist appointment c. Restrain the patient d. Involuntary P a g e 12 | 20 71. Your patient has been prescribed chlorpromazine to treat schizophrenia which of the following is a lifethreatening condition that could result directly from the use of antipsychotics? a. Neuroleptic malignant syndrome b. Metabolic syndrome c. Metabolic malignant syndrome d. Neuroleptic syndrome 72. Which of the following is not true about the phases of a crisis? a. Emergency problem-solving resources may still work- don’t work they are called upon and fail, further increasing the temporary disequilibrium produced in a crisis. b. Crisis produces temporary disequilibrium c. Major disorganization occurs d. Self-concept is threatened- after being confronted by a hazard 73. When counseling a patient with an anxiety disorder about the goals of treatment, which of the following statements is most accurate? a. The goal of treatment is to increase tolerance of anxiety b. The goal of treatment is to decrease the capacity for anxiety c. The goal of treatment is to do what is necessary to eliminate anxiety triggers d. The goal of treatment is to eliminate the source(s) of the anxiety all together 74. You witness a MVA in which a woman was hit by an oncoming bus. She did not have the right of way and the bus was unable to stop in time. As a NP, you rush to her aid, get someone to call 911, and perform CPR until the ambulance arrives. The woman, Nancy survived the incident but is now suing you for denying her right to commit suicide. How would the Good Samaritan statue protect you in this case? a. It protects healthcare providers from lawsuits when they aid at the scene of an accident b. It protects healthcare workers from frivolous lawsuits c. It would reveal the suicidal plaintiff to be mentally ill and without merit d. By law, it obligates healthcare workers to provide reasonable care at the scene of an accident 75. Your patient, Daniel, who is of Argentine descent, moved to Japan with his family at the age of 15. He left Japan years ago to make a new home in the US, as he feared being perceived as different and foreign while in Japan. Daniel has spent the last ten years learning the cultural norms of his new environment. However, as Daniel is proud of his heritage, he has pledged to himself to keep close his own cultural values and norms. He still speaks his first language with his family, and attempts to teach his neighbors and new friend’s words and phrases in his native language. Of the following, which socialization issue has Daniel been dealing with for the last ten years? a. Assimilation- losing all of cultural relation b. Acculturation- attempts to maintain his own cultural values and norms, while accepting and learning a new culture c. Xenophobia- what Daniel experienced in Japan fear of being perceived as foreign d. Ethnocentrism- would have to use heritage as base of judgment, and he does not 76. You suspect that 10yo Joann is being emotionally abused by her mother. Which of the following behavioral sign would most lead you to this conclusion? a. Joann steals food at the behest of her mother- suggests emotional abuse b. Joann answers in short words and sentences- suggests physical abuse P a g e 15 | 20 c. Joann is afraid to go home after your sessions with her- suggests physical abuse d. Joann acts seductive towards adults when she wants something- indicate sexual abuse 77. Your therapy with your client, Ben, is highly structured and short term. You explain that therapy will last 12-16 weeks. Ben is severely depressed and says that nothing he does will ever make a difference in his life. You tell ben that his attitude is rooted in a systemic bias because he is depressed. Your strategy is to modify Ben’s dysfunctional thinking through collaborative empiricism. What therapeutic theory are you practicing? a. Person centered therapy b. Cognitive behavioral therapy c. Gestalt therapy d. Psychoanalytic Therapy 78. What is the purpose of the reporting system established by The Patient Safety and Quality Improvement Act? a. Resolve patient safety and health care quality issues- by providing measurable data for research and analysis. Healthcare providers submit patient data safety events to the reporting system without risk of incurring any liability. The resulting database from the reporting system is then used only by “Patient Safety Organizations” and healthcare providers for research and analysis. The database may provide some information concerning patients with pre-existing conditions to healthcare providers, but this information is only incidentally part of the patient safety event. b. List patients with pre-existing conditions to healthcare providers c. List medial errors of healthcare providers and allocate liability d. Provide patients information about healthcare provider error rates 79. A 30yo comes to your office admitting he has a serious substance abuse problem. He drinks alcohol regularly throughout the day and recognizes several alcoholic traits within himself. While it has not caused any serious problems thus far, he wants to get to the roof of the problem and quit “cold turkey.” Which of the following medications would be most useful in deferring his regular alcohol consumption? a. Benzodiazepines b. Disulfiram c. Clonidine d. Thiamine 80. An 8yo child whose judgments and actions are guided by a fear of punishment as well as the possibility of reward is said to be within the pre-conventional levels according to Lawrence Kohlberg. This stage is most analogous to which of Jean Piaget’s stages of moral development? a. Moral realism b. Autonomous morality c. Social morality d. Amoral 81. You consult with a social worker who is concerned about the erratic and aggressive behavior of 15yo James. The social worker informs you that James comes from a large family and that his father has been incarcerated for domestic violence. In addition, James himself has been linked to a local gang and found guilty of petty theft. Lastly, laboratory tests conducted on James indicate elevated levels of plasma testosterone. What is the most likely diagnosis for James’s disorder? a. Attention-deficit hyperactivity disorder b. Conduct disorder P a g e 16 | 20 c. Communication disorder d. Oppositional defiant disorder 82. A 23yo presents to your office to tell you that he has been having trouble sleeping recently, so he began smoking marijuana. He says that the marijuana helps calm him down before going to sleep, otherwise he has been feeling well. However, according to his parents, he also drinks heavily before he goes to sleep. In addition, he dropped out of college six months ago because of a lack of interest and inability to focus. Additionally, after dropping out, he bought a plane ticket insisting that it was for a trip he was taking with his new girlfriend. His parents slowly realized there was no girlfriend at all, yet he insisted that she was at a nearby restaurant. Finally, the parents decided to send him to a professional. For which of the following should the patient be examined? a. Attention-deficit hyperactivity disorder and delirium tremens b. Schizophrenia and substance abuse c. Insomnia and substance abuse d. Bipolar disorder and substance abuse 83. Alma is being treated for depression with phenetzine sulfate. Which of the following is not a side effect typically associated with the class of this drug? Phenetzine sulfate is a MAOI, which can cause side effects of insomnia, dizziness, vertigo, and headaches. a. Headaches b. Dizziness c. Insomnia d. Nervousness – side effect of SSRIs not MAOIs 84. You are seeing a patient, who is committed to a facility, is threatening the safety of the other patients. What is the best initial course of action? During a possible crisis in the clinical setting, it is of utmost importance to ensure the safety of the patients and the staff. If a patient is making threats against another patient, security personnel should be present to maintain safety. a. Call the police b. Restrain the patient- could injure the patient c. Call security d. Eject the patient 85. Anna presents with an abdominal circumference greater than 37 inches, elevated triglycerides at 150mg/dl, and blood pressure of 136/85 mm Hg. Additionally, she is taking olanzapine for bipolar disorder. Which of the following is the most likely diagnosis? a. Neuroleptic malignant syndrome b. Neuroleptic syndrome c. Metabolic Syndrome d. Metabolic malignant syndrome 86. John is a violent drunkard who often beats his children. His wife, Jane, has instructed their two children to never speak to anyone about their father’s violence for fear the police would take them away and put them in foster care. As a result, the siblings would never see each other again. Jane believed this was the best way to appease John and keep the family together. The result was that one child has stopped talking and the other has P a g e 17 | 20