Neurotransmitters and Mental Disorders, Exams of Nursing

Download Neurotransmitters and Mental Disorders and more Exams Nursing in PDF only on Docsity! 16 QUESTION 1 1. Select the neurotransmitter involved in obsessive-compulsive disorder (OCD) in children and adolescents based on the common comorbidity of tic disorders.A Norepinephrine B GABA . C Dopamine . D Acetylcholine Answer: Dopamine Obsessive-compulsive disorder (OCD) is linked to defects in the cortico-striatal-thalamic-cortical (CSTC) circuitry, which may be linked to neurotransmitter dysregulation throughout this network. Serotonin, dopamine, glutamate, and -aminobutyric acid (GABA) are the main neurotransmitters throughout the CSTC. Compulsive behaviors linked to OCD are likely the product of a related dopaminergic reward system dysfunction. Continuous ventral striatum activation may lead to an undirected expectation of reward. Anxiety and a desire to fill the gap are caused by unfulfilled expectations. Step-by-Step explanation References Richter, M. A., De Jesus, D. R., Hoppenbrouwers, S., Daigle, M., Deluce, J., Ravindran, L. N., ... & Daskalakis, Z. J. (2019). Evidence for cortical inhibitory and excitatory dysfunction in obsessive compulsive disorder. Neuropsychopharmacology, 37(5), 1144-1151. Pittenger, C., Krystal, J. H., & Coric, V. (2016). Glutamate-modulating drugs as novel pharmacotherapeutic agents in the treatment of obsessive-compulsive disorder. NeuroRx, 3(1), 69- 81. 1 points QUESTION 2 1. Select the class of drugs most effective in treating pain disorder. Page 1 of 76 16 Answer : A Opioid analgesics . B TCA and SSRI . antidepressants C Beta-adrenergic . blockers D Mood stabilizers . Opioids analgesics Page 2 of 76 1 points 1 points 16 B Conversion . C Somatic . symptom D Factitious . Factitious disorder is a serious mental disorder in which someone deceives others by appearing sick, by purposely getting sick or by self-injury. QUESTION 5 1. Select two imaging methods used to study anxiety disorders. A CT . B TM . S C MRI . D EKG . QUESTION 6 1. Select the two factors that do not cause dissociative amnesia. A Sexual . abuse B Substance . abuse C Surgical pain . D Partner . betrayal Answer: A . Step-by-Step explanation The correct answer is; A. Sexual abuse D. Partner betrayal Substance abuse and surgical pain can cause dissociative amnesia. Dissociative amnesia is a disorder in which a person loses track of vital details from their past. This forgetfulness can be limited to a few key areas (thematic), or it might encompass a large portion of a person's life history and/or identity (general). Drug and alcohol usage not only raises the risk of having a co-occurring or comorbid substance use disorder, but it can also intensify dissociative amnesia symptoms. Dissociative disorders are essential to the pain physician because persistent pain can be Page 5 of 76 accompanied with dissociative symptoms. A disruption in the integrated functions of consciousness, memory, identity, or perception characterizes dissociative disorders. 16 Reference Page 6 of 76 1 points 1 points QUESTION 8 1.Select the brain region that is most implicated in the function of memory. 1 points QUESTION 9 1.Select the greatest impediment to treating anorexia nervosa patients. 16 Wagener, D. (2019, September 5). Treatment for dissociative amnesia and substance abuse. American Addiction Centers. https://americanaddictioncenters.org/dissociative- disorders/amnesia-substance- abuse-treat QUESTION 7 1. Select the correct epidemiologic fact about major depression in children and adolescents. A There is a 20% incidence by age 18 . B The incidence is equal in adolescent females and males . C There is a decreased incidence after 20 . D The incidence is five- to ten-fold greater in children with a parent or sibling . with major depression Answer:  A. There is 20% incidence by age of 18 years. Step-by-Step explanation Depression takes place at an estimated rate of around two percent during childhood and from four to around seven percent in time of the adolescence stage. This mental illness is a top cause of health impairment called the morbidity and death also known as mortality which is increasing rapidly every time. Depression is common in time of teenage years, having impacts on about 20%of adolescents by the time they reach adulthood, that is the age of 18. Reference. Jacobs, R. H., Reinecke, M. A., Gollan, J. K., & Kane, P. (2008). Empirical evidence of cognitive vulnerability for depression among children and adolescents: A cognitive science and developmental perspective. Clinical psychology review, 28(5), 759-782. A Hippocampu . s B Temporal . lobe C Amygdala . D Corpus . callosum Page 7 of 76 16 University of Amsterdam and Tilburg University and the United Kingdom's Queen Mary University Page 10 of 76 1 points 16 of London used data gathered from 42 previously conducted studies to determine how often people diagnosed with PTSD recover 10 months or more after receiving their initial diagnosis if they don't receive treatment geared toward their condition. The studies under consideration included 81,642 adults diagnosed with the disorder. On average, the studies looked at the outcomes for untreated PTSD patients over the course of 40 months. The researchers looked at the numbers of people who no longer had diagnosable cases of PTSD; they considered cases of "spontaneous" remission rather than cases of remission stemming from PTSD-specific treatment. At the low end, the recovery rate for the participants of one study was just 8 percent; at the high end, the recovery rate for the participants of another study was 89 percent. All told, 44 percent of the participants in all of the studies recovered from their condition and no longer qualified for a PTSD diagnosis. The study's authors note that the highest rates of spontaneous recovery apparently occur among people exposed to natural disaster-related trauma; conversely, the lowest rates of recovery apparently occur among people exposed to physical illness-related trauma. They also note that people diagnosed with PTSD fairly soon after developing their symptoms typically have higher chances of recovering spontaneously than people diagnosed after exhibiting symptoms for extended amounts of time. The authors believe their findings contribute considerably to the understanding of PTSD recovery, as well as the understanding of the lasting effects of specific sources of PTSD. It's critically important to point out that no one can tell who will naturally recover from the condition; for this reason, all affected individuals should seek prompt treatment from qualified mental health professionals. https://www.recoveryranch.com/addiction-blog/who-is-most-likely-to-recover-from-ptsd-without- treatment/ Significance Trauma disorders are a common and costly problem in the United States. An estimated 5.2 million American adults ages 18 to 54, or approximately 3.6 percent of people in this age group in a given year, have PTSD. In 1990, anxiety disorders cost the U.S. an estimated $46.6 billion. Untreated PTSD from any trauma is unlikely to disappear and can contribute to chronic pain, depression, drug and alcohol abuse and sleep problems that impede a person's ability to work and interact with others. According to psychologist R.C. Kessler's findings from The National Cormorbidity Survey Report (NCS) that examined over 8,000 individuals between the ages of 15 to 54, almost 8 % of adult Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely to be victims as men (5%). https://www.apa.org/research/action/ptsd QUESTION 12 1. Select the factor that is required to cause PTSD from a stressor. A Intense horror . B Isolated experience . C Concurrent substance . abuse D Survivor’s guilt . Answer is A, Intense horror. Page 11 of 76 16 Step-by-Step explanation Page 12 of 76 1 points 16 1 points QUESTION 16 1.Select the two comorbid disorders with which Pica occurs most commonly. A Enuresis . Answer : A . D Adolescents aged 13 to 15 . years Step-by-Step explanation According to studies, the prevalence of rumination disorder most often occurs in infants and very young children between 3 and 12 months and in children with intellectual disabilities. Typically, It is rare in older children, adolescents and adults. It may also occur slightly more often in boys than in girls but few studies of the disorder exist to confirm this. Thus, choice A with male infants aged 3- 12 months is the correct answer. Reference:  https://www.webmd.com/mental-health/rumination-disorder  https://www.uptodate.com/contents/ rumination- syndrome#:~:text=In%20two %20population- based%20studies,percent %20%5B7%2C8%5D. QUESTION 15 1. Select the symptom that is least associated with manic and hypomanic episodes. A Suicidal . ideation B Inflated self- . esteem C Distractibility . D Pressured . speech Answer: A . Step-by-Step explanation Hypomania and mania are periods of over-active and excited behaviour that can have a significant impact on day-to-day life. Both are symptom of bipolar disorder.The main difference between mania and hypomania is the intensity of the symptoms. Symptoms of mania are much more intense than those of hypomania. Among the given options, suicidal ideation is the least associated symptom. It can happen yes, but the 3 other choices are most common in hypomania and manic patients. B Encopresis . C Autism Page 15 of 76 16 . Page 16 of 76 Midterm 6635 PMHNP Walden University January 2021 1 points 1 points QUESTION 18 1.Select the characteristic in long sleepers (more than 9 hours) that is absent in shortsleepers (less than 6 hours). D Intellectual . disability Answer: C . and D . Step-by-Step explanation Answer: C and D - Autism and Intellectual disability According to the DSM-5, disorders most commonly comorbid with pica are disorders with impaired in functioning such as Autism Spectrum Disorder and Intellectual Disability, and to a lesser extent, schizophrenia and obsessive-compulsive disorder. Some other lesser known comorbidities are:  Trichotillomania/hair-pulling disorder  Excoriation/skin-picking disorder  avoidant-restrictive food intake disorder source:  American Psychiatric Association. (2013). Feeding and Easting disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.dsm05  https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/pica QUESTION 17 1. Select the third most commonly reported psychiatric symptom. A Depression . B Anxiety . C Psychosis . D Depersonaliza . tion Answer: C . Step-by-Step explanation Psychosis is a condition that affects the way your brain processes information. It causes you to lose touch with reality. You might see, hear, or believe things that aren't real. Common psychotic experiences include hallucinations (hearing, seeing or feeling things that are not there) and delusions (fixed false beliefs or suspicions that are firmly held even when there is evidence to the contrary). https://www.who.int/news-room/fact-sheets/detail/mental-disorders A Mildly . depressed Page 17 of 76 1 points QUESTION 21 1.Select the theorist who is credited with establishing the area of psychosomaticmedicine. A Freud . 1 points Midterm 6635 PMHNP Walden University January 2021 Step-by-Step explanation Correct Answer is Option B & Option C Treatment of dissociative amnesia (disorder) usually consists of psychotherapy, with the goal of helping the person integrate different identities, and to gain control over the dissociative process and symptoms. Therapy can be long and difficult, as it involves remembering and learning to deal with past trauma. Cognitive (that is, dealing with a patient's conscious intellectual activity) behavioral therapy has been found to be effective. Hypnosis may be another helpful treatment. A newer therapy called Eye Movement Desensitization and Reprocessing (EMDR) focuses specifically on the role that disturbing memories play in the development of mental disorders. B Abraha . m C Grodde . ck D Ferencz . i Answer: D . Step-by-Step explanation Franz Gabriel Alexander (January 22, 1891 - March 8, 1964) was a Hungarian-American psychotherapist and physician who is credited with founding psychosomatic medicine and psychoanalytic criminology. Reference Lacan, J. (1950). A theoretical introduction to the functions of psychoanalysis in criminology. Écrits: The first complete edition in English, 103-122. QUESTION 22 1. Select the disorder in children and adolescents that is described by depressed orirritable mood for most of the day for a majority of days in at least one year. A Major . depression B Cyclothymia . C Bereavement . D Persistent . depression Page 20 of 76 1 points QUESTION 23 1.Select the type of dissociative amnesia described by inability to recall any events in aparticular lifespan period. A Selective . Midterm 6635 PMHNP Walden University January 2021 Answer: D . Step-by-Step explanation Persistent depression disorder is an irritable mood that lasts for most of the day form more days than not for about one year. It leads to poor appetite or overeating. Insomnia or hypersomnia. It causes low energy or fatigue. It leads to low self- esteem, poor concentration and feelings of hopelessness. If one has persistent depression, he or she may find it hard to be upbeat even on happy occasions. They may have a gloomy personality, constantly complaining or incapable of having fun. It is usually not as severe as major depression, the depressed mood may be mild, moderate or severe. B Localized . C Generaliz . ed D Continuo . us Answer: C . Step-by-Step explanation The correct answer would be letter C. Generalized Because in this type of dissociative amnesia, a person has inability to recall encompasses the person's entire life. This type of amnesia is rare and is characterized by total loss of memories related to one's past and identity. A person may not remember anything about life before a certainpoint, including where they have been, what they have done or said, or who they were with. A person may even may loss information about the world, history, or previously-held skills. Persons have a complete loss of memory of their entire life history like their own identity. Those who experience this type of amnesia deficits in both semantic and procedural knowledge. This means that people have no common knowledge of the world like cannot identify songs, the current president, or names of colors nor do they have the ability to engage in learned skills like typing shoes and driving car. The onset of generalized amnesia is typically acute. Reference: Leong S, Waits W, Diebold C (January 2006). "Dissociative Amnesia and DSM-IV-TR Cluster C Personality Traits". Psychiatry (Edgmont). 3 (1): 51-5. PMC 2990548. PMID 21103150 Page 21 of 76 QUESTION 25 1. Select the two symptoms that result from prolonged sleep deprivation. 1 points 1 points QUESTION 24 1.Select the frequency range of heritability of bipolar disorder. Midterm 6635 PMHNP Walden University January 2021 A 60%- . 90% B 50%- . 80% C 30%- . 60% D10%-40% Answer: A. 60%-90% Step-by-Step explanation Bipolar disorders are 80% to greater than 90% heritable. Therefore, from the choices given 60% - 90% is the appropriate range. 1 points A Ambition . B Hallucinati . ons C Contented . ness D Irritability . QUESTION 26 1. Select the most likely stressor to cause an adjustment disorder. A Medical . illness B Natural . disaster C Vehicle . accident D Substance Page 22 of 76 Midterm 6635 PMHNP Walden University January 2021 QUESTION 32 1.Select the two medical conditions in which derealization and depersonalization arecommon. A Anorexia . 1 points 1 pointsQUESTION 31 1. Select the behavior that best describes early onset bipolar disorder in children and adolescents. A Aggressi . on B Withdra . wal C Panic . D Exhibitio . n Answer: B . Step-by-Step explanation Bipolar disorder is a chronic mental health condition commonly known as manic-depressive disease or bipolar affective disorder. Bipolar disorder is diagnosed when a youngster goes through episodes of extreme moods, ranging from bursting with so much activity that he can't sleep or sit still to crushing depression that leaves him unhappy and withdrawn. Reference Biederman, J., Mick, E., Wozniak, J., Aleardi, M., Spencer, T., & Faraone, S. V. (2015). An open- label trial of risperidone in children and adolescents with bipolar disorder. Journal of Child & Adolescent Psychopharmacology, 15(2), 311-317. B Migraine . C Parkinso . n’s D Seizures . Answer: A . and D . Step-by-Step explanation Options A and D are the correct answers. In seizure and anorexia, derealization and depersonalization. Depersonalization and or derealization disorder is a form of dissociative illnesscharacterized by chronic or repeated experiences of being disconnected (dissociated) from one's body or mental Page 25 of 76 Midterm 6635 PMHNP Walden University January 2021 processes, sometimes accompanied by a sense of being an outside observer of Page 26 of 76 Midterm 6635 PMHNP Walden University January 2021 one's life (depersonalization) or being disconnected from one's surroundings (derealization) is common. This type of disorder is often triggered by severe stress . In anorexia, a disorder characterized by abnormal low body weight and an intense fear of gaining weight with distorted perception about weight, often cause severe stress due to constant worries about food and weight leading to anxiety, depression, and low self-esteem level. In seizure, both ictal (period from the first symptoms to the end of the seizure activity) or postictal (begins when a seizure subsides and ends when the patient returns to normal), areas of the brain responsible for emotions and responding to stress are greatly affected. Patients with ictal depersonalization-like symptoms have impaired self-identification with their bodies and usually have frontal lobe epilepsy with the epileptogenic zone in the dorsal premotor cortex, whereas patients with derealization-like symptoms have temporal lobe epilepsy with the epileptogenic zone in the temporal lobe. ***Both options B and C are incorrect because there is no substantial evidence that derealization and depersonalization are common in migraine and Parkinson's disease. Reference: 1.Spiegel, D. (2021, March) Depersonalization/Derealization Disorder - Psychiatric Disorders. MSD Manual Professional Edition. Retrieved on May 27, 2021, from https://www.msdmanuals.com/professional/psychiatric-disorders/dissociative- disorders/depersonalization-derealization- disorder#:~:text=Depersonalization %2Fderealization%20disorder%20is%20a,of%20being% 20detached%20from %20one's 2.Heydrich, L., Marillier, G., Evans, N., Seeck, M., & Blanke, O. (2019, August 22) Depersonalization- and derealization-like phenomena of epileptic origin. NCBI. Retrieved on May 27, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764488/ 1 points QUESTION 33 1. Select the age stage of life in which identity crisis typically emerges. A Childhood . B Adolescen . ce C Middle . adult D Elderly . adult Answer: B . Step-by-Step explanation The answer is B. Adolescence. Adolescents are children who are transitioning to be adults. It is at this age that people have to commit to certain life-changing choices such as choosing a career path, dating potential lifetime partners, and sometimes, even moving out of their own homes. Thus, a lot of adolescents end up Page 27 of 76 Midterm 6635 PMHNP Walden University January 2021 A 2 Page 30 of 76 1 points 1 points QUESTION 37 1.Select the minimum treatment time to assess the effectiveness of antidepressantdrug therapy. Midterm 6635 PMHNP Walden University January 2021 . B 3 . C 4 . D 6 . Answer: A . Step-by-Step explanation The correct answer is C not A. Diagnosis of encopresis is done when the child is at least 4 years and is experiencing repeated leakage or passing of faeces in inappropriate places. QUESTION 36 1. Select the mg/dL blood alcohol level range that is associated with causing impairedjudgment and coordination. A 20 to 40 . B 50 to . 100 C 100 to . 130 D 140 to . 190 Answer: B . Step-by-Step explanation The blood alcohol range that the researches have found to be associated with causing impaired judgment and coordination is 50 to 100mg/dl. After that, i.e., from 100-130mg/dl, the condition becomes even more severe and the person also starts exhibiting symptoms of slurred speech, disorientation and loss of control over voluntary muscles. Therefore, the answer is B. 50 to 100 mg/dL Source: Monico, N. (2020). Blood Alcohol Level & Effects on the Body. American Addiction Centres. A 1-2 . weeks Page 31 of 76 1 points QUESTION 39 1.Select the psychiatric disorder for which drug and nondrug treatments are leasteffective. A Dissociative 1 points Midterm 6635 PMHNP Walden University January 2021 B 3-4 . weeks C 6-8 . weeks D 10-14 . weeks Answer: C Step-by-Step explanation When it comes to antidepressant drug therapy, it usually takes 6-8 weeks before the effects of thedrugs are realized. This means that it will take an individual at least six weeks before they start experiencing the benefits of antidepressant drug therapy. For other individuals, it can take up to eight weeks before they can start seeing the benefits of antidepressants. Therefore, anything along the timelines of 6-8 weeks is ideal for a person to start realizing the effects of the drugs. QUESTION 38 1. Select the exposure to violence that is excluded as a DSM-5 diagnostic criterion forPTSD in children and adolescents. A Electronic media . B Directly witnessed . C Report of family . member D Repeated natural . disaster Answer: A . Step-by-Step explanation The answer is A. Electronic Media PTSD--post-traumatic stress disorder--is characterized by exposure to traumatic experiences, hence, the name. Among these experiences, included are: directly experiencing actual or threatened death, serious injury, or sexual violence. PTSD can also be diagnosed if the person experienced the aforementioned events vicariously, either by witnessing it in person or by learning that a loved one went through such experiences. Lastly, repeated exposure to aversive details of the traumatic events can also be considered as a qualifier for a PTSD diagnosis. Among the choices, only option A. Electronic Media is not included in the DSM-V criteria. It is also specifically mentioned in the DSM-V that: "Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related." Page 32 of 76 Midterm 6635 PMHNP Walden University January 2021 Erickson Page 35 of 76 Midterm 6635 PMHNP Walden University January 2021 Erik Erikson developed the 8 stages of Psychosocial Development 1 points QUESTION 44 1. Select the two common characteristics of illness anxiety disorder. A Avoidance of provider . evaluation B Few or lack of somatic . symptoms C Frequent provider visits . D Presence of a fixed . delusion Answer: B . and C . Step-by-Step explanation Illness anxiety disorder (formerly known by its derogatory meaning as hypochondriasis) more commonly starts early in adulthoods and seems to happen similarly in males and females. The worries of a patient might result through misconstruing the physical effects or typical body functioning . It is characterized by an excessive worry of a catastrophic physical issue while having little or no signs. Individuals with IAD see many doctors for signs that they feel are associated with a health concern or that clinical signs are much more significant than what they are. Although there is no medical problem, the worries people experiencing IAD are very significant and the worry they feel can create major disturbances in routine day- to-day operations.Following medical examination and lab testing, a disease anxiety disorder is often identified with normal results, however the person stays concerned and worried over underlying medical conditions. IAD treatment is made on the indications, medical records, test findings and symptoms associated of mental health, such as serious anxiety. The reality that persons with this illness are not comforted by regular tests or lab tests may confound diagnosis and thus ignore their physician's conclusions and look for a different provider. One person must look like the following in order to be diagnosed with illness anxiety disorder: Excessive concern for a critical or existence disease Lack or minor somatic signs, Severe health concerns and anxieties and Frequent illness checks and even illness signs. Individuals with illness anxiety disorder are just so worried that they really are or may become ill that worry affects the functionality of today 's society or causes severe discomfort. Individuals may have physical ailments, or may not, however, if they do, they are more concerned with the probable symptoms than with the symptoms. Several individuals constantly examine themselves . New physical feelings are quicklyfrightened. Some people often see doctors (kind of treatment); others seldom seek medical care. A person monitors the health status constantly or skips visits to the doctor and institutions maladaptively. No or mild somatic symptoms are present in the patient. 1 points QUESTION 45 1. Select the serum assessment that is required when prescribing drugs to treat psychiatric disorders in psychosomatic patients. A Potassium Page 36 of 76 Midterm 6635 PMHNP Walden University January 2021 . Page 37 of 76 QUESTION 49 1. Select the event most associated with the occurrence of dissociative fugue. 1 points 1 points Midterm 6635 PMHNP Walden University January 2021 Step-by-Step explanation Magnesium This is because deficiency of magnesium causes restless leg syndrome. QUESTION 48 1. Select the scientist who is most associated with the development of learning theory. A Piaget . B Ainswor . th C Bowlby . D Pavlov . Answer: A . Step-by-Step explanation From the set of choices given, the scientist who is most associated with the development of learning theory is option (a) which is Piaget. Jean Piaget is mostly associated with the theory of learning due to his development of theory of cognitive development in children. His theory focuses on studying two key aspects that promote learning. These aspects are; how little children acquire knowledge and comprehending the nature of intelligence in children. Piaget presents his theory of cognitive development in four stages which are the sensorimotor, the preoperational, the concrete operational stage and the formal operational stage. A Head trauma . B Substance . abuse C Partner . betrayal D Unplanned . travel Answer: D Step-by-Step explanation Dissociative fugue is a reversible kind of amnesia that affects one's personality, memories, and sense of self. Temporary amnesia can continue for hours, days, weeks, months, or even longer. It Page 40 of 76 Midterm 6635 PMHNP Walden University January 2021 entails a person's wandering or unplanned trip, during which they may form a new identity in a new area that is considerably different from their previous existence. Adults are more likely to have dissociative fugue, which generally happens during the second and fourth decades of life. While males appear to be afflicted at the same rate as women, the number of males suffering from dissociative fugue increases during wartime. Reference Coons, P. M. (1998). The dissociative disorders: Rarely considered and underdiagnosed. Psychiatric Clinics of North America, 21(3), 637-648. 1 points QUESTION 50 1. Select the drug proven most effective in treating PTSD. A Buspiro . ne B Paroxeti . ne C Trazodo . ne D Clonidin . e Answer: B . Step-by-Step explanation Correct answer: B. Paroxetine Hello student, there is not option B so I answered E, but the correct answer is B. Paroxetine. Along with Paroxetine, Sertraline are the only drugs that are approved to treat PTSD. 1 points QUESTION 51 1. Select the percentage that most accurately represents the rate of heritability ofmajor depression. A 1 . 5 B 3 . 0 C 4 . 5 D 6 . 0 Answer: C Step-by-Step explanation Page 41 of 76 Midterm 6635 PMHNP Walden University January 2021 According to research that was done and published by Stanford University, the rate of heritability of major depression is between 40%-50%(F. Levinson and E. Nichols, n.d.). The research even goes on to say that the percentages could be higher in that genetics could play a part in 50% of the cases, whereas other factors could play a part in the rest of the cases(F. Levinson and E. Nichols, n.d.). Therefore, based on the percentages that have been expressed above, I believe that 45% falls between the ranges that have been given in the study, which means that choice C is most likely the correct answer. Reference F. Levinson, D. and E. Nichols, W., n.d. Major Depression and Genetics. [online] Genetics of Brain Function. Available at: <https://med.stanford.edu/depressiongenetics/mddandgenes.html> [Accessed 26 May 2021]. 1 points QUESTION 52 1. Select two neurotransmitters associated with anxiety. A Dopami . ne B Glutam . ate C Serotoni . n D GABA . Dopamine and Serotonin and other nuerotrasmitters like norepinephrine, and gamma-aminobutyric acid (GABA) neurotransmitters are in charge of regulating various bodily and mental functions 1 points QUESTION 53 1. Select the drug with the most rapid onset of action to treat acute mania. A Lithium . B Clonazep . am C Lamotrigi . ne D Valproate . Answer: D . Step-by-Step explanation Unlike Lithium, Valporate has a rapid onset of action producing significant results in clinical trials within the span of 1 week and is effective as well in treating mixed and classic mania. Page 42 of 76 1 points 1 points Midterm 6635 PMHNP Walden University January 2021  GAD affects twice as many women as it does males and it usually manifests itself over the course of a few years in early to middle adulthood. If left untreated, intense concern might gradually impair one's ability to do daily tasks like driving a car or falling asleep.  Patients with a later beginning of GAD are more likely to indicate that their symptoms began as a result of a major stressful incident in their life. When a person is diagnosed with GAD, the illness usually lasts a long time. During times of stress, the intensity of symptoms may fluctuate and worsen. Reference Zimmerman, M., & Chelminski, I. (2003). Generalized anxiety disorder in patients with major depression: is DSM-IV's hierarchy correct?. American Journal of Psychiatry, 160(3), 504-512. QUESTION 56 1. Select the percentage range of correlation between obesity and psychiatric disorders. A 10 to . 20 B 20 to . 30 C 40 to . 60 D 50 to . 70 Answer: B . Step-by-Step explanation Obesity is associated with an approximately 25% increase in odds of mood and anxiety disorders and an approximately 25% decrease in odds of substance use disorders. Variation across demographic groups suggests that social or cultural factors may moderate or mediate the association between obesity and mood disorder. Reference https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1913935/ QUESTION 57 1. Select the obsessive-compulsive disorder for which a patient is likely to initially seekhelp from a non-psychiatric provider. A Hoarding . B Excoriation . C Hair-pulling . D Body . dysmorphia Page 45 of 76 Midterm 6635 PMHNP Walden University January 2021 Answer: Page 46 of 76 1 points QUESTION 59 1.Select the age group in which adjustment disorders occur most frequently. Midterm 6635 PMHNP Walden University January 2021 A . Step-by-Step explanation Hoarding is not a psychiatry disorder while hairpulling, excoriation, and body dysmorphia are mental ailments linked to obsessive-compulsive disorder. Hairpulling and excoriation can lead to harming of the physical body as well as low self-esteem. Body dysmorphia can cause suicidal thoughts because of embarrassment, shame, and poor self-image. These serious consequences can only be solved by a psychiatrist if left untreated. Research has shown that hoarding is unrelated to OCD and can be an indication of a different condition deprivation of items during childhood. Hoarders can get help or support from family members or counselors, not necessarily a psychiatrist. 1 points QUESTION 58 1. Select two types of theories that have contributed to causes of anxiety. A Psychoanalytic . theory B Behavioral . theory C Family . D Group . Answer: A . and B . Step-by-Step explanation A. Psychoanalytic Theory B. Behavioral Theory A and B are two theories that have contributed to causes of anxiety. A Childhood . B Middle . adult C Young . adult D Adolescen . t Page 47 of 76 1 points 1 points Midterm 6635 PMHNP Walden University January 2021 Answer: D . Step-by-Step explanation Anxiety. QUESTION 62 1. Select the public performance that is most associated with social anxiety in children. A Dancin . g B Speaki . ng C Athleti . cs D Eating . Answer: B Step-by-Step explanation Physical symptoms of social anxiety include nausea, stomach pain, flushing, and trembling. It's easy to miss signs of social anxiety. This is due to the fact that at preschool or school, children with social anxiety are frequently quiet and obedient. They may not express their anxieties or concerns. Children who are teased, bullied, rejected, ridiculed or humiliated are more likely to develop social anxiety disorder. Other unpleasant life events, such as family conflict, trauma or abuse, may also be linked to social anxiety disorder. Reference Cartwright-Hatton, S., Tschernitz, N., & Gomersall, H. (2015). Social anxiety in children: social skills deficit, or cognitive distortion?. Behaviour research and therapy, 43(1), 131-141. QUESTION 63 1. Select the anxiety disorder that emerges in ages 9 to 18 months. A Separatio . n B Generaliz . ed C Social . D Traumati . c Page 50 of 76 Midterm 6635 PMHNP Walden University January 2021 Answer: Page 51 of 76 QUESTION 64 1.Select the neurodevelopmental disorder typically diagnosed in childhood. A Bipolar I 1 points QUESTION 65 1.Select the maximum time period recommended for treatment of insomnia withhypnotic drugs. A 1 week Midterm 6635 PMHNP Walden University January 2021 A . Step-by-Step explanation They become fussy when not around their caretaker but gradually goes away throughout early childhood. 1 points . B Major . depression C Intellect . D Agoraphobia . Answer: C . Step-by-Step explanation Intellectual disability (ID) is characterized by less than average intelligence and suffering or struggling mental ability. Children who significantly lack in skills, memory, motor skills, and whatnot (relative to their age and period of development) are symptomatic of ID, which makes children with this neurodevelopment disorder fairly easily recognized in most cases. More mood- related disorders such as depression and bipolar are more often detected in adolescence or adulthood, not childhood. . B 2 . weeks C 1 . month 6 month . s Answer: D . Step-by-Step explanation the hypnotics drugs are generally must be prescribed for a short period of time only, this is because the hypnotic drugs are federally controlled substances and the are also addictive. therefore the maximum time of the prescription is 6 months, so the answer is choice D Page 52 of 76 D 1 points QUESTION 71 1.Select the therapeutic plasma concentration range for lithium in mEq/L. 1 points Midterm 6635 PMHNP Walden University January 2021 A Dopamine . B Corticotrophin . releasing C Serotonin . D Melatonin . Answer: D . Step-by-Step explanation The correct answer is choice D, Melatonin. Melatonin is a key hormone in synchronizing the body's clock. This hormone plays a role in a variety of biological and physiological processes in the body. It's a useful hormone for regulating human biorhythms (circadian rhythm). This hormone's primary function is to regulate the body's rhythm and maintain the biological clock. Melatonin has a sedative impact as well as the ability to synchronize the sleep-wake cycle. It's also important for keeping the body's temperature in check. In a variety of circadian rhythm disorders, melatonin rhythms are disrupted. QUESTION 70 1. Select the cognitive function category in a mental status examination that is represented by the question, “Starting at 3 A.M., count back the time 2 hours at a time.” A Orientation . B Concentrat . ion C Calculation . D Alertness . Answer: B . Step-by-Step explanation The answer is B. Concentration. Mental status examinations usually examine five areas of cognition: alertness, orientation, attention/concentration, memory, and abstract reasoning. Among these, what fits the description mentioned above is attention/concentration. Concentration refers to how attuned the person is to the questions that are being asked. This is usually measured by asking them to do certain tasks such as spelling a word or counting backwards. Page 55 of 76 1 points Midterm 6635 PMHNP Walden University January 2021 A 0.1- . 0.5 B 0.6- . 1.2 C 1.4- . 1.9 D 2.0- . 2.6 Answer: B . Step-by-Step explanation Answer B. 0.6 - 1.2  The therapeutic range for lithium has been established at 0.6 - 1.2 mmol/L. Within this range, most people will respond to the drug without symptoms of toxicity.  Response and side effects vary among individuals. For some people with bipolar disorder, their condition will not be adequately treated at the low end of the therapeutic range. Others may experience excessive side effects at the upper end of the therapeutic range. You should work closely with your healthcare practitioner to find the dose that works best for you.  In general, when lithium results are in the therapeutic range and both your and your healthcare practitioner are satisfied that your bipolar disorder is being appropriately managed, then the dosage of lithium is adequate, particularly if you are not experiencing significant side effects.  If the blood level is below the therapeutic range, it is likely that you are not receiving adequate medication. If levels are above the therapeutic range and if there are significant side effects present at the current dose, then it is likely that the dose is too high. In these cases, your healthcare practitioner may adjust the lithium dose. However, you should not decrease or stop taking your medication without consulting with your healthcare practitioner as it can worsen your bipolar symptoms. Dose determinations and adjustments must be evaluated on a case-by- case basis. https://labtestsonline.org/tests/lithium QUESTION 72 1. Select the rating scale used to assess children and adolescents for ADHD. A Connors . B CBCL . C Achenba . Page 56 of 76 1 points 1 points QUESTION 73 1.Select the primary cause of reactive attachment disorder in children. A Death of mother . Midterm 6635 PMHNP Walden University January 2021 ch D DISC . Answer: B . Step-by-Step explanation Answer: (B). CBCL The Child Behavior Checklist (CBCL). It is a checklist that parents complete to detect emotional and behavioral problems in children and adolescents ages 6 to 18. It is often used as a diagnosticevaluator, but autism spectrum disorders. It was designed by psychologist Thomas M. Achenbach in 1966. In conducting studies of common behaviors and problems in children and adolescents, he used his findings to create a questionnaire that describes and detects those behaviors. These behaviors are meant to be easily identifiable by parents, caregivers, teachers, and others. B Bullying by peers . C Negligent . parenting D Fetal alcohol . syndrome Answer: C . Step-by-Step explanation The correct answer is C. Negligent parenting  Young children develop reactive attachment disorder due to emotional or physical negligence by their parents or their care givers. It occurs when a young children's connection to their caregiver is either absent or disrupted as a result of highly poor treatment. This might occur due to a variety of factors, like ignoring the children's mental demands for comfort, excitement, and love on a regular basis.  If a kid's essential necessities for pleasure, love, and caring are not addressed, and compassionate, loving, solid bonds with others are not created, reactive attachment disorder may emerge. QUESTION 74 1. Select the rating scale used to assess significant alcohol problem. A BPRS . Page 57 of 76 January 2021Midterm 6635 PMHNP Walden University . drugs Page 60 of 76 1 points Midterm 6635 PMHNP Walden University January 2021 B Behavioral . modification C Antianxiety drugs . D Individual . psychotherapy Answer: C . Step-by-Step explanation The correct choice is D. Individual psychotherapy. Individual therapy is a sort of psychotherapy in which a trained professional assists a single person in resolving personal problems. It is a successful treatment for a wide range of emotional problems and mental diseases. 1 points QUESTION 79 1. Select the most exclusive feature rapid eye movement (REM) sleep. A Bradycardia . B Relaxation of skeletal . muscles C Dreaming . D Tachypnea . Answer: B Step-by-Step explanation The answer is C) Dreaming. Note: I have chosen option B because option C was not given. QUESTION 80 1. Select the DSM-5 disorder formerly called multiple personality disorder. A Depersonalizati . on B Dissociative . fugue C Dissociative . identity D Derealization . Page 61 of 76 Midterm 6635 PMHNP Walden University January 2021 Answer: Page 62 of 76 Midterm 6635 PMHNP Walden University January 2021 Denial of symptoms Page 65 of 76 Midterm 6635 PMHNP Walden University January 2021 Insisting weight loss has a medicalcause Secrecy regarding eating rituals 1 points QUESTION 85 1. Select the two types of symptom patterns common to OCD patients. Answer : D . A Recurrent . nightmares B Flight of ideas . C Intrusive . thoughts D Contamination . Step-by-Step explanation Hello dear student. The answers are C and D but I can only check one answer above (no C 1 points QUESTION 86 1. Select the rating scale used to screen for Alzheimer’s disease and other dementias. A BPRS . B YBOC . S C NPI . D BDI . Answer: A . Step-by-Step explanation The BPRS or the Brief Psychiatric Rating scale is actually for the domains of Schizophrenia but isalso used in persons with Alzheimers. This rating scale is composed of 24 symptoms that are to be assessed with a covering range of affective, psychotic and also behavioral disturbances. It is typically done in about 10 minutes. Also, it can be used to be able to assess the different phenomenological changes that are occurring in the psychopathology as the disease progresses just like dementia. References: Kaplan & Sadocks: Synopsis of Psychiatry Page 66 of 76 1 points 1 points January 2021Midterm 6635 PMHNP Walden University retrieved from: https://bjgp.org/content/65/637/416#:~:text=Brief%20Psychiatric%20Rating %20Scale&text=The% 20BPRS%20assesses%2024%20symptoms,psychopathology%20as %20the%20disease%20pro gresses. retrieved from: https://academic.oup.com/geronj/article- pdf/39/2/194/1509043/39-2-194.pdf QUESTION 87 1. Select the most effective treatment for social anxiety disorder in children. A Bupropion and SNRI antidepressants . B Cognitive-behavior therapy (CBT) and SSRI . antidepressants C Cognitive-behavior therapy (CBT) and . amitriptyline D Coaching approach behavior and leading by . modeling Answer: B . Step-by-Step explanation According to research and studies the most effective treatment for social anxiety disorder in children are cognitive behavioral theraphy CBT and SSRI antidepressants. Cognitive behavioral therapy (CBT) is a type of psychotherapy that is especially useful for treating social anxiety disorder because it teaches an individual different ways of thinking, behaving, and reacting to situations that help him feel less anxious and fearful. It can also help the individuals having social anxiety disorder to learn and practice social skills which is very helpful and effective to kids. While SSRI or selective serotonin reuptake inhibitors, are kind of antidepressants that have proven effective at managing some symptoms of social anxiety disorder. Medications called beta blockers may also be prescribed to curb the fear response and reduce physical symptoms of anxiety, such as palpitations and sweating. QUESTION 88 1. Select the two diagnostic criteria of somatic symptom disorder or hypochondriasis. A Persistence for at least 6 . months B Presence of suicidal . ideation C Lack of medical evidence . D Co-occurrence of . substance abuse Answer: Page 67 of 76 January 2021Midterm 6635 PMHNP Walden University Answer: C . Step-by-Step explanation Answer: 3 days A drug detection window is the amount of time that a drug may be detected in a biological sample for instance urine, blood, breath, or oral secretions. The presence of the significant THC-COOH > LOQ implies that the individual was exposed to THC within 3 days of a single usage, up to 30 days in strong chronic users. Reference Huestis, M. A., Henningfield, J. E., & Cone, E. J. (2018). Blood cannabinoids. II. Models for the prediction of time of marijuana exposure from plasma concentrations of Δ9-tetrahydrocannabinol (THC) and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THCCOOH). Journal of analytical toxicology, 16(5), 283-290. 1 points QUESTION 92 1. Select the delay of time between exposure to the stressor and onset of PYSD symptoms. A 1 month to 3 . years B 6 weeks to 10 . years C 6 months to 5 . years D 1 week to 30 . years 1 points QUESTION 93 1. Select the nondrug therapy approved for use in patients who have failed to achievesatisfactory improvement with correctly prescribed antidepressant drugs. A Transcranial magnetic .stimulation B Phototherapy . C Vagal nerve stimulation . D Psychoanalysis . Answer: The correct answer is (A). Transcranial magnetic stimulation. Page 70 of 76 January 2021Midterm 6635 PMHNP Walden University 1 points QUESTION 94 1.Select a provider’s most important knowledge area essential to a successful mentalhealth interview of a child.  Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression.  When other depression therapies have failed, TMS is commonly employed.  Repeating TMS or rTMS, is a therapy for depression that includes the delivery of repetitive magnetic pulses.  An electromagnetic coil is placed on your scalp near your forehead during a rTMS session.  The electromagnet emits a painless magnetic pulse that activates nerve cells in the part ofyour brain that controls mood and sadness.  It's supposed to stimulate brain areas that are less active in depressed people.  Though the biochemistry of why rTMS works isn't fully known the stimulation appears to change the way the brain function which appears to alleviate depressive symptoms and enhance mood. Step-by-Step explanation Reference Cleare, A., Pariante, C. M., Young, A. H., Anderson, I. M., Christmas, D., Cowen, P. J., ... & members of the Consensus Meeting. (2015). Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. Journal of Psychopharmacology, 29(5), 459-525. A Normal . development B Cultural . background C Sibling position . D Medical history . Answer: D . Step-by-Step explanation As according to the experts, the mental health interview of a child is conducted by a clinicians in order to gathered informations about the child and help them assess his or her mental health and be able to provide the support and necessary treatment. In addition, experts noted that the interview must conduct in a quiet place in a friendly and professional manner. Moreover, in doing the mental health interview of a child, a provider must have the essential knowledge in the most important area which is the medical history. As experts stated, a medical history have all the necessary informations such as past diseases, present illness, symptoms, diseases in the family and contents about the child medical concern which will allow the provider to fully analyze and evaluate a child during the interview. Therefore, a provider who knows the medical history of a child will be able to conduct an effective interview which will allow to determine the child's mental health status by relating symptoms to the past illness and connect it to the present illness. With that, a provider will be able to identify the support needed and the most appropriate treatment plan for the child. Page 71 of 76 1 points January 2021Midterm 6635 PMHNP Walden University 1 points QUESTION 96 1.Select the youngest age range at which alarm therapy is effective to treat enuresis. Overall, medical history is the most important knowledge area that the provider must have in order to conduct a successful mental health interview which will allow them to clearly diagnose the child's mental health status which leads to provide the medicinal support and treatment plan suitable for the child. QUESTION 95 1. Select the drug that has been effective in treating social anxiety in children. A Bupropion . B Carbamaze . pine C Amitriptylin . e D Fluoxetine . Answer: D . Step-by-Step explanation SSRIs, or selective serotonin reuptake inhibitors, have proven effective at managing some symptoms of social anxiety disorder. Medications called beta blockers may also be prescribed to curb the fear response and reduce physical symptoms of anxiety, such as palpitations and sweating. Fluoxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. A 11 to . 12 B 9 to . 10 C 6 to 7 . D 5 to 6 . Answer: C . Step-by-Step explanation The answer is c.) ages 6 to 7 Page 72 of 76 January 2021Midterm 6635 PMHNP Walden University significant spaces of working consistently. Page 75 of 76 1 points QUESTION 100 1.Select two signs and symptoms of bulimia nervosa. Midterm 6635 PMHNP Walden University January 2021 A Weekly binge eating for at least three . months B Abuse of emetic drugs and substances . C Greater weight loss than with anorexia . nervosa D Binge eating and purging is most . common in winter Answer: A . and B . Step-by-Step explanation Individuals suffering from Bulimia Nervosa have recurrent episodes of binge eating followed by inappropriate compensatory behaviors in order to prevent weight gain. These compensatory behavior may include self-induced vomiting or the use of laxatives or some emetic drugs to induced vomiting. And in order to qualify for the diagnosis these binge eating and inappropriate compensatory behavior has been present on an average of at least once a week for 3 months. Page 76 of 76