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NR 547 PMHNP MIDTERM AND FINAL EXAM
ACCURATE REAL EXAM
QUESTIONS WITH DETAILED ANSWERS GRADED A+
The Criterion A for Acute Stress Disorder include traumatic events that are experienced directly such as exposure to war, threatened or actual violent assault, natural or manmade disasters and severe accidents. - ✔✔✔ Correct Answer > Acute Stress disorder Criterion A Soledad meets the DSM-5 criteria for illness anxiety disorder. No somatic symptoms are present. Repeated and excessive reassurance and medical care visits are present. The preoccupation with having a serious illness has been present for at least 6 months. There is a high level of anxiety about personal health status. - ✔✔✔ Correct Answer > Illness anxiety disorder Roberto is a 26-year-old male who intentionally punctured his foot with a rusty nail and smothered the wound with dirt. Several days later he sought medical care. He verbalized to his PCP that he must have stepped on something while walking his dog. In the absence of secondary gain, this example best represents factitious disorder. - ✔✔✔ Correct Answer > Factitious disorder
Schizophrenia is associated with high hereditability. In identical twins, the concordance rate of schizophrenia is close to 50%. - ✔✔✔ Correct Answer > Schizophrenia A dissociative episode characterized by sudden violent behavior often followed by amnesia, mostly found amongst males in Malaysia and Indonesia. - ✔✔✔ Correct Answer > Amok The examiner palpates in the right upper abdominal quadrant below the costal margin while the patient breathes in; positive if pain is observed during inhalation. - ✔✔✔ Correct Answer > Murphy's sign Factors that increase the likelihood of homelessness, with education being an exception for single female-headed households. - ✔✔✔ Correct Answer > Risk factors for homelessness Electrophysiologic test that depicts electrical activity on the surface of the brain. - ✔✔✔ Correct Answer > EEG Being loyal and keeping promises; faithfulness to one's duties, promise keeping or the commitment to obligations. - ✔✔✔ Correct Answer > Fidelity
A diagnostic imaging test that uses magnetic fields and radio waves to create detailed images of the brain. - ✔✔✔ Correct Answer > Brain MRI A state of increased physical movement associated with mental tension. - ✔✔✔ Correct Answer > Psychomotor agitation A test that measures porphobilinogen levels in urine, often used in evaluating certain metabolic disorders. - ✔✔✔ Correct Answer > Urinary porphobilinogen The condition in which the patient is unable to discriminate between objects based on touching. - ✔✔✔ Correct Answer > Astereognosis A systematic inquiry that elaborates on the chief complaint while eliciting pertinent positive and negative factors from the history. - ✔✔✔ Correct Answer > Review of systems A chronic condition that affects the way the body processes blood sugar (glucose).
- ✔✔✔ Correct Answer > Type 2 diabetes A decline in cognitive function that affects memory, thinking, and reasoning. - ✔✔✔ Correct Answer > Cognitive impairment
A lack of emotional expression. - ✔✔✔ Correct Answer > Flat affect The inability to feel pleasure in normally pleasurable activities. - ✔✔✔ Correct Answer > Anhedonia A measure of the amount of alcohol present in a person's bloodstream. - ✔✔✔ Correct Answer > Blood alcohol level A test that examines urine for various substances and characteristics. - ✔✔✔ Correct Answer > Urinalysis A test to measure the amount of acetaminophen in the blood, often used in cases of suspected overdose. - ✔✔✔ Correct Answer > Acetaminophen level Housing options that are not available or affordable for certain populations. - ✔✔✔ Correct Answer > Inaccessible housing options
The first action the PMHNP should take when evaluating a patient with potential hearing issues. - ✔✔✔ Correct Answer > Ear canal examination A condition evaluated in a patient with a history of alcohol use disorder and negative blood alcohol level. - ✔✔✔ Correct Answer > Altered mental status A test that should be ordered before diagnosing psychosis not otherwise specified. - ✔✔✔ Correct Answer > Serum ceruloplasmin A lung sound most likely heard in a patient in acute respiratory distress after choking. - ✔✔✔ Correct Answer > Stridor A treatment for treatment-resistant depression with amnesia as the most common adverse effect. - ✔✔✔ Correct Answer > Electroconvulsive therapy (ECT) Chest pain with activity and relieved at rest, indicative of myocardial ischemia. - ✔✔✔ Correct Answer > Angina pectoris A stage not mastered by a timid middle-school girl who avoids risks and does not ask questions. - ✔✔✔ Correct Answer > Developmental stage: Initiative versus Guilt
The most important test to determine the etiology of new onset psychosis in a patient with poly substance use disorder. - ✔✔✔ Correct Answer > Human Immunodeficiency Virus (HIV) testing Chlordiazepoxide should not be used in a patient with familial fatty liver disease and elevated liver enzymes. - ✔✔✔ Correct Answer > Benzodiazepine contraindication Recurrent bouts of anxiety associated with chest pain, tachycardia, tremors, nausea, diaphoresis, and an impending sense of doom. - ✔✔✔ Correct Answer > Anxiety symptoms The most appropriate adjunctive psychotherapy for a patient with ongoing symptoms despite SSRI treatment. - ✔✔✔ Correct Answer > Cognitive behavioral therapy Worry that is in proportion to the impact of the anticipated event. - ✔✔✔ Correct Answer > Non pathological worry
400 mg taken by the patient for pain relief. - ✔✔✔ Correct Answer > Ibuprofen dosage Blood pressure 120/80, heart rate 88, respiratory rate 12, SPO2 96% on room air. - ✔✔✔ Correct Answer > Vital signs Occasional occurrences where a child fears not finding parents in a large gathering. - ✔✔✔ Correct Answer > Nightmares The creation of false memories in the absence of the intention to deceive. - ✔✔✔ Correct Answer > Confabulation A condition that may develop alongside cognitive decline in dementia with Lewy Bodies. - ✔✔✔ Correct Answer > Parkinsonism 20 years of consumption that may lead to major neurocognitive disorder. - ✔✔✔ Correct Answer > Heavy alcohol use A symptom indicating possible mixed delirium in a patient. - ✔✔✔ Correct Answer > Agitation in emergency department
Variability in cognitive function that can occur in dementia with Lewy Bodies. - ✔✔✔ Correct Answer > Cognitive fluctuations A condition often associated with dementia with Lewy Bodies. - ✔✔✔ Correct Answer > REM sleep disorder A diagnosis that may include symptoms like amnesia and confabulation due to substance use. - ✔✔✔ Correct Answer > Major neurocognitive disorder Symptoms presented by a patient in the emergency department over a 3-day period. - ✔✔✔ Correct Answer > Sore throat and fever Commonly associated with separation anxiety disorder. - ✔✔✔ Correct Answer > Nighttime fears in children An alternative psychotherapy option for patients with anxiety disorders. - ✔✔✔ Correct Answer > Interpersonal therapy Another potential therapy for patients experiencing anxiety symptoms. - ✔✔✔ Correct Answer > Supportive psychotherapy
Speak in a calm reassuring voice and evaluate for comorbid conditions. - ✔✔✔ Correct Answer > Best action for PMHNP with isolated patient Diagnosis for a patient displaying 2 distinct personality states and experiencing gaps in memory beyond ordinary forgetting. - ✔✔✔ Correct Answer > Dissociative identity disorder Ego-dystonic and reality testing is intact. - ✔✔✔ Correct Answer > Experience of depersonalization Depression. - ✔✔✔ Correct Answer > Condition most associated with microvascular ischemia Provide information about support resources. - ✔✔✔ Correct Answer > Next step for PMHNP with domestic violence victim Doxepin. - ✔✔✔ Correct Answer > Medication likely prescribed for urinary hesitancy and xerostomia
Major depressive disorder. - ✔✔✔ Correct Answer > Mental illness with the highest rate Increasing isolation, neglecting self-care, and collecting various things of no real value. - ✔✔✔ Correct Answer > Symptoms of a 55-year-old female patient Unkempt appearance and flat affect. - ✔✔✔ Correct Answer > Patient's appearance and affect Displays 2 distinct personality states and experiences gaps in memory beyond ordinary forgetting. - ✔✔✔ Correct Answer > Symptoms of Erin, a 19-year-old female Patient seems to be talking to herself audibly and makes poor eye contact. - ✔✔✔ Correct Answer > PMHNP's observation during consultation Requests something to calm her nerves due to stress from domestic violence. - ✔✔✔ Correct Answer > Patient's request during consultation Urinary hesitancy, xerostomia, and intermittent lightheadedness. - ✔✔✔ Correct Answer > Common side effects of Doxepin
A milder form of bipolar disorder characterized by at least one major depressive episode and at least one hypomanic episode. - ✔✔✔ Correct Answer > Bipolar 2 An anxiety disorder characterized by unwanted and intrusive thoughts (obsessions) and repetitive behaviors (compulsions). - ✔✔✔ Correct Answer > Obsessive compulsive disorder A personality disorder characterized by a pervasive pattern of disregard for and violation of the rights of others. - ✔✔✔ Correct Answer > Antisocial personality disorder Psychosis that is caused by the effects of a substance, such as drugs or alcohol. - ✔✔✔ Correct Answer > Substance-induced psychosis Psychosis that occurs without any prior history of mental illness. - ✔✔✔ Correct Answer > De novo psychosis Having a parent diagnosed with schizophrenia, which increases the risk of developing the disorder. - ✔✔✔ Correct Answer > Parent with history of schizophrenia
A treatment method for mental health disorders that involves talking with a trained therapist. - ✔✔✔ Correct Answer > Psychotherapy A personality disorder characterized by excessive emotionality and attentionseeking behavior. - ✔✔✔ Correct Answer > Histrionic personality disorder A personality disorder characterized by instability in moods, behavior, self-image, and functioning. - ✔✔✔ Correct Answer > Borderline personality disorder Behaviors that are harmful to oneself, often seen in borderline personality disorder. - ✔✔✔ Correct Answer > Self-destructive reactions An intense fear of being abandoned or rejected, commonly associated with borderline personality disorder. - ✔✔✔ Correct Answer > Fear of abandonment Anxiety characterized by excessive worry about being infected with the Covid- 19 virus despite negative test results. - ✔✔✔ Correct Answer > Covid-19 anxiety disorder
Participating in a community-focused program that promotes mental health and reduces the risk of mental health problems. - ✔✔✔ Correct Answer > Leadership competency for APRNs Regulates the Nurse Practice Act and scope of practice. - ✔✔✔ Correct Answer > Board of Nursing Process of integrating the best research evidence with clinical expertise and client needs and values. - ✔✔✔ Correct Answer > Evidence-based practice May govern the profession of the PMHNP. - ✔✔✔ Correct Answer > Statutory law The act of measuring one's body temperature frequently, often seen in individuals with health anxiety. - ✔✔✔ Correct Answer > Temperature checking A test result indicating that an individual does not have an active Covid- 19 infection. - ✔✔✔ Correct Answer > Negative Covid-19 test Persistent and intrusive thoughts that cause distress, often seen in obsessivecompulsive disorder. - ✔✔✔ Correct Answer > Recurrent thoughts
Thoughts that cause significant anxiety or discomfort, often leading to compulsive behaviors. - ✔✔✔ Correct Answer > Distressing thoughts Outbursts of anger that disrupt relationships, often seen in borderline personality disorder. - ✔✔✔ Correct Answer > Angry disruptions Using deceitful tactics to achieve personal benefits, commonly associated with antisocial personality disorder. - ✔✔✔ Correct Answer > Manipulation for personal gain Sleep inertia refers to a groggy period lasting minutes to hours, which includes impaired alertness upon awakening and is specific to hypersomnolence disorder. - ✔✔✔ Correct Answer > Sleep inertia John is a 22-year-old RN who has started his first job in the cardiothoracic ICU. After his orientation he began his full-time position working three 12-hour night shifts per week. On his days off he reports excessive fatigue during the day with periods of falling asleep while driving. He also reports difficulty staying awake at work during his first night back to work. - ✔✔✔ Correct Answer > Circadian rhythm sleep disorder
