NR546 Actual Final Exam -with 100% verified solutions- 2024-2025.docx, Exams of Nursing

Download NR546 Actual Final Exam -with 100% verified solutions- 2024-2025.docx and more Exams Nursing in PDF only on Docsity! NR546 Actual Final Exam -with 100% verified solutions- 2024-2025 1. A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical examination is unremarkable. Laboratory results are within normal limits except for a markedly elevated alkaline phosphatase level. The psychiatric-mental health nurse practitioner: a) interprets the findings as normally occurring during a rapid adolescent growth spurt. b) obtains a rheumatoid profile because elevated alkaline phosphatase is a sign of early rheumatic fever. c) orders a repeat blood test. d) suspects that the patient has acute pancreatitis. interprets the findings as normally occurring during a rapid adolescent growth spurt. 2. Laboratory findings for a patient with an alcohol use disorder indicate increased liver function values and: a) a decreased mean corpuscular volume (MCV) and normal triglyceride levels. b) elevated potassium and chloride levels. c) increased MCV and elevated triglyceride levels. d) increased urine and serum creatinine levels. increased MCV and elevated triglyceride levels. 3. A new patient arrives at the office for treatment for depression. The patient reports taking simvastatin (Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatric- mental health nurse practitioner eliminates fluoxetine (Prozac), based on the knowledge that the combination can lead to increased plasma levels of the statin, resulting in an increased risk of muscle damage and rhabdomyolysis. The nurse practitioner's reason is that: a) both medications are CYP450 3A4 inhibitors. b) both medications are CYP450 3A4 substrates. c) one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inducer. d) one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor. one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor. 4. A 28-year-old patient who is psychotic arrives at the clinic with family members but refuses to meet if the family members are present. The psychiatric-mental health nurse practitioner: a) allows the family members to stay for the appointment. b) asks the family members and the patient to leave. c) asks the family members to leave for the appointment. d) speaks with the family members after the appointment. asks the family members to leave for the appointment. 5. The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement at a community mental health clinic. The effective strategy for evaluating the clinic's services is to: a) analyze the data from epidemiological studies. b) conduct a root cause analysis. c) interview patient families. d) use a survey to elicit patient satisfaction responses. use a survey to elicit patient satisfaction responses. 6. The psychiatric-mental health nurse practitioner evaluates a new adult patient via telemedicine. The patient has questions about a new medication that he or she recently started. The nurse practitioner decides to provide psychoeducation and to: a) e-mail drug information and resources. b) encourage the patient to seek information on the internet. c) have a phone conference with a family member. d) refer patient to a local primary care provider. e-mail drug information and resources. 7. Any court of law that evaluates the standards of care provided by a psychiatric- mental health nurse practitioner: a) compares the actions to the standard of care provided by a psychiatrist. b) considers what a reasonably prudent health care provider would do. c) evaluates patient satisfaction data. d) reviews the nurse practitioner's charts for similar patients. considers what a reasonably prudent health care provider would do. 8. The psychiatric-mental health nurse practitioner and a team of local mental health professionals are asked to provide crisis counseling service, after a gunman recently took a class hostage at a local elementary school, wounded several students, and then shot himself. In preparing for this assignment, the nurse practitioner recognizes that: a) a child's developmental stage will influence his or her response to catastrophic stress. b) a child's lack of an emotional response to a catastrophic event is a predictor of negative long-term consequences. c) it is necessary for the child's guardian to be present. meets with the parent and patient together to explore the discrepant report. 17. The psychiatric-mental health nurse practitioner is employed in a newly created attending role on a psychiatric inpatient unit. To promote an interprofessional environment, the nurse practitioner: a) discusses the resistance directly with the physicians. b) assigns a role for all staff members in improving patient outcomes. c) educates staff members on the role of a psychiatric-mental health nurse practitioner. d) works with the nurse manager to organize all levels of nursing staff. assigns a role for all staff members in improving patient outcomes. 18. The psychiatric-mental health nurse practitioner sees a 12-year-old patient who takes lisdexamfetamine (Vyvanse) 50 mg daily for attention-deficit hyperactivity disorder. The nurse practitioner observes a tic, which the parents report began after the patient began taking the psychostimulant, and it has been increasing in severity. Both the parents and the school report that the medication is helpful. The nurse practitioner: a) continues the psychostimulant and has the parents and school observe the patient. b) increases the dose of the psychostimulant and schedules a follow-up appointment in three months. c) discontinues the psychostimulant, prescribes guanfacine extended release (Intuniv), and monitors the patient. d) prescribes methylphenidate extended release (Concerta) on a dose appropriate for the patient's age and monitors the patient. discontinues the psychostimulant, prescribes guanfacine extended release (Intuniv), and monitors the patient. 19. A patient from India emphasizes a strong feeling that he or she is one with Brahma and connected to life through this being. While developing a treatment plan, the psychiatric- mental health nurse practitioner realizes that this patient's spirituality also guides his or her: a) ability to engage in treatment. b) interpretation of life events. c) predisposition to illness. d) response to medication. interpretation of life events 20. The psychiatric-mental health nurse practitioner is tasked with continually improving the quality of care on an inpatient unit. The nurse practitioner implements: a) a chart review analysis. b) a root cause analysis. c) a plan-do-study-act process. d) failure effect mode analysis. a plan-do-study-act process. 21. To improve treatment and patient outcomes, the psychiatric-mental health nurse practitioner utilizes evidence-based practices. An acceptable resource for evidence- based meta analysis is the: a) Cochrane database. b) Medscape database. c) PubMed database. d) WebMD database. Cochrane database. 22. The psychiatric-mental health nurse practitioner is concerned about access-to-care issues in the local community and wants to help develop health care policy to help patients access care more effectively. The nurse practitioner knows one of the most effective avenues for developing and advocating for policy is: a) asking the clinic manager explore options for access. b) organizing a political protest. c) working with the local chapter of the nurse's professional association. d) writing letters to the editor of the local newspaper. working with the local chapter of the nurse's professional association. 23. A patient is referred to an outpatient psychiatric clinic for evaluation of depressive episodes after bouts of overeating. Assessment reveals a five-year history of episodes of uncontrollable overeating precipitated by feelings of tension. This occurs about two to three times per week and for the past year has been associated with laxative use, self- induced vomiting, and periods of fasting to maintain body weight. The patient reports becoming increasingly depressed and has considered suicide in the past. The treatment plan includes medical evaluation with electrolyte studies and: a) bupropion (Wellbutrin) for depressive symptoms. b) lorcaserin HCl (Belviq) for eating disorder. c) recommendation for psychological and personality testing. d) referral for cognitive behavioral therapy. referral for cognitive behavioral therapy 24. The psychiatric-mental health nurse practitioner evaluates a female patient referred with a three-month history of moderate to severe postpartum depression. The patient has been in therapy for three weeks and has not been prescribed medication, despite several interactions with her obstetrician and primary care provider. After researching the health care system's organizational factors that contributed to this fragmented care, the nurse practitioner: a) advocates for including mental health content in nonpsychiatric graduate specialties. b) discusses the lack of mental health education. c) files a complaint with the appropriate regulatory boards regarding the patient's prior care. d) presents at the local American Congress of Obstetricians and Gynecologists meeting. advocates for including mental health content in nonpsychiatric graduate specialties. 25. The neuroprotective treatment of choice for bipolar disorder is: a) carbamazepine (Tegretol). b) divalproex sodium (Depakote). c) lithium (Eskalith). d) risperidone (Risperdal). lithium (Eskalith)