NRNP 6675 Midterm and Final Exam New2024 Version with All Questions from Actual Past Exam, Exams of Nursing

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NRNP 6675 Midterm and Final Exam New2024 Version

with All Questions from Actual Past Exam and Correct

Answers

Mid-Term Exam

Ethical questions about what we "ought" to do or be are addressed within which domain of ethics? ----------- Correct Answer ---------- Normative ethics looks into the questions that arise regarding how one ought to act in a moral sense. It is also the study of ethical behavior Which of the following meds are approved by the FDA for tx of mania in children 12-17? ----------- Correct Answer ---------- Lithium first FDA approved med for children ages 12-17 with mania Which of the following is important to realize when tx a child with an anxiety disorder? -- --------- Correct Answer ---------- B. Repeated exposures of a feared situation will always help the child to unlearn the fear response Discrepancy between anatomical sex and gender is known as? ----------- Correct Answer ---------- B) Gender Discordance Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply ----------- Correct Answer ---------- Rapid dose escalation; parental route of administration; higher potency typical antipsychotics Antipsychotic medication provides D2 blockage in the meso-coritcal pathway causing which of the following effects? ----------- Correct Answer ---------- B) Increases EPS Incorrect: reduces negative s/s, causes prolactinemia, reduces positive symptoms Phencyclidine (PCP) and ketamine exert their unique behavioral effects by blocking which of the following receptors? ----------- Correct Answer ---------- D) NMDA type receptors Incorrect: GABA, serotonin, dopamine "receptors" The diagnosis used to describe a syndrome characterized by specific s/s resulting from recent ingestion or exposure to a substance is known as which of the folllowing? --------- -- Correct Answer ---------- C) Substance use disorder

Incorrect: substance intox, substance withdrawal, all of the above Abnormal involuntary movements in a rhythmic pattern affecting the face, mouth, tongue jaw is known as which of the following? ----------- Correct Answer ---------- C) Tardive dyskinesia Incorrect: akathisia, dystonia, EPS A deeply held belief despite evidence to the contrary, lasting at least 1 month, without prominent hallucinations, with functional impairment that relates to the delusional system disorder called? ----------- Correct Answer ---------- Delusional disorder Which of the following is true about preoccupation with castration? ----------- Correct Answer ---------- A) This can be serious and life threatening if castration is carried out without medical supervision Incorrect: consistent with transvestiatic disorder, other specified paraphillic disorder, or sexual machochism disorder Which of the following is a system that provides a uniform language for describing medical and surgical procedures and diagnostics services rendered by clinicians? ------- ---- Correct Answer ---------- CPT Incorrect: HIPPA, DSM5-, DRG A patient on Chlorpromazine states his orgasm is dry and afterwards he will commonly have milky urine. The APRN realizes this is which of the following? ----------- Correct Answer ---------- A) This is likely a harmless response to the Chlorpromazine "Thorazine" A condition which results from absence of second female sex chromosome (XO) and is associated with web neck, dwarfism, cubitus valgus and infertility is known as which of the following? ----------- Correct Answer ---------- B) Turners Syndrome Turners syndrome: tx involves hormone therapy; fertility treatments for women when they decide to have a baby Which of the following would be characterized as a negative s/s of schizophrenia? ------- ---- Correct Answer ---------- B & C only B) impaired social and occupational functioning C) isolation and impaired self-care

Which of the following are keys to distinguishing OCD from psychosis? ----------- Correct Answer ---------- Patients with OCD can almost always acknowledge the unreasonable nature of their symptoms A federal program administered nationally and locally which covers enrolled individuals 65+ who pays premiums and disabled individuals ----------- Correct Answer ---------- Both A& B (Medicare and Medicaid) Having an adequate legal description of nurse practitioner (NP) scope of practice according to state law is important for which of the following reasons? ----------- Correct Answer ---------- All of the above (to avoid any charges of practicing medicine without a license, to place accountability for both benefits and harm to patients squarely on the NP, to get reimbursed for physician services when provided by a NP Which of the following is the most widely consumed psychoactive substance? ----------- Correct Answer ---------- B) Caffeine Incorrect: alcohol, heroin, cannabis Which of the following is used to tx TD? ----------- Correct Answer ---------- None of the above (cogentin, artane, catapress) The APRN consensus model did which of the following? ----------- Correct Answer -------- -- B & C B) adult and gerontology were merged and identified as PCP or acute care C) psychiatric mental health foci were stipulated as across the lifespan Which of the following behaviors are associated with an alcohol blood level of 0.05%? -- --------- Correct Answer ---------- B) Thought judgement and restraints are impaired According to HIPPA, which of the following must the NP share their NPI with? Check all the above ----------- Correct Answer ---------- A) Health Plans B) Other providers C) Any entity that may need it for a billing purpose A patient presents with delusions, disorganized thoughts, and speech with poor self care all of which has persisted for the past 7 months. The APRN knowns this presentation means what diagnosis? ----------- Correct Answer ---------- Schizophrenia Major neurotransmitters possibly involved in developing substance abuse and substance dependence are which of the following? ----------- Correct Answer ---------- A) Dopamine

Incorrect: GABA, serotonin, A& B only The dopamine hypothesis of schizophrenia, which of the following? ----------- Correct Answer ---------- A) Schizophrenia results from too much dopaminergic activity incorrect: results from a deprivation of dopamine A patient reports a panic attack several years ago in an elevator and since then has avoided elevators. The pt meets the criteria for: ----------- Correct Answer ---------- B) Specific phobia A patient with a substance use disorder who does not meet clinical criteria for hospitalization but lacks sufficient social and vocational skills and lack substance-free social supports is to ----------- Correct Answer ---------- D) All of the above (Residential tx, partial hospitalization, outpt tx) Obscene phone calling to an unsuspecting partner for sexual arousal is known as? ------ ----- Correct Answer ---------- C) Telephone Scatologia (not telephillia, partialism, normal adolescent prank) The main psychological difference between fear and anxiety is best described by which of these statements? ----------- Correct Answer ---------- B) Anxiety is insidious, fear is sudden A diffuse, unpleasant, vague sense of apprehension often accompanied by autonomic symptoms varies upon persons is commonly known as which of the following? ----------- Correct Answer ---------- C) Normal anxiety (incorrect- fear, stress, pathological anxiety If a pregnancy begins while the woman is taking high doses of methadone and withdrawal is desired during which trimester is the least hazardous? ----------- Correct Answer ---------- D) Withdrawal from methadone should never be done while the woman is pregnant Neurochemical or neurophysiological changes in the body that results from the repeated administration of a drug is known as which of the following? ----------- Correct Answer --- ------- C) Neuroadaption incorrect: cross-tolerance, neurotransformation, neurocognitive adjustment The recurrent and intense sexual arousal from the physical and psychological suffering of another person is known as which of the following? ----------- Correct Answer ---------- C) Sexual sadism

Which of the following is not consistent with the onset of OCD? ----------- Correct Answer ---------- D) The onset of OCD is typically preceded by OCD personality traits True answers about OCD:

• more than 1/2 of pts with OCD have a sudden onset of symptoms
• the onset of symptoms for about 50-70% of patients occurs after a stressful event
• most patients keep their symptoms secret initially The recurrent urge to expose one's genitals to a stranger is known ass which of the following? ----------- Correct Answer ---------- C) Exhibitionism Which of the following patients would be appropriate for hospitalization for substance use disorder? Select all that apply ----------- Correct Answer ---------- D) A&B only (Patients who have a substance overdose who cannot be safely tx in an outpt setting & pts who are at risk for severe or medically complicated withdrawal symptoms The nursing practice model recommendation for NPs by the NAtional Academy of Medicine and the National Council of State Boards of Nursing is which of the following? ----------- Correct Answer ---------- A) Full practice Which of the following groups does medicare cover? Select all the above ----------- Correct Answer ---------- A) Individuals 65+ years and older who have enrolled and pay premiums B) Disabled individuals who quality for social security disability payments and benefits Which of the following neurotransmitters increases libidio? ----------- Correct Answer ----- ----- D) Dopamine Incorrect: GABA, serotonin, oxytocin Which of the following factors are associated with poor prognosis for patients with OCD? ----------- Correct Answer ---------- D) A & C (Childhood onset & Co-existing major depressive disorder) Which of the following is inconsistent with current knowledge about schizophrenia? ------ ----- Correct Answer ---------- C) Dopamine level is a laboratory tests that assists in the diagnosis of schizophrenia A chronic disorder characterized by repetitive hair pulling leading to variable hair loss that may be..to others known as? ----------- Correct Answer ---------- C) Trichotillomania Which of the following are risk factors for neuroleptic malignant syndrome? ----------- Correct Answer ---------- B) Rapid dose escalation

C) Parental route of admin D) High potency typical antipsychotics A method of therapy used to tx individuals with substance use based on the fundamental principle of a psychology that reinforced behaviors are likely to be..is known as the following? ----------- Correct Answer ---------- B) Contingency Management The conditions in which people are born, grow, work, live and age are known as? -------- --- Correct Answer ---------- Social determinants of health All of the following is consistent with the ANCCs rules regarding recertification EXCEPT: ----------- Correct Answer ---------- A) You are required to have a maximum of 25 credit hours during each certification period Correct: B) you can start the recert process 1 year before your expiration date, but no later than 3 months before C) You must have 1000 clinical practice hours in a clinical speciality within the preceding 5 years D)you must have at least 25 contact hours in pharmacotherapy Risks factors for school violence include which of the following? Select all that apply ----- ------ Correct Answer ---------- A) Bullying B) Being bullied C) Isolation Persons who subordinate their own needs to those of others, get others to assume responsibility for major areas in the lives, lack of self-confidence, and may experience intense discomfort when alone for more than a brief period of time are demonstrating characteristics with which of the following personality disorders? ----------- Correct Answer ---------- C) Dependent personality disorder Incorrect: avoid PD, passive PD, antisocial PD Generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following lithium levels? ----------- Correct Answer ---------- D) >25 mEq/L (TOXICITY) A form of child abuse in which a patient or character repeatedly fabricates or actually inflicts injury or illness in a child for whom medical intervention is then sought in an ER is known as which of the following? ----------- Correct Answer ---------- D) Munchausen Syndrome by Proxy Self-care strategies for the ARNP in preparing for the certification exam include all of the following EXCEPT? ----------- Correct Answer ---------- D) plan to study for short periods over a longer period of time

A patient presents with a formal, tense manner. He reluctantly reports a longstanding (since early adulthood) pervasive suspiciousness of others, preoccupied with..trustworthiness of friends, unjustified concerns about others deceiving him, angry about perceived insults and slights, reluctant to confide in the ARNP. The ARNP suspects that the pt likely has which of the following PDs? ----------- Correct Answer ------ ---- B) Paranoid PD Incorrect: schizoid PD, BDP, Antisocial PD A pt will a hx of alcohol use presents to the ED with oculomotor disturbances, cerebellar ataxia, and confusion. Symptoms are consistent with which of the following psychiatric emergencies? ----------- Correct Answer ---------- C) Wernickes Encephalopathy Incorrect: akathisia, korsakoff's syndromes, idiosyncratic alcohol intoxication Cluster A personality disorders are more common in biological families of pts with which of the following disorders? ----------- Correct Answer ---------- D) Schizophrenia Incorrect: depression, OCD, alcohol use disorder NP core competencies for INDEPENDENT practice includes all of the following EXCEPT: ----------- Correct Answer ---------- B) Demonstrates the highest level of accountability for professional practice NP competencies for independent practice: ----------- Correct Answer ---------- A) Maintain a collaboration agreement with physician C) Practices independently managing previously diagnosed and under-diagnosed pts D) Practices patient centered care recognizing culture diversity and the pt or designee as a full practice in decision making Cluster A personality traits consists of which of the following? ----------- Correct Answer - --------- A) Schizotypal, schizoid, and paranoid subtypes The misuse of the charge's funds for personal gain is known as which of the following? - ---------- Correct Answer ---------- C) Financial abuse /exploitation the ARNP recognizes which of the following as long term effects of sex trafficking on victims? ----------- Correct Answer ---------- D) All of the above A) Severe depression B) Spiritual questions C) Trauma bonding In about half of the cases in which suicides occur while pts are on a psychiatric unit, a lawsuit results; which of the following is NOT consistent with what courts..related to

impatient psychiatric unit suicide events? ----------- Correct Answer ---------- B) Courts provide ZERO suicide rates in inpt setting Cultural Dimensions Therapy is a framework for cross-cultural communication that describes the effects of a society's culture on the values of its members..by which of the following therorists? ----------- Correct Answer ---------- A) Hofstede The tx of choice for pts with paranoid PD includes which of the following? ----------- Correct Answer ---------- D) B&C B) Behavioral Therapy and C) Psychotherapy The differences in quality of healthcare actions across individuals or groups regard to access, tx options and p..following? ----------- Correct Answer ---------- B) Health disparities The incidence of suicide is highest for which of the following populations? ----------- Correct Answer ---------- D) Older African American men The pt on lithium with a hx of alcohol use disorder presents with dry mouth, ataxia, dizziness, abdominal pain, and slurred speech. The ARNP should do which of the following? ----------- Correct Answer ---------- C) The ARNP recognizes the symptoms of moderate lithium toxicity, discontinues the lithium immediately, orders lithium level, serum electrolytes and renal function tests The ARNP takes a position in which a specific amount is paid according to a set job description. The ARNP should do which of the following? ----------- Correct Answer ------- --- C) The ARNP recognizes these are symptoms of mild to moderate lithium toxicity, discontinues the lithium immediately, orders a lithium level, serum electrolytes and renal function tests The ARNP takes a position in which a specific amount is paid according to a set job description. This type of pay structure is known as? ----------- Correct Answer ---------- D) Hourly rate A PD characterized by emotional constriction, orderliness, perseverance, stubbornness, indecisiveness, a inflexibility as which of the following? ----------- Correct Answer ---------- Obsessive compulsive PD Which of the following is consistent with what is known about the epidemiology of anxiety? ----------- Correct Answer ---------- B) Women have a higher lifetime prevalence of anxiety than men

Which of the following is consistent with NP practice parameters when prescribing buprenorphine? ----------- Correct Answer ---------- D) the NP is require to complete specific training to prescribe and dispense buprenorphine Which of the following are consistent with current data related to the prevalence of drinking alcohol? ----------- Correct Answer ---------- B) Men and women with higher education and income are more likely to drink alcohol A pt with hx of hypoglycemia reports feelings of fear, worry and restlessness that has persisted over the past 6 months. The pt states these feelings are worse when glucose is low. the ARNP suspects the pt has which of the following dx? ----------- Correct Answer ---------- A_) GAD attributable to another medical condition Which of the following is not consistent with benzo withdrawal? ----------- Correct Answer ---------- B) The best way to proceed with benzo withdrawal is to stop it immediately and tx withdrawal s/s Which of the following is true about the legal practice of the PMHNP? ----------- Correct Answer ---------- D) A&B only A) all have some degrees of prescriptive privileges in all states and the district of columbia B) all are considered primary providers in all states and the district of columbia Flashbacks in which the individual may act and feel as if the trauma were reoccurring represent which of the following clinical features of PTSD? ----------- Correct Answer ----- ----- A) Intrusion Symptom B) Symptom of Avoidance In which ways are NPs and PAs different? ----------- Correct Answer ---------- D) A&B A) NPs differ from PAs in legal definition, scope of practice, licensure, and independence of practice B) NPs practice under their own license and independent of the physician, PAs always work under the supervision of a physician Which of the following initials would a PMHNP use to designate appropriate credentials? ----------- Correct Answer ---------- PMHNP-BC Variations from norms in gender roles such as toy preferences, rough and tumble play, aggression, or playmate gender is known as which of the following? ----------- Correct Answer ---------- B) Gender role behavior 3 major neurotransmitters associated with anxiety, based on animal studies and response to drug tx include? ----------- Correct Answer ---------- B) GABA, norepinephrine and serotonin

Which of the following is consistent with the epidemiology of schizophrenia in the US? -- --------- Correct Answer ---------- D) Onset of schizophrenia before the age of 25 is extremely rare Clinical findings that may indicate abuse include which of the following? Select all that apply ----------- Correct Answer ---------- B) Explanation by the pt which is inconsistent with the type of injury C) Psychological distress such as depression, anxiety, SI, and/or sleep disorder D) Explanation by the parent that is inconsistent with the type of injury According to the APA, which of the following is consistent with the EBP for telepsych? -- --------- Correct Answer ---------- B) In populations with severe anxiety, tele psychiatry is preferred Which of the following is consistent with literature regarding the term psychosexual? ---- ------- Correct Answer ---------- D) None of the above

• psychosexual is used to describe personality development and functioning
• psychosexual is synonymous with libidio in the Freudian sense
• Psychosexual basically refers only to sexual feelings and behavior Bleuler identified 4 fundamental s//s of schizophrenia, known as the 4 A's, which include which symptoms? ----------- Correct Answer ---------- A) Associations, Affect, Autism, Ambivalence The fear/anxiety regarding places from which escape may be difficult is known as which of the following: ----------- Correct Answer ---------- C) Agoraphobia All of the following are one of the 5 major categories of third-party payers EXCEPT: ----- ------ Correct Answer ---------- D) only A & B A) Medicare/medicaid B) Managed care organization (MCOs) Which of the following are risk factors for sexual assault EXCEPT: ----------- Correct Answer ---------- A) Religion Incorrect: serious mental illness, substance use disorder, family hx of sexual abuse Which of the following is consistent with what is known about PP depression? ----------- Correct Answer ---------- D) All of the above (feelings of guilt/ and inadequacy are often present and excessive; thoughts of harming the baby are often present; typical onset is within 3-06 months of delivery)

Affirmatively acting to benefit another or others, going beyond what is required by law is known as which of the following?> ----------- Correct Answer ---------- C) Beneficence Which of the following is used for treating alcohol dependence individuals seeking to continue to remain alcohol free after they have stopped drinking? ----------- Correct Answer ---------- D) Acamprosate The NP can impact health policy and healthcare by doing which of the following? --------- -- Correct Answer ---------- D) All of the above

• becomes an active member of local, state, and/or national NP
• becomes familiar with the resources available on NP organization websites
• Volunteer to serve on legislature committees within professional NP organizations The tx of others equitably and distribution of benefits/burdens fairly is known as? --------- -- Correct Answer ---------- B) Justice Which of the following is INCONSISTENT with current literature about victims of sexual abuse? ----------- Correct Answer ---------- C) The pre-existing relationship and\ familiarity with the abuser may impeded the victim's ability to make rational decisions Which of the following would constitute negligence? Select all that apply ----------- Correct Answer ---------- A) Failure to give necessary care B) Failure to refer when necessary C) Failure to follow up with a patient D) Failure to disclose necessary info to a patient Which of the following developed a biblically-based cultural competence model for healthcare professionals? ----------- Correct Answer ---------- B) Camipinha-Cacote` the ARNP recognizes which of the following as long term effects of sex trafficking on victims? ----------- Correct Answer ---------- D) All of the above
• severe depression
• spiritual questions
• trauma bonding A patient appears odd, with a pervasive hx of magical thinking, ideas of reference, illusions or derealization. This is consistent with which of the folllowing PDs? ----------- Correct Answer ---------- C) Schizotypal PD Which of the following are criteria for a particular suicide to be considered inevitable? --- -------- Correct Answer ---------- D) All of the above
• strong genetic hx of suicide in one or more family members
• a strong genetic loading of mental illness in the family
• the pt may have received the highest standard of tx and that txd failed

A pt with a hx of alcohol use disorder presents to the ED with oculomotor disturbances, cerebellar ataxia, and confusion. The ARNP recognizes these symptoms as consistent with which of the following psych emergencies? ----------- Correct Answer ---------- C) Wernicke's encephalopathy The emotional burnout and lack of empathy towards clients that healthcare providers experience after treating victims is known as the following? ----------- Correct Answer ---- ------ B) Primary traumatization The ACE study found that which of the following relationships between child traumatic events and high-risk behaviors exhibited by adults? ----------- Correct Answer ---------- D) The study revealed an indirect relationship between child traumatic events and high risk adult behaviors Walking on eggshells and appeasement/avoidance behaviors by the victim is characteristic of which phase of the cycle of DV? ----------- Correct Answer ---------- A) Honeymoon phase What are the different phases of DV? ----------- Correct Answer ---------- 1. Tension building phase

2. Incident
3. Reconciliation
4. Calm The only appproved therapy in the US for moderate to severe Alzheimers Disease is which of the following? ----------- Correct Answer ---------- B) Memantine Memantine is? ----------- Correct Answer ---------- A) Namenda, cognition enhancing medication for alzheimers/dementia A term that defines a person who has distress with clinical symptomology because their gender identity is not consistent with gender assigned at birth is which of the following? ----------- Correct Answer ---------- D) Gender Dysphoria Narcissistic, borderline, antisocial, and histrionic subtypes are associated with which cluster of PDs? ----------- Correct Answer ---------- B) Cluster B Odd, eccentric cluster of PDs? ----------- Correct Answer ---------- Cluster A a. Paranoid PD b. Schizoid PD C. Schizotypal PD

Characterized by appearing dramatic, emotional, or erratic PD? ----------- Correct Answer ---------- Cluster B a., antisocial b. borderline c. histrionic d. narcissistic inner emptiness, unstable relationships and emotional dysregulation? ----------- Correct Answer ---------- BPD Attention seeking and excessive emotionability? ----------- Correct Answer ---------- Histrionic Social irresponsibility, diregard for others, deceitfulness, and manipulation of others for personal gain ----------- Correct Answer ---------- Antisocial Self-grandiosity, need for admiration and lack of empathy ----------- Correct Answer ------ ---- Narcissistic PD Eccentric ideas and behaviors PD? ----------- Correct Answer ---------- Schizotypal PD Disinterest in others PD? ----------- Correct Answer ---------- Schizoid Mistrust and suspicion PD? ----------- Correct Answer ---------- Paranoid PD Characterized by appearing anxious or fearful. it includes which PDs? ----------- Correct Answer ---------- Cluster C a. avoidant PD b. dependent PD c. obsessive compulsive PD Perfectionism, rigidity and obstinacy traits PD? ----------- Correct Answer ---------- OCD PD Avoidance of interpersonal contact due not rejection sensitivity PD? ----------- Correct Answer ---------- `Avoidant Submissiveness and a need to be taken care of PD? ----------- Correct Answer ---------- Dependent PD Which of the following is NOT consistent with recommendations for psychiatric hx taking and the MSE of older adults? ----------- Correct Answer ---------- B) Pt should be seen alone even in cases of clear evidence of impairment to persevere the privacy of a doctor/pt relationship

Low health literacy has been linked with which of the following? ----------- Correct Answer ---------- D_ All of the above

• poor health outcomes
• lower rates of hospitalization
• less frequent use of preventative services A claim of malpractice requires that a patient/plaintiff prove which of the following? Select all that apply ----------- Correct Answer ---------- A) The existence of a client- professional relationship--duty ti care C) a causal link b/t the provider's failure to confirm to tx standards and harm to the pt D) Actual injury to the pt According to USDHHS and the Federal Bureau of Primary Health Care, which of the following individuals would be considered homeless? ----------- Correct Answer ---------- D) All of the above
• an individual whose primary residence during the night is a supervised public or private facility that provides temporary living accommodations
• an individual who is a resident in transitional housing
• a person who is living w /a friendA particular form of psychotherapy used for pts with BPD, especially those with parasuicidal behaviors, such as frequent cutting is known as which of the following? ----- ------ Correct Answer ---------- A) DBT incorrect: mentalization based tx; transference focused psychotherapy and exposure therapy As a pmhnp, one of the most common areas you will counsel your patients about is the importance of sleep hygiene. Which of the following is NOT consistent with common recommendations for good sleep hygiene? ----------- Correct Answer ---------- B) Set a cool room temp True sleep hygiene tips:
• avoid alcohol and caffeine
• set TV to turn off within 1 hr of falling asleep
• go to bed at the same time each night The need for NPs to practice to the full extent of their education and training is necessary for which of the following reasons? Select all of the above ----------- Correct Answer ---------- A) The growth in number and proportion of older Americans B) The projected PCP shortages by 2025 C) increased number of individuals who have access to healthcare

according to Freud, stubborn, parsimonious and highly conscientious traits are associated with? ----------- Correct Answer ---------- B) Anal stage Freud's Psychosexual Theory and 5 Stages of Human Development? ----------- Correct Answer ---------- 1.Oral stage

2. Anal stage
3. Phallic stage
4. Latent stage
5. genital stage The mouth, sucking, swallowin ect ----------- Correct Answer ---------- Stage 1- oral stage EGO develops in which phase? ----------- Correct Answer ---------- ORAL phase 1 The penis or vagina-sexual intercourse? ----------- Correct Answer ---------- Stage 5 genital `The anus- withholding or expelling feces ----------- Correct Answer ---------- 2. Anal stage Little to no sexual motivation present? ----------- Correct Answer ---------- Stage 4. Latent phase The penis or clitoris- masturbation ----------- Correct Answer ---------- Stage 3 Phallic the SUPEREGO develops at what phase? ----------- Correct Answer ---------- Stage 3 Phallic Features that point to a medical cause of a mental disorder includes which of the following? ----------- Correct Answer ---------- D) A& C A) Acute onset C) Visual hallucinations A patient currently on risperidone presents to the ED with increased agitation, restlessness, muscle discomfort and dysphoria. the ARNP recognizes these symptoms of akathisia and recommends which of the following? Select all that apply ----------- Correct Answer ---------- B) Benztropine IM only incorrect: reduce antipsychotic dosage, Benadryl PO or IM, B&C only Self-care strategies in preparation for the certificate exam includes all of the following EXCEPT: ----------- Correct Answer ---------- C) Drink lots of caffeine and eat high concentrated sugars good self care strategies:

• plan to study for short periods over a long time
• study in a distraction free environment
• 6 - 8 hours of sleep is recommended Which of the following professionals would be able to precept a NP student? ----------- Correct Answer ---------- D) A&B A) ARNP B) Physician the ARNP is txing a 27 year old female who bipolar disorder who is obese and has renal; dysfunction. Which of the following is true? ----------- Correct Answer ---------- C) An atypical antipsychotic such as olanzapine or risperidone should be used Pts with this PD are described as excitable, emotional and behave in a colorful, dramatic, extroverted, attention-seeking fashion, often with an inability to maintain deep long-lasting attachments ----------- Correct Answer ---------- B) Histrionic PD a PD characterized by emotional constriction, orderliness, perseverance, stubbornness, indecisiveness and a pattern of perfectionism and inflexibility is known as which of the following? ----------- Correct Answer ---------- D) OCD PD Which of the following core competencies are quality competencies? ----------- Correct Answer ---------- D) A&C A) use best available evidence to continually improve quality of practice C) evaluates the relationship among access cost quality safety and their influence on health care Non-pharmacologic tx for abuse includes all of the following EXCEPT: ----------- Correct Answer ---------- D) Involve the abuser in the tx planning Non-pharmacologic tx options for abuse victims?
• CBT
• build a community of support
• assist pt to devise a safe escape plan a PD characterized by extraordinarily unstable affect, mood, behavior, object relations and self-image is known as? ----------- Correct Answer ---------- BPD A particular form of psychotherapy based on Otto Kernbeg's object relations theory is known as which of the following?> ----------- Correct Answer ---------- C) Transference- focused psychotherapy generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following Lithium levels? ----------- Correct Answer ---------- C) > 2.5 mEq/L

nausea, vomiting, anorexia, blurred vision, clonic limb movements, convulsions, oliguria and renal failure ----------- Correct Answer ---------- Moderate Lithium toxicity: 2.0-2. Lithium therapeutic window ----------- Correct Answer ---------- 0.6-1.2 mEq/L first med approved for bipolar d/o ----------- Correct Answer ---------- lithium Common side effects of Lithium, ----------- Correct Answer ---------- tremor, nausea., fatigue, increased thirst, slowed thinking Important serious side effects of Lithium: ----------- Correct Answer ---------- hypothyroidism, weight gain, diabetes insipidus, and lithium toxicity How do we decrease the risk of lithium toxicity? ----------- Correct Answer ---------- Blood level monitoring therapeutic range: 0.6 - 1. Lithium levels are known to (increase/decrease) when used concurrently with diuretics, thiazides, ACE inhibitors and NSAIDs? ----------- Correct Answer ---------- Increase ACE inhibitors: lisinopril, catopril, enalapril Lithium levels are known to (increase/decrease) when used with drugs including caffeine, acetazolamide and theophylline ----------- Correct Answer ---------- Decrease concurrent use of lithium and antidepressants and/or antipsychotics can cause what? --- -------- Correct Answer ---------- Serotonin syndrome & Neuroleptic malignant syndrome The term "suicide survivor" refers to which of the following? ----------- Correct Answer ---- ------ A) those who have lost a loved one to suicide At a minimum, a psychiatric evaluation in an emergency should include which of the following? Select all the above ----------- Correct Answer ---------- C) is the problem organic, functional or a combination? A pt presents with a formal, tense manner. He reluctantly responds a longstanding (since early adulthood) pervasive suspiciousness of others, preoccupied with trustworthiness of friends, unjustified concerns about others deceiving him, angry about perceived insults and slights, reluctant to confide in the ARNP. The ARNP suspects the pt likely has which of the following PDs? ----------- Correct Answer ---------- B) Paranoid PD

The obligation to not inflict harm or balancing unavoidable harm with benefits of good achieved is known as which of the following? ----------- Correct Answer ---------- B) Beneficence `In about 1/2 the cases in which suicides occur while pts are in a psychiatric unit, a lawsuit occurs. Which of the following is NOT consistent with what court expects related to inpt psych unit suicide events? ----------- Correct Answer ---------- D) Evidence of formulation of a tx plan with a high level of security Using the LIAASE: A general cultural competency tool, the ARNP would do which of the following? ----------- Correct Answer ---------- D) all of the above

• agree to disagree on differences in values
• solicit other options or points of view
• acknowledge and validate powerful emotions when expressed Which of the following is NOT consistent with what is known about PP psychosis? ------- ---- Correct Answer ---------- A) symptoms of PP psychosis can often begin within days of delivery Concerns when treating geriatric patients with psychotherapeutic drugs includes all of the following EXCEPT: ----------- Correct Answer ---------- B) Elderly persons may be more susceptible to adverse effects of psychotherapeutic drugs A clause in an employment contract that specifies that an employer and employee may end the working agreement without cause within a specific number of days is known as which? ----------- Correct Answer ---------- C) Termination clause Standards of care are now being set, modified, monitored and publicized by certain self- appointed consumer-oriented agencies as well as government agencies, including which of the following? ----------- Correct Answer ---------- D) All of the above
• Medicare
• the Joint Commission
• The agency for healthcare research and quality The differences in the quality of healthcare across individuals and groups in regards to access of care, treatment options, and preventative services is known as? ----------- Correct Answer ---------- B)Health disparities incorrect: racism, vulnerable populations, SDOH Which of the following medical conditions can present with prominent mental status changes that mimic common psychiatric illnesses. Select all that apply ----------- Correct Answer ---------- B) Thyroid diseases C) Head trauma

Incorrect: DM, AIDS Risks factors for school violence include which of the following? Select all the above ---- ------- Correct Answer ---------- A) bullying B) being bullied C) Isolation Being knowledgeable about one's own thoughts, feelings and sensations as well as the ability to reflect on how these can affect one's interactions with others is known as? ------ ----- Correct Answer ---------- A) Cultural awareness A pt with an inability to conform to the social norms that ordinarily govern many aspects of a person's behavior is consistent with which of the following PDs? ----------- Correct Answer ---------- D) Narcissistic PD Which of the following meds are associated with neural tube defects when given during pregnancy? ----------- Correct Answer ---------- C. Valproic acid curriculum content supports the NP scientific competency area includes which of the following? Select all that apply ----------- Correct Answer ---------- A) Comparison of pt data sets with evidenced based standards to improve care B) Science from other disciplines relevant to heath care Self-injurious behaviors with a nonfatal outcome, accompanied by explicit or implicit evidence that the person intended to die, is most specifically known as what? ----------- Correct Answer ---------- C) Suicide attempt The ARNP is working with a pt who has heightened sense of self-importance and grandiose feelings of uniqueness. The pt also lacks empathy for others, although is very sensitive to minor criticisms. The ARNP recognizes these s/s as consistent with which of the following PD? ----------- Correct Answer ---------- C) Narcissistic PD The degree to which individuals have the cognitive and social capacity to access, process, and utilize basic health info and services to maintain good health, make appropriate health decisions and meet their goals is known as? ----------- Correct Answer ---------- A) Health Literacy Risk factors for physical abuse includes all of the following EXCEPT: ----------- Correct Answer ---------- A) Literacy Risk factors for physical abuse?:

• pregnancy, serious mental illness, hx of victimization during the developmental years According to Freud, passive and dependent personality traits are associated with which stage of development? ----------- Correct Answer ---------- B) Anal stage

Sexual assault is most often which of the following? ----------- Correct Answer ---------- C) family member incorrect: stranger, acquaintance, professional Which of the following is the tx of choice for pt's with depressive personality? ----------- Correct Answer ---------- A) Exposure therapy incorrect: light exposure therapy, insight oriented psychotherapy, transmagnetic stimulation (TMS) Which of the following medications is associated with Ebstein's anomaly when gievn during pregnancy? ----------- Correct Answer ---------- B) Lithium *Actually a very small risk to pregnancy-- should be used more In Canterbury v Spence in the US Court of Appeals for the District of Columbia Circuit listed physician responsibilities for disclosure. Which of the following is NOT listed as a responsibility? ----------- Correct Answer ---------- D) inform the pt about precautionary therapy that he or she should seek in the future Ethnocentrism results in which of the following? ----------- Correct Answer ---------- C) Provides caregivers with the ability to better care for pt's of various culture Which of the following demographic characteristics is consistent with high suicide risk? - ---------- Correct Answer ---------- D) Over 45 years of age An ARNP takes a position in which the ARNP is guaranteed a set salary but can make additional salary if he/or she generates practice income over some set amount; this is known as what type of pay structure? ----------- Correct Answer ---------- C) Base salary plus percentage Which of the following is NOT consistent with guidelines as a mentor? ----------- Correct Answer ---------- D) Be specific and kind when giving constructive feedback that ay not be what the mentee might want to hear Which stage of the cycle of DV is characterized by overt aggressive ----------- Correct Answer ---------- Cluster A PD includes which 3 disorders? ----------- Correct Answer ---------- Schizotypal, schizoid, paranoid subtypes Cultural dimensions therapy: ----------- Correct Answer ---------- Hofstede describes the effects of a society's culture on the values of its members

Tx of choice with a pt with paranoid PD? ----------- Correct Answer ---------- B&C

• behavioral therapy
• psychotherapy Which of the following is NOT a common physical effect of cannabis? ----------- Correct Answer ---------- B) Mild bradycardia s/.s of cannabis physical effects? ----------- Correct Answer ---------- Mild tachycardia, orthostatic hypotension, dilation of the conjunctival blood vessels A conscious standard recurrent behavior such as counting, checking, avoiding that interferes with the person's normal routine and functioning is known as? ----------- Correct Answer ---------- A_ Compulsion Most everyone has a firm conviction that they are male or female by which age range? - ---------- Correct Answer ---------- B) 2-3 years of age A pt who presents absent movements with difficulty starting activities, flat affect and avolition would be assessed as having? ----------- Correct Answer ---------- D)_ Pseduo- parkinsonism What of the following is consistent with current epidemiology literature about gender and OCD? ----------- Correct Answer ---------- D) Adult men and women are equally likely to have OCD A type of schizophrenia in which the individual has a marked disturbance of motor function and may involve stupor, negativism, rigidity, excitement or posturing or mutism is? ----------- Correct Answer ---------- B) Catatonic A pt who presents with the inability to remain still with motor restlessness, would be assessed to have? ----------- Correct Answer ---------- B) Akathisia method of therapy used to tx individuals with substance use disorders? ----------- Correct Answer ---------- B) Contingency Management Ethnocentrism results in which of the following? ----------- Correct Answer ---------- C) provides care givers the ability to care for pts of various cultures Which of following demographic characteristics is consistent with high suicide risk? ------ ----- Correct Answer ---------- D) Over age 45 In educating the pt beginning to take Lithium, the ARNP explains which of the following is related to diet and fluid intake? ----------- Correct Answer ---------- D) All of the above

• caffeine and alcohol act as hydration agents and can raise your lithium concentrations
• drink @ least 1 gal of water or more each day & limit your salt intake
• if you go on A diet, your doctor may need to increase the frequency of blood tests Three major neurotransmitters associated with ANXIETY, based on animal studies and response to drug tx include? ----------- Correct Answer ---------- B) GABA, norepinephrine and serotonin What neurotransmitter increases libidio? ----------- Correct Answer ---------- D) Dopamine Concerns when treating geriatric pts with psychotherapeutic drugs includes all of the following EXCEPT? ----------- Correct Answer ---------- C) Elderly persons may metabolize psychotherapeutic drugs more rapidly Concerns when treating geriatric pts with psychotherapeutic drugs? ----------- Correct Answer ---------- A) Elderly people can be more susceptible to adverse effects of drugs B) Elderly persons may metabolize drugs more slowly D) Elderly people may excrete psychotherapeutic drugs more slowly. Persons who subordinate their own needs to those of others, get other to assume responsibility for major areas of their lives, lack self-confidence and may experience intense discomfort when alone for more than a brief period of time are demonstrating characteristics consistent with what PD? ----------- Correct Answer ---------- C) Dependent PD According to Sullivan, which of the following are consistent with a mentor/mentee relationship? ----------- Correct Answer ---------- C) Goals for the mentoring relationship are set mutually incorrect: mentors are assigned; mentor relationships are shorter term; A&B only The need for NPs to practice to their full extent of their education and training is necessary: select all of the above ----------- Correct Answer ---------- ALl of the above The ARNP assessing lifestyle as a social determinant of health would ask about which of the following? ----------- Correct Answer ---------- A) Diet What are social determinants of health and lifestyle choices? ----------- Correct Answer -- -------- The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. In educating the pt about Lithium, the NP explains which of the following is related to diet and fluid intake? ----------- Correct Answer ---------- D) All of the above

The goal of psychotropic tx is to eliminate all manifestations of a disorder to below the syndromal threshold, which is defined as which of the following? ----------- Correct Answer ---------- B) Remission The NP can impact health policy and healthcare by doing which of the following? --------- -- Correct Answer ---------- D) All of the above A term used to describe individuals and families who are found to live in overcrowded homes, relocate frequently and struggle to pay rent and monthly expenses is which of the following? ----------- Correct Answer ---------- D) A& B Which of the following is consistent with current literature regarding the epidemiology of dependent PD? ----------- Correct Answer ---------- C) Persons with chronic physical illness in childhood may be the most susceptible to this disorder Pts who injure themselves by self-mutalization but usually do not wish to die are said to have which of the following? ----------- Correct Answer ---------- C) Parasuicidial behaviors The NP preceptor should have which of the following? ----------- Correct Answer ---------- D) All of the above The tx choice of pts with histrionic PD include which of the following? ----------- Correct Answer ---------- D) A & B The antipsychotics that are most likely to cause neuroleptic induced parkinsonism have which of the following effects? ----------- Correct Answer ---------- C) High potency drugs with high levels of anticholinergic activity Tx aimed at reducing intimate partner violence and DV includes which of the following? ----------- Correct Answer ---------- D) A&B only Pt presents with a formal, tense manner. He reluctantly reports a longstanding pervasive suspiciousness of others, preoccupied with trustworthiness of friends, unjustified concerns that others are deceiving him, angry about perceived insults and slights, reluctant to confide in the ARNP; we suspect the pt most likely has the following PDs? ----------- Correct Answer ---------- B) Paranoid PD Which of the following is consistent with current perspectives on NP competencies? ----- ------ Correct Answer ---------- A) The National Organization of NPs Faculties have developed a list of core competencies that all students should have upon graduation from a master's program Which of the following core competencies are quality competencies? ----------- Correct Answer ---------- D) A& C

Which of the following are criteria for a particular suicide to be considered inevitable? --- -------- Correct Answer ---------- D) All of the above According to Freud, passive and dependent personality traits are associated with what stage of development? ----------- Correct Answer ---------- A) Oral stage SIB with a nonfatal outcome, accompanied by explicit or implicit evidence that the person intended to die, is known as?q ----------- Correct Answer ---------- B) Suicide intent "Assumes complex and advanced leadership roles to initate and guide change" is a NP core competency for which area? ----------- Correct Answer ---------- C) Leadership competencies At a minimal, a psych eval in an Emergency should include what? Select all that apply -- --------- Correct Answer ---------- A, B, C Which stage of the DV cycle is characterized by the abuser subconsciously implementing defense mechanisms and cognitive distortions to alleviate the ego dystonic implication of the abuse? ----------- Correct Answer ---------- D) Defensive phase A pt with a hx of schizophrenia, currently prescribed Haldol, presents to the ED with hyperthermia, muscle rigidity, autonomic instability and elevated phosphokinase. The ARNP recognizes these symptoms are consistent with? ----------- Correct Answer ---------

• D) Neuroleptic malignant syndrome Pts with extreme sensitivity to rejection who are socially withdrawn because they consider themselves to be socially inept, although they are not antisocial, and show a great desire for companionship are demonstrating symptoms most consistent with which of the following PDs ----------- Correct Answer ---------- B) Avoidant PD OCD PD, dependent PD and avoidance PD traits are associated with which class of PDs? ----------- Correct Answer ---------- C) Cluster C Therapeutic blood level range for lithium? ----------- Correct Answer ---------- 0.8 - 1.2
• can be as low as 0.6 for some and be therapeutic The obligation to not inflict harm or balancing unavoidable harm with benefits of good achieved is known as? ----------- Correct Answer ---------- C) Non-maleficence Acknowledging a person's right to make choices, to hold views and take actions based on personal value is known as which of the following? ----------- Correct Answer ---------- D) Respect for autonomy

Narcissistic, BPD, antisocial and histrionic subtypes are part of what cluster of PDs? ---- ------- Correct Answer ---------- B) Cluster B Being knowledgeable about one's own thoughts, feelings and sensations as well as the ability to reflect on how these can affect one's interactions with others is known as? ------ ----- Correct Answer ---------- A) Cultural awareness The NP recognizes which are the long-term effects of sex trafficking on victims? ----------

• Correct Answer ---------- D) All of the above wernickles encephalopathy= considered a medical emergency or not? ----------- Correct Answer ---------- is a medical emergency Is a degenerative brain disorder caused by lack of vitamin B1 Aim of tx for wernickles encephalopathy ----------- Correct Answer ---------- Prompt and quick correction of the thiamine deficiency in the brain Is wernickles encephalopathy reversible? ----------- Correct Answer ---------- it is considered reversible Wernickles encephalopathy is caused from? ----------- Correct Answer ---------- Alcohol abuse, dietary deficiencies, prolon ged vomiting, eating disorders, effects of chemotherapy =s/s mental confusion, vision problems, coma, hypothermia, low bp, lack of muscle coordination (ataxia) lack of muscle coordination? ----------- Correct Answer ---------- Ataxia Clinical triad of ophthalmoplegia, ataxia and confusion? ----------- Correct Answer ---------
• Wernickles encephalopathy = acute neurological condition Korsakoff's Syndrome: ----------- Correct Answer ---------- neuropsychiatric disorder associated with confabulation and significant deficits in anterograde and retrograde memory This disorder is associated with pts fabricating stories in the setting of clear consciousness ----------- Correct Answer ---------- Korsakoff's A common inciting event that precepitates WE is? ----------- Correct Answer ---------- an acute infection other triggers include: prolonged carb or glucose loading in the presence of thiamine deficiency