NRNP 6675 MIDTERM EXAM WITH ACTUAL CORRECT QUESTIONS , Exams of Nursing

Download NRNP 6675 MIDTERM EXAM WITH ACTUAL CORRECT QUESTIONS and more Exams Nursing in PDF only on Docsity! NRNP 6675 MIDTERM EXAM WITH ACTUAL CORRECT QUESTIONS AND VERIFIED RATIONALISED ANSWERS| ALREADY GRADED A+| LATEST UPDATE 2022/2023 |100% GUARANTEED PASS!! Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply 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? 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? 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? 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? 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? Delusional disorder Which of the following is true about preoccupation with castration? 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? 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? 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? 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? 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? 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 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? 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? Which of the following patients would be appropriate for hospitalization for substance use disorder? Select all that apply 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? A) Full practice Which of the following groups does medicare cover? Select all the above 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? D) Dopamine Incorrect: GABA, serotonin, oxytocin Which of the following factors are associated with poor prognosis for patients with OCD? D) A & C (Childhood onset & Co-existing major depressive disorder) Which of the following is inconsistent with current knowledge about schizophrenia? 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? C) Trichotillomania Which of the following are risk factors for neuroleptic malignant syndrome? 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? B) Contingency Management The conditions in which people are born, grow, work, live and age are known as? Social determinants of health All of the following is consistent with the ANCCs rules regarding recertification EXCEPT: 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 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? 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? 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? D) Munchausen Syndrome by Proxy Self-care strategies for the ARNP in preparing for the certification exam include all of the following EXCEPT? 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? 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? 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? D) Schizophrenia Incorrect: depression, OCD, alcohol use disorder NP core competencies for INDEPENDENT practice includes all of the following EXCEPT: B) Demonstrates the highest level of accountability for professional practice NP competencies for independent practice: 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? A) Schizotypal, schizoid, and paranoid subtypes The misuse of the charge's funds for personal gain is known as which of the following? C) Financial abuse /exploitation the ARNP recognizes which of the following as long term effects of sex trafficking on victims? 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? 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? A) Hofstede B) In populations with severe anxiety, tele psychiatry is preferred Which of the following is consistent with literature regarding the term psychosexual? 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? A) Associations, Affect, Autism, Ambivalence The fear/anxiety regarding places from which escape may be difficult is known as which of the following: C) Agoraphobia All of the following are one of the 5 major categories of third-party payers EXCEPT: D) only A & B A) Medicare/medicaid B) Managed care organization (MCOs) Which of the following are risk factors for sexual assault EXCEPT: 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? 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?> 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? D) Acamprosate The NP can impact health policy and healthcare by doing which of the following? 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? B) Justice Which of the following is INCONSISTENT with current literature about victims of sexual abuse? 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 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? B) Camipinha-Cacote` the ARNP recognizes which of the following as long term effects of sex trafficking on victims? 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? C) Schizotypal PD Which of the following are criteria for a particular suicide to be considered inevitable? 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? 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? B) Primary traumatization The ACE study found that which of the following relationships between child traumatic events and high- risk behaviors exhibited by adults? 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? A) Honeymoon phase What are the different phases of DV? 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? B) Memantine Memantine is? 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? D) Gender Dysphoria Narcissistic, borderline, antisocial, and histrionic subtypes are associated with which cluster of PDs? B) Cluster B Odd, eccentric cluster of PDs? Cluster A a. Paranoid PD b. Schizoid PD C. Schizotypal PD 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 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? B) Anal stage Freud's Psychosexual Theory and 5 Stages of Human Development? 1.Oral stage 2. Anal stage 3. Phallic stage 4. Latent stage 5. genital stage The mouth, sucking, swallowin ect Stage 1- oral stage EGO develops in which phase? ORAL phase 1 The penis or vagina-sexual intercourse? Stage 5 genital `The anus- withholding or expelling feces 2. Anal stage Little to no sexual motivation present? Stage 4. Latent phase The penis or clitoris- masturbation Stage 3 Phallic the SUPEREGO develops at what phase? Stage 3 Phallic Features that point to a medical cause of a mental disorder includes which of the following? 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 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: 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? 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? 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 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? D) OCD PD Which of the following core competencies are quality competencies? 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: 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? BPD A particular form of psychotherapy based on Otto Kernbeg's object relations theory is known as which of the following?> C) Transference-focused psychotherapy generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following Lithium levels? C) > 2.5 mEq/L nausea, vomiting, anorexia, blurred vision, clonic limb movements, convulsions, oliguria and renal failure Moderate Lithium toxicity: 2.0-2.5 Lithium therapeutic window 0.6-1.2 mEq/L first med approved for bipolar d/o lithium Common side effects of Lithium, tremor, nausea., fatigue, increased thirst, slowed thinking Important serious side effects of Lithium: hypothyroidism, weight gain, diabetes insipidus, and lithium toxicity How do we decrease the risk of lithium toxicity? Blood level monitoring therapeutic range: 0.6 - 1.2 Lithium levels are known to (increase/decrease) when used concurrently with diuretics, thiazides, ACE inhibitors and NSAIDs? Increase ACE inhibitors: lisinopril, catopril, enalapril Lithium levels are known to (increase/decrease) when used with drugs including caffeine, acetazolamide and theophylline 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? 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? 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? A) Health Literacy Risk factors for physical abuse includes all of the following EXCEPT: 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? B) Anal stage Sexual assault is most often which of the following? C) family member incorrect: stranger, acquaintance, professional Which of the following is the tx of choice for pt's with depressive personality? 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? 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? D) inform the pt about precautionary therapy that he or she should seek in the future Ethnocentrism results in which of the following? 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? 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? C) Base salary plus percentage Which of the following is NOT consistent with guidelines as a mentor? 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 Cluster A PD includes which 3 disorders? Schizotypal, schizoid, paranoid subtypes Cultural dimensions therapy: Hofstede describes the effects of a society's culture on the values of its members Tx of choice with a pt with paranoid PD? B&C -behavioral therapy -psychotherapy Which of the following is NOT a common physical effect of cannabis? B) Mild bradycardia s/.s of cannabis physical effects? 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? A_ Compulsion Most everyone has a firm conviction that they are male or female by which age range? 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? D)_ Pseduo-parkinsonism What of the following is consistent with current epidemiology literature about gender and OCD? 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? B) Catatonic A pt who presents with the inability to remain still with motor restlessness, would be assessed to have? B) Akathisia method of therapy used to tx individuals with substance use disorders? B) Contingency Management Ethnocentrism results in which of the following? C) provides care givers the ability to care for pts of various cultures Which of following demographic characteristics is consistent with high suicide risk? 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? 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? B) GABA, norepinephrine and serotonin What neurotransmitter increases libidio? D) Dopamine Concerns when treating geriatric pts with psychotherapeutic drugs includes all of the following EXCEPT? C) Elderly persons may metabolize psychotherapeutic drugs more rapidly Concerns when treating geriatric pts with psychotherapeutic drugs? Which of the following is consistent with current perspectives on NP competencies? 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 3 MULTIPLE CHOICE OPTIONS Which of the following core competencies are quality competencies? D) A& C 3 MULTIPLE CHOICE OPTIONS Which of the following are criteria for a particular suicide to be considered inevitable? D) All of the above 3 MULTIPLE CHOICE OPTIONS According to Freud, passive and dependent personality traits are associated with what stage of development? A) Oral stage 3 MULTIPLE CHOICE OPTIONS SIB with a nonfatal outcome, accompanied by explicit or implicit evidence that the person intended to die, is known as?q B) Suicide intent 3 MULTIPLE CHOICE OPTIONS "Assumes complex and advanced leadership roles to initate and guide change" is a NP core competency for which area? C) Leadership competencies 3 MULTIPLE CHOICE OPTIONS At a minimal, a psych eval in an Emergency should include what? Select all that apply A, B, C 3 MULTIPLE CHOICE OPTIONS 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? D) Defensive phase 3 MULTIPLE CHOICE OPTIONS 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? D) Neuroleptic malignant syndrome 3 MULTIPLE CHOICE OPTIONS 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 B) Avoidant PD 3 MULTIPLE CHOICE OPTIONS OCD PD, dependent PD and avoidance PD traits are associated with which class of PDs? C) Cluster C 3 MULTIPLE CHOICE OPTIONS Therapeutic blood level range for lithium? 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? C) Non-maleficence 3 MULTIPLE CHOICE OPTIONS 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? D) Respect for autonomy 3 MULTIPLE CHOICE OPTIONS Narcissistic, BPD, antisocial and histrionic subtypes are part of what cluster of PDs? 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? A) Cultural awareness The NP recognizes which are the long-term effects of sex trafficking on victims? D) All of the above 3 MULTIPLE CHOICE OPTIONS wernickles encephalopathy= considered a medical emergency or not? is a medical emergency Is a degenerative brain disorder caused by lack of vitamin B1 Aim of tx for wernickles encephalopathy Prompt and quick correction of the thiamine deficiency in the brain Is wernickles encephalopathy reversible? it is considered reversible Wernickles encephalopathy is caused from? 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? Ataxia Clinical triad of ophthalmoplegia, ataxia and confusion? Wernickles encephalopathy = acute neurological condition Korsakoff's Syndrome: 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 Korsakoff's A common inciting event that precepitates WE is? an acute infection other triggers include: prolonged carb or glucose loading in the presence of thiamine deficiency Hallmark sign of WE? is ocular abnormalities especially nystagmus other oculomotor s/s: include cranial nerve involvement of oculomotor, abducens and vestibular nuclei causing conjugate gaze palasises; pupillary sluggishness, ptsosis and anisocoria is also common Some pts can present with hyperactive delirium secondary to possible alcohol withdrawal symptoms alongside this disorder? A pt appears odd with a pervasive hx of magical thinking, ideas of reference, illusions and derealization. This is consistent with which of the following? C) Schizotypal PD 3 MULTIPLE CHOICE OPTIONS Which of the following symptoms of BPD assist in differetianting BPD from schizophrenia? D) A& C only 3 MULTIPLE CHOICE OPTIONS pt is exhibiting being unapproachable, poor eye contact, reporting a lifetime pattern of isolation, uncomfortableness with human interaction and constricted affect. This presentation is consistent with which of the PDs? A) Schizoid PD 3 MULTIPLE CHOICE OPTIONS NP preceptors should have at least how much experience as a NP in the specialty prior to precepting? D) Minimum of 2 years as an experienced NP in the specialty Heightened sense of self-importance, grandiose feelings of uniqueness, lacking empathy for others and is very sensitive to minor criticism? C) Narcissistic PD the NP recognizes which of the following are short-term effects of sex trafficking on victims? D) A&C only 3 MULTIPLE CHOICE OPTIONS according to Freud, stubborn, parsimonious (frugal) and high conscientious traits are associated with what stage of development? C) Phallic stage 3 MULTIPLE CHOICE OPTIONS Which of the following is NOT consistent with common recommendations for good sleep? B) Set up a cool room temp 3 MULTIPLE CHOICE OPTIONS Curriculum content that supports the NP scientific foundation competency areas includes which of the following? Select all that apply A&C 3 MULTIPLE CHOICE OPTIONS In Canterbury V Spence, listed physician responsibilities for disclosure--which is not listed? D) Inform the pt about precautionary therapy that he/she should seek in the future 3 MULTIPLE CHOICE OPTIONS Which of the following is the tx of choice for pts with depressive personality? C) Insight-oriented psychotherapy 3 MULTIPLE CHOICE OPTIONS Which of the following should be avoided when working with practice guidelines? A) write guidelines with minute details that everyone will follow in the exact same way A claim of malpractice requires a pt/plaintiff prove which of the following? select all that apply B, C & D C) a casual link between the NPs failure to conform to tx standards and harm to the pt D) actual injury to the pt 3 MULTIPLE CHOICE OPTIONS Which of the following is consistent with what is known about terrorist-bomber suicides? D) A&B 3 MULTIPLE CHOICE OPTIONS NP working as an at will employee realizes which of the following. Unless the NP has a contract for a specified term of employment, the employee: D) A&C only 3 MULTIPLE CHOICE OPTIONS The US supreme court upheld the psychotherapist-pt privilege in which of the following cases? A) Jaffee vs Redmond 3 MULTIPLE CHOICE OPTIONS Loyalty, fairness, truthfulness, advocacy and dedication in professional relationships is known as? B) Fidelity 3 MULTIPLE CHOICE OPTIONS Which of the following is consistent with PDs? C) Involves impairment in at least 1 out of 4 areas of cognition, affectivity, interpersonal function or impulse control 3 MULTIPLE CHOICE OPTIONS A late appearing adverse effect of neuroleptic drugs is known as? D) Neuroleptic induced tardive dyskinesia the failure of a professional to exercise that degree of skill and learning commonly applied by the average prudent, reputable member of the profession is known as? B) Malpractice 3 MULTIPLE CHOICE OPTIONS a somatpsychic illness triggered by changing levels of sex steroids that accompany an ovulatory menstrual cycle about one week before the onset of menses characterized by irritability, emotional liability, HA, anxiety and depression is known as? D) Premenstrual psychosomatic disorder 3 MULTIPLE CHOICE OPTIONS persons who exhibit impulsive traits also show high levels of which of the following hormones? select all that apply D) A& C only 3 MULTIPLE CHOICE OPTIONS in educating a pt beginning on lithium, the NP explains which of the following related to need for blood tests? D) A&B only 3 MULTIPLE CHOICE OPTIONS the incidence of suicide is highest for which of the following populations? B) Older white men 3 MULTIPLE CHOICE OPTIONS Which of the following defense mechanisms does the abuser use during the honeymoon phase? B) Projection 3 MULTIPLE CHOICE OPTIONS SIB patients should be engaged in what type of therapy (BPD individuals who engage in SIB) A) DBT 3 MULTIPLE CHOICE OPTIONS the _____stage begins at 18 months of age and lasts until the age of 3 Stage 7: Generativity vs Stagnation is associated with what age and virtue? 40-65 years care Stage 8: Integrity vs Dispair is associated with what age and virtue? 65 + older wisdom at the beginning of early childhood (18 months to 3 years old), the child is still in the _____ stage (Erikson) stage 2: autonomy vs shame By age 3, the child begins what stage? Stage 3: initiative vs guilt -children take initiative to talk to think of ideas and act -beginning to use their imagination* build forts, play magic & issue tickets for who wants to come -children are curious at this age, start to ask questions so they can learn about the world Which of the following is not consistent with the purpose of the ANAs code of ethics? D) It clearly determines how ethical obligations are met 3 MULTIPLE CHOICE OPTIONS Which of the following meds are approved by the FDA for the tx of excessive sleepiness in narcolepsy? C) Pitolisant (Wakix) 3 MULTIPLE CHOICE OPTIONS Which of the following s/s are assoicated with MDD with melancholic features? D) B&C 3 MULTIPLE CHOICE OPTIONS sleep related hallucinations that occur at sleep onset are known as? A) Hypnagogic hallucinations 3 MULTIPLE CHOICE OPTIONS sleep related hallucinations that occur while waking up from sleep are known as? Hypnopompic hallucinations hypnopompic hallucinations are primarily what type of hallucination? visual (86%). between 8-34% involve auditory hallucinations Applied behavioral analysis is typically indicated for which disorder? C) Autism 3 MULTIPLE CHOICE OPTIONS ADHD, impulse contorl, conduct disorder and intellectual disabilities with anxiety disorders are predominant during which age range? B) ages 6-12 3 MULTIPLE CHOICE OPTIONS Which of the following is consistent with what is known about Bipolar I disorder? D) Equal prevalence among men and women Psychotherapy is important tx strategy for young people for which of the following reasons? select all that apply C & D 3 MULTIPLE CHOICE OPTIONS When evaluating a child with poor academic performance, which of the following diagnostic catergories should be considered first? B & D 3 MULTIPLE CHOICE OPTIONS Which of the following meds is FDA approved for the tx of MDD with seasonal variation? D) Buproprion HCL ER 3 MULTIPLE CHOICE OPTIONS a period of at least one week in which both a manic episode and a major depressive episode occur almost daily is consistent with which dx? C) Bipolar I disorder, mixed episode 3 MULTIPLE CHOICE OPTIONS According to APA "psychologists seek to promote accuracy, honesty and truthfulness in the practice of psychology' reflecting which of the following ethical principles? A) Integrity 3 MULTIPLE CHOICE OPTIONS Promoting the Welfare of children and adolescents addresses which of the following ethical issues? C) beneficence 3 MULTIPLE CHOICE OPTIONS Which of the following disorders is characterized by episodic bouts of intake of excessive amount of food without purging or similar compensatory behavior C) Binge eating The ARNP working w a 5 year old child in a busy pediatric practice is seeking to use levl 1 and level 2 cross-cutting symptoms measures. Which of the following is true in this situation? B) These level 1 and 2 assessments can help the NP identify the presenting problem for the kid 3 MULTIPLE CHOICE OPTIONS Which of the following meds are approved by the FDA for treating OCD in children ages 6-17? C) Zoloft (age 6+) 3 MULTIPLE CHOICE OPTIONS A form of CBT that requires attending skills group in addition to individual therapy sessions are known as which of the following? D) DBT 3 MULTIPLE CHOICE OPTIONS Manic episodes are considered distinct when they are separated by what length of time without significant symptoms of mania or hypomania? C) 2 months 3 MULTIPLE CHOICE OPTIONS Which of the following meds are NOT FDA approved to tx restless leg syndrome? B) Modafinil 3 MULTIPLE CHOICE OPTIONS Persistant Depressive Disorder lasts at least? 2 years MDD episodes are separated by how long? at least 2 months The clinician asks the adolescent how long they have been sad--greater than 1 year? C) MDD A 15-year-old girl presents with symptoms that include restrictive eating and food avoidance, with a desire to avoid obesity, which persists despite negative consequences. This presentation is consistent with which of the following? Anorexia nervosa which of the following antidepressants are FDA approved to tx depression in children 8-17? B) Fluoxetine (Prozac) When assessing for substance use in an adolescent, the clinician should initially assess for which of the following? A) Safety The main risk factor for developing NMS? Taking an antipsychotic Risk factors for NMS? Dehydration, agitation, exhausting, malnutrition, organic brain syndromes, nonschizophrenia mental illness, lithium use, past hx of ECT The mesocortical pathway is responsible for (3): Cognitive function Reward Motivation Antipsychotics provide D2 blockage in what pathway? Mesocoritical this causes: increased EPS SAD? SSRIs tx this Short term side effects of the medications that tx RLS? (Rotigotine, Pramipexole) mild: cause nausea, lightheadedness and fatigue Rotigotine= Neupro (tx RLS) Pramipexole= Mirapex (tx RLS) Dopamine agonists? First medicines used to tx RLS (Mirapex, Neupro, Requip) Do bananas help RLS? yes- eating more vegetables including leafy greens can help Ziprasidone injection is used to tx occurrences with severe agitation in pts with schizophrenia? help[s restore the balance of neurotransmitters- quick relief antipsychotic ATYPICAL Maximum IM dosage of Zipraisdone? 40 mg/day Indicators for a good prognosis in MDDD includes which of the following? select all that apply B & D 3 MULTIPLE CHOICE OPTIONS During an initial interview with a 15 year old female, the PMHNP notes the presence of peripheral edema & Russell's sign; what do these indicate? Anorexia Nervosa peripheral edema can be caused by a variety of conditions, but the presence of Russell's sign indicates possible anorexia. What is Russell's sign? scarring or callouses on the dorsal surface of the hand caused by self-induced vomiting anorexia 82 year old woman arrives at the office with her son; over the past year, she has had trouble remembering once-familiar things, such as phone #s and friends names. She also does not recognize family members who visit often; she has become unusually moody and struggles with written tasks. What is the most likely dx? A) Alzheimers Disease alzheimers can be associated with: deficits in language, motor function and recognition 3 MULTIPLE CHOICE OPTIONS Dementia with Lewy Bodies typically is accompanied by? EPS Huntington's disease is accompanied by? spasmodic movement and incoordination Frontotemporal dementia is normally accompanied by? extremely talkative and disinhibited ___ is one of the most usual symptoms of anxiety and a direct response to the activation of your sympathetic NS shaking The comorbid psychiatric dx frequently associated with anorexia is? OCD OCD-PD is also another comorbidity of those with anorexia Ethical questions about what we "ought" to do or be are addressed within which domain of ethics? 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? 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? B. Repeated exposures of a feared situation will always help the child to unlearn the fear response Developmental impairments and disruptive behavior problems are predominant issues during which of the age ranges? A. 0-5 Flashbacks in which the individual may act and feel as if the trauma were reoccurring represent which of the following clinical fts of PTSD A) Intrusive s/s 3 MULTIPLE CHOICE OPTIONS AFAB assigned female at birth AMAB assigned male at birth _____is good for older adults with anxiety and depression? -this tx TD as TD s/s are likely caused by hypersensitivity to dopamine *VERY EXPENSIVE, 1 year= 70,000+; approximately $6K/month Tetrabenazine (Xenazine) original VMAT inhibitor for the tx of HD off label used for TD tx Tetrabenazine is less expensive than deutetrabenazine but requires more frequent dosing and may have higher likelihood to causing depression & suicidiality ____is an anticholinergic medication FDA approved to tx EPS but requires TID dosing Trihexyphenidyl (Artane) *Second line tx choice due to TID dosage *only available in PO formulations Common SE of Artane? anticholinergic/antihistamine dry mouth, constipation, urinary retention, sedation, blurred vision (Trihexyphenidyl) Valbenazine (Ingrezza) was the first VMAT inhibitor to? be approved for the tx of TD in 2017 Valbenazine (Ingrezza) is FDA approved to tx: TD; off label to tx HD and tourettes Which medication used to treat TD is used in once daily dosing and is less likely to cause depression? Valbenazine (Ingrezza)-- once daily dosage, start @ 40 mg /day, then after 1 week, can increase to 80 mg/day *EXPENSIVE 6,000/month Avoid with use of _______ when taking any VMAT2 medication, such as Valbenazine (Ingrezza), Tetrabenazine (Xenazine) and duetetrabenazine (Austedo)? MAOIs what medication is used to tx antipsychotic induced weight gain and type 2 diabetes? Metformin average of 3k weight loss Metformin works by _______ appetite while _____insulin sensitivity? decreasing appetite while increasing insulin sensitivity MOA: decreases glucose production by liver and increases insulin sensitivity common se of metformin? GI side effects diarrhea, nausea, abdominal bloating, flatuence and discomfort Typical dose of Metformin used to reduce weight related to antipscyhotics? 500-1000mg BID --average of 3k of weight loss in pts How can you decrease the nausea and diarrhea side effect of Metformin? (affects 50% of patients) take with food or use ER formulation Best tool for assessing TD? AIMS 12 item test, takes approx 10 minutes. Best tool for monitoring the severity of TD What causes TD? antipsychotics but other medications (nausea and reflux meds) can cause TD as well: reglan, compazine and other agents that block dopamine Medications used to tx TD? (3) FDA approved: Valbenazine (Ingrezza) + Deutrabenazine (Austedo) Not FDA approved for TD, but FDA approved for HD: tetrazbenazine (Xenazine) Meds that cause severe weight gain? Antipsychotics- especially clozapine, olanzapine, quetiapine Antidepressants- mirtazepine, TCAs, Paxil Mood stabilizers- Lithium, Valproic Acid meds that cause moderate weight gain? risperidone and invega meds that cause less weight gain? ability, haldol, geodon, lurasidone First line tx for weight gain for psych meds? A. Topamax ----se: cognitive dulling B. Metformin ER C. Olanzapine/Samidorphan (Lybalvi)--used as an alternative to zyprexa to help reduce weight gain D. Orlistat (Xenical). ---se: diarrhea E. Abilify--may be useful for olanzapine induced weight gain as an adjunct Second line tx for weight loss? A. Wellburin SR B. Any stimulant C. Naltrexone/Bupropion (Contrave). --*antiobesity drug D. Phentermine (Suprenza)-*antiobesity drug E. Phentermine/topimate (Qsymia). ---*antiobesity drug F. Glucagon like peptide agonists---such as Liraglutide or Ozempic (Semaglutide) G. Nizatidine (Axid) ---antacid OTC H. Amantadine (symmetrel) Tx of akathisia? First line: propanolol, inderal LA, benzos second line: cogentin, amandtadine, clonidine, gabapentin, trazodone, mirtazepine, Cyproheptadine Blocks D2 blockade? decreases akathisia high potency antipsychotics increase risk of? Akathisia ex. Haldol, Abilify, Invega, Risperidone, Brexipiprazole Akathisia typically has an onset of? can be within a few hours, but normally takes days to weeks to appear ______ invol grinding of teeth Bruxism How to tx Bruxism?