NRNP 6675 Midterm Exam with correct answers, Exams of Nursing

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1 / 72 NRNP 6675 Midterm Exam with correct answers 1.Discrepancy between anatomical sex and gender is known as?: B) Gender Discordance 2.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 3.Antipsychotic medication provides D2 blockage in the meso-coritcal path- way causing which of the following effects?: B) Increases EPS Incorrect: reduces negative s/s, causes prolactinemia, reduces positive symptoms 4.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" 5.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 6.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 7.A deeply held belief despite evidence to the contrary, lasting at least 1 month, without prominent hallucinations, with functional impairment that re- lates to the delusional system disorder called?: Delusional disorder 8.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 9.Which of the following is a system that provides a uniform language for de- scribing medical and surgical procedures and diagnostics services rendered by clinicians?: CPT

2 / 72 Incorrect: HIPPA, DSM5-, DRG 10.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

3 / 72 "Thorazine" 11.A condition which results from absence of second female sex chromo- some (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 12.Which of the following would be characterized as a negative s/s of schiz- ophrenia?: B & C only B) impaired social and occupational functioning C) isolation and impaired self-care 13.Which of the following are keys to distinguishing OCD from psychosis?:

• Patients with OCD can almost always acknowledge the unreasonable nature of their symptoms 14.A federal program administered nationally and locally which covers en- rolled individuals 65+ who pays premiums and disabled individuals: Both A& B (Medicare and Medicaid) 15.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 16.Which of the following is the most widely consumed psychoactive sub- stance?: B) Caffeine Incorrect: alcohol, heroin, cannabis 17.Which of the following is used to tx TD?: None of the above (cogentin, artane, catapress) 18.The APRN consensus model did which of the following?: B & C B) adult and gerontology were merged and identified as PCP or acute care

4 / 72 C) psychiatric mental health foci were stipulated as across the lifespan

19. Which of the following behaviors are associated with an alcohol blood level of 0.05%?: B) Thought judgement and restraints are impaired

5 / 72 20.According to HIPPA, which of the following must the NP share their NPI with? Check all the above: A) Health Plans B) Other providers C) Any entity that may need it for a billing purpose 21.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?: Schizophrenia 22.Major neurotransmitters possibly involved in developing substance abuse and substance dependence are which of the following?: A) Dopamine Incorrect: GABA, serotonin, A& B only 23.The dopamine hypothesis of schizophrenia, which of the following?: A) Schizophrenia results from too much dopaminergic activity incorrect: results from a deprivation of dopamine 24.A patient reports a panic attack several years ago in an elevator and since then has avoided elevators. The pt meets the criteria for:: B) Specific phobia 25.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: D) All of the above (Residential tx, partial hospitalization, outpt tx) 26.Obscene phone calling to an unsuspecting partner for sexual arousal is known as?: C) Telephone Scatologia (not telephillia, partialism, normal adolescent prank) 27.The main psychological difference between fear and anxiety is best de- scribed by which of these statements?: B) Anxiety is insidious, fear is sudden 28.A diffuse, unpleasant, vague sense of apprehension often accompanied by autonomic symptoms varies upon persons is commonly known as which of the following?: C) Normal anxiety (incorrect- fear, stress, pathological anxiety 29.If a pregnancy begins while the woman is taking high doses of methadone and withdrawal is desired during which trimester is the least hazardous?: D) Withdrawal from methadone should never be done while

6 / 72 the woman is pregnant 30.Neurochemical or neurophysiological changes in the body that results from the repeated administration of a drug is known as which of the follow- ing?: C) Neuroadaption

7 / 72 incorrect: cross-tolerance, neurotransformation, neurocognitive adjustment 31.The recurrent and intense sexual arousal from the physical and psycho- logical suffering of another person is known as which of the following?: C) Sexual sadism 32.Which of the following is not consistent with the onset of OCD?: 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 33.The recurrent urge to expose one's genitals to a stranger is known ass which of the following?: C) Exhibitionism 34.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 35.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 36.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 37.Which of the following neurotransmitters increases libidio?: D) Dopamine Incorrect: GABA, serotonin, oxytocin 38.Which of the following factors are associated with poor prognosis for patients with OCD?: D) A & C (Childhood onset & Co-existing major depressive disorder) 39.Which of the following is inconsistent with current knowledge about

8 / 72 schiz- ophrenia?: C) Dopamine level is a laboratory tests that assists in the diagnosis of schizophrenia 40.A chronic disorder characterized by repetitive hair pulling leading to vari- able hair loss that may be..to others known as?: C) Trichotillomania

9 / 72 41.Which of the following are risk factors for neuroleptic malignant syn- drome?: B) Rapid dose escalation C) Parental route of admin D) High potency typical antipsychotics 42.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 43.The conditions in which people are born, grow, work, live and age are known as?: Social determinants of health 44.All of the following is consistent with the ANCCs rules regarding recertifi- cation 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 45.Risks factors for school violence include which of the following? Select all that apply: A) Bullying B) Being bullied C) Isolation 46.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 47.Generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following lithium levels?: D) >25 mEq/L (TOXICITY) 48.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

10 / 72 49.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 50.A patient presents with a formal, tense manner. He reluctantly reports a longstanding (since early adulthood) pervasive suspiciousness of others, pre- occupied 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 51.A pt will a hx of alcohol use presents to the ED with oculomotor distur- bances, 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 52.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 53.NP core competencies for INDEPENDENT practice includes all of the following EXCEPT:: B) Demonstrates the highest level of accountability for profes- sional practice 54.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 de- signee as a full practice in decision making 55.Cluster A personality traits consists of which of the following?: A) Schizo- typal, schizoid, and paranoid subtypes 56.The misuse of the charge's funds for personal gain is known as which of the following?: C) Financial abuse /exploitation 57.the ARNP recognizes which of the following as long term effects of sex trafficking on victims?: D) All of the above A) Severe depression

11 / 72 B) Spiritual questions C) Trauma bonding

12 / 72 58.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 59.Cultural Dimensions Therapy is a framework for cross-cultural communi- cation that describes the effects of a society's culture on the values of its members..by which of the following therorists?: A) Hofstede 60.The tx of choice for pts with paranoid PD includes which of the following?- : D) B&C B) Behavioral Therapy and C) Psychotherapy 61.The differences in quality of healthcare actions across individuals or groups regard to access, tx options and p..following?: B) Health disparities

62. The incidence of suicide is highest for which of the following populations?- : D) Older African American men
63. 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?: C) The ARNP recognizes the symptoms of moderate lithium toxicity, discontinues the lithium immediately, orders lithium level, serum electrolytes and renal function tests 64.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?: 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 65.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?: D) Hourly rate 66.A PD characterized by emotional constriction, orderliness, perseverance, stubbornness, indecisiveness, a inflexibility as which of the following?: Ob- sessive compulsive PD 67.Which of the following is consistent with what is known about the epidemi- ology of anxiety?: B) Women have a higher lifetime prevalence of anxiety than men 68.Which of the following is consistent with NP practice parameters when

13 / 72 prescribing buprenorphine?: D) the NP is require to complete specific training to prescribe and dispense buprenorphine 69.Which of the following are consistent with current data related to the prevalence of drinking alcohol?: B) Men and women with higher education and income are more likely to drink alcohol

14 / 72 70.A pt with hx of hypoglycemia reports feelings of fear, worry and restless- ness 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?: A_) GAD attributable to another medical condition 71.Which of the following is not consistent with benzo withdrawal?: B) The best way to proceed with benzo withdrawal is to stop it immediately and tx withdrawal s/s 72.Which of the following is true about the legal practice of the PMHNP?: 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 73.Flashbacks in which the individual may act and feel as if the trauma were reoccurring represent which of the following clinical features of PTSD?: A) Intrusion Symptom B) Symptom of Avoidance 74.In which ways are NPs and PAs different?: D) A&B A) NPs differ from PAs in legal definition, scope of practice, licensure, and indepen- dence of practice B) NPs practice under their own license and independent of the physician, PAs always work under the supervision of a physician 75.Which of the following initials would a PMHNP use to designate appropri- ate credentials?: PMHNP-BC 76.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?: B) Gender role behavior

77. 3 major neurotransmitters associated with anxiety, based on animal stud- ies and response to drug tx include?: B) GABA, norepinephrine and serotonin 78.Which of the following is consistent with the epidemiology of schizophre- nia in the US?: D) Onset of schizophrenia before the age of 25 is extremely rare 79.Clinical findings that may indicate abuse include which of the following? Select all that apply: B) Explanation by the pt which is inconsistent with the type of injury

15 / 72 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 80.According to the APA, which of the following is consistent with the EBP for telepsych?: B) In populations with severe anxiety, tele psychiatry is preferred

16 / 72 81.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 82.Bleuler identified 4 fundamental s//s of schizophrenia, known as the 4 A's, which include which symptoms?: A) Associations, Affect, Autism, Ambivalence 83.The fear/anxiety regarding places from which escape may be difficult is known as which of the following:: C) Agoraphobia 84.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) 85.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 86.Which of the following is consistent with what is known about PP depres- sion?: 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) 87.Affirmatively acting to benefit another or others, going beyond what is required by law is known as which of the following?>: C) Beneficence 88.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 89.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

17 / 72 websites -Volunteer to serve on legislature committees within professional NP organizations 90.The tx of others equitably and distribution of benefits/burdens fairly is known as?: B) Justice

18 / 72 91.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 92.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 93.Which of the following developed a biblically-based cultural competence model for healthcare professionals?: B) Camipinha-Cacote` 94.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 95.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 96.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 97.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 98.The emotional burnout and lack of empathy towards clients that healthcare providers experience after treating victims is known as the following?: B) Primary traumatization 99.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

100. Walking on eggshells and appeasement/avoidance behaviors by the vic- tim is characteristic of which phase of the cycle of DV?: A) Honeymoon phase

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101. What are the different phases of DV?: 1. Tension building phase
102. Incident

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3. Reconciliation
4. Calm
5. The only appproved therapy in the US for moderate to severe Alzheimers Disease is which of the following?: B) Memantine
6. Memantine is?: A) Namenda, cognition enhancing medication for alzheimers/dementia
7. 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
8. Narcissistic, borderline, antisocial, and histrionic subtypes are associat- ed with which cluster of PDs?: B) Cluster B
9. Odd, eccentric cluster of PDs?: Cluster A a. Paranoid PD b.Schizoid PD C. Schizotypal PD
10. Characterized by appearing dramatic, emotional, or erratic PD?: Cluster B a., antisocial b.borderline c. histrionic d. narcissistic
11. inner emptiness, unstable relationships and emotional dysregulation?: - BPD
12. Attention seeking and excessive emotionability?: Histrionic
13. Social irresponsibility, diregard for others, deceitfulness, and manipula- tion of others for personal gain: Antisocial
14. Self-grandiosity, need for admiration and lack of empathy: Narcissistic PD
15. Eccentric ideas and behaviors PD?: Schizotypal PD
16. Disinterest in others PD?: Schizoid
17. Mistrust and suspicion PD?: Paranoid PD
18. Characterized by appearing anxious or fearful. it includes which PDs?: - Cluster C

21 / 72 a. avoidant PD b.dependent PD c. obsessive compulsive PD

116. Perfectionism, rigidity and obstinacy traits PD?: OCD PD

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117. Avoidance of interpersonal contact due not rejection sensitivity PD?: - `Avoidant
118. Submissiveness and a need to be taken care of PD?: Dependent PD
119. Which of the following is NOT consistent with recommendations for psychiatric hx taking and the MSE of older adults?: B) Pt should be seen alone even in cases of clear evidence of impairment to persevere the privacy of a doctor/pt relationship
120. Low health literacy has been linked with which of the following?: D_ All of the above -poor health outcomes -lower rates of hospitalization -less frequent use of preventative services
121. A claim of malpractice requires that a patient/plaintiff prove which of the following? Select all that apply: 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
122. According to USDHHS and the Federal Bureau of Primary Health Care, which of the following individuals would be considered homeless?: 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 friend`
123. A 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?: A) DBT incorrect: mentalization based tx; transference focused psychotherapy and exposure therapy`
124. 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?: B) Set a cool room temp

23 / 72 True sleep hygiene tips:

24 / 72 -avoid alcohol and caffeine -set TV to turn off within 1 hr of falling asleep -go to bed at the same time each night

125. 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
126. according to Freud, stubborn, parsimonious and highly conscientious traits are associated with?: B) Anal stage
127. Freud's Psychosexual Theory and 5 Stages of Human Development?: -
128. Oral stage
129. Anal stage
130. Phallic stage
131. Latent stage
132. genital stage
133. The mouth, sucking, swallowin ect: Stage 1- oral stage
134. EGO develops in which phase?: ORAL phase 1
135. The penis or vagina-sexual intercourse?: Stage 5 genital
136. `The anus- withholding or expelling feces: 2. Anal stage
137. Little to no sexual motivation present?: Stage 4. Latent phase
138. The penis or clitoris- masturbation: Stage 3 Phallic
139. the SUPEREGO develops at what phase?: Stage 3 Phallic
140. 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
141. A patient currently on risperidone presents to the ED with increased agi- tation, 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
142. 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

25 / 72 good self care strategies: -plan to study for short periods over a long time