NRNP 6675 Week 6 Midterm Exam, Exams of Nursing

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1. Antipsychotic medications can cause metabolic symptoms. Which of the following is not consistent with metabolic syndrome Obesity Dyslipidemia C. Hypotension Impaired glucose tolerance 2. Abnormal involuntary movements in a rhythmic pattern affecting face, mouth, tongue, jaw is known as which of the following? Akathisia Dystonia Tardive dyskinesia Extrapyramidal side effect 3. A patient presents with delusions, disorganized thoughts and speech with poor self- care, all of which have persisted for the past 7 months. The aprn realize this presentation is consistent with which of the following diagnoses? Schizophrenia Schizophreniform disorder Brief psychotic disorder Delusional disorder 4. A period of at least 6 months of recurrent and intense sexual arousal from cross dressing that causes clinically significant distress or impairment is consistent with which

of the following? Gender dysphoria Turners syndrome Transvestic disorder Klinefelters syndrome

5. Which of the following id consistent with current epidemiology literature about gender obsessive compulsive disorder Adult men are more likely to have ocd than adult women Adult women are more likely to have ocd than adult men Adolescents’ girls are more likely to have ocd than adolescent boys Adult men and adult women are equally likely to have ocd 6. Which of the following is not a common physical effect of cannabis? Mild tachycardia Mild bradycardia Orthostatic hypotension Dilation of the conjunctival blood vessel 7. Obsessive compulsive disorder is associated with dysregulation of which of the following neurotransmitters? Dopamine Serotonin Norepinephrine

Gaba

8. Which of the following initials would a psychiatric mental health nurse practitioner use to designate appropriate credentials? Anp-c Cpnp Cpnp Pmhnp-bc 9. Nystagmus or marked slurring of speech and blackouts are more likely impairment as which of the blood alcohol concentrations? 30- 80mg/dl 80- 200- 300- 10. Which of the following neurotransmitters is released with orgasm and is believed to reinforce pleasurable activities? Gaba Serotonin Oxytocin Dopamine 11. A disorder characterized by acquiring and not discarding things that deemed to be of little or no valuable resulting in excessive clutter of

Specific phobia Trichotillomania Hoarding disorder Obsessive compulsive disorder

12. Which of the following is true about use of CPT codes? CPT codes are optional but often used to assist providers in billing Cpt codes are required by HIPPA to be used to record care by all health care professionals in the United States Cpt codes are an international classification of disorders Cpt codes are not required by non-government insurance companies

95. Billing responsibilities related to Medicare providers include which of the following A. Collecting patient employment and insurance information B. Identifying payers other than medicare C. Determining if medicare is a primary or secondary provider D. All of the above According to HIPPA which of the following must the NP share their NPI number with that apply A. Health Plan B. Other providers C. Any entity that may need it for billing purpose D. D. A and C only
96. Fantasies and sexual urges to dress in opposite gender clothing as means of arousal and

as an adjunct to masturbation or coitus is known as which of the following? Fetishism Voyeurism

Transvestism Scatologia As a Medicare part B provider, you should do which of the following? Which of the following would be characterized as a negetaive symptoms of schizophrenia B. Impaired social and occupational C. Isolation and impaired self care D. B and C

14. According to the American psychiatric association which of the following is consistent with the evidence base practice for telepsychiatry? There are few studies exploring the evidence for telepsychiatry In population With severe anxiety, telepsychiatry is preferred The effectiveness is comparable to in person care in terms of therapeutic engagement, quality of care, validity/reliability of assessment The evidence base for children and adolescent is very weak Non- bizarre delusions present for a least 1 month without other symptoms of schizophrenia or mood disorder warrants a diagnosis of which of the following B. Delusional disorder

15. Antipsychotic medications provide D2 blockade in nigrostriatal, which causes which of the following? Prolactinoma Galactorrhea Gynecomastia Extrapyramidal symptoms
16. Antipsychotic medications provide D2 blackade in the mesolimbic system which result in which of the following C. Increase extrapyramidal symptoms Adeeply held belief despite evidence to the contrary, lasting a least one month, without prominent hallucinations with functional impairment that relates to the delusional system is consistent with which of the following diagnosis? B. Delusional disorder Neurochemical or neurophysiologic changes in the body that result from the repeated administration of a drug is known as which of the following C. Neurocognitive adjustment
17. The experience of anxiety had which of the following components? Increased self awareness and afear

Awareness of physiological sensations and shame Awareness of being nervous of frightened and shame E. Awareness of physiological sensations and awareness of being nervous or frightened

28. Which of the following behaviors are associated with an alcohol blood level od 0. percent? B. Thought, Judgment, and restraint are impaired
29. A nursing practice model recommended for NPs by the national academy of medicine and the national council of state boards of nursing is which of the following? Full practice Reduced practice Restricted practice Artitrary practice
30. Which of the following anticholinergic medications is used to treat extrapyramidal symptoms? Diphenhydramine Amantadine Propranolol D. Benztropine
31. A patient who presents absent movement with difficulty starting activities, flat affect, and avolition would be assess as having which of the following?

Dystonia Akathisia Akinesia D. Psudo-parkinsons

58. Which of the following are risk factor for neuroleptic malignant syndrome? Select all the apply A. Rapid dose escalation B. Parental route of administration c. Higher potency typical antipsychotics
59. Use of any drug, usually by self-administration in a manner that deviates from approved social or medical pattern is known as which of the following? A. Abuse Dependence Addiction Intoxication
60. Which of the following neurological symptoms are consistent with inhalant use? Sensory illusions, distortions of body size Fearfulness, auditory and visual hallucinations Irritability, emotional lability, euphoria

D. Slurred speech, decreased rate speech, ataxia

22. The ability of one drug to be substituted for another each usually producing the same physiological and psychological effect is known as which of the following? Tolerance Co-dependence B. Cross-tolerance Neuroadaptation
23. Which of the following is a system that provides a uniform language for describing medical and surgical procedures and diagnostic services rendered clinicians Hippa Dsm- C. Cpt Drg Phencyclidine(PCP) and ketamine exert their unique behaviors effects by blocking which of the following receptors D. NMDA type receptors
24. Variations from norms in gender role behavior such as toy preferences, rough and tumble play, aggression or playmate gender is known as which of the following? Gender discordance

Gender role behavior Gender identity variance D. Childhood gender nonconformity

25. Which of the following groups does Medicare cover? Select all that apply. A. Individual 65 years and older who have enrolled and pay premiums B. Disabled individuals who qualify for social security disability payments and benefits Adults who are disabled for one year or less and who qualify on the basis of poverty Mothers and children who qualify on the bias of poverty
26. Which of the following is not true about reimbursement from third party payers? Each of third party payer has its own reimbursement policies and fee schedules Each type of third party payer operates under a separate body of law Not very third party payer will pay every np for very service D. All third-party payers must reimburse nps in the same manner that they reimburse physicians
27. The fear or anxiety regarding places from which escape might be difficult ids known as which of the following? Depression Panic disorder C. Agoraphobia Generalized anxiety disorder

28. A rare life threatening condition that can occur at any time in a patient receiving antipsychotic medication with symptoms which include increase creatine, phosphokinanse, leukocytosis, hyperthermia, and tachycardia is known as which of the following? Tardive dyskinesia Psudeo parkinsons C. Neuroleptic malignant syndrome Extrapyramidal side effects
29. Substance seeking activities along with related evidence of pathological use patterns are emphasized when discussion which of the following concepts related to substance use and addictive disorders? Addiction B. Behavioral dependence Physical dependence Psychological dependence
30. All of the following are one of the five major categories of third party payers except: Medical/Medicaid Managed care organizations (mcos)f C. Indemnity insurance companies Only A and B

31. Which of the neurotransmitters increases libido? GABA Serotonin Oxytocin D. Dopamine 71 Which of the following is true about the fifth editon of the diagnostic and Statistical manual of mental Disorders (DSM-S) A. Combine the first three DSM-IV TR axes into one list that contains all mental disorder
32. Researchers have identified particular neurotransmitters or neurotransmitter receptors involved with most substance of abuse except for which of the following? Alcohol Opioids Amphetamines Cocaine
33. The fear of social situations including situations that involve scrutiny or contact with strangers is known as which of the following? Specific phobia B. Social anxiety disorder Generalized anxiety disorder

Avoidant personality disorder

34. Which of the following id the leading cause of premature death among people with schizophrenia? Cardiovascular disease Substance abuse C. Suicide Diabetes mellitus
35. Discrepancy between anatomical sex and gender identity is known as which of the following? Gender role behavior B. Gender discordance Gender nonconformity Internalized sexual prejudice
36. The diagnosis used to describe a syndrome characterized by specific signs and symptoms resulting from recent ingestion or exposure to a substance is known as which of the following? Substance intoxication Substance withdrawal C. Substance use disorder Any of the above

37. Clinical findings that may indicate abuse include which of the following? Select all that apply. Delay between onset of injury and seeking treatment Explanation by the patient which is inconsistent with the type of injury Psychological distress such as depression, anxiety, suicidal ideations and or sleep disorder Explanation by the patient which is inconsistent with the type of injury
38. A federal program administered nationally and locally which covers enrolled individuals 65 years and older who pay premiums and disabled individuals who qualify got social security disability payments and benefits is: A. Medicare Medicaid Both A and B None of the above
39. Methadone withdrawal usually begins how soon after the last dose D.1-3 days after the last dose
40. Which of the following services are usually excluded from both primary and secondary MEDICARE BENEFITS? A. Medicare does not reimburse for the same service covered by VA benefits.

B. Medicare does not reimburse for services covered under the Federal black Lung program C. A and B Only

36. 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
37. Which of the following is consistent with what is known about the epidemiology of anxiety? Men have a higher lifetime prevalence of anxiety than women ‘B.Women have a higher lifetime prevalence of anxiety than men Men and women have equal lifetime prevalence The lifetime prevalence of anxiety id not gender specific
38. Which of the following is used to treat tardive dyskinesia? Cogentin Artane Catapress None of the above A Patient report having a panic attack several years ago in an elevator and since than has avoided using elevators. This patient meets criteria for which of the following B. Specific Phobia Which of the following is used to treat Tardive Dyskinasia?

Cogentin (Benztropine) Artane(Trihexyphenidyl) C. Catapress(clonidine D. None of the above The APRN consensus model did which of the following B. Adult and gerontology were merged and identified as primary care or acute care C. Psychiatric mental health foci was stipulated as across the lifespan D. B and CF

41. Which of the following antipsychotic medication have been shown to shorten QTC? A. Aripiprazole Risperidone Quetiapine Haloperidol Major neurotransmitters possibly involved in developing substance abuse and substance dependence include which of the following A. Dopamine
42. The genotype xxy is associated with which of the following? A. Kinefelters syndrome Androgen insensitivity syndrome

Terners syndrome Adrenogenital syndrome

43. A patient who present with the inability to remain still with motor restlessness would be assessed to have which of the following? dystonia B.Akathisia Akinesia Tardive dyskinesia
44. Preoccupation with an imagined defect in appearance that causes clinically distress or impairment areas of function is consistent with which of the following disorders? Anorexia B.body dysmorphic disorder Obsessive compulsive disorder Dissociative disorder
45. Which of the following is considered a typical feature during a panic attack? Chest pain, shaking Dizziness, paresthesia Shortness of breath, chills Alteration in consciousness, bladder dyscontrol

46. Which of the following are consistent with current data related to the prevalence of drinking alcohol? Men and women with higher education and income less likely to drink alcohol Men and women with higher education and income are more likely to drink alcohol. Men and women with lower education and higher income are more likely to drink alcohol Education and income are not a factor in prevalence of drinking alcohol
47. Which of the following is consistent with current literature regarding positive and negative symptoms of schizophrenia? Negative symptoms occur earlier in the disease process; positive symptoms tend to decrease over time Positive symptoms occur earlier in the disease process; negative symptoms tend to decrease over time Positive and negative symptoms occur and vary simultaneously throughout course of the disease None of the above
48. A patient with a substance abuse disorder who does not meet the clinical criteria for hospitalization but who lacks sufficient social and vocational and lack substance free social support is appropriate for which of the following levels of treatment? Residential treatment Partial hospitalizations Outpatient treatment

All the above Which of the following patient would be appropriate for hospitalization for substance use disorder? Select all the apply A. A patient who have a substance overdose who cannot bre safely treated in an outpatient setting B. Patient who are at risk for severe or medically complicated withdrawal syndromes C. Patient who has history of not benefiting from treatment in a less intensive setting

49. Which of the following are used to treat symptoms of neuroleptic malignant syndrome? Dantrolene Bromocriptine Chlorpromazine A and B only
50. The inability to recall important personal information, usually of a traumatic or stress nature that is too extensive to be explained by normal forgetfulness, direct physiological effects of a substance or other medical condition is the main feature of which of the following disorders? Dissociate amnesia Derealization disorder Depersonalization disorder Posttraumatic stress disorder

51. A term used to designate the behavioral patterns of family members who have been significantly affected by another family members substance use or addiction is which of the following? Denial Enabling Codependence Enmeshment
52. An excessive anxiety and worry about several events or activities for most days during at least 6-month period is known as which of the following? Specific phobia Social anxiety disorder Anxiety personality disorder Generalized anxiety disorder
53. An adaptive response to threat that prepares the organism for flight or fight is known as which of the following? Anxiety Specific phobia Generalized anxiety disorder None of the above

54. Telepsychiatry adjust clinical care in which of the following ways to make it as personal as in person care? Use fewer physical gestures as patients are not able to clearly appreciate them anyway Check in with the patient to see how the patient is experiencing telepsychiatry Insist every other appointment is an in-person appointment Send things to the patient such as box of tissues to facilitate the patient feeling cared for
55. Which of the following is consistent with the epidemiology of schizophrenia in the United States? The lifetime prevalence of schizophrenia is bout 50 percent Schizophrenia is more prevalent in children than in adolescents Peak age of onset in men is 10 to 25 years of age Onset of schizophrenia before the age of 25 is extremely rare
56. Flashbacks in which the individual may act and feel as if the trauma were reoccurring represent which of the following clinical features of ptsd? Intrusion symptoms Symptoms of avoidance Symptoms of increased autonomic arousal Derealization

57. Which of the following symptoms represent peripheral manifestations of anxiety? Hyperreflexia Palpitations Hyperhidrosis All of above
58. When a manic or depressive syndrome develops concurrently with the major symptoms of schizophrenia, the appropriate diagnosis would be which of the following? Bipolar schizophrenia Mood disorder with psychosis Schizoaffective disorder Bipolar disorder with psychosis
59. A patient with a history of alcohol use disorder presents with confusion, clouding of consciousness, myoclonus, oppositional hypertonia, fatigue, apathy irritability, anorexia, and insomnia. Symptoms do not improve with thiamine treatment, The presentation is consistent with which of the following? Wernike-korsakoff syndrome Idiosyncratic alcohol intoxication Alcoholic pellagra encephalopathy Alcohol induced persisting dementia

76. In the DSM-IV the need for treatment is based on assessment of diagnosis and which of the following A. A severity of symptoms B. Dangerous to self or others C. Disability in social and self-care spheres D. All of the above There are five schedules of controlled substances which schedule of controlled substances have no accepted medical use in the United States and have high abuse potential? A. Schedule 1 A conscious, Standardized, recurrent behaviors such as counting, checking, avoiding that interferes significantly with the person normal routine and functioning is known as which of the following? A. A compulsion
77. A disorder characterized by an emotional response to a stressful event within three months of the stressor is known as which of the following? Insomnia Conduct disorder

Adjustment disorder Generalized anxiety disorder

61. Which of the following is consistent with literature regarding the term psychosexual? Psychosexual is used to describe personality development and functioning Psychosexual is synonymous with libido in the fredian sense Psychosexual basically reefers only to sexual feelings and behavior None of the above
62. Which of the following is true about the Global Assessment of functioning GAF)? C. The clinician-researchers at the APA developing the DSM-5 recommend the GAF be used only by clinicians and researchers who have specific training to support good reliability of the used only by clinicians and researchers who have specific training to support good reliability of
63. The recurrent urge to expose one’s genitals to a stranger is known as which of the following? Fetishism Voyeurism Exhibitionism Paraphilic disorder One’s sense of being male female is known as which of the following FA. Gender Identity