NRNP 6675 Week 6 Midterm Exam, Exams of Nursing

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Question 1

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?

A

Substance

.

intoxication

B

Substance

.

withdrawal

C

Substance use

.

disorder

D Any of the above

.

Question 2

Data indicate which of the following regarding women drinking while pregnant or breast feeding?

A Women who are pregnant or are breast-feeding should not drink alcohol.

.

B

Women who are pregnant should not drink alcohol but drinking alcohol while breast-

.

feeding is not a risk to the baby.

C Women who are pregnant or breast-feeding can drink one alcoholic drink up to 3

.

times per week without concern for risk to the fetus or baby.

D

Women who are pregnant or breastfeeding can safely drink occasionally without risk

.

to the fetus.

Question 3

Neurochemical or neurophysiologic changes in the body that result from the repeated administration of a drug is known as which of the following?

A Cross-tolerance

.

B Neurotransformation

.

C Neuroadaptation

.

D

Neurocognitive

.

adjustment

Question 4

One’s sense of being male or female is known as which of the following?

A

Gender

.

identity

B

Sexual

.

orientation

C Sexual

.

behavior

D

Sexual

.

preference

Question 5

Which of the following is true about the Global Assessment of Functioning (GAF)?

A

The GAF is still an essential score in the DSM-5 diagnosis.

.

B

The clinician-researchers at the APA do not believe that a single GAF score is

.

adequate to assess all aspects of functioning.

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 GAF score.

D The GAF should only be used for patients who are suicidal.

.

Question 6

In the DSM-V the need for treatment is based on assessment of diagnosis and which of the following?

A Severity of symptoms

.

B Dangerous to self or others

.

C Disability in social and self-care

.

spheres

D All of the above

.

Question 7

Having an adequate legal description of nurse practitioner (NP) scope of practice according to state law is important for which of the following reasons?

A To avoid any charges of practicing medicine without a license.

.

B

To place accountability for both benefits and harm to patients

.

squarely on the NP.

C To get reimbursement for physician services when provided by and

.

NP.

D All the above.

.

Question 8

A deeply 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 diagnoses?

A Schizophrenia

.

B Delusional disorder

.

C

Brief psychotic

.

disorder

D

Schizophreniform

.

disorder.

Question 9

All of the following are one of the five major categories of third-party payers EXCEPT:

A Medicare/Medicaid

.

B Managed-care organizations

.

(MCOs)

C

Indemnity insurance

.

companies

D Only A and B

.

Question 10

Which of the following factors are associated with poor prognosis for patients with OCD?

A Childhood onset

.

B

The presence of a precipitating

.

event

C

Co-existing major depressive

.

disorder

D A and C

.

Question 11

A delusional disorder in which the patient is focused on bodily functions, perceived physical ailments, malodorous, malformed, or infected would be consistent with which of the following subtypes?

A Grandiose

.

B

Persecutor

.

y

C Somatic

.

D

Erotomani

.

ac

Question 12

Which of the following behaviors are associated with an alcohol blood level of 0.05 percent?

A

Voluntary motor actions usually become

.

perceptibly clumsy.

B Thought, judgment, and restraint are impaired.

.

C Confusion, stupor

.

D None of the above

.

Question 13

Which of the following is true about the legal practice of the psychiatric-mental health nurse practitioner?

A

All have some degree 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.

.

C

All have the ability to manage patients medically within their scope of practice

.

without a collaborative practice agreement.

D A and B only

.

Question 14

Which of the following should be considered when prescribing medications? Check all that apply.

A Can the patient afford the medication?

.

B

Is the drug available at the hospital or at a local

.

pharmacy?

C Can the patient read?

.

D Is there potential for abuse?

.

Question 15

Obscene phone calling to an unsuspecting partner for sexual arousal is known as which of the following?

A Telephilia

.

B Partialism

.

C Telephone scatologia

.

D

Normal adolescent

.

prank

Question 16

Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects?

A Reduces negative symptoms

.

B

Increases extrapyramidal

.

symptoms (EPS)

C Causes prolactinemia

.

D Reduces positive symptoms

.

Question 17

A term used to designate the behavioral patterns of family members who have been significantly affected by another family member’s substance use or addiction is which of the following?

A Denial

.

B Enabling

.

C Codepende

.

nce

D

Enmeshmen

.

t

Question 18

Which of the following is true about the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

A Combines the first three DSM-IV TR axes into one list that contains all mental

. disorders.

B While it combines the first three DMS-IV TR axes, personality disorders and medical

. disorders are still recorded separately, using the multi-axial framework.

C Psychosocial and environmental factors still need to be specified as part of the DSM-

.^5 diagnosis.

D A and C only

.

Question 19

Abnormal involuntary movements in a rhythmic pattern affecting face, mouth, tongue, jaw in known as which of the following?

A Akathisia

.

B Dystonia

.

C Tardive dyskinesia

.

D

Extrapyramidal side

.

effects

Question 20

Which of the following are considered atypical features during a panic attack?

A Chest pain, shaking

.

B Dizziness, paresthesias

.

C Shortness of breath, chills

.

D

Alterations in consciousness, Bladder

.

dyscontrol

Question 21

Antipsychotic medications provide D2 blockade in the nigrostriatal, which causes which of the following?

A Prolactinemia

.

B Galactorrhea

.

C Gynecomastia

.

D

Extrapryramidal symptoms

.

(EPS)

Question 22

A federal program administered nationally and locally which covers enrolled individuals 65 years and older who pay premiums and disabled individuals who qualify for Social Security disability payments and benefits is

A Medicare

.

B Medicaid

.

C Both A and B

.

D

None of the

.

above

Question 23

Variations from norms in gender role behavior such as toy preferences, rough-and-tumble play, aggression, or playmate gender in known as which of the following?

A Gender discordance

.

B Gender role behavior

.

C Gender identity variance

.

D

Childhood gender non-

.

conformity

Question 24

The fear of or anxiety regarding places from which escape might be difficult is known as which of the following?

A Depression

.

B Panic disorder

.

C Agoraphobia

.

D

Generalized anxiety

.

disorder

Question 25

The fear of social situations, including situations that involve scrutiny or contact with strangers is known as which of the following?

A Specific phobia

.

B Social anxiety disorder

.

C

Generalized anxiety

.

disorder

D

Avoidant personality

.

disorder

Question 26

Which of the following is inconsistent with current knowledge about schizophrenia?

A Schizophrenia is one of the most common of the serious mental disorders.

.

B A diagnosis of schizophrenia is based entirely on the psychiatric history and mental

.

status examination.

C Dopamine level is a laboratory test that assists in the diagnosis of schizophrenia.

.

D

Schizophrenia likely comprises a group of disorders with heterogeneous etiologies

.

and variable presentations.

Question 27

A patient on chlorpromazine states that his orgasm is dry and afterward he will commonly have milky urine. The ARNP realizes which of the following?

A This is likely a harmless response to the chlorpromazine.

.

B This is abnormal and needs to be evaluated by a specialist.

.

C It is critical to stop the Chlorpromazine immediately.

.

D

This has nothing to do with the chlorpromazine the patient should be referred to his

.

PCP for follow-up.

Question 28

The main psychological difference between fear and anxiety is best described by which of the following statements?

A Fear is insidious; anxiety is sudden.

.

B Anxiety is insidious; fear is sudden.

.

C There is no difference between fear and

.

anxiety.

D

Both anxiety and fear are alerting

.

signals.

Question 29

Which of the following is consistent with what is known regarding metabolism of alcohol?

A

About 90 percent of absorbed alcohol is metabolized through oxidation in the liver,

.

the remaining 10 percent is excreted unchanged by the kidneys and lungs.

B

About 70 percent of absorbed alcohol is metabolized in the liver, 20 percent

.

metabolized and excreted through the kidneys.

C The body can metabolize 50 mg/dL or 40% alcohol per hour.

.

D Alcohol is metabolized by alcohol hydrogenase (ADH) and aldehyde hydrogenase.

.

Question 30

A rare life-threatening condition that can occur at any time in a patient receiving antipsychotic medication with symptoms which include increased creatinine phosphokinase, leukocytosis, hyperthermia, and tachycardia in known as which of the following?

A Tardive dyskinesia

.

B Pseudo-Parkinson’s

.

C Neuroleptic malignant

.

syndrome

D Extrapyramidal side effects

.

Question 31

A psychotic disorder lasting more than a month but less than 6 months is known as which of the following?

A Brief psychotic disorder

.

B Schizophreniform disorder

.

C Psychotic depression

.

D

Schizotypal personality

.

disorder

Question 32

Which of the following initials would a psychiatric-mental health nurse practitioner use to designate appropriate credentials?

A ANP-C

.

B CPNP

.

C CPNP-AC

.

D PMHNP-

.

BC

Question 33

Bleuler identified four fundamental symptoms of schizophrenia known as the 4 As, which include which of the following symptoms?

A

Associations, affect, autism and

.

ambivalence.

B Associations, alogia, abstraction,

.

anxiety

C

Affect, apraxia, anhedonia, audible

.

thoughts

D

Autism, apperception, amotivation,

.

automatism

Question 34

According to the AANP State Practice Environment, the following statement is consistent with which level of practice? “State practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. State law requires career-long supervision, delegation or team management by another health provider in order for the NP to provide patient care.”

A Full practice

.

B

Reduced

.

practice

C

Restricted

.

practice

D

None of the

.

above

Question 35

The phenomenon in which, after repeated administration, a given dose of drug produces a decreased effect is known as which of the following?

A Tolerance

.

B

Cross-

.

tolerance

C Addiction

.

D Intoxication

.

Question 36

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

.

Question 37

If a pregnancy begins while the woman is taking high doses of methadone and withdrawal is desired, during which trimester is this least hazardous?

A First trimester

.

B Second trimester

.

C Third trimester

.

D

Withdrawal from methadone should never be done while the woman

.

is pregnant.

Question 38

Which of the following is not a common physical effect of cannabis?

A Mild tachycardia

.

B Mild bradycardia

.

C Orthostatic hypotension

.

D

Dilation of the conjunctival blood

.

vessels

Question 39

A condition which results from absence of second female sex chromosome (XO) and is associated with web neck, dwarfism, cubitus valgus, and infertility in known as which of the following?

A Hermaphroditism

.

B Turner’s syndrome

.

C Adrenogenital syndrome

.

D

Androgen insensitivity

.

syndrome

Question 40

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was developed for which of the following purposes?

A

To facilitate a seamless transition into immediate use by clinicians and insurers to

.

maintain continuity of care

B To facilitate more precisely identifying and diagnosing mental disorders

.

C To eliminate need for ICD-9 codes

.

D A and B

.

Question 41

Telepsychiatrists adjust clinical care in which of the following ways to make it as personal as in- person care?

A

Use fewer physical gestures as patients are not able to clearly appreciate

.

them anyway.

B Check in with the patient to see how the patient is experiencing

.

telepsychiatry.

C Insist every other appointment is an in-person appointment.

.

D

Send things to the patient such as a box of tissues to facilitate the patient

.

feeling cared for.

Question 42

Which of the following is consistent with literature regarding the term psychosexual?

A

Psychosexual is used to describe personality development and

.

functioning.

B Psychosexual is synonymous with libido in the Freudian sense.

.

C Psychosexual basically refers only to sexual feelings and

.

behavior.

D None of the above

.

Question 43

The Dopamine hypothesis of schizophrenia posits which of the following?

A

Schizophrenia results from too much

.

dopaminergic activity.

B

Schizophrenia results from a deprivation of

.

dopamine.

C Schizophrenia is not related to dopamine activity.

.

D None of the above

.

Question 44

According to the American Psychiatric Association (APA) which of the following is consistent with the evidence base practice for telepsychiatry?

A There are few studies exploring the evidence for telepsychiatry.

.

B In populations with severe anxiety, telepsychiatry is preferred.

.

C

The effectiveness is comparable to in-person care in terms of therapeutic

.

engagement, quality of care, validity/reliability of assessment, and clinical outcomes.

D The evidence base for children and adolescents is very weak.

Question 45

Which of the following is consistent with current literature regarding positive and negative symptoms of schizophrenia?

A

Negative symptoms occur earlier in the disease process; positive symptoms tend to

.

decrease over time.

B

Positive symptoms occur earlier in the disease process; negative symptoms tend to

.

decrease over time.

C

Positive and negative symptoms occur and vary simultaneously throughout the

.

course of the disease.

D None of the above

.

Question 46

Which of the following is consistent with current epidemiology literature about gender and Obsessive-Compulsive Disorder (OCD)?

A

Adult men are more likely to have OCD than adult

.

women.

B

Adult women are more likely to have OCD than adult

.

men.

C

Adolescent girls are more likely to have OCD than

.

adolescent boys.

D

Adult men and adult women are equally likely to have

.

OCD.

Question 47

Which of the following neurotransmitters exerts an inhibitory effect of sexual function?

A

Dopami

.

ne

B

Oxytoci

.

n

C

Serotoni

.

n

D

Glutama

.

te

Question 48

Sexual stimuli or acts that are deviations from normal sexual behaviors but are necessary for some persons to experience arousal and orgasm are known as which of the following?

A Paraphilias

.

B Dyspareunium

.

C Orgasmic anhedonias

.

D

Persistent genital arousal

.

disorder

Question 49

Nsytagmus, or marked slurring of speech and blackouts, are likely impairments at which of the following blood alcohol concentrations?

A 30 – 80 mg/dL

.

B 80 – 200

.

mg/dL

C

200 – 300

.

mg/dL

D 300 – 400

.

mg/dL

Question 50

Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply.

A Age

.

B Rapid dose escalation

.

C Parental route of administration

D Higher potency typical

.

antipsychotics

Question 51

Nurse practitioners (NPs) differ from other advanced practice nurses in which of the following ways?

A

NPs offer a wide range of services to a wide portion of the

.

population.

B

NPs offer a narrow range of services to a narrow base of

.

patients.

C NPs offer a medium range of series to a narrow patient base.

.

D NPs^ offer^ a^ narrow^ range^ of^ services^ to^ a^ medium-sized^ base

.

of patients.

Question 52

Researchers have identified particular neurotransmitters or neurotransmitter receptors involved with most substances of abuse except for which of the following?

A Alcohol

.

B Opioids

.

C

Amphetamin

.

es

D Cocaine

.

Question 53

Which of the following neurological symptoms are consistent with inhalant use?

A

Sensory illusions, distortions of body

.

size

B

Fearfulness, auditory and visual

.

hallucinations

C Irritability, emotional lability, euphoria

.

D

Slurred speech, decreased rate of

.

speech, ataxia

Question 54

Which of the following is a guideline for prescribing legally?

A Prescribe the right medicine at the right times for the right indication for the right

.

patient.

B If there is a practice protocol or guideline in the facility, follow it.

.

C

If there is no facility-wide protocol for prescribing, the standard of care for

.

prescribing may be assumed to be the Physician’s Desk Reference or Epocrates.

D All the above

.

Question 55

Substance seeking activities, along with related evidence of pathological use patterns, are emphasized when discussing which of the following concepts related to substance use and addictive disorders?

A Addiction

.

B

Behavioral

.

dependence

C Physical dependence

.

D

Psychological

.

dependence

Question 56

A patient with a substance abuse disorder who does not meet the clinical criteria for hospitalization but who lacks sufficient social and vocational skills and lack substance-free social supports, is appropriate for which of the following levels of treatment?

A

Residential

.

treatment

B Partial

.

hospitalizations

C

Outpatient

.

treatment

D All of the above

.

Question 57

Recurrent preoccupation with sexual urges and fantasies involving the act of being humiliated, beaten, bound, or otherwise made to suffer is known as which of the following?

A Frotteurism

.

B Sexual Sadism

.

C Sexual Masochism*

.

D

Other Specified Paraphilic

.

Disorder

Question 58

The three major neurotransmitters associated with anxiety, based on animal studies and response to drug treatment, include which of the following?

A

Glutamate, Norepinephrine,

.

Serotonin

B

GABA, Norepinephrine,

.

Serotonin

C GABA, Dopamine, Glutamate

.

D

Dopamine, Norepinephrine,

.

Serotonin

Question 59

Because the DSM-V and ICD disorders names may not match, the ARNP should document which of the following?

A The DSM-V diagnosis is all that is required, so if there is not a match the ICD code is

. not needed.

B As the ICD code is what is used for billing, this is the only documentation required.

.

C The DSM-V diagnosis should always be recorded by name in the medical record in

. addition to listing the ICD code.

D Document the DSM-V code and several ICD codes so the insurer cannot deny the

. claim.

Question 60

Methadone withdrawal usually begins how soon after the last dose?

A 6–8 hours after the last

.

dose

B

8–12 hours after the last

.

dose

C 24 hours after the last

dose

D

1–3 days after the last

.

dose

Question 61

The object of a person’s sexual impulses is known as which of the following?

A Sexual

.

behavior

B

Sexual

.

orientation

C Gender

.

identity

D Sexual identity

.

Question 62

Which of the following are consistent with what is known about the effect of alcohol on sleep?

A

Drinking alcohol in the evening increases the ease of falling and

.

staying asleep.

B Alcohol use is associated with an increase in rapid eye movement

.

sleep.

C Alcohol use is associated with increase in Stage 4 sleep.

.

D Alcohol increases sleep fragmentation.

.

Question 63

The genotype XXY is associated with which of the following?

A Klinefelter’s syndrome

.

B

Androgen insensitivity

.

syndrome

C Turner’s syndrome

.

D Adrenogenital syndrome

.

Question 64

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. This presentation is consistent with which of the following?

A Wernicke-Korsakoff syndrome

.

B

Idiosyncratic alcohol

.

intoxication

C

Alcoholic pellagra

.

encephalopathy

D

Alcohol-induced Persisting

.

Dementia

Question 65

Which of the following neurotransmitters is released with orgasm and is believed to reinforce pleasurable activities?

A GABA

.

B

Serotoni

.

n

C

Oxytoci

.

n

D

Dopami

.

ne

Question 66

Which of the following are used to treat symptoms of Neuroleptic Malignant Syndrome?

A Dantrolene

.

B

Bromocriptin

.

e

C

Chlorpromazi

.

ne

D A and B only

.

Question 67

Which of the following services are usually excluded from both primary and secondary Medicare benefits?

A Medicare does not reimburse for the same services covered by VA benefits.

.

B

Medicare does not reimburse for services covered under the Federal Black

.

Lung program.

C Medicare does not reimburse for services related to workers compensation.

.

D A and B only

.

Question 68

The APRN consensus model did which of the following?

A

Merged adult, gerontology and pediatric foci so that all NPs could truly work across

.

the lifespan.

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 C

.

Question 69

A type of schizophrenia in which the individual has a marked disturbance in motor function and may involve stupor, negativism, rigidity, excitement or posturing or mutism is

A Residual Type

.

B Catatonic Type

.

C Disorganized Type

.

D

Undifferentiated

.

Type

Question 70

A patient reports having a panic attack several years ago in an elevator and since then has avoided using elevators. This patient meets criteria for which of the following?

A Social phobia

.

B Specific phobia

.

C

General anxiety disorder

.

unspecified

D Obsessive-compulsive disorder

.

Question 71

Which of the following is consistent with what is known about the epidemiology of anxiety?

A

Men have a higher lifetime prevalence of anxiety

.

than women.

B

Women have a higher lifetime prevalence of anxiety

.

than men.

C Men and women have equal lifetime prevalence.

.

D

The lifetime prevalence of anxiety is not gender

.

specific.

Question 72

A psychotic condition that involves the sudden onset of psychotic symptoms, which lasts one day or more but less than 1 month with full return to the premorbid level of functioning is known as which of the following?

A Brief psychotic disorder

.

B Schizophreniform disorder

.

C Schizophrenia, first episode

.

D

Schizophrenia,

.

undifferentiated type

Question 73

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?

A Tolerance

.

B

Codependenc

.

e

C Cross-tolerance

D

Neuroadaptati

.

on

Question 74

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 realizes this presentation is consistent with which of the following diagnoses?

A Schizophrenia

.

B Schizophreniform

.

disorder

C

Brief psychotic

.

disorder

D Delusional disorder

.

Question 75

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?

A Schizoaffective disorder

.

B Delusional disorder

.

C

Borderline personality

.

disorder

D Brief psychotic disorder

.

Question 76

A diffuse, unpleasant, vague sense of apprehension, often accompanied by autonomic symptoms which varies among persons is commonly known as which of the following?