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PMHNP ANCC Mental Health Care & Treatment-
multiple choice Questions with Answers Rated A+.
- The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing: Scope and Standards of Practice is to A. Define the role and actions for the NP Establish the legal authority for the prescription of psychotropic B. medications C. Define the legal statutes of the role of the PMHNP D. Define the differences between the physician role and the NP role - Answers-Correct Answer: A. The ANA's Psychiatric-Mental Health Nursing: Scope and Standards of Practice defines the role and actions of the nurse practitioner.
- Primary prevention care practices are an essential aspect of the PMHNP role. Which of the following is the best example of a primary prevention care strategy for community behavioral health? a) Aftercare program for chronically mentally ill clients recently discharged from the hospital b) Court-ordered counseling for abusive parents c) 24-hour crisis hotlines d) Parenting skills classes for pregnant adolescents - Answers-Correct Answer: D. Information reduces incidence of disease. 3 The trend in legal rulings on cases involving mental illness over the past 25 years has been to a) Encourage juries to find defendants not guilty by reason of insanity b) Protect the person's freedoms or rights when he or she is committed to a mental hospital c) Place increasing trust in mental health professionals to make good and ethical decisions d) Decrease the "red tape" associated with commitments so that commitments are faster and easier - Answers-B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric clients. 4 Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to take any of his ordered medication because he believes "Jesus Christ told me I am the prophet and must fast for a year." Your actions should be based on your knowledge of which of the following? a) Psychiatric clients cannot refuse treatment b) Psychiatric clients do not always know what is good for them c) Psychiatric clients can refuse treatment d) Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore, the nurse's best clinical judgment should guide actions - Answers-C. As with
any client, psychiatric clients can refuse treatment un- less a legal process resulting in involuntary commitment or mandatory court order for treatment has been obtained.
- Which of the following statements best reflects the difference between the nurse- client (N-C) relationship and a social relationship? a) In the N-C relationship, the primary focus is on the client and the client's needs. b) Goals in the N-C relationship are deliberately left vague and unspoken so that the client can work on any issue. c) In the N-C relationship, the nurse is solely responsible for making the relationship work. d) In the N-C relationship, there is no place for social interaction. - Answers-A. Social relationships are mutual interpersonal relationships in which the needs of both parties are addressed. The N-C relationship is most con- cerned with meeting the needs of the client.
- A community has an unusually high incidence of depression and drug use among the teen- age population. The public health nurses decide to address this problem, in part, by modifying the environment and strengthening the capacities of families to prevent the development of new cases of depression and drug use. What is this is an example of? a) Primary prevention b) Secondary prevention c) Tertiary prevention d) Protective factorial prevention - Answers-A. This action focuses on interventions designed to reduce the incidence of new cases of disease. 7 Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes to leave because "this place can't help me." The best nursing action that reflects the legal right of this client is a) Discharge the client b) Explain that the client cannot leave until you can complete further assessment c) Allow the client to leave but have her sign forms stating she is leaving against medical advice d) Immediately start the paperwork to commit the client and to allow you to treat her against her wishes - Answers-Correct Answer: B. Almost every state allows for a brief period of detainment to as- sess a client for dangerousness to self or others before allowing the client to leave a hospital setting, even if the admission was voluntary. 8 In many characteristics that are known to be helpful in relationship-building. Which of the fol- lowing is an essential part of building a therapeutic relationship? forming a therapeutic relationship with clients, the PMHNP must consider developing a) Collecting a family history b) Like-mindedness c) Authenticity
these are just random behaviors that have no particular meaning. Which Freudian- based psychodynamic principle assumes that all behavior and actions are purposeful? a) Pleasure principle b) Psychic determinism principle c) Reality principle d) Unconsciousness principle - Answers-B. The psychic determinism principle states that all behavior has purpose and meaning, often unconscious in nature, and that no behaviors occur randomly or by coincidence. 13
- An example of a mature, healthy defense mechanism is a) Denial b) b. Rationalization c) Repression d) Suppression - Answers-Correct Answer: D. Suppression is the only defense mechanism listed in which the client channels conflicting energies into growth-promoting activities. 14 Mr. Johnson is a 54-year-old client you have been seeing for several weeks in therapy. While discussing his current concerns of marital stress, he lies on the floor and assumes the fetal position. This is most likely an example of a) Immature regressive defense mechanism b) Denial of reality c) Immature fantasy defense mechanism d) Repressive behavior - Answers-Correct Answer: A. Immature regressive defense mechanism is a return to a behav- ior common to an earlier stage of development. 15 Defense mechanisms are best viewed as a function of the ego a) To alert us to harm and danger b) To alert us to problems c) Used to resolve a conflict d) Used to protect the id - Answers-Correct Answer: C. Defense mechanisms are a function of the ego used to resolve a conflict. 16 One of the health care changes that has occurred as a result of the affordable care act (ACA) is that doctors/hospitals/clinic groups or health systems are coming together and assum- ing the responsibility for quality care to large groups of individuals insured by Medicare. The health care clinics/systems doctors or hospitals that join together are called which of the following? a) Health Maintenance Organization (HMO) b) Preferred Provider Network (PPO) c) Accountable Care Organization (ACO)
d) Individual Health Plan (IHP) - Answers-Correct Answer: C. ACO's are groups of doctors or other health care providers who voluntarily come together and assume the care provided to Medicare patients. 17 Health care economics is concerned with making decisions so the benefits outweigh the cost of resource utilization. What are two concepts that healthcare economics is concerned with in regard to fair distribution of resources and allocation? a) Equity and efficiency b) Cost and benefits c) Opportunity and waste d) Affordable and quality - Answers-Correct Answer: A. Health care efficiency is making risk and benefit decision about how care resources are allocated and equity is ensuring that there is a fair distribu- tion of the resources. 18 What four elements need to be present for a malpractice lawsuit to be filed? a) Beneficence, Non-Maleficence, Truthfulness, and Justice b) Duty of care, Breach of standard of care, Injury, and Injury must be related to breach of the standard of care c) Abandonment, Breach of care, Violation of ethics, and Reimbursement for poor care d) Breach of standard of care, Injury, Deceit, and Malpractice - Answers-B. The four elements that must be satisfied for malpractice to have occurred are a duty of care between clinician and patient, breach of standard of care, an injury to the patient, and the patient's injury must be related to the clinician's breach of care. 19 Mary is a Psychiatric-Mental Health Nurse Practitioner (PMHNP) who is working in a hospitalist role. Mary has encountered over five incidences in which attending psychiatrists and medical residents have been demeaning to nursing staff and not answering calls in the middle of the night or telling the nursing staff to write orders and the MD would sign offin the a.m. Mary is concerned about errors and wants to improve quality, reduce errors to promote safety. What concept is Mary employing? a) Bullying b) Abuse c) Civil Disobedience d) Just Culture - Answers-D. The ANA has a position statement that nurses are responsible for developing health care settings that include just culture initiatives understanding that human error can cause error and harm by creating an open and fair environment. 20 The role of neurotransmitters in the central nervous system is to function as a) A communication medium b) A gatekeeper for transmissions c) A building block for amino acids
care, the PMHNP should apply his or her knowledge that these symptoms represent problems with the a) Frontal lobe b) Temporal lobe c) Parietal lobe d) Occipital lobe - Answers-A. Problems with working memory, planning and prioritizing, insight into problems, and impulse control indicate a problem in the frontal lobe. 27
- The concept of target symptom identification is best explained as a) Identification of the major clinical presentation of the client b) Identification of specific, precise, and individualized symptoms reasonably expected to improve with medication c) Identification of the secondary messenger system syndrome d) Intentional modulation of synaptic pathways - Answers-B. Target symptom identification is the identification of specific, precise, and individualized symptoms reasonably expected to improve with a given medication. 28 The goal of the psychiatric assessment process performed by the PMHNP is to a) Gain an understanding of the life experiences of the client b) Correctly diagnose the client c) Identify the mental health needs of the client d) Be able to communicate with other staff about the client's health needs - Answers- Correct Answer: C. Although diagnosis is an important aspect of the assessment process, the assessment ultimately should identify the needs of the client. 29 Mr. Johnson is a client newly admitted to an inpatient psychiatric hospital. The PMHNP on call at the facility plans to perform the initial intake assessment and diagnostic process. Mr. Johnson asks to please talk in his room because, he says, "People make me nervous." His room is at the end of the hallway and is the farthest away from the nursing station. The PMHNP's action should be based on awareness that the best location to do the assessment is a) In Mr. Johnson's room, because it is least noisy and most comfortable for him, thus facilitating data collection b) In the dayroom, which is full of people, to observe his interactions with other people c) In a quiet place, but public enough to get assistance with client care should it be re- quired during the assessment d) In the treatment room with the door closed, a neutral location - Answers-C. One PMHNP role is to control the milieu as an aspect of as- sessment, so the PMHNP should choose a quiet place that is public enough to get assistance with client care should it be required during the assessment. 30
Which communication technique is the PMHNP using in the following situation? Client: "Sorry I was late. I didn't realize what time it was." PMHNP: "This is the third time now that you have been late for our sessions. I am wondering how committed you are to our working on your problems." a) Theming b) Recognizing c) Validating d) Sequencing - Answers-B. This exchange is an illustration of the technique of recognizing.
- In assessing a client, you ask him the meaning of the proverb "People who live in glass houses shouldn't throw stones." He replies, "Because it will break the windows." The correct interpretation of this findings is a) Client has a probable mood disorder b) Client has a probable anxiety disorder c) Client has limited intellectual ability d) Unable to interpret the finding without knowing the client's age - Answers-D. The answer demonstrates concrete thought processes, which are normal in persons younger than age 12 but are abnormal after age 12. To inter- pret the finding, the PMHNP must know the age of the client. 32 The PMHNP is planning to work with a client using an individual therapy model of care. During the first session, the client makes the following statement: "This is the third time my son has run away. I've grounded him, taken away his bike, even tried cutting off his allowance and confining him to his room. What should I do now?" The most therapeutic response for the PMHNP to make is a) "I wonder if confining him to his room was abusive?" b) "Maybe that depends on what you are trying to accomplish." c) "Perhaps talking to his friends and teachers would help." d) Remain silent - Answers-B. This response will be the most therapeutic in moving forward with the client. 33 A client says to the PMHNP, "Some days life is just not worth it. All my wife and I ever do is fight and scream. Things at home would be calmer and simpler if I just wasn't there any- more." The most therapeutic response for the PMHNP to make is a) "Do you mean that you are thinking about leaving your wife and moving out?" b) "Tell me what you mean by 'it would be simpler if you just weren't there anymore.'" c) "So you are thinking suicide might be an option for you?" d) Remain silent - Answers-B. This response is the most therapeutic, allowing the client to further clarify and express feelings. 34 Mrs. Shea has come to the mental health center seeking treatment for depression. She has a history of a suicide attempt by overdose 1 month ago. She was started on
d) Clarithromycin - Answers-B. Beta blockers can cause or exacerbate depression. 38 When treating older adults, you should keep in mind that they are more sensitive to issues of drug toxicity because of which of the following reasons? a) Decreased body fat b) Increased liver capacity c) Decreased protein binding d) Increased muscle concentration - Answers-C. Older adults usually have decreased protein levels. Most psycho- tropic medications are highly protein-bound. It is the unbound (free) concentrationof the drug that is active; the bound concentration of the drug is inert. Thus, with decreased protein available for binding, more free (active) drug remains in the body, which then predisposes older adults to toxicity. 39 Which known teratogenic effects can be caused by the common psychotropic medications divalproex and lithium? a) Divalproex—Epstein anomaly; lithium—cleft palate b) Divalproex—spina bifida; lithium—Epstein anomaly c) Divalproex—limb malformations; lithium—seizure disorder d) Divalproex—mental retardation; lithium—spina bifida - Answers-B. Divalproex can cause spina bifida and lithium can cause Epstein's anomaly.
- The study of what the body does to drugs is called a) Pharmacodynamics b) Pharmacology c) Pharmacokinetics d) Distribution - Answers-C. Pharmacokinetics is the study of what the body does to drugs. 41
- Your client Sam is being treated for panic disorder with agoraphobia. He currently is being prescribed paroxetine (Paxil CR, 37.5 mg q.d.) and clonazepam (Klonopin, 0. mg q.d., p.r.n.). He has been on clonazepam for 2 years and admits to needing 4 pills to achieve the same effect that 1 pill initially produced. This is possibly an example of which process? a) Kindling b) Addiction c) Tolerance d) Potency - Answers-C. Tolerance means needing more to achieve the same effect. 42
- Why is group therapy beneficial? a) It assists the client to focus on self b) It lacks theoretical frameworks c) It enables participants to acquire therapeutic factors
d) It is always time limited - Answers-D. Group therapy is beneficial because it increases social skills, is cost-effective, and enables participants to acquire the curative factors. 43 Which of the following is the best rationale for using cognitive behavioral therapy? a) Recognize and change his or her automatic thoughts b) See reality as you see it c) Change his or her reality by changing his or her environment d) Recognize and accept that automatic thoughts suggest delusional thinking - Answers-A. Cognitive behavioral therapy helps clients recognize and change their automatic thoughts. 44 When working with a dysfunctional family, you find that the father, Jim, worries excessively and is resistant to change. You give Jim a paradoxical directive to worry extremely well for 1 hour per day, knowing that he will likely be noncompliant, and thus change will occur. With this technique, you are using which type of therapy? a) Experiential therapy b) Structural therapy c) Strategic therapy d) Solution-focused therapy - Answers-C. Paradoxical directives are used in strategic therapy. 45 Which of the following best describes homeostasis in a family system? a) Choices a family makes to keep the peace b) Balance or stability that the family returns to despite its dysfunction c) Need for change and balance in a family d) Calm in a family that returns after a crisis - Answers-B. Homeostasis is balance or stability that the family returns to despite its dysfunction. 46 In an attempt to bring the client toward the goal he or she is working on, you ask the client, "If a miracle were to happen tonight while you slept, and you awoke in the morning and the problem no longer existed, how would you know, and what would be different?" This technique is used in which type of therapy? a) Behavioral therapy b) Solution-focused therapy c) Adlerian therapy d) Existential therapy - Answers-B. Miracle questions are used in solution-focused therapy. 47
- Ms. Thomas has been diagnosed with major depressive disorder (MDD) and is placed on fluoxetine 20 mg for her depression. For the PMHNP to effectively monitor
drinks "2 to 3 beers" on weekends as well. According to the DSM-5, does the student have a mental disorder? a) Yes, alcohol use disorder, mild b) Yes, generalized anxiety disorder c) No, at this point, the student does not meet criteria for a mental disorder. d) Yes, adjustment disorder with mixed features - Answers-C. The student does not meet criteria for alcohol use or other disorder at this point, but if he does not learn alternative coping skills to deal with his shyness, he is at risk of developing an alcohol use disorder. 52 Jason misses several appointments. The PMHNP notes she feels resentful toward Jason and is struggling with how to respond to Jason when he finally comes in for his appoint- ment. Which of the following demonstrates a therapeutic response? a) "Jason, since you have missed several appointments, we are closing your case." b) "Jason, it's pretty clear to me that you don't want to be here." c) "Jason, you are ambivalent about seeking treatment." d) "Jason, help me understand what's going on so we can figure out how to proceed." - Answers-D. Although the PMHNP's resentment is in response to actual behavior by Jason (his missing several appointments), clarifiying what is going on for him, his expectations for treatment and the PMHNP's (and the clinic's) expectations in a non- judgemental manner will help to develop a therapeutic alliance. 53 Which is true about pharmacologic treatment of anxiety in older adults? a) Course of treatment is generally shorter than for younger adults. b) Drugs that are highly oxidized are more unpredictable than drugs that are mostly conjugated. c) The therapeutic dose of SSRIs is generally lower than for young adults. d) Highly lipophilic drugs have a more linear elimination in older adults. - Answers-B. Liver enzyme functioning (among other things) diminishes as we age. All of the other statements are false. 54
- A client returns for a follow-up appointment 3 weeks after starting on fluoxetine 20 mg. During this appointment you notice that her speech is a little rapid, in marked contrast tothe psychomotor retardation and paucity of spontaneous speech she displayed on her first visit. Instead of looking at the floor, she now makes normal eye contact. Her affect has gone from constricted to expansive. She continues to have difficulty sleeping, but her energy has improved and she states she feels "so much better!" What should you conclude about the shift in the client's presentation? a) She is experiencing the activating side effects of fluoxetine. b) She is becoming euthymic. c) She is becoming hypomanic.
d) She is in a mixed state. - Answers-C. In this case, you see a shifting set of symptoms, the most impor- tant being her expansive mood and statement "so much better" that indicates she has gone beyond euthymia. 55 Mr. D. is a 35-year-old, married, high-tech industry executive who is referred to the PMHNP for "insomnia." Mr. D. reports that he falls asleep quickly, but has difficulty staying asleep. He wakes up several times during the night, and believes he tosses and turns even when he is sleeping. He wakes up feeling exhausted and drinks "a pot of coffee" to stay awake and concentrate during his long work day. He drinks 1 glass of wine most evenings. He denies any illicit substance use. He denies any symptoms of a mood or anxiety disorder, but is feel- ing increasingly frustrated and concerned about his sleep. Which of the following is the most likely contributing factor to Mr. D.'s ongoing middle insomnia? a) Obstructive sleep apnea (OSA) b) Caffeine dependence c) Alcohol withdrawal d) Attention-deficit hyperactivity disorder (ADHD) - Answers-A. OSA is the only plausible possibility if the rest of the information given by the client is accurate. OSA causes clients to have frequent awakenings and a sense that they are not sleeping deeply ("tossing and turning") that is caused by apnea. The client should be assessed further for snoring and awareness of apnea. Although the client states he drinks a lot of coffee, this is driven by his sleep issues. Drinking 1 glass of wine in the evening would not cause the degree of sleep pathol- ogy he is exhibiting. Other than diminishing concentration that is consistent with sleep deprivation, there are no other signs and symptoms of ADHD. 56 Tina is a 54-year-old single white woman who has been a Psychiatric-Mental Health Nurse Practitioner for over 20 years. She is considering making application to a Doctor of Nursing Practice (DNP) program but states "if a DNP is required to practice I'll get grandfathered in, no need for me to go back to school." Following the 2008 License, Accreditation, Certification, and Education (LACE) Consensus Model for Advanced Practice Registered Nurse Regulation, which statement is correct? a) Tina is correct: if the DNP becomes a requirement, she will be grandfathered in and obtain a DNP degree. b) The DNP is an academic terminal degree and there will not be an opportunity for Tina to be grandfathered in a DNP. c) Tina will be grandfathered in and obtain a DNP only if her state requires a DNP to prac- tice as an APRN. d) The DNP is a certification and Tina will have to take an examination to be grandfathered in to obtai - Answers-B. APRNs are not grandfathered into an academic degree; degrees must be earned from accredited academic institutions. 57
You are asked by a church organization to work with members within your health system to develop a flu vaccination program. According to public health principles, this is an example of what level of prevention? a) Secondary b) Preventative c) Tertiary d) Primary - Answers-D. Prevention of illness is primary prevention and administration of flu vaccinations in a community is intended to prevent a flu outbreak. 61
- A client with bipolar I disorder presents to your PMHNP office for a follow-up visit. During the visit the client informs you that he no longer wants to be treated with medication,and he does not have bipolar disorder, that was a misdiagnosis. He further informs you he stopped all his medication 2 months ago and is here to thank you for your care and tell you that he no longer needs follow-up appointments. Understanding the ethical conflict, you use which of the following ethical principles in working with this client? a) Autonomy b) Nonmaleficence c) Justice d) Beneficence - Answers-A. Clients who are legally competent have the ability to make medi- cal decisions and maintain individual autonomy. 62
- A new client reveals to the PMHNP that her boyfriend screams at her and has repeatedly slapped and pushed her in front of her 3-year-old son. She goes on to say that the boyfriend has thrown things at her and on one occasion threw a glass of water at her that hit her son in the back. Should the PMHNP report this to child protective services (CPS)? a) Yes, the client is issuing a cry for help for her son. b) Yes, the PMHNP has a duty to report. c) No, this does not constitute a reportable offense. d) No, a report to CPS will escalate the violence. - Answers-B. PMHNPs are mandated reporters of child abuse. The 3-year-old is being exposed to violence and although not the target, could have been injured when the boyfriend threw the glass of water. 63
- Which of the following is a function of the psychiatric interview? a) Understand the client's psychosocial needs and communicate them to the treatment team b) Identify the mental health needs of the client c) Review previous medical records d) Evaluate a treatment plan - Answers-B. During a psychiatric interview, the PMHNP is responsible to iden- tify symptoms and needs of a client to develop an appropriate treatment plan.
- A 74-year-old married white woman was referred to you by her primary care provider for a psychiatric evaluation. She had a normal medical and neurological examination in the last 2 months. The client presents with her husband of 45 years who states, "My wife is just not the same anymore, she is irritable and asks the same question several times, even though I've answered it many times." The client responds, "Oh, Henry, you do the same thing, it's just a normal part of getting older, and the kids think everything is fine." During the assessment you compete the mini mental status examination (MMSE) and the client scores 18. As the PMHNP treating the client, you know the results of her MMSE indicate which level of cognitive impairment? a) No cognitive impairment b) Mild cognitive impairment c) Moderate cognitive impairment d) Severe cognitive impairment - Answers-C. Cut points on the MMSE are as follows: total score 30, 25-30 questionable significance, 20-25 mild impairment, 10-20 moderate impairment, and 10 or lower severe impairment. 65 You are the PMHNP treating Tim, a 10-year-old child, for ADHD and social anxiety disorder. His mother presents with Tim for his scheduled individual therapy session. At the end of the session his mother says, "I need to take Tim to see his pediatrician and at the last visit I was told he needed some HPV shot. I don't know, he's a boy, why would he need that? What do you think?" What is the PMHNP's best response to her question? a) "The Centers for Disease Control and Prevention (CDC) recommends the human papillomavirus (HPV) vaccine for all boys and girls at age 10. HPV can cause cancer in both men and women, and the vaccine is effective in protecting against the virus. Can you tell me your concerns about Tim getting this vaccine?" b) "While the Centers for Disease Control and Prevention (CDC) recommends the vaccine, every parent has the right to choose and if you do not think Tim needs this vaccine, as his parent - Answers-A. When family members or clients ask questions about illnesses and treatment, it is the PMHNP's responsibility to provide data and then assess understanding and meaning. 66 As a PMHNP working in a crisis evaluation center, you are aware that the initial focus of a crisis assessment is on which of the following? a) Client's past diagnosis and medication trials b) Psychosocial history and supports c) Safety of the client and others d) Current living situation and coping skills - Answers-C. In a crisis, the first assessment should be safety of the client and those near the client. 67
Which of the following client statements best describes imitative behavior as a therapeutic factor in group therapy? a) Group members talk over one another so the loudest person is heard b) Group members begin to model aspects of other members of the group and group leaders c) Group members discuss past situations when they were bullied and felt ashamed d) Group leaders take charge of the group and redirect members when they monopolize the group - Answers-B. As group progresses the leader is less active and the members of the group take over and begin to model other members and the leaders. 72 Dialectical behavioral therapy (DBT) draws on cognitive theory and behavioral theory, along with other theories. Elements of behavioral theory in DBT include which of the following? a) Skills training and exposure b) Examination of feelings and relating feelings to visceral sensations c) Working through the transference with the therapist d) Cognitive interpretation of past traumatic experiences - Answers-A. DBT focuses on cognitive and behavioral techniques, mindful- ness including meditation, and emotional regulation. Dialectical behavioral therapy (DBT) affirms dialectical thinking, which involves examining and discussing opposing ideas to find the truth. This philosophy is a supportive principle of DBT training. The central dialectical pattern emphasized in DBT involves the tension between: a) Radical acceptance and change b) Cue exposure and block avoidance c) Problem avoidance and problem-solving d) Crisis survival and acceptance - Answers-A. DBT emphasis acceptance of the current reality of what is and the ability to engage in personal change. 74
- Samantha is a 26-year-old partnered woman who works full time as a teacher. She is in a long-term relationship with Mary and they are getting along well, and doing well financially. They have two children, ages 2 and 6. Samantha is seeing the PMHNP to address her concerns that she is feeling down and sad for no reason and states, "I know my life is going well but I just don't feel happy. I have always worried a lot and have been sad most of my life." As a PMHNP trained in transactional analysis (TA), you understand that personality is multifaceted and wonder if which of the following is affecting her ability to experience happiness: a) She had long periods of separation from her primary caregiver as a child and now has a difficult time accepting and receiving love and experiencing happiness b) She likely had a traumatic event in her childhood and her thoughts and feelings related to the event are locked togethe - Answers-B. According to TA, when a person is traumatized the thoughts and feelings get tied together and the process of therapy is to unlock the two.
You have been working with a 54-year-old man who has been treated for schizophrenia since age 19. He has limited social interactions, likes to be alone, and has never dated nor had a desire to date. His symptoms are best explained by which of the following? a) Antisocial personality disorder b) Lack of personal hygiene c) Negative symptoms d) Positive symptoms - Answers-C. Negative symptoms include flat affect, alogia, avolition, poor attention, and anhedonia. In the case study, the symptoms are avolition and anhedonia. 76 Following evidence-based (EB) practice, which laboratory screening tests and assessments should be completed prior to placing a person on a second-generation ("atypical") antipsychotic medication? a) Serum glucose, lipid profile, weight, blood pressure, waist circumference, and family history of cardiovascular disease b) Comprehensive metabolic panel, body mass index, complete blood count, and thyroid panel c) Serum glucose or hemoglobin A1c, lipid profile, weight, body mass index, blood pressure, waist circumference, and family history of cardiovascular disease. d) Serum glucose, complete blood count, assessment of family history of cardiovascular disease and cancer - Answers-C. EB practice guidelines indicate that all clients should have the fol- lowing prior to starting antipsychotic medication: fasting glucose or A1c, lipid profile, weight, body mass index, blood pressure, waist circumference, and family history of cardiovascular disease. 77 Which type of hallucination is rare in persons with psychotic illnesses and is often associ- ated with an organic etiology? a) Auditory hallucinations b) Gustatory hallucinations c) Visual hallucinations d) Combination hallucinations - Answers-B. The most common type of hallucinations in persons with psy- chotic illnesses are auditory and visual. Tactile and gustatory hallucinations are less common and more likely related to an organic illness. 78 What differentiates atypical antipsychotic medications from first-generation or typical anti- psychotic medications? a) 5HT2a receptor antagonist properties b) 5HT2a receptor agonist properties c) Specific dopamine receptor 3 and 5HT2a blockade
