Psychiatric Disorders and Treatments, Exams of Nursing

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NRNP 6675 Midterm Exam NEW

VERSION LATEST UPDATE 2024- 2025

WITH ACCURATE ANSWERS

GUARANTEED PASS BEST STUDYING

MATERIAL WITH 400 QUESTIONS

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 Major neurotransmitters possibly involved in developing substance abuse and substance dependence are which of the following? A) Dopamine Incorrect: GABA, serotonin, A& B only The dopamine hypothesis of schizophrenia, which of the following? A) Schizophrenia results from too much dopaminergic activity incorrect: results from a deprivation of dopamine 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 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) Obscene phone calling to an unsuspecting partner for sexual arousal is known as? C) Telephone Scatologia (not telephillia, partialism, normal adolescent prank)

The main psychological difference between fear and anxiety is best described by which of these statements? B) Anxiety is insidious, fear is sudden 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 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 the woman is pregnant Neurochemical or neurophysiological changes in the body that results from the repeated administration of a drug is known as which of the following? C) Neuroadaption incorrect: cross-tolerance, neurotransformation, neurocognitive adjustment The recurrent and intense sexual arousal from the physical and psychological suffering of another person is known as which of the following? C) Sexual sadism 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 The recurrent urge to expose one's genitals to a stranger is known ass which of the following? C) Exhibitionism Which of the following patients would be appropriate for hospitalization for substance use disorder? Select all that apply D) A&B only (Patients who have a substance overdose who cannot be safely tx in an outpt setting & pts who are at risk for severe or medically complicated withdrawal symptoms

The nursing practice model recommendation for NPs by the NAtional Academy of Medicine and the National Council of State Boards of Nursing is which of the following? A) Full practice Which of the following groups does medicare cover? Select all the above A) Individuals 65+ years and older who have enrolled and pay premiums B) Disabled individuals who quality for social security disability payments and benefits Which of the following neurotransmitters increases libidio? D) Dopamine Incorrect: GABA, serotonin, oxytocin Which of the following factors are associated with poor prognosis for patients with OCD? D) A & C (Childhood onset & Co-existing major depressive disorder) Which of the following is inconsistent with current knowledge about schizophrenia? C) Dopamine level is a laboratory tests that assists in the diagnosis of schizophrenia A chronic disorder characterized by repetitive hair pulling leading to variable hair loss that may be..to others known as? C) Trichotillomania Which of the following are risk factors for neuroleptic malignant syndrome? B) Rapid dose escalation C) Parental route of admin D) High potency typical antipsychotics A method of therapy used to tx individuals with substance use based on the fundamental principle of a psychology that reinforced behaviors are likely to be..is known as the following? B) Contingency Management The conditions in which people are born, grow, work, live and age are known as? Social determinants of health All of the following is consistent with the ANCCs rules regarding recertification EXCEPT: A) You are required to have a maximum of 25 credit hours during each certification period Correct: B) you can start the recert process 1 year before your expiration date, but no later than 3 months before

C) You must have 1000 clinical practice hours in a clinical speciality within the preceding 5 years D)you must have at least 25 contact hours in pharmacotherapy Risks factors for school violence include which of the following? Select all that apply A) Bullying B) Being bullied C) Isolation Persons who subordinate their own needs to those of others, get others to assume responsibility for major areas in the lives, lack of self-confidence, and may experience intense discomfort when alone for more than a brief period of time are demonstrating characteristics with which of the following personality disorders? C) Dependent personality disorder Incorrect: avoid PD, passive PD, antisocial PD Generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following lithium levels? D) >25 mEq/L (TOXICITY) A form of child abuse in which a patient or character repeatedly fabricates or actually inflicts injury or illness in a child for whom medical intervention is then sought in an ER is known as which of the following? D) Munchausen Syndrome by Proxy Self-care strategies for the ARNP in preparing for the certification exam include all of the following EXCEPT? D) plan to study for short periods over a longer period of time A patient presents with a formal, tense manner. He reluctantly reports a longstanding (since early adulthood) pervasive suspiciousness of others, preoccupied with..trustworthiness of friends, unjustified concerns about others deceiving him, angry about perceived insults and slights, reluctant to confide in the ARNP. The ARNP suspects that the pt likely has which of the following PDs? B) Paranoid PD Incorrect: schizoid PD, BDP, Antisocial PD A pt will a hx of alcohol use presents to the ED with oculomotor disturbances, cerebellar ataxia, and confusion. Symptoms are consistent with which of the following psychiatric emergencies? C) Wernickes Encephalopathy Incorrect: akathisia, korsakoff's syndromes, idiosyncratic alcohol intoxication

Cluster A personality disorders are more common in biological families of pts with which of the following disorders? D) Schizophrenia Incorrect: depression, OCD, alcohol use disorder NP core competencies for INDEPENDENT practice includes all of the following EXCEPT: B) Demonstrates the highest level of accountability for professional practice NP competencies for independent practice: A) Maintain a collaboration agreement with physician C) Practices independently managing previously diagnosed and under-diagnosed pts D) Practices patient centered care recognizing culture diversity and the pt or designee as a full practice in decision making Cluster A personality traits consists of which of the following? A) Schizotypal, schizoid, and paranoid subtypes The misuse of the charge's funds for personal gain is known as which of the following? C) Financial abuse /exploitation the ARNP recognizes which of the following as long term effects of sex trafficking on victims? D) All of the above A) Severe depression B) Spiritual questions C) Trauma bonding In about half of the cases in which suicides occur while pts are on a psychiatric unit, a lawsuit results; which of the following is NOT consistent with what courts..related to impatient psychiatric unit suicide events? B) Courts provide ZERO suicide rates in inpt setting Cultural Dimensions Therapy is a framework for cross-cultural communication that describes the effects of a society's culture on the values of its members..by which of the following therorists? A) Hofstede The tx of choice for pts with paranoid PD includes which of the following? D) B&C B) Behavioral Therapy and C) Psychotherapy

The differences in quality of healthcare actions across individuals or groups regard to access, tx options and p..following? B) Health disparities The incidence of suicide is highest for which of the following populations? D) Older African American men 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 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 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 A PD characterized by emotional constriction, orderliness, perseverance, stubbornness, indecisiveness, a inflexibility as which of the following? Obsessive compulsive PD Which of the following is consistent with what is known about the epidemiology of anxiety? B) Women have a higher lifetime prevalence of anxiety than men Which of the following is consistent with NP practice parameters when prescribing buprenorphine? D) the NP is require to complete specific training to prescribe and dispense buprenorphine 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 A pt with hx of hypoglycemia reports feelings of fear, worry and restlessness 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 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 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 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 In which ways are NPs and PAs different? D) A&B A) NPs differ from PAs in legal definition, scope of practice, licensure, and independence of practice B) NPs practice under their own license and independent of the physician, PAs always work under the supervision of a physician Which of the following initials would a PMHNP use to designate appropriate credentials? PMHNP-BC 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 3 major neurotransmitters associated with anxiety, based on animal studies and response to drug tx include? B) GABA, norepinephrine and serotonin Which of the following is consistent with the epidemiology of schizophrenia in the US? D) Onset of schizophrenia before the age of 25 is extremely rare 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 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 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 Which of the following is consistent with literature regarding the term psychosexual? D) None of the above

• psychosexual is used to describe personality development and functioning

• psychosexual is synonymous with libidio in the Freudian sense
• Psychosexual basically refers only to sexual feelings and behavior Bleuler identified 4 fundamental s//s of schizophrenia, known as the 4 A's, which include which symptoms? A) Associations, Affect, Autism, Ambivalence The fear/anxiety regarding places from which escape may be difficult is known as which of the following: C) Agoraphobia All of the following are one of the 5 major categories of third-party payers EXCEPT: D) only A & B A) Medicare/medicaid B) Managed care organization (MCOs) Which of the following are risk factors for sexual assault EXCEPT: A) Religion Incorrect: serious mental illness, substance use disorder, family hx of sexual abuse Which of the following is consistent with what is known about PP depression? D) All of the above (feelings of guilt/ and inadequacy are often present and excessive; thoughts of harming the baby are often present; typical onset is within 3-06 months of delivery) Affirmatively acting to benefit another or others, going beyond what is required by law is known as which of the following?> C) Beneficence Which of the following is used for treating alcohol dependence individuals seeking to continue to remain alcohol free after they have stopped drinking? D) Acamprosate The NP can impact health policy and healthcare by doing which of the following? D) All of the above
• becomes an active member of local, state, and/or national NP
• becomes familiar with the resources available on NP organization websites
• Volunteer to serve on legislature committees within professional NP organizations The tx of others equitably and distribution of benefits/burdens fairly is known as?

B) Justice Which of the following is INCONSISTENT with current literature about victims of sexual abuse? C) The pre-existing relationship and\ familiarity with the abuser may impeded the victim's ability to make rational decisions Which of the following would constitute negligence? Select all that apply A) Failure to give necessary care B) Failure to refer when necessary C) Failure to follow up with a patient D) Failure to disclose necessary info to a patient Which of the following developed a biblically-based cultural competence model for healthcare professionals? B) Camipinha-Cacote` the ARNP recognizes which of the following as long term effects of sex trafficking on victims? D) All of the above

• severe depression
• spiritual questions
• trauma bonding A patient appears odd, with a pervasive hx of magical thinking, ideas of reference, illusions or derealization. This is consistent with which of the folllowing PDs? C) Schizotypal PD Which of the following are criteria for a particular suicide to be considered inevitable? D) All of the above
• strong genetic hx of suicide in one or more family members
• a strong genetic loading of mental illness in the family
• the pt may have received the highest standard of tx and that txd failed A pt with a hx of alcohol use disorder presents to the ED with oculomotor disturbances, cerebellar ataxia, and confusion. The ARNP recognizes these symptoms as consistent with which of the following psych emergencies? C) Wernicke's encephalopathy The emotional burnout and lack of empathy towards clients that healthcare providers experience after treating victims is known as the following? B) Primary traumatization The ACE study found that which of the following relationships between child traumatic events and high-risk behaviors exhibited by adults?

D) The study revealed an indirect relationship between child traumatic events and high risk adult behaviors Walking on eggshells and appeasement/avoidance behaviors by the victim is characteristic of which phase of the cycle of DV? A) Honeymoon phase What are the different phases of DV?

1. Tension building phase
2. Incident
3. Reconciliation
4. Calm The only appproved therapy in the US for moderate to severe Alzheimers Disease is which of the following? B) Memantine Memantine is? A) Namenda, cognition enhancing medication for alzheimers/dementia A term that defines a person who has distress with clinical symptomology because their gender identity is not consistent with gender assigned at birth is which of the following? D) Gender Dysphoria Narcissistic, borderline, antisocial, and histrionic subtypes are associated with which cluster of PDs? B) Cluster B Odd, eccentric cluster of PDs? Cluster A a. Paranoid PD b. Schizoid PD C. Schizotypal PD Characterized by appearing dramatic, emotional, or erratic PD? Cluster B a., antisocial b. borderline c. histrionic d. narcissistic

inner emptiness, unstable relationships and emotional dysregulation? BPD Attention seeking and excessive emotionability? Histrionic Social irresponsibility, diregard for others, deceitfulness, and manipulation of others for personal gain Antisocial Self-grandiosity, need for admiration and lack of empathy Narcissistic PD Eccentric ideas and behaviors PD? Schizotypal PD Disinterest in others PD? Schizoid Mistrust and suspicion PD? Paranoid PD Characterized by appearing anxious or fearful. it includes which PDs? Cluster C a. avoidant PD b. dependent PD c. obsessive compulsive PD Perfectionism, rigidity and obstinacy traits PD? OCD PD Avoidance of interpersonal contact due not rejection sensitivity PD? `Avoidant Submissiveness and a need to be taken care of PD? Dependent PD 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 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 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 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**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 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 True sleep hygiene tips:
• avoid alcohol and caffeine
• set TV to turn off within 1 hr of falling asleep
• go to bed at the same time each night The need for NPs to practice to the full extent of their education and training is necessary for which of the following reasons? Select all of the above A) The growth in number and proportion of older Americans B) The projected PCP shortages by 2025 C) increased number of individuals who have access to healthcare according to Freud, stubborn, parsimonious and highly conscientious traits are associated with?

B) Anal stage Freud's Psychosexual Theory and 5 Stages of Human Development? 1.Oral stage

2. Anal stage
3. Phallic stage
4. Latent stage
5. genital stage The mouth, sucking, swallowin ect Stage 1- oral stage EGO develops in which phase? ORAL phase 1 The penis or vagina-sexual intercourse? Stage 5 genital `The anus- withholding or expelling feces
6. Anal stage Little to no sexual motivation present? Stage 4. Latent phase The penis or clitoris- masturbation Stage 3 Phallic the SUPEREGO develops at what phase? Stage 3 Phallic Features that point to a medical cause of a mental disorder includes which of the following? D) A& C A) Acute onset C) Visual hallucinations A patient currently on risperidone presents to the ED with increased agitation, restlessness, muscle discomfort and dysphoria. the ARNP recognizes these symptoms of akathisia and recommends which of the following? Select all that apply B) Benztropine IM only incorrect: reduce antipsychotic dosage, Benadryl PO or IM, B&C only Self-care strategies in preparation for the certificate exam includes all of the following EXCEPT:

C) Drink lots of caffeine and eat high concentrated sugars good self care strategies:

• plan to study for short periods over a long time
• study in a distraction free environment
• 6 - 8 hours of sleep is recommended Which of the following professionals would be able to precept a NP student? D) A&B A) ARNP B) Physician the ARNP is txing a 27 year old female who bipolar disorder who is obese and has renal; dysfunction. Which of the following is true? C) An atypical antipsychotic such as olanzapine or risperidone should be used Pts with this PD are described as excitable, emotional and behave in a colorful, dramatic, extroverted, attention-seeking fashion, often with an inability to maintain deep long-lasting attachments B) Histrionic PD a PD characterized by emotional constriction, orderliness, perseverance, stubbornness, indecisiveness and a pattern of perfectionism and inflexibility is known as which of the following? D) OCD PD Which of the following core competencies are quality competencies? D) A&C A) use best available evidence to continually improve quality of practice C) evaluates the relationship among access cost quality safety and their influence on health care Non-pharmacologic tx for abuse includes all of the following EXCEPT: D) Involve the abuser in the tx planning Non-pharmacologic tx options for abuse victims?
• CBT
• build a community of support
• assist pt to devise a safe escape plan a PD characterized by extraordinarily unstable affect, mood, behavior, object relations and self-image is known as? BPD

A particular form of psychotherapy based on Otto Kernbeg's object relations theory is known as which of the following?> C) Transference-focused psychotherapy generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following Lithium levels? C) > 2.5 mEq/L nausea, vomiting, anorexia, blurred vision, clonic limb movements, convulsions, oliguria and renal failure Moderate Lithium toxicity: 2.0-2. Lithium therapeutic window 0.6-1.2 mEq/L first med approved for bipolar d/o lithium Common side effects of Lithium, tremor, nausea., fatigue, increased thirst, slowed thinking Important serious side effects of Lithium: hypothyroidism, weight gain, diabetes insipidus, and lithium toxicity How do we decrease the risk of lithium toxicity? Blood level monitoring therapeutic range: 0.6 - 1. Lithium levels are known to (increase/decrease) when used concurrently with diuretics, thiazides, ACE inhibitors and NSAIDs? Increase ACE inhibitors: lisinopril, catopril, enalapril Lithium levels are known to (increase/decrease) when used with drugs including caffeine, acetazolamide and theophylline Decrease concurrent use of lithium and antidepressants and/or antipsychotics can cause what? Serotonin syndrome & Neuroleptic malignant syndrome The term "suicide survivor" refers to which of the following?

A) those who have lost a loved one to suicide At a minimum, a psychiatric evaluation in an emergency should include which of the following? Select all the above C) is the problem organic, functional or a combination? A pt presents with a formal, tense manner. He reluctantly responds a longstanding (since early adulthood) pervasive suspiciousness of others, preoccupied with trustworthiness of friends, unjustified concerns about others deceiving him, angry about perceived insults and slights, reluctant to confide in the ARNP. The ARNP suspects the pt likely has which of the following PDs? B) Paranoid PD The obligation to not inflict harm or balancing unavoidable harm with benefits of good achieved is known as which of the following? B) Beneficence `In about 1/2 the cases in which suicides occur while pts are in a psychiatric unit, a lawsuit occurs. Which of the following is NOT consistent with what court expects related to inpt psych unit suicide events? D) Evidence of formulation of a tx plan with a high level of security Using the LIAASE: A general cultural competency tool, the ARNP would do which of the following? D) all of the above

• agree to disagree on differences in values
• solicit other options or points of view
• acknowledge and validate powerful emotions when expressed Which of the following is NOT consistent with what is known about PP psychosis? A) symptoms of PP psychosis can often begin within days of delivery Concerns when treating geriatric patients with psychotherapeutic drugs includes all of the following EXCEPT: B) Elderly persons may be more susceptible to adverse effects of psychotherapeutic drugs A clause in an employment contract that specifies that an employer and employee may end the working agreement without cause within a specific number of days is known as which? C) Termination clause Standards of care are now being set, modified, monitored and publicized by certain self-appointed consumer-oriented agencies as well as government agencies, including which of the following? D) All of the above

• Medicare
• the Joint Commission
• The agency for healthcare research and quality The differences in the quality of healthcare across individuals and groups in regards to access of care, treatment options, and preventative services is known as? B)Health disparities incorrect: racism, vulnerable populations, SDOH Which of the following medical conditions can present with prominent mental status changes that mimic common psychiatric illnesses. Select all that apply B) Thyroid diseases C) Head trauma Incorrect: DM, AIDS Risks factors for school violence include which of the following? Select all the above A) bullying B) being bullied C) Isolation Being knowledgeable about one's own thoughts, feelings and sensations as well as the ability to reflect on how these can affect one's interactions with others is known as? A) Cultural awareness A pt with an inability to conform to the social norms that ordinarily govern many aspects of a person's behavior is consistent with which of the following PDs? D) Narcissistic PD Which of the following meds are associated with neural tube defects when given during pregnancy? C. Valproic acid curriculum content supports the NP scientific competency area includes which of the following? Select all that apply A) Comparison of pt data sets with evidenced based standards to improve care B) Science from other disciplines relevant to heath care Self-injurious behaviors with a nonfatal outcome, accompanied by explicit or implicit evidence that the person intended to die, is most specifically known as what? C) Suicide attempt

The ARNP is working with a pt who has heightened sense of self-importance and grandiose feelings of uniqueness. The pt also lacks empathy for others, although is very sensitive to minor criticisms. The ARNP recognizes these s/s as consistent with which of the following PD? C) Narcissistic PD The degree to which individuals have the cognitive and social capacity to access, process, and utilize basic health info and services to maintain good health, make appropriate health decisions and meet their goals is known as? A) Health Literacy Risk factors for physical abuse includes all of the following EXCEPT: A) Literacy Risk factors for physical abuse?:

• pregnancy, serious mental illness, hx of victimization during the developmental years According to Freud, passive and dependent personality traits are associated with which stage of development? B) Anal stage Sexual assault is most often which of the following? C) family member incorrect: stranger, acquaintance, professional Which of the following is the tx of choice for pt's with depressive personality? A) Exposure therapy incorrect: light exposure therapy, insight oriented psychotherapy, transmagnetic stimulation (TMS) Which of the following medications is associated with Ebstein's anomaly when gievn during pregnancy? B) Lithium *Actually a very small risk to pregnancy-- should be used more In Canterbury v Spence in the US Court of Appeals for the District of Columbia Circuit listed physician responsibilities for disclosure. Which of the following is NOT listed as a responsibility? D) inform the pt about precautionary therapy that he or she should seek in the future Ethnocentrism results in which of the following? C) Provides caregivers with the ability to better care for pt's of various culture

Which of the following demographic characteristics is consistent with high suicide risk? D) Over 45 years of age An ARNP takes a position in which the ARNP is guaranteed a set salary but can make additional salary if he/or she generates practice income over some set amount; this is known as what type of pay structure? C) Base salary plus percentage Which of the following is NOT consistent with guidelines as a mentor? D) Be specific and kind when giving constructive feedback that ay not be what the mentee might want to hear Which stage of the cycle of DV is characterized by overt aggressive Cluster A PD includes which 3 disorders? Schizotypal, schizoid, paranoid subtypes Cultural dimensions therapy: Hofstede describes the effects of a society's culture on the values of its members Tx of choice with a pt with paranoid PD? B&C

• behavioral therapy
• psychotherapy Which of the following is NOT a common physical effect of cannabis? B) Mild bradycardia s/.s of cannabis physical effects? Mild tachycardia, orthostatic hypotension, dilation of the conjunctival blood vessels A conscious standard recurrent behavior such as counting, checking, avoiding that interferes with the person's normal routine and functioning is known as? A_ Compulsion Most everyone has a firm conviction that they are male or female by which age range? B) 2-3 years of age A pt who presents absent movements with difficulty starting activities, flat affect and avolition would be assessed as having?

D)_ Pseduo-parkinsonism What of the following is consistent with current epidemiology literature about gender and OCD? D) Adult men and women are equally likely to have OCD A type of schizophrenia in which the individual has a marked disturbance of motor function and may involve stupor, negativism, rigidity, excitement or posturing or mutism is? B) Catatonic A pt who presents with the inability to remain still with motor restlessness, would be assessed to have? B) Akathisia method of therapy used to tx individuals with substance use disorders? B) Contingency Management Ethnocentrism results in which of the following? C) provides care givers the ability to care for pts of various cultures Which of following demographic characteristics is consistent with high suicide risk? D) Over age 45 In educating the pt beginning to take Lithium, the ARNP explains which of the following is related to diet and fluid intake? D) All of the above

• caffeine and alcohol act as hydration agents and can raise your lithium concentrations
• drink @ least 1 gal of water or more each day & limit your salt intake
• if you go on A diet, your doctor may need to increase the frequency of blood tests Three major neurotransmitters associated with ANXIETY, based on animal studies and response to drug tx include? B) GABA, norepinephrine and serotonin What neurotransmitter increases libidio? D) Dopamine Concerns when treating geriatric pts with psychotherapeutic drugs includes all of the following EXCEPT? C) Elderly persons may metabolize psychotherapeutic drugs more rapidly Concerns when treating geriatric pts with psychotherapeutic drugs?

A) Elderly people can be more susceptible to adverse effects of drugs B) Elderly persons may metabolize drugs more slowly D) Elderly people may excrete psychotherapeutic drugs more slowly. Persons who subordinate their own needs to those of others, get other to assume responsibility for major areas of their lives, lack self-confidence and may experience intense discomfort when alone for more than a brief period of time are demonstrating characteristics consistent with what PD? C) Dependent PD According to Sullivan, which of the following are consistent with a mentor/mentee relationship? C) Goals for the mentoring relationship are set mutually incorrect: mentors are assigned; mentor relationships are shorter term; A&B only The need for NPs to practice to their full extent of their education and training is necessary: select all of the above ALl of the above The ARNP assessing lifestyle as a social determinant of health would ask about which of the following? A) Diet What are social determinants of health and lifestyle choices? The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. In educating the pt about Lithium, the NP explains which of the following is related to diet and fluid intake? D) All of the above The goal of psychotropic tx is to eliminate all manifestations of a disorder to below the syndromal threshold, which is defined as which of the following? B) Remission The NP can impact health policy and healthcare by doing which of the following? D) All of the above A term used to describe individuals and families who are found to live in overcrowded homes, relocate frequently and struggle to pay rent and monthly expenses is which of the following? D) A& B Which of the following is consistent with current literature regarding the epidemiology of dependent PD?

C) Persons with chronic physical illness in childhood may be the most susceptible to this disorder Pts who injure themselves by self-mutalization but usually do not wish to die are said to have which of the following? C) Parasuicidial behaviors The NP preceptor should have which of the following? D) All of the above The tx choice of pts with histrionic PD include which of the following? D) A & B The antipsychotics that are most likely to cause neuroleptic induced parkinsonism have which of the following effects? C) High potency drugs with high levels of anticholinergic activity Tx aimed at reducing intimate partner violence and DV includes which of the following? D) A&B only Pt presents with a formal, tense manner. He reluctantly reports a longstanding pervasive suspiciousness of others, preoccupied with trustworthiness of friends, unjustified concerns that others are deceiving him, angry about perceived insults and slights, reluctant to confide in the ARNP; we suspect the pt most likely has the following PDs? B) Paranoid PD Which of the following is consistent with current perspectives on NP competencies? A) The National Organization of NPs Faculties have developed a list of core competencies that all students should have upon graduation from a master's program Which of the following core competencies are quality competencies? D) A& C Which of the following are criteria for a particular suicide to be considered inevitable? D) All of the above According to Freud, passive and dependent personality traits are associated with what stage of development? A) Oral stage SIB with a nonfatal outcome, accompanied by explicit or implicit evidence that the person intended to die, is known as?q B) Suicide intent

"Assumes complex and advanced leadership roles to initate and guide change" is a NP core competency for which area? C) Leadership competencies At a minimal, a psych eval in an Emergency should include what? Select all that apply A, B, C Which stage of the DV cycle is characterized by the abuser subconsciously implementing defense mechanisms and cognitive distortions to alleviate the ego dystonic implication of the abuse? D) Defensive phase A pt with a hx of schizophrenia, currently prescribed Haldol, presents to the ED with hyperthermia, muscle rigidity, autonomic instability and elevated phosphokinase. The ARNP recognizes these symptoms are consistent with? D) Neuroleptic malignant syndrome Pts with extreme sensitivity to rejection who are socially withdrawn because they consider themselves to be socially inept, although they are not antisocial, and show a great desire for companionship are demonstrating symptoms most consistent with which of the following PDs B) Avoidant PD OCD PD, dependent PD and avoidance PD traits are associated with which class of PDs? C) Cluster C Therapeutic blood level range for lithium? 0.8 - 1.2

• can be as low as 0.6 for some and be therapeutic The obligation to not inflict harm or balancing unavoidable harm with benefits of good achieved is known as? C) Non-maleficence Acknowledging a person's right to make choices, to hold views and take actions based on personal value is known as which of the following? D) Respect for autonomy Narcissistic, BPD, antisocial and histrionic subtypes are part of what cluster of PDs? B) Cluster B Being knowledgeable about one's own thoughts, feelings and sensations as well as the ability to reflect on how these can affect one's interactions with others is known as? A) Cultural awareness

The NP recognizes which are the long-term effects of sex trafficking on victims? D) All of the above wernickles encephalopathy= considered a medical emergency or not? is a medical emergency Is a degenerative brain disorder caused by lack of vitamin B1 Aim of tx for wernickles encephalopathy Prompt and quick correction of the thiamine deficiency in the brain Is wernickles encephalopathy reversible? it is considered reversible Wernickles encephalopathy is caused from? Alcohol abuse, dietary deficiencies, prolon ged vomiting, eating disorders, effects of chemotherapy =s/s mental confusion, vision problems, coma, hypothermia, low bp, lack of muscle coordination (ataxia) lack of muscle coordination? Ataxia Clinical triad of ophthalmoplegia, ataxia and confusion? Wernickles encephalopathy = acute neurological condition Korsakoff's Syndrome: neuropsychiatric disorder associated with confabulation and significant deficits in anterograde and retrograde memory This disorder is associated with pts fabricating stories in the setting of clear consciousness Korsakoff's A common inciting event that precepitates WE is? an acute infection other triggers include: prolonged carb or glucose loading in the presence of thiamine deficiency Hallmark sign of WE? is ocular abnormalities especially nystagmus other oculomotor s/s: include cranial nerve involvement of oculomotor, abducens and vestibular nuclei causing conjugate gaze palasises; pupillary sluggishness, ptsosis and anisocoria is also common

Some pts can present with hyperactive delirium secondary to possible alcohol withdrawal symptoms alongside this disorder? WE Can WE cause death? Yes- less than 5% of pts with WE can present with a severely depressed level of consciousness that will eventually lead to coma or death Warning s/s of WE that could indicate coma or death? Hyperthermia and hypotension other s/s include peripheral neuropathy--lower extremities are normally involved and the exam would reveal distal sensory los clinical dx of WE is present if the pt has two of the following features: A) eye signs B) Dietary deficiency in thiamine C) AMS D) Cerebellar dysfunction Normal brain imaging cannot rule out? WE - therefore not very beneficial What does thiamine do? help brain cells produce energy from sugar Korsakoff's syndrome is often, but not always, preceded by an episode of? WE however, it can occur in someone who has never had a prior episode of WE S/s of Korsakoff's syndrome? problems learning new information, inabilty to remember recent events and long-term memory gaps. =confabulation

• hallucinations may be present Cornerstone of effective long term tx of Korsakoffs /WEs? Abstaining fro alcohol and maintaining a healthy diet pt on lithium with a hx of ETOH presents with dry mouth, ataxia, dizziness, abdominal pain and slurred speech-the NP should do what? B) recognizes these are s/s of mild to moderate lithium toxicity--the NP decreases the lithium by half and encourages the pt to drink more fluids