WALDEN UNIVERSITY NRNP 6665 FINAL EXAM 2024 NEWEST VERSION WITH COMPLETE QS & AS, Exams of Nursing

Download WALDEN UNIVERSITY NRNP 6665 FINAL EXAM 2024 NEWEST VERSION WITH COMPLETE QS & AS and more Exams Nursing in PDF only on Docsity!

WALDEN UNIVERSITY NRNP 6665 FINAL

EXAM 2024 NEWEST VERSION WITH

COMPLETE QUESTIONS AND CORRECT

SOLUTIONS/GRADED A+

The Confusion Assessment Methods Instrument (CAMI) is a standardized assessment tool for which of the following disorders? A. Dementia B. Delirium C. Pick's Disease D. A and C - ANSWER B A person who erroneously believes that they have sustained an emotional or physical trauma in early life is known as which of the following? A. Ganser Syndrome B. False Memory Syndrome C. Factitious Dissociative Identity Disorder D. Imitative Dissociative Disorder - ANSWER B Persons who continually use the internet to play games to the extent that it interferes with social relations and work performance are exhibiting symptoms most specifically consistent with which of the following conditions? A. Obsessive gaming disorder B. Internet gaming disorder C. Internet use D. Internet abuse - ANSWER B (does not have to just be gaming) Synopsis P. 332 A new diagnosis in the DSM-5 is characterized by a person being preoccupied with being sick or developing a disease of some kind is known as? A. Conversion Disorder

B. Illnesses Anxiety Disorder C. Somatic Symptom Disorder D. Functional Neurological Symptom Disorder - ANSWER B The PMHNP is working with the family of a patient with Alzheimer's Disease who keeps stating that the family is plotting against her and trying to snuff her out. The family is distraught because they state that they are doing the best that they can to make sure the family member is safe. The PMHNP explains which of the following? A. The patient is hallucinating. An estimated 20-30% of patients with dementia have hallucinations. B. The patient is delusional. An estimated 30-40% of patients with dementia have delusions. C. The patient likely has a valid concern and APS needs to be called. D. Disturbances in perception in common in patients with Alzheimer's and the patient needs to be hospitalized. - ANSWER B (Synopsis p. 235) The PMHNP notice a patient with conversion disorder unable to walk has an inappropriate cavalier attitude towards what seems like a major impairment and recognizes this associated psychological symptom is known as? A. Indentification B. Primary Gain C. Secondary Gain D. La belle indifference - ANSWER D The principal theoretician to being psyche and soma together was which of the following? A. Sigmund Freud B. Anna Freud C. Karl Abraham D. Georg Grodecki - ANSWER A A disorder characterized by the presence of two or more distinct identities which differ from each other in that each has it's own pattern of perceiving, relating to, and thinking about the environment and self.

A. Dissociative Identity Disorder B. Imitative Dissociative Identity Disorder C. Factitious Dissociative Identity Disorder D. Malingered Dissociative Identity Disorder - ANSWER A Which of the following conversion disorder symptoms are associated with a GOOD prognosis? - ANSWER Good prognosis: Paralysis, aphonia, blindness Poor prognosis: Tremors, seizures Synopsis p. 464 A type of delirium characterized by psychomotor retardation and apathy is know as: - ANSWER Hypoactive Delirium (PMHNP review p. 127) Which of the following symptoms assist in the differentiating of a seizure from pseudo-seizure? A. Tongue biting is typical not seen in pseudo-seizures B. Urinary incontinence is typically not seen in pseudo-seizures C. Injuries from falling are typically not seen in pseudo-seizures D. All of the above - ANSWER D (Synopsis p. 455) Which of the following are true about impulses? SATA A. Impulses are acted upon with the expectation of receiving pleasure. B. Impulses are usually ego-dystonic (Compulsions) C. Impulsive behaviors are characterized by their repetitive nature D. The repeated acting out of impulses leads to psychological impairment. - ANSWER A, C, D (Synposis p. 55) Which of the following are included in the clinical features of anxiety illness disorder? SATA A. Person maintain that they have a particular disease or as time progresses their belief may transfer to another disease. B. Lab results, lack of progression of disease, and appropriate reassurance from their provider ARE helpful treatments for the person with the disease.

C. Preoccupation with illness may or may not interfere with their interactions with family, friends and coworkers. D. They are often addicted to internet searches about their illness, inferring the worst from the information. - ANSWER A and D (Synopsis p. 451/453) Which of the following are common disorders that must be differentiated from dissociative identity disorder? SATA A. Perimenstrual Disorder B. PTSD C. OCD D. B and C only - ANSWER D? Synopsis p. 444 table 11- 8 Which of the following would demonstrate the normal achievement of gross motor development milestone of a 6 month old? A. Pulls to stand B. Transfers items hand to hand C. Briefly sits alone/pivots in prone D. Feeds self crackers and stares at new faces - ANSWER B Which of the following is consistent with normal range gross motor developmental milestone for a 4-year-old? A. Walk down stairs B. Balances on one foot, can broad jump 1 ft C. Writes part of name, copies a square D. Eats independently, unbuttons items - ANSWER B? Which of the following questions would be important when differentiating pyromania from schizophrenia. A. Was the fires set in response to a delusion or hallucination? B. Was the fire set deliberately, not a failure to resist an impulse? C. Was the fire set as an act of sabotage? D. Was the fire set with a failure to appreciate the consequences of the act? - ANSWER A A cognitive assessment should include which of the following?

A. Baseline cognitive functioning B. Changes from baseline functioning C. Speed of onset of cognitive changes D. All of the above - ANSWER D A frontotemporal dementia with with onset in 5th or 6th decade of life, more common in men, marked by personality changes and cognitive decline? - ANSWER Pick's disease (Synopsis p. 243) Differential diagnosis to be considered in Ganser include: - ANSWER synopsis 445 organic dementia, depressive pseudodementia, Korsakoff syndrome, organic dysphagia, reactive psychosis, occasionally dissociative identity disorder Which of the following is known regarding ECT use in patient with dissociative identity disorder? - ANSWER (Synopsis p 448) in some patients ECT helps to ameliorate refractory mood disorders and does not worsen dissociate memory problems. Which of the following is consistent with brain imaging findings related to autism? - ANSWER increased brain volume A precipitous onset prion disease with rapid decline, progressing to to death within 6 months is known as? - ANSWER Creutzfeldt-Jakob Disease (Synopsis p. 256) A child who demonstrates repetitive significant violations of social rules and the rights of others over the course of a year-would likely be diagnosed as: A. ADHD B. ASD C. Conduct Disorder D. ODD - ANSWER C (conduct disorder) Which of the following is consistent with what is known about treating individuals with kleptomania?

A. Insight-oriented psychotherapy has been shown to be effective regardless of motivational level of the individual. B. Psychoanalysis is the treatment of choice. C. Behavioral therapy including aversive therapy has been reported to be successful with highly motivated individuals. D. A combination of aversive conditioning and alter social contingencies has been reported to be successful even when self-motivation was lacking. - ANSWER D (Synopsis p. 557) Most patients with dissociative identity disorder meet criteria for which of the following? A. Schizophrenia B. Cyclic Mood Disorder C. Schizoaffective Disorder D. Unspecified mood disorder with depressive symptoms. - ANSWER D An acute episode of violent behavior in which the person claims amnesia is? A. Amok B. Abulia C. Akathisia D. Abreation - ANSWER A (Synopsis p. 556) Which of the following questions would be important when differentiating pyromania from conduct disorder or antisocial disorder? SATA A. Was the fire set r/t to a delusion or hallucination? B. Was the fire set deliberately, not a failure to resist an impulse? C. Was the fire set as an act of sabotage? D. Was the fire set with a failure to appreciate the consequences of the act? - ANSWER B and C (Synopsis p. 556) (A-schizophrenia) (D-mental retardation, substance intoxication, dementia) Precipating factors for delirium do NOT include which of the following? A. Pain

B. Surgery C. Age 65 and older D. Use of physical restraints - ANSWER C (Synopsis p. 232 table 3-12) (age is considered a predisposing factor vs a precipitating factor) A child 0-3 months would be expected to be able to do which of the following? SATA A. Develop a social smile B. Reacts and turns towards sound C. Watches faces, follows objects D. All of the above - ANSWER D (certification review book p. 195) Which of the following is true regarding how intermittent explosive disorders differentiated from antisocial or borderline personality disorder? A. In personality disorders the aggressive and impulsivity are mild. B. In personality disorders the person is much less aware of the symptoms. C. In personality disorders, functioning is less likely to be affected. D. In personality disorders, aggressiveness and impulsivity is part of the person's character and is present between outbursts. - ANSWER D Indicators of imitative dissociative identity disorder include which of the following symptoms A. Symptom Exaggeration B. Confusion and shame related to symptoms C. Use of symptoms to excuse antisocial behaviors D. A and C - ANSWER D (Synopsis page 444) All of the following medications are used to treat Parkinson's Disease EXCEPT: A. NuLaid B. Rivastigmine C. Pimavanserin D. Memantine - ANSWER D

An acute onset, short term confusion, with changes in cognition and level of awareness due to a physiological cause is known as which of the following? A. Delirium B. Dementia C. Psychosis D. Traumatic Brain Injury - ANSWER A (Synopsis page p. 224) Which of the following is recommended in the treatment of pyromania? A. Psychoanalysis B. Cognitive Therapy C. Supervision of patient to prevent repeated episodes of fire setting D. All the above - ANSWER D (Synopsis page 558) A neurodevelopmental disorder characterized by impairment confined to a specific area of academic achievement (i.e. reading, writing, arthemic, spelling) without deficits in intellectual and adaptive behaviors. A. Intellectual Disability B. Communication Disorder C. Specific Learning Disorder D. Autism Spectrum Disorder - ANSWER C (Rutter's page 702) According to the DSM-5 delirium is specified as acute or persistent. Which of the following time frames are consistent with acute delirium specifications? A. A few hours or days B. Three weeks or less C. One month or less D. Less than 3 months - ANSWER A (Synopsis page 226) MRI findings in patients with intermittent explosive disorder may reveal changes in which area of the brain that is associated with a loss of impulse control A. Cerebellum B. Prefrontal Cortex

C. Temporal Lobe D. Parietal Lobe - ANSWER B (Synopsis page 555) Patient's with kleptomania have a high lifetime comorbidity of which of the following? A. Mood disorders B. Schizophrenia C. Dissociative Disorders D. All the Above - ANSWER A The PMHNP is meeting with a person who reports a fascination with fire, along with recurrent deliberate and purposeful setting of fires. The PMHNP realizes that these behaviors are consistent with: A. Pyromania B. OCD C. Intermittent explosive disorder D. Pyrophobia - ANSWER A The symptoms of giving approximate answers is known as which of the following? A. Alogia B. Paralogia C. Analogia C. Symlogia - ANSWER B (common in Ganser syndrome) Predisposing factors for delirium include which of the following (SATA) A. Dementia B. History of falls C. Age 65 and older D. Sensory impairment - ANSWER All of them A temporary marked alteration in the state of consciousness or by the customary sense of personal identity without the replacement by an alternate sense of identity is known as:

A. Ganser Syndrome B. Dissociative Trance Disorder C. Dissociative Identity Disorder D. Factitious Dissociative Identity Disorder - ANSWER B A major neurocognitive disorder with severe impairment in memory, judgment, orientation, and cognition is known as: A. Delirium B. Dementia C. Psychosis D. Amnesia - ANSWER B Difficulty with immediate memory is attributed to impairment in which of the follwing regions of the brain? A. Broca B. Wernicke C. Occipital D. Temporal - ANSWER D A condition characterized by the person giving approximate answers with clouding of consciousness, frequent accompanied by hallucinations or other dissociative, somatoform or conversion symptom is: A. Ganser syndrome B Schizophrenia C. Dissociative Trance Disorder D. Dissociative Identity Disorder - ANSWER A The second most common type of dementia caused by cardiovascular and cerebrovascular disease with progressive cognitive decline in stepwise fashion is known as: A. Pick's disease B. HIV Dementia C. Vascular Dementia D. Lewy-Body Dementia - ANSWER C

A subcortical dementia characterized by motor abnormalities including psychomotor slowing, choreo-athetoid movements, executive dysfunction, complicated by impaired language, memory and insight later as disease progresses is: A. Vascular Dementia B. Huntington Disease C. Creutzfeldt-Jakob Disease D. Alzheimer's Disease - ANSWER B Which of the following are common visceral symptoms of conversion disorder? A. Seizures B. Diarrhea C. Paralysis D. Mid-Line anesthesia - ANSWER B (also urinary retention, vomiting, syncope) Visual hallucinations are associated which impairment in which of the following regions? A. Occipital B. Temporal C. Left Parietal D. Frontal - ANSWER A A type of delirium characterized by cycling through psychomotor agitation and retardation from apathy to hyper-vigilance. A. Mixed Delirium B. Bipolar Delirium C. Hyperactive Delirium D. A and B - ANSWER A A tension state that can exist WITHOUT an action is known as? A. Obsession B. Compulsion

C. Impulse D. Ego Dystonia - ANSWER C A tension state that ALWAYS has an action component is known as? A. Compulsion B. Obsession C. Impulse C. Ego Dystonia - ANSWER A Interest in fires and deliberate setting of a fire for FINANCIAL GAIN is known as? A. Arsonist B. Pyromania - ANSWER A Which of the following can cause delirium (SATA)? A. Polypharmacy B. Sleep Deprivation C. Admission/transfer/discharge from healthcare facility D. None of the above - ANSWER A, B. C A person reveals that they steal to get the things they want and cannot afford. They state they cannot help themselves because they are a kleptomaniac. The PMHNP realizes that? A. This is consistent with kleptomania. B. This is not consistent because those with kleptomania do not realize they have it. C. This person likely does not have it because those who do are more concerned with the act of stealing rather than obtaining objects. D. It is consistent with kleptomania because they are stealing the things they need. - ANSWER C Which of the following is consistent with current literature about the relationship between obstetrical complications and Autism Spectrum Disorders?

A. Its unclear whether they are true risk factors. B. Research proves a negative correlation C. Research proves a positive correlation D. Research strongly supports a positive correlation. - ANSWER A Which of the following would NOT be included in the treatment plan for a patient with illnesses anxiety disorder? A. Behavioral therapy B. Group Therapy C. Insight Orientated Psychotherapy D. Exploratory invasive procedures to obtain diagnosis - ANSWER D A dissociative disorder described as an identity disturbance d/t prolonged and intense coercive persuasion is known as: A. Brainwashing B. Ganser Syndrome C. Imitative Dissociative Identity Disorder D. Factitious Dissociative Identity Disorder - ANSWER Brainwashing (Synopsis p. 444) A process by which repressed material is brought back to consciousness and the person relives the repressed material accompanied by the appropriate affective response: A. Abulia B. Abreaction C. Adynamia D. Alexithymia - ANSWER B The therapeutic approach that has the best chance of success for the person with intermittent explosive disorder is which of the following? A. Psychotherapy only B. Psychopharmacology only C. Family Therapy only D. A combination of psychotherapy and psychopharmacology - ANSWER D

Schizophrenia in a patient with ESRD is an example of which clinical problem in psychsomatic conditions? A. Co-occurring medical and psychiatric conditions B. Psychiatric symptoms secondary to a medical condition C. Psychiatric symptoms as a reaction to a medical condition D. Psychiatric complications of medical and psychiatric treatments - ANSWER A Which of the is NOT consistent with what is known about depersonalization and derealization? A. They are the third most commonly reported psychiatric symptom. B. Derealization is two to four times more often in men than women. C. One survey found a one-year prevalence rate of 19% of the general population. D. Transient experiences of depersonalization and derealization are extremely common in normal and clinical populations - ANSWER B (Synopsis page 449) Which of the following is a common sensory deficit of conversion disorder? A. Blindness B. Tunnel vision C. Anesthesia (especially of extremities, midline) D. Deafness - ANSWER All listed (Synopsis P. 454/table 12-4) A patient who has been raped presents with the inability to recall important information and any information about the rape but does recall events prior and since. There does not appear to be any psychological reason for this. This presentation is most consistent with? A. Dissociative Amnesia B. Localized dissociative amnesia with dissociative fugue C. Localized dissociative amnesia D. Generalized dissociative amnesia - ANSWER C A term used to describe a neurodevelopmental disorder characterized by impairments in reciprocal social communication and a tendency to engage in repetitive stereotyping patterns of behaviors, interests and activities is?

A. Intellectual disabilities B. Specific Learning Disorder C. Autism Spectrum Disorder D/ Attention Deficit Hyperactivity Disorder - ANSWER C Discrete episodes of losing control of aggressive episodes grossly out of proportion to any stressors which can result in serious assault or destruction of property are symptoms of? A. Conduct Disorder B. Antisocial Personality Disorder C. Borderline Personality Disorder D. Intermittent Explosive Disorder - ANSWER D (Synopsis p. 554) A subcortical dementia with parencymal abnormalities which can be visualized on MRI is known as? A. HIV Dementia B. Kluver-Bucy Syndrome C. Alzheimer's Dementia D. Creutzfeldt-Jakob Disease - ANSWER A (Synopsis p. 244) Which of the following medications is used to treat irritability in Autism? A. fluoxetine B. aripiprazole C. alprazolam D. guanfacine - ANSWER B (also risperdal is FDA approved) A congenital neurodevelopmental disorder primarily occurring in females, characterized by specific deficits following a period of normal functional growth? A. PANDAS B. Rett Syndrome C. Reye's Syndrome D. Kluver-Bucy Syndrome - ANSWER B

Somatoform disorders represent which type of clinical problem in psychosomatic medicine? A. Co-occuring medical and psychiatric conditions B. Psychiatric complications of medical condition or treatment C. Psychiatric symptoms secondary to a medical condition D. Psychological factors precipitating medical symptoms. - ANSWER D Which is NOT consistent with what is known regarding Ganser Syndrome? A. 3 of Ganser's first 4 cases were convicts B. Cases have been reported in a variety of cultures C. Woman outnumber men by approximately 2 to 1 D. It is considered by some to be an indicator of potential malingering. - ANSWER C (men outnumber woman 2:1) Synopsis p. 449 Deficits in attention and the ability to complete multi-step commands are associated with impairment in which of the following regions of the brain? A. Frontal B. Prefrontal C. Cingulate Gyrus D. All the Above - ANSWER D (PMHNP review p. 130)