NSG 6320 AGNP BOARD EXAM_PSYCHIATRY ASSESSMENT (40 QUESTIONS)
Question:
A 48-year-old woman states that she began smoking about 10 cigarettes
... [Show More] per day at 20 years of age. How should this subjective history be documented?
10 pack year history
14 pack year history Correct
18 pack year history 20 pack year history
Explanation:
The pack year history is calculated by the number of pack years = (number of cigarettes smoked per day/20, the number of cigarettes in a pack) × number of years smoked. This patient smokes 10 cigarettes per day / 20 x 28 years smoked = 14 pack year history.
Question:
An example of an alcohol assessment screening tool is the:
Kessler 6. PHQ-9.
CAGE. Correct
A-SSRS.
Explanation:
The CAGE Assessment is a quick questionnaire to help determine if an alcohol assessment is needed. If a person answers yes to two or more questions, a complete assessment is advised. The Kessler 6 & Kessler 10 are mental health screening tools used with a general adult population. Patient Health Questionnaire (PHQ-9) is the most
common screening tool to identify depression. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a questionnaire used for suicide assessment.
Question:
A seven- year -old is suspected of having conduct disorder. Which one of the following topics should the nurse practitioner include in the assessment history?
Stuttering
Animal abuse Correct
Worrying excessively about mother Refusing to perform chores
Explanation:
Animal abuse is often seen in children who display conduct disorder behaviors and would be a topic of concern if the child was abusing animals. Stuttering, worrying excessively about mother, and refusing to perform chores fall into other behavioral disorders.
Question:
The personality disorder characterized by patterns of attention-seeking, often dramatic behavior to gain the approval of others is:
histrionic. Correct antisocial. borderline. narcissistic.
Explanation:
Histrionic personality disorder is a diagnosis assigned to patients who display patterns of attention-seeking, often dramatic behavior to gain the approval of others.
Characteristics of histrionic personality disorder include: over-the-top behavior, such as emotional outbursts, noisy displays of temper, compulsive attention seeking and self-
centered actions. Antisocial personality disorder is a diagnosis given to patients who habitually and pervasively disregard or violate the rights and considerations of others without remorse. Borderline personality disorder is defined as a pervasive pattern of instability with interpersonal relationships, self-image, and affect, and marked impulsivity.
Question:
What is the leading cause of serious injury among U.S. women of reproductive age? Alcohol and illicit drug use
Motor vehicle accidents Suicide
Intimate partner and domestic violence Correct Explanation:
Intimate partner and domestic violence is the leading cause of serious injury and the second leading cause of death among U.S. women of reproductive age. The U.S. Preventive Services Task Force recommends routine screening of all women of childbearing age for intimate partner violence and referring those who screen positive to intervention services.
Question:
Which of the following statements made by a parent would alert the nurse practitioner to suspect autism spectrum disorder?
He is negative, disobedient and defiant.
He acts very impulsively and speaks out of turn. He seems to be speaking less and less. Correct He can't sit still for a short story.
Explanation:
Communication difficulties are common in the child with autism spectrum disorder. They often speak very little or lose language abilities if early interventions are not started that encourage and build language/communication abilities. The other choices are consistent in children with Attention Deficit Hyperactivity Disorder (ADHD).
Question:
Which mental health disorder is characterized by reoccurring thoughts, feelings, images, and sensations that lead to repetitive behaviors?
Major depressive disorder (MDD) Generalized anxiety disorder (GAD)
Obsessive-compulsive disorder (OCD) Correct
Somatic symptom disorder (SSD)
Explanation:
Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes unwanted repeated thoughts, feelings, images, and sensations (obsessions) and prompts patients to engage in behaviors or mental acts in response to these thoughts or obsessions. Major depressive disorder (MDD) is characterized by an overwhelming feeling of sadness, isolation, and despair lasting 2 weeks or longer. Generalized anxiety disorder (GAD) is characterized by persistent and excessive worry about a number of different things.
People with generalized anxiety disorder (GAD) may anticipate disaster and may be overly concerned about money, health, family, work, or other issues. Patients with GAD find it difficult to control their worry. Somatic symptom disorder (SSD) causes extreme anxiety about physical symptoms such as pain or fatigue. The person has intense thoughts, feelings, and behaviors about the symptoms that interfere with daily life.
Question:
Physical manifestations of anxiety disorder would include all of the following except: increased blood pressure.
increased heart rate. dilated pupils. drowsiness. Correct
Explanation:
Anxiety is defined as a state of apprehension, dread, uneasiness, or fear of the unknown. The blood pressure, heat and respiratory rates are usually elevated. The pupils may be dilated and there can be urinary frequency.
Question:
Social phobia, panic disorder, and post-traumatic stress disorder (PTSD) are all examples of:
major depressive disorder (MDD). generalized anxiety disorder (GAD). Correct obsessive-compulsive disorder (OCD). seasonal affective disorder (SAD).
Explanation:
Social phobia, panic disorder, post-traumatic stress disorder, and acute stress disorder are all examples of generalized anxiety disorder (GAD). Depression disorders include: major depressive disorder (MDD), persistent depressive disorder, bipolar disorder, seasonal affective disorder (SAD), psychotic depression, peripartum (postpartum) depression, premenstrual dysphoric disorder (PMDD), and situational depression.
Examples of obsessive-compulsive disorder (OCD) are checking, hoarding, ruminations, and intrusive thoughts.
Question:
A multifactorial geriatric condition or syndrome characterized by an age-related lack of adaptive physiological capacity occurring in the absence of identifiable illness is known as:
delirium.
cognitive impairment. functional impairment. frailty. Correct
Explanation:
A multifactorial geriatric condition or syndrome characterized by an age-related lack of adaptive physiological capacity occurring in the absence of identifiable illness is known
as frailty. Delirium is a serious disturbance in a person's mental abilities that results in a decreased awareness of one's environment and confused thinking. In the older adult, it is defined as a geriatric syndrome or condition occurring as a temporary state of confusion and may be the first clue to infection or problems with medications. Cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Functional impairment is a health condition in which the normal function of a part of the body is less than full capacity.
One of the defining characteristics of functional impairment is that the reduction in physical or mental capacity is sufficient to interfere with managing day-to-day tasks.
Question:
A 65-year-old man presents with complaints of daytime sleepiness, unrestful sleep, and loud snoring. These symptoms are MOST consistent with:
narcolepsy. nocturnal asthma.
obstructive sleep apnea (OSA). Correct
chronic obstructive pulmonary disease (COPD).
Explanation:
OSA complaints include daytime sleepiness, unrestful sleep, and loud snoring. Narcolepsy presents with symptoms of cataplexy, sleep paralysis, hypnogogic hallucinations, and excessive daytime sleepiness. Nocturnal asthma symptoms include chest tightness, shortness of breath, cough and wheezing. Signs of COPD include nighttime wheezing, coughing, and chest tightness, and morning phlegm and cough.
Question:
The Clinical Institute Withdrawal Assessment for Alcohol Withdrawal (CIWA) recommends inpatient management for scores higher than:
2
4
6
8 Correct
Explanation:
The Clinical Institute Withdrawal Assessment for Alcohol Withdrawal (CIWA) can be incorporated into the usual clinical care of patients undergoing alcohol withdrawal and into clinical drug trials of alcohol withdrawal. Scores of 7 or less do not require inpatient admission, but outpatient treatment is recommended. A score greater than 8 requires inpatient admission and medication management.
Question:
Anticipatory guidance for the family of a pre-adolescent with a cognitive impairment should include information about:
institutional placement. sexual development. Correct environmental stimulation. self-care activities.
Explanation:
Pre-adolescents who have a cognitive dysfunction may have normal sexual development without age appropriate emotional and cognitive abilities. It is important to assist the family and child through this developmental stage. Pre-adolescence does not require the child to be institutionalized. By the time a child reaches pre-adolescence, the family should have received instructions on ways to encourage and reinforce self-care activities and strategies to enhance the environment to encourage growth and development.
Question:
Extreme anxiety about physical symptoms (i.e., pain or fatigue) that causes intense thoughts and behaviors that interfere with daily life is classified as:
major depressive disorder (MDD). generalized anxiety disorder (GAD). obsessive-compulsive disorder (OCD). somatic symptom disorder(SSD). Correct
Explanation:
Somatic symptom disorder (SSD) occurs when a person feels extreme anxiety about physical symptoms such as pain or fatigue. The person has intense thoughts, feelings, and behaviors related to the symptoms that interfere with daily life. Major depressive disorder (MDD) is characterized by an overwhelming feeling of sadness, isolation, and despair that lasts two weeks or longer at a time. Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about a number of different things.
People with generalized anxiety disorder (GAD) may anticipate disaster and may be overly concerned about money, health, family, work, or other issues. Patients with GAD find it difficult to control their worry. Obsessive-compulsive disorder (OCD) is an anxiety disorder in which people have unwanted and repeated thoughts, feelings, images, and sensations (obsessions) and engage in behaviors or mental acts in response to these thoughts or obsessions.
Question:
Which of the following is NOT a symptom associated with the formal diagnosis of attention-deficit hyperactivity disorder (ADHD) in a child?
Difficulty organizing tasks and activities
Inability to play or engage in leisure activities quietly
Exhibiting symptoms of insomnia, restless sleep, and occasional noctambulism Correct
Inability to follow through on instructions and failure to finish schoolwork
Explanation:
Attention-deficit hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Six or more of the symptoms must persist for at least 6 months, to a degree that is inconsistent with developmental level and that negatively impacts social and academic/occupational activities. Some of the symptoms of ADHD include: difficulty organizing tasks and activities, inability to quietly play or engage in leisure activities, inability to follow instructions, and failing to finish schoolwork.
Criteria for ADHD do not include symptoms related to insomnia and sleep disturbance.
Question:
What is the second leading cause of death among U.S. women of reproductive age? Alcohol and illicit drug use
Motor vehicle accidents Suicide
Intimate partner and domestic violence Correct Explanation:
Intimate partner and domestic violence is the second leading cause of death among U.S. women of reproductive age and is the leading cause of serious injury in this group. The
U.S. Preventive Service Task Force recommends routine screening of all women of childbearing age for intimate partner violence and referring for intervention services those who screen positive.
Question:
An intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia is known as:
delirium.
cognitive impairment. Correct
functional impairment. frailty.
Explanation:
Cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Delirium is a serious disturbance in a person's mental abilities that results in a decreased awareness of one's environment and confused thinking. In the older adult, it is defined as a geriatric syndrome or condition occurring as a temporary state of confusion and may be the first clue to infection or problems with medications. Functional impairment is a health condition in which the normal function of a part of the body is less than full capacity.
One of the defining characteristics of functional impairment is that the reduction in physical or mental capacity is sufficient to interfere with managing day-to-day tasks. A multifactorial geriatric condition or syndrome characterized by an age-related lack of
adaptive physiological capacity occurring in the absence of identifiable illness is known as frailty.
Question:
Which one of the following questions is NOT asked in the CAGE questionnaire? Have you ever felt you needed to cut down on your drinking?
Have you ever been found guilty of driving under the influence of alcohol? Correct
Have people annoyed you by criticizing your drinking?
Have you ever felt you needed a drink first thing in the morning ?
Explanation:
The CAGE questionnaire contains four screening questions. It is widely used in the primary care setting to assess for alcohol abuse and potential alcoholism. The four screening questions are: Have you ever felt you needed to Cut down on your drinking? Have people Annoyed you by criticizing your drinking? Have you ever felt Guilty about drinking? Have you ever felt you needed a drink first thing in the morning (an Eye- opener) to steady your nerves or to get rid of a hangover? The questionnaire does not assess for driving under the influence (DUI) history.
Question:
Assessment findings of Russell’s sign is NOT indicative of:
anorexia nervosa.
body dysmorphic disorder. Correct
bulimia nervosa. binge eating disorder.
Explanation:
Russell's sign is defined as calluses on the knuckles or back of the hand due to repeated self-induced vomiting over long periods of time. The condition generally arises from the patient's knuckles making contact with the incisor teeth during the act of inducing the gag reflex at the back of the throat with their finger and is associated with bulimia nervosa, anorexia nervosa, and binge eating disorder. Body dysmorphic disorder (BDD) is a debilitating disorder characterized by obsessions and compulsions relating specifically to perceived appearance
Question:
A soldier states that since returning from active duty 2 months ago, he is experiencing sleep disturbance, irritability, low energy, and difficulty with concentration. These findings are consistent with:
adjustment disorder. panic disorder.
post-traumatic stress disorder. Correct
depression.
Explanation:
Post-traumatic stress disorder is a constellation of maladaptive symptoms that persist beyond 30 days after exposure to a traumatic event, for example military combat or physical assault. Adjustment, panic, and depression are symptoms related to PTSD.
Question:
Symptoms of Sundown syndrome may include:
alternating patterns of hyperactivity. impairment in recent and remote memory.
cyclic alternating periods of coherence with periods of confusion. Correct
vivid and terrifying dreams and nightmares.
Explanation:
Sundown symptoms become evident around sunset each day. Medically, it refers to nocturnal delirium, and is associated with increased disorientation, confusion and
agitation in late afternoon. The other symptoms are associated with delirium but not with sundown syndrome.
Question:
Which one of the following is at the HIGHEST risk for suicide? A 32-year old Asian woman
A 15-year-old Hispanic girl An 86-year-old black man
A 52-year-old white man Correct Explanation:
In 2015, the highest suicide rate (19.6%) was among adults between 45 and 64 years of age. The second highest rate (19.4%) occurred in adults 85 years or older. Younger groups have had consistently lower suicide rates than middle-aged and older adults.
Men have suicide rates nearly four times greater than women, however, women are three times more likely to attempt suicide. In 2015, adolescents and young adults aged 15 to 24 had a suicide rate of 12.5%. In 2015, the highest U.S. suicide rate (15.1%) was among white people and the second highest rate (12.6%) was among American Indians and Alaska Native people. Much lower and roughly similar rates were found among people of Asian and Pacific Islander descent (6.4%), and black people (5.6%).
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