NURS 6670 Midterm Exam Questions and Answers
NURS 6670 Midterm Exam Questions and Answers
Question 1
Histrionic
Narcissistic
... [Show More] Borderline
Schizoid
Question 2
The physiologic symptoms of withdrawal may require a short-term hospitalization
Unlike other substances of abuse, there are no medications to help reduce the intensity of withdrawal
She will need to be monitored for depression
Overcoming the intense craving for cocaine is the biggest issue
Clare’s history of personal relationships is characterized by complete intolerance of being alone. Whether it is an intimate-partner relationship or a close friend, Clare appears to always need someone in her life. She had a live-in boyfriend of 3 years, and while they were together, he took care of everything. The PMHNP expects all of the following to be additional features of Clare’s history except:
Has disproportionate anger toward an abusive spouse
Question 4
Clothing
Speech pattern
Anger
Anxiety
Question 5
A 27-year-old female with a 1-month history of social withdrawal, anorexia, hypersomnia, unprovoked outbursts of anger, and a strong family history of endogenous depression
A 41-year-old male with a history of childhood sexual abuse, loss of interest in both his professional and personal life, an unplanned 10 lb. weight loss in the last 3 months, and perceptual disturbances
A 65-year-old male whose wife died 2 months ago and he reports a 3-week history of generally depressed
mood, guilt about his wife’s death, insomnia, difficulty focusing on daily tasks, with increasing thoughts of dying
Question 6
SSRIs
TCAs
Antiadrenergics
Antipsychotics
Question 7
Stuttered
Increased
Childlike
Confused
Question 8
History and symptoms are most consistent with antisocial personality disorder
Fletcher needs a neurological workup to include an EEG and assessment for neurological soft signs
Consistent with his symptoms, Fletcher will likely respond well to a stress interview
It is likely that substance abuse is the underlying cause of symptoms and should be explored further
Question 9
Which among the following neurotransmitters is decreased in depression and increased in mania?
Dopamine
Norepinephrine
Serotonin
Glutamate
Question 10
Mentalization-based treatment (MBT)
Transference-focused psychotherapy (TFP)
Countertransference-focused psychotherapy (CTFP)
Dialectical behavioral therapy (DBT)
Question 11
A history of schizophrenia of a first-degree relative
Sustained psychosis predating his mother’s death
Comorbid Asperger’s syndrome
Apparent frank thought disorder
Question 12
Which of the following is a true statement with respect to the treatment of narcissistic personality disorder?
Psychoanalytic psychotherapy has strong empiric support
Both serotonergic drugs and lithium are useful
Group therapy is rarely helpful
Immobilized patients (hospitalized or incarcerated) have the best outcomes
Question 13
Schizoid personality disorder
Schizotypal personality disorder
Paranoid personality disorder
Delusional disorder
Question 14
A history of racing thoughts
Difficulty interacting with others
Extremely high expectations of self
Significant impairment at work
Question 15
Hugo’s wife meets diagnostic criteria for this disorder
A trial period with no wine ingestion is necessary to assess for withdrawal symptoms
The family history should be assessed for genetic tendency
Hugo may have unreasonable expectations
Question 20
Dependence
Abuse
Adaptation
Addiction
Question 16
Antidepressant discontinuation syndrome
Rebound depressive symptoms
A manic or hypomanic episode
Unresponsiveness to medication with future episodes
Question 17
Which of the following is a true statement with regard to the etiology of substance abuse?
Neurotransmitters or receptors have been identified with most substances of abuse except for alcohol
Twin and sibling studies do not support a genetic component with respect to the etiology of substance abuse
Substances of abuse decrease activity in the amygdala and anterior cingulate
The WHO schematic of drug use and dependence identifies immediate antecedents as the central element of abuse
Question 18
Assessment of the manic state in a patient with bipolar disorder is likely to include all the following except:
Mood-congruent delusions of grandeur
Suicidal or homicidal ideation
Impaired judgment with no insight
Unrestrained flow of ideas
Question 19
An important part of the history will come from the caregiver
The patient must also be interviewed alone to preserve privacy of the relationship
A sexual history is not necessary in patients who are not sexually active
All of the above.
Question 21
Diazepam
Pimozide
Psychotherapy
Group therapy
Question 22
She should be admitted for inpatient detoxification
People in good physical health rarely have DTs
A beta adrenergic antagonist medication can minimize her risk of DTs
Women rarely experience DTs
Question 23
Venlafaxine and clozapine
Fluoxetine and olanzapine
Amitriptyline and haloperidol
Paroxetine and buspirone
Question 24
Sense of self-importance
Defense mechanisms
Self-esteem
Interpersonal relationships
Question 25
Discontinuing medication presents a marked risk of return to alcohol
A program of psychotherapy should be started before stopping medication
She needs to continue medication for a minimum of 3 months
Cessation of mood stabilizers prematurely increases risk for a depressive episode
Question 26
SCID
BPRS
PANSS
HAM-D
Question 27
Eye movement desensitization and reprocessing therapy
Implosive therapy
Systematic desensitization
Relaxation and cognitive techniques
Question 28
When symptoms are preceded by antidepressant therapy, a diagnosis of bipolar does not apply
His symptoms may be consistent with bipolar disorder if they persist for at least 2 weeks
A formal assessment of the social and occupational implications of his symptoms should be performed
The symptoms are most likely a physiologic adaptation to the sertraline and most often normalize
Question 29
Lamotrigine
Valproic acid
Lithium
Amitriptyline
Question 30
Insight-oriented psychotherapy
Behavior therapy
Virtual therapy
Pharmacotherapy
Question 31
Cannabis intoxication delirium is characterized by all of the following except:
Impaired memory
Perception
Psychosis
Motor coordination
Question 32
Avoidant personalities have a strong desire for personal relationships
Avoidant personalities may have an active fantasy life
Schizoid personalities are perceived as distant and aloof
Schizoid personalities may be very attached to animals
Question 33
Affect
Cognition
Thought process
Abstract reasoning
Question 34
Have a family history of the same disorder
Respond well to dialectical behavioral therapy
Have impaired emotional defense mechanisms
Come from smaller nuclear families
Question 35
An acute change in mental status
Angry verbal outbursts that seem unwarranted
Death of her best friend
An unplanned weight loss despite consistent oral intake
Question 36
Psychoanalytic
Behavioral
Existential
Cognitive
Question 37
An SNRI will likely be the most appropriate choice if pharmacotherapy is indicated for this episode
This may be an inaccurate characterization, as depressed patients tend to overemphasize negatives
In some circumstances patients will purposefully mischaracterize the efficacy of medications they feel were ineffective
Some forms of recurrent depression are best managed with nonpharmacologic strategies
Question 38
The treatment of dependent personality is rarely successful
Occupational dysfunction is rarely impaired
Dependent personalities tend to have long-term relationships with one person
This disorder tends to be more common in men
Question 39
The physiologic stress accompanying her first episode of depression may have produced changes in brain biology that makes her susceptible to subsequent episodes without an external trigger
The pharmacotherapy required to achieve remission with her first episode resulted in neuroplastic changes that increased her likelihood of experiencing additional depressive episodes
The scientific literature suggests that the loss of a sibling is the life event most closely associated with recurrent episodes of major depressive disorder throughout adulthood
Response to pharmacotherapy often takes a minimum of 8 weeks and that M.T. is much more likely to achieve remission if he can continue to provide the necessary support throughout her remission period.
Question 40
A thorough physical examination
A family history of mental health disease
A urine drug screen
An assessment for phobic disorder
Question 41
The difference between a manic and hypomanic episode is best characterized by all the following except:
The duration of symptoms is shorter for hypomanic episodes
Hypomanic episodes do not cause marked impairment in function
There are no psychotic features with hypomanic episodes
Hypomanic episodes may occur as a response to antidepressants
Question 42
Pharmacotherapy
Psychoanalytic psychotherapy
Transference-focused psychotherapy
A stress interview
Question 43
Urinary tract infection
Mild cognitive impairment
Normal pressure hydrocephalus
Depression
Question 44
In documenting a mental status exam (MSE) for Janet, a 54-year-old female, the PMHNP notes that she is bradykinesic, has poverty of speech, is depressed, and appears flat. This includes all the following elements of physical examination except:
Appearance Motor activity Mood
Affect
Question 45
Low-grade chronicity for at least 2 years
Insidious onset, usually in childhood or adolescence
Strong family history of depression and bipolar disorder
Long asymptomatic periods between episodes
Question 46
Which of the following personality disorders is associated with females with fragile X syndrome?
Borderline
Narcissistic
Dependent
Schizotypal
Question 47
Borderline personality disorder
Structural brain damage
Substance abuse disorder
Question 48
Family therapy
Behavior therapy
Psychoanalytic therapy
Interpersonal therapy
Question 49
He needs to be increased to 200 mg today and follow up in 4 weeks
He should maintain this dose for 4 weeks and reassess
He should change his therapy to an SNRI
Addition of cognitive behavioral therapy would likely improve response
Question 50
Pharmacologic treatment is not indicated
The etiology is different
Perfectionism is common
Physical symptoms are lacking
Question 51
Intrusion symptoms
Avoiding stimuli
Autonomic arousal
Clinical significance
Question 52
At least 90 minutes
Person-centered
Comprehensive
Insight-oriented
Question 53
Patients who require long-term benzodiazepine management should be maintained on long-acting agents
The use of benzodiazepines long term for anxiety does not pose a high risk of dependence and abuse
The panel supports increased federal and/or state restrictions on benzodiazepine prescribing
When detoxifying from therapeutic dosages, daily intake should be decreased by 10–25%
Question 54
The time course of symptoms
Presence of physiologic arousal
Reexperiencing the event
Response to pharmacotherapy
Question 55
Urine drug screen
Hepatic function test
Pulmonary function test
12-lead ECG
Question 56
Reinforcement
Reassurance
Encouragement
Acknowledgement
Question 57
Macrocytosis
Transaminitis
Uremia
Hypertriglyceridemia
Question 58
Fluoxetine
Paroxetine
Escitalopram
Sertraline
Question 59
Alcohol
Cannabis
Opiate
Hallucinogen
Question 60
Caffeine intake
Use of dietary supplements
Testosterone level
Liver function tests
Question 61
From a biological perspective, all of the following neurotransmitters are implicit in the anxiety response except:
Gamma-aminobutyric acid
Norepinephrine
Serotonin
Dopamine
Question 62
BPRS
Toxicology screen
Head imaging
Family history
Question 63
Schizophrenia
Social anxiety
Schizoid personality
Agoraphobia
Question 64
Any history of suicidal attempts or serious ideation
History and current patterns of substance abuse
Concomitant psychotic features such as hallucination or delusion
Manic symptoms that are sustained most of the day for at least 2 weeks
Question 65
Lithium carbonate is the drug of choice for Joe
Joe would be best managed with injectable antipsychotics
Risperidone is an appropriate choice when mania is characterized by anger and violence
Symbyax (olanzapine/fluoxetine) is the safest choice for Joe given his psychosis
Question 66
Reveal a very strong desire for an intimate relationship
Become very engaged in group therapy
Describe an active fantasy life with imaginary friends
Demonstrate psychotic or delusional features
Question 73
The major defensive mechanisms employed by patients with histrionic personality disorder include:
Repression and dissociation
Projective identification
Fantasy and isolation
Splitting
Question 74
Lorazepam
Venlafaxine
Propranolol
Buspirone
Question 67
Patients on lithium carbonate for management of bipolar disorder should be subject to routine assessment of:
CBC and BMP
TSH and serum Na+
CMP and ECG
LFTs and EEG
Question 68
Depression presents with more somatic symptoms as compared to younger age groups
Ageism may cause primary care clinicians to accept depressive symptoms in the elderly as normal
Risk factors include loss of spouse, physical illness, and social isolation
Incidence of geriatric depression is estimated at 60–75% of the population
Question 69
When differentiating a major depressive episode from dysthymic disorder, the PMHNP considers that:
The cognitive theory of depression does not apply to dysthymia
Hospitalization is typically indicated early in the course of dysthymia
Dysthymia is more subjective in its presentation than depression
Insight-oriented therapy is the most effective treatment for dysthymia
Question 70
Reconsider the diagnosis of major depressive episode
Add bupropion to her medication regimen
Increase the dose of fluoxetine
Change to another antidepressant medication
Question 71
Internal consistency reliability
Parallel form reliability
Construct validity
Face validity
Question 72
The presence of fixed delusional thought
Disdain for weak or sickly people
A history of antisocial behavior
Extreme ―drama‖ in most personal relationships
Question 75
Pharmacotherapy with clonazepam
Free-association, nondirective therapy
Interpersonal therapy
Serotonergic agents [Show Less]