PMHNP Test Bank Part 3

An appropriate rating scale to use for patients with obsessive compulsive disorder is:
Ashley, 28 years old, presents for a psychiatric evaluation stating, “The doctor thought I might have panic disorder.” She states she has had 2 panic attacks that caused her to go to the emergency department (ED) where she had a thorough work-up that d reveal any serious physical health problems. She was told to seek psychiatric care. Which of the following statements would not consistent with the diagnosis of panic disorder?
“My attacks always happen after I’ve had a bad argument with my boyfriend.”
Approximately what percent of patients with post-traumatic stress disorder (PTSD) recover completely without treatment?
PTSD treatments with the most robust outcomes are those that include pharmacotherapy as the primary The diagnosis of PTSD is usually made within the first 4 weeks after a traumatic event.
A 32-year-old female with generalized anxiety disorder has been on alprazolam 1 mg TID for 6 months. When considering discontinuation, which of the following is false?
Essential aspects of trauma-informed care include all of the following except:
Encouraging the individual to expose him/herself to triggers associated with re-traumatization.
A construction crane has collapsed onto a crowded city block, resulting in multiple injuries, including families waiting to enter a museum. Psychological first aid efforts include all of the following elements except:
12Which of the following statements is false regarding schizophrenia?
According to DSM criteria, which of the following are characteristics of schizophrenia?
(More than one option can apply.)
Laura, a 24-year-old woman, was diagnosed with schizophrenia 18 months ago and presents for follow -up. She mentions that sh has felt “out of it” most of the day since her medication change 5 weeks ago. She also states that she has gained 10 lbs (4.54 k patient is most likely taking:
Indicate whether each of the following is a positive (P) or negative (N) schizophrenia symptom.
____ Hallucination
____ Poverty of speech
___ Avoidance of eye contact
____ Disorganized behavior
Mrs. Engel is a 75-year-old woman with a 25-year history of type 2 diabetes mellitus who was referred for consultation of new-o visual hallucinations. She describes that she sees pictures of familiar scenes and people but does not hear voices. She is aware these are not real and during the periods of hallucination she is lucid and alert. She has no cognitive impairment and no past psychiatric history. Her vision has been slowly deteriorating for the past 7 years due to macular degeneration. Which of the follo is the most likely explanation for this patient?
A 22-year-old male diagnosed with paranoid schizophrenia has been taking haloperidol for the past 6 months. During this visit,
An appropriate next course of action will be to:
A 22-year-old patient is newly diagnosed with schizophrenia without hallucinations. Which of the following does the PMHNP reali the most critical task to complete at this visit?
The PMHNP would anticipate that treatment commonly employed to reduce the morbidity of schizophrenia include all of the foll except:
A 34-year-old male is brought into the ED with symptoms of muscle rigidity, hyperthermia, and altered mental status. He has be receiving fluphenazine for the past 2 months and initiated lithium therapy only recently. An expected finding from this patient is Serum creatine kinase >1000 IU/L.
13Marcus, a 24-year-old student who is at risk for failing out of law school, is referred by his academic advisor for psychiatric evalu He states that he drinks an average of 6 beers per night and last year had a driving under the influence (DUI) arrest. Marcus sta “I don’t think my beer drinking has anything to do with my bad grades. I really only have a couple of beers every night and it he to relax.” This statement is an example of:
The PMHNP’s response to Marcus that best illustrates motivational interviewing would be:
Rank the following from highest alcohol content (1) to
12 oz. (0.36 L) beer (7.2-proof)– 3
6 oz. (.18 L) wine (22-proof)– 2
3 oz. (0.09 L) liquor (80-proof)—1
Consider that each person listed below has been consuming drinks that meet the standard definition. Which of the following is l have the highest BAC?
Gary, a 54-year-old man with moderate liver disease, has a history of alcohol abuse but has been abstinent for the past 3.5 yea this visit, he reports a number of unfortunate events that have happened recently, including the death of a close sibling and los employment. As a result, he states that he is having increased urges to drink again. The PMHNP realizes that:
To prevent a possible relapse by Gary, the PMHNP recommends counseling and treatment with:
Sarah is 27 years old and smokes 1 marijuana cigarette on average, 2 to 3 days per week. She weighs 145 pounds (65.77 kg). S decides to stop smoking for a job interview that includes a urine drug screen. Detection of cannabis in her urine can last up to: 1 month
Match the substance with the withdrawal symptoms below.
Correct answers are:
Amphetamine withdrawal– Depressed mood, fatigue, vivid dreams, psychomotor agitation Cocaine withdrawal– Depressed mood, fatigue, vivid dreams, psychomotor agitation
Alcohol withdrawal– Increased HR, increased BP, diaphoresis, hand tremor, agitation, hallucinations Opioid withdrawal– Muscle cramps, arthralgia, diarrhea
Randy, a 32-year-old single manager of a sporting goods store, is being seen for follow-up after a 30-day inpatient stay for alcoh dependence. He has been sober for 45 days and continues to crave alcohol throughout the day. Which medication can be presc for Randy as a part of his treatment recovery plan to target alcohol cravings?
Dana, a 44-year-old registered nurse, is preparing to be discharged from a 30-day inpatient treatment facility for alcohol and methamphetamine dependence. She wishes to start a medication to help keep her abstinent from alcohol. She has extensive de work planned to begin within the next month. Which medication would be contraindicated for use given this information? Naltrexone
The region of the brain that is responsible for conditioned learning and connecting an experience with emotion is the:
Strategies to prevent remission among patients with substance use disorders include all of the following except:
When deciding on a treatment setting to manage withdrawal symptoms for a 46-year-old man with a history of alcohol abuse, w the following factors is most prominent in favoring hospitalization?
A 19-year-old man is brought into the emergency department by his friends who are concerned about his health. Physical exam reveals muscle weakness, dilated pupils, heart rate=140 bpm, blood pressure=180/115 mm Hg. His friends say that he may ha “taken something” orally about 2 hours ago. Which of the following is the most likely illicit substance?
14 Match the personality disorder symptom to the disorder type.
No conscience and no remorse
Suspicious of others’ motives
Need for admiration and lacks empathy
Unstable interpersonal relationships, self-image and impulsivity
Excessive emotionality and attention-seeking
Submissive, fears separation, clinging
Detached from social relationships and a restriction of affect interpersonally
Answers: No conscience and no remorse: Antisocial
Suspicious of others’ motives: Paranoid
Need for admiration and lacks empathy: Narcissistic
Unstable interpersonal relationships, self-image and impulsivity: Borderline
Excessive emotionality and attention -seeking: Histrionic
Submissive, fears separation, clinging: Dependent
Detached from social relationships and a restriction of affect interpersonally: Schizoid
Which of the following is not a Cluster B personality disorder?
Which of the following is not a Cluster B personality disorder?
Cluster A disorders are best characterized as:
Aamil is a 34-year-old married physician you see approximately monthly for counseling related to various work and relationship He is diagnosed with Cluster B traits. He recently presented with a one-month history of symptoms consistent with major depre disorder. An appropriate first-line psychotropic agent would be:
You are interviewing Adriana, a 34-year-old married mother of two, who has feelings of depression. As the interview progresses, become concerned that borderline personality disorder is a possible diagnosis and you ask more focused questions. Which of th following statements is least likely to be characteristic of a statement made by a person with borderline personality disorder?
“I left the party after about 20 minutes. Not one person had commented on my 10-pound (4.54 kg) weight loss and new dress.”
Jamie is a 27-year-old single mother who is being seen every two weeks for counseling regarding borderline personality disorde describes an episode last week when her significant other left for a trip for a few days and she became enraged when he did no one night, fearing that he will not return. In her rage, she destroyed most of his belongings. The PMHNP recognizes that this beh likely stems from which of the following?
When initiating psychotherapy for a patient with borderline personality disorder, an important first step in establishing the thera patient relationship is:
15Among the elderly (age 65 years and older), the highest suicide rate is observed in:
White men
Suicide: True or false?
Males represent nearly 80% of all completed suicides.
When compared to males, female attempts at suicide are approximately 2−3 times more common.
The highest rate of completed suicide is found in adolescent males.
Inquiring about suicidal ideation could precipitate the act.
Which of the following is false regarding suicides?
The highest suicide rate in men is from age 25−34 years.
True or False?
Asking about suicide will make the person think more about committing suicide.
Most people who die from suicide do not talk about it ahead of time.
If a person has a firm plan to commit suicide, clinical intervention is unlikely to alter the outcome.
The PMHNP is evaluating a 38-year- old man, an Iraq war veteran, in the emergency department (ED) for admission. He has a his disorder and says, “This isn’t about the war, it is about my crazy wife.” He is angry and agitated and makes a direct threat agai response includes all of the following except:
Mr. Adams is a 38-year- old construction worker seen in the ED for suicidal ideation. He has a history of major depressive disorde traits. He has not been on psychiatric medication for 10 months. His wife found him seated at the kitchen table with a gun and His blood alcohol concentration is 0.05 mg/dL. The ED provider has cleared him medically and you are asked to evaluate him fo you begin to talk to him you notice that he appears agitated and he states “I’m really angry! Why do I have to be in this goofy g someone let me go home? Just let me out of here!” Which of the following would be a sign of impending violence? (More than o Verbal threats, Increasing psychomotor agitation, Escalation in volume of voice
Which of the following is the least sensitive in predicting potential escalation of violence?
Which of the following is false regarding complicated grief?
The PMHNP is working with Mrs. Randolph whose husband is seriously ill with stage 4 lung cancer. Mr. Randolph’s oncology heal that hospice care is the most appropriate option at this point and that comfort is the main therapeutic goal. The patient states, prognosis but I have told the doctors that I want a second opinion.” According to Kubler-Ross, which stage of grief does this stat Bargaining
Which of the following statements is least accurate regarding suicide risk assessment documentation principles? An adequate assessment can reliably predict suicide.
When considering the use of a no-suicide contract, all of the following should be considered except:
Well-designed studies demonstrate their effectiveness in preventing suicide attempts
16True or false?
Most standardized screening instruments for depression are not valid in people >65 years of age.
Advanced age is a risk factor for developing depression.
Most elderly persons who commit suicide do not talk about their plans.
Up to 50% of people with dementia also are depressed.
A 73-year-old man who lives independently is accompanied by his daughter for evaluation. The daughter expresses concern tha forgetful, especially in keeping appointments and paying bills on time. The daughter notes that his change in mental function h after his wife of 45 years passed away about 6 months ago. You administer the mini mental status exam and he scores 22. This Mild cognitive impairment
A PMHNP is asked to evaluate a 78-year-old woman residing in a nursing home for potential dementia. Which of the following w dementia? (Indicate all that apply.)
-Unable to recall recent events, such as what she had for breakfast -Presence of visual hallucinations
-Difficulty finding the right word to use in conversation
-Failure to recognize objects
Mrs. Little is a 78-year-old woman with recently-diagnosed Alzheimer disease (AD) who is here today for an office visit with her According to her daughter, Mrs. Little struggles with word finding and has difficulty following directions. She seems “not to care her,” while other times is engaged in family activities. According to her daughter, Mrs. Little will have an angry verbal outburst t problem. Her daughter states, “This is not like my mother. Usually she is very patient.” Mrs. Little currently resides with her dau desire for this to continue “as long as possible and safe.” When evaluating Mrs. Little’s healthcare needs, choose all the pertine A home safety evaluation should be conducted and appropriate modifications carried out.
If Mrs. Little has a sudden change in mental status; her healthcare provider should be contacted as soon as possible.
Behavioral difficulties often arise in individuals with AD if their usual routine is disrupted.
The use of a cholinesterase inhibitor will likely improve her mental status to a point that is nearly equivalent to her predementia baseline.
Mrs. Little should be evaluated for a concomitant mood disorder.
The most common adverse effects from cholinesterase inhibitor use include nausea and diarrhea.
A second-generation antipsychotic* should be started to help avoid the angry outbursts.
Correct answers:
-A home safety evaluation should be conducted and appropriate modifications carried out.
-If Mrs. Little has a sudden change in mental status; her healthcare provider should be contacted as soon as possible.
-Behavioral difficulties often arise in individuals with AD if their usual routine is disrupted.
-Mrs. Little should be evaluated for a concomitant mood disorder.
-The most common adverse effects from cholinesterase inhibitor use include nausea and diarrhea.
Which of the following is the least likely characteristic of Alzheimer disease?
A 74-year-old male is brought into the clinic for evaluation after recent erratic behavior, including confusion that can last a few times per day, over the past month. The caregiver reports that he recently started to take a new medication. Which of the follow to cause these episodes
Which of the following is least likely to be noted in the person with Lewy body dementia?
In what stage of dementia do cholinesterase inhibitors demonstrate the most benefit?
Early AD
Mild-to-moderate AD
Severe AD
Your patient with dementia develops severe bradykinesia, gait disturbances, rigidity and tremor after taking a low-dose SGA for of the following dementia types do you suspect?
Which of the following is least essential to the work up for ACUTE memory loss?

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