NRNP 6675-15 Week 6 Midterm Exam 2022
(100% Correct Answers)
1. Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply Age
Rapid dose escalation
Parental route of administration Higher potency typical antipsychotics
2. Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects?
Reduces negative symptoms
Increases extra pyramidal symptoms (EPS)
Causes prolactinemia
Reduces positive symptoms
3. Phencyclidine (PCP) and Ketamine exert their unique behavioral effects by blocking which of the following receptors?
GABA type receptors
Serotonin receptors
Dopamine receptors
NMDA type receptors
4. The diagnosis used to describe a syndrome characterized by specific signs and symptoms resulting from recent ingestion or exposure to a substance is known as which of the following?
Substance intoxication
Substance withdrawal
Substance use disorder
Any of the above
5. Abnormal involuntary movements in a rhythmic pattern affecting face, mouth, tongue, jaw is known as which of the following?
Akathisia
Dystonia
Tardive dyskinesia
Extrapyramidal side effects
6. A deeply held belief despite evidence to the contrary, lasting at least one month, without prominent hallucinations, with functional impairment that relates to the delusional syste.....
Schizophrenia
Delusional disorder
Brief psychotic disorder
Schizophreniform disorder
7. Which of the following is true about preoccupation with castration?
This can be serious and life-threatening if castration is carried out without medical supervision.
This is consistent with Transvestic Disorder
This is consistent with other specified paraphilic disorder
This is consistent with sexual masochism disorder
8. Which of the following is a system that provides a uniform language for describing medical and surgical procedures and diagnostic services rendered by clinicians?
HIPPA
DSM-5
CPT
DRG
9. A patient on Chlorpromazine states that his orgasm is dry and afterward he will commonly have milky urine. The ARNP realizes which of the following?
This is likely a harmless response to the Chlorpromazine
This is abnormal and needs to be evaluated by a specialist
It is critical to stop the Chlorpromazine immediately
This has nothing to do with the Chlorpromazine the patient be referred to his PCP for follow-up
10. A condition which results from absence of second female sex Chromosome (XO) and is associated with web neck, dwarfism, cubitus valgus, and infertility is known as which of the following?
Hermaphroditism
Turner's syndrome
Adrenogenital syndrome
Androgen insensitivity syndrome
11. Which of the following would be characterized as a negative symptom of schizophrenia? Hallucinations and delusions
Impaired social and occupational functioning Isolation and impaired self-care
B and C only
Which of the following are keys to distinguishing OCD from psychosis? Patients with OCD can almost always acknowledge the unreasonable nature of their symptoms
Patients with OCD are better able to control their compulsions.
Patients with psychosis will have more obsessive thoughts.
Patients with OCD have less bizarre obsessions.
13. Which of the following is a system that provides a uniform language for describing medical
and surgical procedures and diagnostic services rendered by clinicians...
HIPPA
B. DSM-5
CPT DRG
A federal program administered nationally and locally which covers enrolled individuals 65 years and
older who pay premiums and disabled individuals....
Medicare
Medicaid
Both A and B
None of the above
Having an adequate legal description of nurse practitioner (NP) scope of practice according to state law is important for which of the following reasons?
To avoid any charges of practicing medicine without a license
To place accountability for both benefits and harm to patients squarely on the NP
To get reimbursement for physician services when provided by an NP
All of the above
Which of the following is the most widely consumed psychoactive substance?
Alcohol
Caffeine
Heroine
Cannabis
Which of the following is used to treat Tardive Dyskinesia?
Cogentin (benztropine)
Artane (trihexyphenidyl)
Catapress (Clonidine)
None of the above
The APRN consensus model did which of the following?
Merged adult, gerontology and pediatric foci so that all NPs could truly work across the....
Adult and gerontology were merged and identified as primary care or acute care Psychiatric mental health foci were stipulated as across the lifespan B and C
Which of the following behaviors are associated with an alcohol blood level of 0.05 percent?
Voluntary motor actions usually become perceptibly clumsy
Thought judgment, and restraint are impaired
Confusion, stupor
None of the above
According to HIPPA, which of the following must the NP share their NPI with? Check all that apply.
Health plans
Other providers
Any entity that may need it for billing purpose
A and C only
A patient presents with delusions, disorganized thoughts, and speech with poor self care all of which have persisted for the past 7 months. The APRN this presentation is.......with which of the following diagnosis?
Schizophrenia
Schizophreniform disorder
Brief psychotic disorder
Delusional disorder
Major neurotransmitters possibly involved in developing substance abuse and substance dependence.....
which of the following?
Dopamine
GABA
Serotonin
A and B only
The Dopamine hypothesis of schizophrenia....which of the following?
Schizophrenia results from too much dopaminergic activity
Schizophrenia results from a deprivation of dopamine. Schizophrenia is not related to dopamine activity None of the above
A patient reports a panic attack several years ago in an elevator and since then has avoided using elevators. This patient meets criteria for which of the following?
Social phobia
Specific phobia
General anxiety disorder unspecified
Obsessive-compulsive disorder
A patient with a substance abuse disorder who does not meet the clinical criteria for hospitalization but who lacks sufficient social and vocational skills and lack substance-free social supports is ap
Residential treatment
Partial hospitalizations
Outpatient treatment
All of the above
Obscene phone calling to an unsuspecting partner for sexual arousal is known as which of the following?
Telephilia
Partialism
Telephone scatologia
Normal adolescent prank
The main psychological difference between fear and anxiety is best described by which of the following statements?
Fear is insidious; anxiety is sudden
Anxiety is insidious; fear is sudden.
There is no difference between fear and anxiety.
Both anxiety and fear are alerting signals
A diffuse, unpleasant, vague sense of apprehension often accompanied by autonomic symptoms which varies among persons is commonly known as which of the following?
Fear
Stress
Normal anxiety
Pathological anxiety
If a pregnancy begins while the woman is taking high doses of methadone and withdrawal is desired, during which trimester is this least hazardous?
First trimester
Second trimester
Third trimester
Withdrawal from methadone should never be done while the woman is pregnant
Neurochemical or neurophysiologic changes in the body that result from the repeated administration of a drug is known as which of the following?
Cross-tolerance
Neurotransformation
Neuroadaptation
Neurocognitive adjustment
The recurrent and intense sexual arousal from the physical and psychological suffering of another person is known as which of the following?
Frotteurism
Voyeurism
Sexual sadism
Sexual masochism
Which of the following is not consistent with the onset of OCD?
More than half of patients with OCD have a sudden onset of symptoms
The onset of symptoms for about 50-70 percent of patients occurs after a stressful event.
Most patients keep their symptoms secret initially.
The onset of OCD is typically preceded by OCD personality traits.
The recurrent urge to expose one's genitals to a stranger is known as which of the following? Fetishism
Voyeurism
Exhibitionism
Paraphilic disorder
Which of the following patients would be appropriate for hospitalization for substance use disorder? Select all that apply.
Patients who have a substance overdose who cannot be safely treated in an outpatient setting
Patients who are at risk for severe or medically complicated withdrawal syndromes
Patients who have a history of not benefiting from treatment in a less intensive setting
A and B only
The nursing practice model recommended for NPs by the National Academy of Medicine and the National Council of State Boards of Nursing is which of the following?
Full practice
Reduced practice
Restricted practice
Arbitrary practice
Which of the following groups does Medicare cover? Select all that apply.
Individuals 65 years and older who have enrolled and pay premiums
Disabled individuals who qualify for Social Security Disability payments and benefits
Adults who are disabled for one year or less and who qualify on the basis of poverty
Mothers and children who qualify on the basis of poverty.
Which of the following neurotransmitters increases libido?
GABA
Serotonin
Oxytocin
Dopamine
Which of the following factors are associated with poor prognosis for patients with OCD? Childhood onset
The presence of a precipitating event
Co-existing major depressive disorder
A and C
Which of the following is inconsistent with current knowledge about schizophrenia?
Schizophrenia is one of the most common of the serious mental disorders.
A diagnosis of schizophrenia is based entirely on the psychiatric history and mental status examination.
Dopamine level is a laboratory test that assists in the diagnosis of schizophrenia.
Schizophrenia likely comprises a group pf disorders with heterogeneous etiologies and variable presentations.
A Chronic disorder characterized by repetitive hair pulling leading to variable hair loss that may be....to
others is known as which of the following?
Obsessive-Compulsive Disorder
Impulse Control Disorder
..... Trichotillomania
.....
Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply. Age
Rapid dose escalation
Parental route of administration
Higher potency typical antipsychotics
Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects?
Reduces negative symptoms
Increases extrapyramidal symptoms (EPS)
Causes prolactinemia
Reduces positive symptoms
Phencyclidine (PCP) and Ketamine exert their unique behavioral effects by blocking which of the following receptors?
GABA type receptors
Serotonin receptors
Dopamine receptors
NMDA type receptors
The diagnosis used to describe a syndrome characterized by specific signs and symptoms resulting from recent ingestion or exposure to a substance is known as which of the following?
Substance intoxication
Substance withdrawal
Substance use disorder
Any of the above
A deeply held belief despite evidence to the contrary, lasting at least one month, without prominent hallucinations with functional impairment that relates to the delusional system...
Schizophrenia
Delusional disorder
Brief psychotic disorder
Schizophreniform disorder
A method of therapy used to treat individuals with substance abuse based on the fundamental principle of a psychology that reinforced behaviors are likely to be...is known as which of the following?
Exposure therapy
Contingency management
Motivational interviewing
Cognitive behavioral therapy
The conditions in which people are born, grow, work, live, and age are known as which of the following? Health literacy
Health disparities
Health vulnerabilities
Social determinants of health
All the following is consistent with ANCC rules regarding recertification EXCEPT:
You are required to have a maximum of 25 credit hours during each certification period
You can start the recertification process 1 year before your expiration date, but no later than 3 months before.
You must have 1000 clinical practice hours in the clinical specialty within the preceding 5 years.
You must have at least 25 contact hours in pharmacotherapy.
Risk factors for school violence include which of the following? Select all that apply.
Bullying
Being bullied
Isolation......
Involvement in school organizations.
Persons who subordinate their own needs to those of others, get other to assume responsibility for major areas of the lives, lack of self-confidence, and may experience intense discomfort when alone for more than a brief period of time are demonstrating characteristics consistent with which of the following personality disorders?
Avoidant personality disorder
Passive personality disorder
Dependent personality disorder
Antisocial personality disorder
Generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following lithium levels?
0.8-1.5 mEq/L
1.5-2.0 mEq/L
2.0-2.5 mEq/L
>2.5 mEq/L
.....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 emergency setting is known as which of the following?
Korsakoff's syndrome
Snyder's syndrome
Munchausen syndrome
Munchausen syndrome by proxy
Self-care strategies for the ARNP in preparing for the certification exam include all of the following EXCEPT?
Study in a distraction free environment
Six to eight hours of sleep is recommended
Drink lot of caffeine and eat high concentrated sugars
Plan to study for short periods of time over a longer time period.
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 patient likely has which of the following personality disorders?
Schizoid personality disorder
Paranoid personality disorder
Borderline personality disorder
Antisocial personality disorder
Generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following lithium levels?
0.8-1.5 mEq/L
1.5-2.0 mEq/L
2.0-2.5 mEq/L
> 2.5 mEq/L
A patient with a history of alcohol use presents to the emergency department with oculomotor disturbances, cerebellar ataxia, and confusion.... Symptoms as consistent with which of the following psychiatric emergencies?
Akathisia
Korsakoff's syndrome
Wernicke's encephalopathy
Idiosyncratic alcohol intoxication
Cluster A personality disorders are more common in biological families of patients with which of the following disorders?
Depression
Obsessive-compulsive disorder
Alcohol use disorders
Schizophrenia
NP core competencies for INDEPENDENT practice include all of the following EXCEPT:
Maintains a collaboration agreement with physician
Demonstrates the highest level of accountability for professional practice... Practices independently managing previously diagnosed and undiagnosed patient
Practices patient-centered care recognizing culture diversity and the patient or designee as a full partner in decision making
Cluster A personality traits consist of which of the following?
Schizotypal, schizoid, and paranoid subtypes
Narcissistic, borderline, antisocial, and histrionic subtypes
Obsessive-compulsive, dependent, and avoidant subtypes
Depressive, anxious, hypomanic subtypes
The misuse of the charge's funds for personal gain is known as which of the following?
Neglect
Physical abuse
Financial abuse/exploitation
Emotional/psychological abuse
The ARNP recognizes which of the following as long term effects of sex trafficking on victims?
Severe depression
Spiritual questions
Trauma bonding
All of the above
In about half of the cases in which suicides occur while parents 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?
Courts expect suicides to occur in inpatient settings
Courts require zero suicide rates in inpatient setting
Periodic patient evaluation for suicide risk
Evidence of formulation of a treatment plan with a high level of security
Cluster A personality traits consist of which of the following?
Schizotypal, schizoid, and paranoid subtypes
Narcissistic, borderline, antisocial, and histrionic subtypes
Obsessive-compulsive, dependent, and avoidant subtypes
Depressive, anxious, hypomanic subtypes
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 theorists?
Hofstede
Leininger
Purcell
Campinha-Bacote
The treatment of choice for patients with paranoid personality disorder includes which of the following?
Group therapy
Behavioral therapy
Psychotherapy
B and C
The differences in the quality of healthcare across individuals or groups in regard to access, treatment options, and p....following?
Racism
Health disparities
Vulnerable populations
Social determinants of health
The incidence of suicide is highest for which of the following populations?
Older Latino men
Older Caucasian men
Older Caucasian women
Older African American men
A patient on lithium with a history of alcohol use disorder presents with dry mouth, ataxia, dizziness, abdominal pain, and slurred speech. The ARNP should do which of the following?
The ARNP recognizes this is likely a relapse on alcohol so sends the patient home to sleep it off.
The ARNP recognizes these are symptoms of mild to moderate lithium toxicity, decreases the lithium by half, and encourage the patient to drink more fluids
The ARNP recognizes these are symptoms of mild to moderate lithium toxicity, discontinues the lithium immediately, orders lithium level, serum electrolytes, and renal function tests
The ARNP recognizes these are symptoms of moderate to severe lithium toxicity, discontinues the lithium and tells the patient hemodialysis will most probably be needed.
An 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 which of the following?
Straight salary
Average percentage of net receipts
Base salary plus percentage
Hourly rate
A personality disorder characterized by emotional constriction, orderliness, perseverance, stubbornness, indecisiveness, a.....inflexibility as which of the following?
Depressive personality disorder
Borderline personality disorder
Dependent personality disorder
Obsessive-compulsive personality disorder
Which of the following is consistent with what is known about the epidemiology of anxiety? Men have a higher lifetime prevalence of anxiety than women.
Women have a higher lifetime prevalence of anxiety than men Men and women have equal lifetime prevalence.
The lifetime prevalence of anxiety is not gender specific
Which of the following is consistent with NP practice parameters when prescribing buprenorphine?
NPs with full practice authority can prescribe and administer buprenorphine under their state NP license.
As a qualified practitioner the NP simply needs to notify SAMHSA prior to prescribing or administering buprenorphine
The NP can provide buprenorphine to 300 patients per month
The NP is required 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?
Men and women with higher education and income are less likely to drink alcohol.
Men and women with higher education and income are more likely to drink alcohol
Men and women with lower education and higher income are more likely to drink alcohol.
Education and income are not a factor in prevalence of drinking alcohol.
A patient with history of hypoglycemia reports feelings of fear, worry, and restlessness that has persisted over the past 6 months. The patient states these feelings are worse when glucose is low. The ARNP suspects the patient has which of the following diagnoses?
Generalized anxiety disorder attributable to another medical condition
Panic attacks attributable to another medical condition
Hypoglycemia with anxiety
None of the above
Which of the following is not consistent with benzodiazepine withdrawal?
Benzodiazepine withdrawal can continue to develop for several weeks
The best way to proceed with benzodiazepine withdrawal is to stop it immediately and treat withdrawal symptoms
It may be helpful to switch to a long-acting benzodiazepine for withdrawal
If patient is on a therapeutic benzodiazepine dose, initiate 10-25 percent dose reduction and evaluate response.
Which of the following is true about the legal practice of the psychiatric-mental health nurse practitioner?
All have some degree of prescriptive privileges in all states and the District of Columbia.
All are considered primary providers in all states and the District of Columbia.
All have the ability to manage patients medically within their scope of practice without a collaborative practice agreement.
A and B only
Flashbacks in which the individual may act and feel as if the trauma were reoccurring represent which of the following clinical features of PTSD?
Intrusion symptom
Symptom of avoidance
Symptom of increased autonomic arousal
Derealization
In which ways are nurse practitioners (NPs) and physician's assistants (Pas) different?
NPs differ from PAs in legal definition, scope of practice, licensure, and independence of practice.
NPs practice under their own license and independent of the physician, PAs always work under the supervision of a physician.
There is essentially no difference functionally between an NP and a PA.
A and B
Which of the following initials would a psychiatric-mental health nurse practitioner use to designate appropriate credentials?
ANP-C
CPNP
CPNP-AC
PMHNP-BC
Variations from norms in gender role behavior such as toy preferences, rough-and-tumble play, aggression, or playmate gender is known as which of the following?
Gender discordance
Gender role behavior
Gender identity variance
Childhood gender non-conformity
The three major neurotransmitters associated with anxiety, based on animal studies and response to drug treatment include which of the following?
Glutamate, Norepinephrine, Serotonin
GABA, Norepinephrine, Serotonin
GABA, Dopamine, Glutamate
Dopamine, Norepinephrine, Serotonin
A method of therapy used to treat individuals with substance abuse based on the fundamental principle of a psychology that reinforced behaviors are likely to be....is known as which of the following?
Exposure therapy
Contingency management
Motivational interviewing
Cognitive behavioral therapy
