NU665 Primary Care of the Psychiatric Mental Health Client II
Week 8 Quiz
Question 1A rural and underserved community has an unusually elevated incidence of depression and drug use. This is detected among the teenage population. To address this issue, you will modify the environment and strengthen the capacity of families. You do this to ward off the development of new cases of depression and drug use. This is known as ________.
Select one:
a.primary prevention
b.secondary prevention
c.tertiary prevention
d.protective factor prevention
Question 2Contemporary therapy approaches are grounded on a core set of values, which are neither value-neutral nor applicable to all cultures.?
Select one:
True
False
Question 3Any court of law that evaluates the standard of care provided by a PMHNP ________.
Select one:
a.compares the action to the standard of care provided by a psychiatrist
b.considers what a reasonably prudent healthcare provider would do
c.evaluates patient satisfaction data
d.reviews the nurse practitioner's charts for similar patients
e.All of these answers are
Question 4The tendency for individuals to relate external events to themselves, even when there is no basis for making this connection, is known as:?
Select one:
a.? labeling and mislabeling.
b.? overgeneralization.
c.? arbitrary inferences.
d.? personalization.
Question 5The first step in making an ethical decision is to:?
Select one:
a.? look at the relevant ethics codes.
b.? identify the problem.
c.? consider the applicable laws and regulations.
d.? seek consultation.
Question 6__________ ethics focuses on doing what is in the best interest of clients.
Select one:
a.Mandatory
b.Minimal
c.Positive
d.Aspirational
Question 7Match the following statement with the appropriate leadership skill term:
To let clients know they are heard and understood beyond the level of words requires
Select one:
a.Active listening
b.Restating
c.Clarifying
d.Empathizing
e.Reflecting feelings
Question 8Overemphasizing cultural differences is always appropriate in a counseling context.?
Select one:
True
False
Question 9The PMHNP knows that an essential component embedded in the role and scope of practice is critical thinking. Critical thinking ________. (Choose all that apply.)
Select one:
a.is defined as rehabilitative services
b.entails making clinical decisions based on evidence-based practice
c.develops self-awareness by a metacognitive mechanism to gather additional insights about one’s self
d.None of the answers is
Question 10__________ involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it.?
Select one:
a.?Informed consent
b.?Confidentiality
c.?Privileged communication
d.?Breach of confidentiality
Question 11Clinicians who work in community mental health agencies, private practice, and other human service settings are generally expected to assess client problems within the framework of the National Association of Social Workers' Diagnostic and Assessment Protocol Manual (3rd ed.).?
Select one:
True
False
Question 12The brain structure associated with new memories and consolidation of new memories is the ________.
Select one:
a.frontal cortex
b.amygdala
c.hippocampus
d.hypothalamus
Question 13Serotonin is produced in which part of the brain?
Select one:
a.Locus ceruleus
b.Nucleus basalis
c.Raphi nuclei
d.Substantia nigra
e.None of the answers are
Question 14Sarah has been diagnosed with MDD. She is started on Sertraline 25 mg for her depression. She will take one-half of the dose in the a.m. for two weeks. You will follow up with her. To effectively monitor the client's use of medication, which of the following steps will be part of her ongoing care?
Select one:
a.Monitoring for potential cardiac side effects
b.Monitoring for potential abuse of the medication
c.Monitoring of baseline labs of renal functioning
d.Use of a standardized rating scale of depression
Question 15What teratogenic effects can occur by the psychotropics divalproex and lithium?
Select one:
a.Divalproex-Epstein Anomaly; lithium-cleft palate
b.Lithium-spina bifida; divalproex-mental retardation
c.Lithium-Epstein anomaly; divalproex-spina bifida
d.Divalproex-limb malformations; lithium-seizure disorder
Question 16A 24-year-old female is brought to the ER after attempting suicide by swallowing a bottle of her pills. Select the nursing action of highest priority that the PMHNP will take initially, once the patient is medically stable.
Select one:
a.Take her vital signs.
b.Assess her health history.
c.Assess her coping behaviors.
d.Assess her current level of suicidality.
Question 17Some family therapists focus primarily on the nuclear family, which is based on Western notions, and this could clearly be a shortcoming in working with clients in extended families.?
Select one:
True
False
Question 18 All of the following are characteristics of the behavioral approaches except:
Select one:
a.? behavior therapy relies on the principles and procedures of the scientific method.
b.? behavior therapy specifies treatment goals in concrete and objective terms.
c.? behavior therapy focuses on the client's current problems and the factors influencing them.
d.? behavior therapy employs the same procedures to every client with a particular dysfunctional behavior.
Question 19Which of the following is not a basic characteristic of behavior therapy?
Select one:
a.Treatment goals are specific and concrete.
b.It is grounded in learning theory.
c.Many specific techniques are supported by research.
d.The therapist is manipulative and controlling.
Question 20The techniques of joining, boundary setting, unbalancing, reframing, ordeals, enactments, and paradoxical interventions are most likely to be part of which approach to family therapy??
Select one:
a.?Bowenian family therapy
b.?Adlerian family therapy
c.?Structural-strategic family therapy
d.?Strategic family therapy
Question 21Motivational interviewing (MI) is a therapy technique commonly used with persons who abuse substances. One of the MI pitfalls is the "righting reflex. Which statement best describes this concept?
Select one:
a.The nurses urge to another person's course of action is usually right.
b.People who go into the helping professions have a powerful desire to set things right.
c.When we notice someone going down the wrong path, we are usually right.
d.Being right in knowing what to do is usually the job of the therapist.
Question 22?Modeling methods have been used in treating people with anger management issues and in teaching new behaviors to children with attention-deficit/hyperactivity disorder.
Select one:
True
False
Question 23Bibliotherapeutic approaches have empirical support for the treatment of depression, for a variety of anxiety disorders, and for a range of clinical problems.
Select one:
True
False
Question 24The PMHNP uses which technique to encourage patients to give expression to one side of themselves that they rarely express?
Select one:
a.The reversal technique
b.The implosive technique
c.The exaggeration technique
d.The go-around technique
e.None of the answers is
Question 25Sadie comes to the primary care clinic with feelings of depression. She is being treated for asthma and hypertension by her primary family nurse practitioner. Which one of the following medications can cause or exacerbate depression?
Select one:
a.Omeprazole
b.Propranolol
c.Levothyroxine
d.Clarithromycin
Question 26Suicide among those diagnosed with schizophrenia spectrum is:
Select one:
a.most common during the 1st few years of the illness
b.low
c.usually due to command hallucinations
d.rare unless co-occurring with personality disorder
Question 27When talking to parents who have brought their child in to see you for what they believe might be ADHD, you inform them that ________.
Select one:
a.the incidence of ADHD is estimated to be 25-35% of U.S. school age children
b.this disorder will definitely lead to difficulties with academics and substance abuse and probably employment issues
c.it is equally common in boys and girls
d.the pathology of the disease is not clear
Question 28?Modeling methods have been used in treating people with anger management issues and in teaching new behaviors to children with attention-deficit/hyperactivity disorder.
Select one:
True
False
Question 29Following are some of the main findings from the epidemiological research on PTSD. All are true EXCEPT ________.
Select one:
a.the majority of people will experience at least one traumatic event in their lifetime
b.intentional acts of interpersonal violence, in particular sexual assault, and combat are more likely to lead to PTSD than accidents or disasters
c.men tend to experience more traumatic events than women, but women experience higher impact events (that is, events that are more likely to lead to PTSD)
d.children are not at risk to experience PTSD
Question 30People at risk of PTSD include all of the following EXCEPT ________.
Select one:
a.victims of violent crime (such as physical and sexual assaults, sexual abuse, bombings, and riots)
b.members of the armed forces, police, and prison service; journalists; fire service members; ambulance and emergency personnel, including those no longer in service
c.victims of war, torture, state-sanctioned violence or terrorism, and survivors of accidents or disasters
d.women following traumatic childbirth and individuals diagnosed with a life-threatening illness
e.All of the answers are
Question 31? All of the following are true as they apply to self-instructional training, except that:
Select one:
a.? it was developed by Meichenbaum.
b.? it is a form of cognitive restructuring.
c.? it is an outgrowth of an approach used widely by crisis intervention workers called self-induced change therapy.
d.? it is also known as cognitive behavior modification.
Question 32You are the PMHNP treating a combat veteran following a deployment to Afghanistan. You have diagnosed him with PTSD and have decided to start him on Paroxetine. Which of the following is the LEAST likely reason to use an SSRI with this client?
Select one:
a.SSRIs can improve sleep disturbances associated with PTSD.
b.SSRIs reduce the re-experiencing, avoidance or numbing, and hyper-arousal associated with PTSD.
c.SSRIs have been shown to be effective for treating dissociative and psychotic states with 80% efficacy in some trials.
d.SSRIs can be effective for the treatment of co-morbid psychiatric disorders that often accompany PTSD.
Question 33Commonly cited predictors of dangerousness to others include:
Select one:
a.Chronic anger or hostility
b.Early loss of parent
c.Prior violent acts
d.All of the above
Question 34A tell-tale sign that indicates trauma or psychopathology has taken place is ________.
Select one:
a.a change in school performance
b.a change in behavior at home
c.a change in usual behavior
d.a change from usual behavior
e.All of the answers are
Question 35Research informs us that many children in classrooms across America have experienced at least one traumatic event. The term trauma is used to describe an event, series of events, or set of circumstances that is experienced as physically or emotionally harmful or life threatening and that has lasting adverse effects on daily functioning and mental, physical, social, emotional, or spiritual well-being (SAMHSA, 2014). Which of the following statements is FALSE about children and trauma events?
Select one:
a.Children exposed to violence are more likely to abuse drugs and alcohol; suffer from depression, anxiety, and post-traumatic disorders; fail or have difficulty in school; and become delinquent and engage in criminal behavior.
b.Sixty percent of American children were exposed to violence, crime, or abuse in their homes, schools, and communities.
c.Almost 40 percent of American children were direct victims of two or more violent acts, and one in ten were victims of violence five or more times.
d.Almost one in ten American children saw one family member assault another family member, and more than 25 percent had been exposed to family violence during their life.
e.All of these answers are True.
Question 36The PMHNP considers prescribing the following medication for a 45-year-old male who has been diagnosed with PTSD and continues to suffer with nightmares.
Select one:
a.Benadryl
b.Wellbutrin
c.Hydroxyzine
d.Prazosin
e.None of the answers are
Question 37Risk factors associated with intimate partner violence includes all the following EXCEPT ________.
Select one:
a.younger age
b.being a victim of physical or psychological abuse
c.history of experiencing physical discipline as a child
d.childhood abuse or witness to partner abuse
e.All of the answers are
Question 38Serving as a member on a crisis team, a PMHNP provides crisis intervention to the survivors of a plane crash. Forty hours after the accident, the survivors describe vivid flashbacks, startle reactions, and disrupted sleep patterns. How should the NP respond?
Select one:
a.Advising the survivors to consider using a hypnotic medication for a brief period of time.
b.Educating the survivors about prodromal symptoms of PTSD.
c.Encouraging the survivors to rest during the day.
d.Suggesting that the survivors join a post-trauma support group.
e.All of the answers are
Question 39A screening tool developed specifically to screen adolescents for high risk alcohol and other drug use is ________.
Select one:
a.PACES
b.HEEADSSS
c.CRAFFT
d.M-CHAT
e.None of the answers is
Question 40A 14-year-old boy is brought to the ED by the police after the boy assaulted a passerby. The patient is slurring his speech and appears unsteady. On physical exam, he is found to have nystagmus, generalized muscle weakness, and depressed reflexes. He is sluggish and complains that he is seeing double. Which substance is most likely causing his intoxication syndrome?
Select one:
a.Inhalants
b.Stimulants
c.Alcohol
d.Amphetamines
e.Hallucinogens
Question 41Which medication has been FDA approved for treating both alcohol and opiate addiction?
Select one:
a.Verenicline (Chantax)
b.Wellbutrin (Bupropion)
c.Naltrexone (Revia)
d.Buprenorphine (Suboxone)
Question 42Anorexia nervosa has a mortality rate of up to approximately:
Select one:
a.1%
b.18%
c.30%
d.42%
Question 43Which of the following features can be associated with bulimia nervosa?
Select one:
a.Previous episode of anorexia nervosa
b.Abnormal insulin secretion
c.Undeveloped breasts
d.Endocrine disorder
Question 44A two year old boy presents with his mother because of the parents’ concern that he is not developing appropriately. The child relates poorly to others, is often unable to engage using eye contact, and does not play with other children during play dates. He has trouble expressing himself. Which of the following is the most likely diagnosis?
Select one:
a.Fetal alcohol syndrome
b.Tourette's disorder
c.Schizotypal personality disorder
d.Autism
Question 45Which screening tool is now being used consistently by pediatric providers to screen for autism?
Select one:
a.Conners
b.Vanderbilt
c.HAM-A
d.M-CHAT
e.A-CHAT
Question 46Which of the following characteristics does not necessarily present in fetal alcohol syndrome?
Select one:
a.Heart defects
b.Facial dysmorphology
c.Growth retardation
d.Central nervous system dysfunction
Question 47You are interviewing a 16-year-old boy in your office. Part of your assessment includes getting a good developmental history from his mother and assessing him for characteristics that might lead you to make certain conclusions. You notice that he is a bit small for his age, has skin folds at the corners of his eyes, a thin upper lip, and low nasal bridge. What conclusion have you made?
Select one:
a.He has suffered head trauma.
b.He was born with a chromosomal aberration.
c.His condition was a result of perinatal alcohol use
d.His mother most likely had an infection when she was pregnant.
e.None of the answers is
Question 48What is the most frequent presenting complaint of parents about their child when suspecting a diagnosis of autism?
Select one:
a.Their lack of usual play skills
b.Delays in acquisition of language
c.Stereotyped movements
d.Their lack of interest in social interaction
Question 49Which of the following statements is true?
Select one:
a.Rhett syndrome is most often seen in females
b.Rhett syndrome is most often seen in males and rarely in females
c.Fragile X syndrome is primarily seen in females
d.An infant with Rhett syndrome usually has normal development for the first 3 years of life
Feedback
The answer is: Rhett syndrome is most often seen in females
Question 50A 13-year-old girl's family brings her to treatment against her wishes. The family reports that she is very short tempered, always arguing at home and with teachers, and blames them (teachers and parents) for the behaviors she’s exhibiting. She denies being depressed or anxious. No psychotic symptoms are reported. Based on the information you have, what might be the best diagnosis at this time?
Select one:
a.Antisocial personality disorder
b.Conduct disorder
c.Oppositional Defiant Disorder
d.Borderline Personality Disorder
