NR607 Study Guide Questions with Verified
Correct Answers
A 16-year-old boy is consistently on the honor roll at school. Neither his school nor his
community offers extracurricular activities, but he plans to apply to prestigious colleges
when he graduates from high school. His parents believe that he should get a job
immediately after graduation as they cannot help him financially, and they believe
college is a "waste of time." In which category does the boy have the most protective
factors against perpetrating violence?
A. society
B. individual
C. family
D. community
B. individual
Rationale: The strongest protective factors described are individual factors: strong academic
achievement, future orientation, and a clear goal of attending college. The family is not
providing educational encouragement or financial support, and the school/community lack
extracurricular opportunities, so the boy's personal strengths are the most prominent
protective category.
A client presents with hand tremor and confusion. The client reports having a "stomach
bug" last week with vomiting and diarrhea. She states she takes a "psych" medication
but cannot remember what it is called. Which medication should the PMHNP suspect as
a cause of the client's symptoms?
,A. lithium
B. clozapine
C. bupropion
D. aripiprazole
A. lithium
Rationale: Lithium is cleared by the kidneys, and dehydration or sodium loss from vomiting
and diarrhea can raise serum lithium concentrations. Tremor and confusion are classic
neurologic signs of lithium toxicity, making lithium the medication that should be suspected
first.
Which is a common factor found in those who perpetrate child sexual abuse?
A. high IQ
B. high IQ
C. exposure to sexually explicit behavior at an early age
D. low economic status
C. exposure to sexually explicit behavior at an early age
Rationale: Early exposure to sexualized behavior or sexual victimization is recognized as one
potential developmental risk factor among some people who later perpetrate child sexual
abuse. It is not deterministic, but it is more relevant to the question than intelligence level or
low economic status, neither of which is a defining common factor.
,A client presents to the emergency department with sudden vision loss. The attending
physician finds no immediate medical cause. Which finding best supports a diagnosis of
functional neurological symptom disorder?
A. The client does not appear distressed by the vision changes
B. The client has a history of borderline personality disorder
C. The client is able to touch his fingers to his nose
D. The client has been drinking alcohol
A. The client does not appear distressed by the vision changes.
Rationale: The answer reflects the classic exam concept of la belle indifference, in which a
person with a functional neurologic symptom may appear unexpectedly unconcerned about a
dramatic deficit. Clinically, lack of distress is neither required nor diagnostic by itself;
functional neurologic symptom disorder is established by positive findings showing
incompatibility with recognized neurologic disease rather than simply by a normal workup.
A client reports intermittent heart palpitations for several months. Cardiac testing is
normal. He has stopped exercising due to fear of a heart attack and frequently seeks
reassurance online. Which diagnosis best fits this presentation?
A. Factitious disorder
B. Somatic symptom disorder
C. Illness anxiety disorder
D. Conversion disorder
, C. Illness anxiety disorder
Rationale: Illness anxiety disorder involves persistent fear or preoccupation with having a
serious illness despite normal evaluation and absent or only mild physical symptoms.
Repeated reassurance seeking, online symptom checking, and avoidance of exercise because
of fear of a heart attack all support illness anxiety disorder rather than factitious disorder,
conversion disorder, or somatic symptom disorder.
A client with a history of significant childhood trauma asks about alternative
treatments to help manage symptoms of complex trauma. Which option may be
recommended?
A. Acupuncture
B. Reiki
C. Passionflower extract
D. Structured walking programs
A. Acupuncture
Rationale: Acupuncture may be used as a complementary intervention for trauma-related
symptoms and has more clinical evidence as an adjunct than Reiki or passionflower in this
context. It should be viewed as an adjunct rather than a replacement for evidence-based
trauma-focused psychotherapy.
For which client is the use of restraints most appropriate?
A. A client who is actively suicidal and threatening staff.
Correct Answers
A 16-year-old boy is consistently on the honor roll at school. Neither his school nor his
community offers extracurricular activities, but he plans to apply to prestigious colleges
when he graduates from high school. His parents believe that he should get a job
immediately after graduation as they cannot help him financially, and they believe
college is a "waste of time." In which category does the boy have the most protective
factors against perpetrating violence?
A. society
B. individual
C. family
D. community
B. individual
Rationale: The strongest protective factors described are individual factors: strong academic
achievement, future orientation, and a clear goal of attending college. The family is not
providing educational encouragement or financial support, and the school/community lack
extracurricular opportunities, so the boy's personal strengths are the most prominent
protective category.
A client presents with hand tremor and confusion. The client reports having a "stomach
bug" last week with vomiting and diarrhea. She states she takes a "psych" medication
but cannot remember what it is called. Which medication should the PMHNP suspect as
a cause of the client's symptoms?
,A. lithium
B. clozapine
C. bupropion
D. aripiprazole
A. lithium
Rationale: Lithium is cleared by the kidneys, and dehydration or sodium loss from vomiting
and diarrhea can raise serum lithium concentrations. Tremor and confusion are classic
neurologic signs of lithium toxicity, making lithium the medication that should be suspected
first.
Which is a common factor found in those who perpetrate child sexual abuse?
A. high IQ
B. high IQ
C. exposure to sexually explicit behavior at an early age
D. low economic status
C. exposure to sexually explicit behavior at an early age
Rationale: Early exposure to sexualized behavior or sexual victimization is recognized as one
potential developmental risk factor among some people who later perpetrate child sexual
abuse. It is not deterministic, but it is more relevant to the question than intelligence level or
low economic status, neither of which is a defining common factor.
,A client presents to the emergency department with sudden vision loss. The attending
physician finds no immediate medical cause. Which finding best supports a diagnosis of
functional neurological symptom disorder?
A. The client does not appear distressed by the vision changes
B. The client has a history of borderline personality disorder
C. The client is able to touch his fingers to his nose
D. The client has been drinking alcohol
A. The client does not appear distressed by the vision changes.
Rationale: The answer reflects the classic exam concept of la belle indifference, in which a
person with a functional neurologic symptom may appear unexpectedly unconcerned about a
dramatic deficit. Clinically, lack of distress is neither required nor diagnostic by itself;
functional neurologic symptom disorder is established by positive findings showing
incompatibility with recognized neurologic disease rather than simply by a normal workup.
A client reports intermittent heart palpitations for several months. Cardiac testing is
normal. He has stopped exercising due to fear of a heart attack and frequently seeks
reassurance online. Which diagnosis best fits this presentation?
A. Factitious disorder
B. Somatic symptom disorder
C. Illness anxiety disorder
D. Conversion disorder
, C. Illness anxiety disorder
Rationale: Illness anxiety disorder involves persistent fear or preoccupation with having a
serious illness despite normal evaluation and absent or only mild physical symptoms.
Repeated reassurance seeking, online symptom checking, and avoidance of exercise because
of fear of a heart attack all support illness anxiety disorder rather than factitious disorder,
conversion disorder, or somatic symptom disorder.
A client with a history of significant childhood trauma asks about alternative
treatments to help manage symptoms of complex trauma. Which option may be
recommended?
A. Acupuncture
B. Reiki
C. Passionflower extract
D. Structured walking programs
A. Acupuncture
Rationale: Acupuncture may be used as a complementary intervention for trauma-related
symptoms and has more clinical evidence as an adjunct than Reiki or passionflower in this
context. It should be viewed as an adjunct rather than a replacement for evidence-based
trauma-focused psychotherapy.
For which client is the use of restraints most appropriate?
A. A client who is actively suicidal and threatening staff.
