NURS 6660 Midterm Exam, 2-Versions Latest Versions|75 Q & A| Verified and 100 % Correct|

Question.57 Harmony is a 4-year-old female who has been through several evaluations for behavioral abnormalities that have become increasingly disruptive, and the family is concerned for the safety of both Harmony and her 2-year-old brother. Comprehensive assessment of Harmony includes neuropsychiatric testing. The PMHNP documents the presence of neurological hard signs. These suggest: A. Brain lesions B. Early-onset schizophrenia C. Low intelligence D. Learning disability Question.58 The PMHNP is preparing an educational program for primary care providers about child abuse awareness. The goal of the program is to increase the understanding of primary care providers regarding risk factors for child abuse so that at-risk families may be identified and primary preventive strategies implemented before any harm occurs to children. The program emphasizes risk factors for child maltreatment to include all of the following except: A. Single-parent families B. Low parental education C. Parental substance abuse D. Firstborn child in the family Question.59 Kristina is a 17-year-old female who was encouraged to care by her parents because they have been worried about her. She has always been very healthy, happy, and active in school and sports. Her boyfriend of three years broke up with her last fall, right before he left for college. Since then she has lost all interest in her friends and school. Her parents say that she doesn’t do anything after school except go to her room. She has lost 16 pounds in the last 9 months. During the second session with the PMHNP, Kristina insists that her parents are overreacting, that she is doing OK in school and is eating just fine. She says of course she was sad that her boyfriend broke up with her, but she has gotten over it and moved on. During this session, the PMNHP appreciates that Kristina’s clothes are clearly too big for her, her eyes fill up with tears whenever her boyfriend is mentioned, and she does not seem engaged in the interview. While considering her assessment, the PMHNP recognizes that: A. The absence of a remote history of psychiatric disease makes a true psychiatric diagnosis unlikely B. The PMHNP must prioritize Kristina’s subjective report versus her parents’ report C. A standardized assessment tool such as the Patient Health Questionnaire (PHQ)-9 will be required for diagnosis D. The objective signs evident in Kristina’s examination are more compelling than her perspective on symptoms Question.60 Mrs. Jacobs has accompanied her son to today’s session. Her son is in psychiatric care because he has developed disciplinary issues and for the last several months has been challenging authority, truant from school, and openly defiant of the household rules. Mrs. Jacobs is understandably distraught and is adamant that her son must be the victim of bullying because yesterday he came home from school with a black eye and a swollen lip. While this has never happened before, she believes that bullying is the only explanation for his behavior at home. While counseling Mrs. Jacobs about bullying, the PMHNP emphasizes that, by definition, bullying: A. At some point will always involve physical aggression B. Does not occur unless more than one aggressor participates C. Is always unprovoked and intentionally cruel D. Rarely results in permanent, irreversible physical harm