NURS 6640 Midterm Exam

QUESTION 1 1. A PMHNP is caring for a 21-year-old woman who is suffering from anxiety and is having difficulty managing stress. Which of the following would be an appropriate step by the PMHNP? 1 points lOMoARcPSD| Downloaded by Boom Amor () D. Impact of Event Scale D 1 points True 1 points 1 points QUESTION 5 1. True or false: A PMHNP may ask his patient to describe her relationship with her father, both as a child and now, in order to assess interpersonal style. hours.” B. “Restrict the amount of time you spend in bed.” C. “Restrict the amount of exercise you do prior to going to bed.” D. “Restrict the amount of food you eat before bedtime.” B True A. Young Mania Rating Scale B. Hamilton Anxiety Rating Scale C. Dissociative Experiences Scale A. Group therapy B. Controlled confrontation C. A safe-place exercise D. Body and energy work 2 QUESTION 7 1. The PMHNP is caring for a patient who seems to seek affection and attention from the PMHNP and others in the clinic, as well as displays heightened emotional responses to feelings of being excluded. What therapeutic approach does the PMHNP use to decrease autonomic arousal in the patient? QUESTION 6 1. An initial evaluation reveals that an 11-year-old patient has moved to a new school after her parents‟ recent divorce, and is having trouble making friends. The patient has normal mental status and exhibits appropriate behavior. What is the most appropriate scale for the PMHNP to use to get False lOMoARcPSD| Downloaded by Boom Amor () NURS-6640 Midterm. C QUESTION 8 3 1 points NURS-6640 Midterm. lOMoARcPSD| Downloaded by Boom Amor () 35-year-ol pat ent seeks tre atment for D. QUESTION 10 1. A PMHNP‟s patients have already signed confidentiality agreements, including limits that will be imposed on confidentiality. Months later, the state‟s laws have changed that affect confidentiality promises the PMHNP has already made. What is an appropriate step for the PMHNP to take after finding out this information? 1 points QUESTION 11 1. The PMHNP is working with a school-aged child who has been diagnosed with depression. The child has attended several sessions with the PMNHP, but recently presents with avoidant behavior by showing increased distress and being late to sessions. What approach does the PMHNP need to employ with 1 points A. adaptive regression in the service of the ego B. regulation and control of affects and Q Ui m E SpTuIlsOeNs 9 1. AC. defensivedand iinterpersonal functioningdepression and anxiety after an abusive relationship. To help empower the patient, the PMHNP wants to tea s c e h ns th e e of saref e a - l p i t l y ac o e f t e h x e r w ci o s r e l d to an c d re o a f teth a e feeling of calm. In order to walk thesepla f tient through the exercise, the PMHNP first says: C A.“Identify an image of a safe place that makes you feel calm.” B. “Think about the things that cause you anxiety and let them go.” C. “Take a deep breath and start to relax with each new breath.” D. “Picture a beautiful beach and describe to me what you see.” A A. Revise intake forms to align with state laws B. Review confidentiality revisions with patients C. Have patients give informed consent again D. All of the above 1. A PMHNP is assessing ego functioning of his 40-year-old patient by asking what she feels is the cause of her problems. She attributes her problems to her overprotective parents not letting her have enough freedom growing up. Based on her answer, the PMHNP is testing . 1 points NURS-6640 Midterm. lOMoARcPSD| Downloaded by Boom Amor () must be completed, I will often complete it myself versus depending on someone else.” 1 points D. All of the above 1 points QUESTION 12 1. The PMHNP is treating a 35-year-old male officer in the military. He discloses that both of his parents are deceased and that he loved them. However, he says that he had feelings of inadequacy because his parents held him to a standard that he could never achieve. He went on to say that nothing he did ever felt good enough. The PMHNP assesses that this patient has perfect creases in his uniform with no strings or tags out of place; she also notices that he has perfect posture and questions him about ritualistic behaviors. She suspects that this patient has maladaptive responses to the expectations placed on him as a teenager and young adult. Which QUESTION 13 1. During a therapy session with an 18-year-old female the PMHNP learns that she has lived in six different foster homes in the last 24 months. She states that her mother is in a correctional facility for drug abuse and prostitution. During the assessment, the PMHNP notices multiple superficial cuts to each wrist. The patient appears tearful, withdrawn, and never makes direct eye contact. The PMHNP believes that this patient may have feelings of insecurities as well as abandonment issues and is aware that which the child to continue making therapeutic progress? A. Remaining quiet until the child is ready to talk B. Using communication techniques that are expressive C. Inviting the child‟s parents to speak on behalf of the child A. “I typically don‟t listen to anyone. I take care of my own wants and needs so I feel like no one can judge me or criticize me, period.” B. “I don‟t mean to hurt other people‟s feelings. When people cry or say that I have made them upset in some way, that‟s not my fault; some people are just sensitive.” C. “I like to listen to the beat of my own drum; I don‟t mind spending most of my days alone. I don‟t need recognition or praise; I would just like to be left alone.” D. “I believe in systems; I have to have order and rules in my everyday life. If a task A. Narcissistic personality disorder B. Obsessive-compulsive personality disorder C. Borderline personality disorder NURS-6640 Midterm. lOMoARcPSD| Downloaded by Boom Amor () D. Paranoid personality disorder QUESTION 14 1 points NURS-6640 Midterm. lOMoARcPSD| Downloaded by Boom Amor () QUESTION 15 1. The PMHNP is working with a patient who experiences anxiety around her parents that later leads to poor impulse control. What will the PMHNP do to employ psychodynamic psychotherapy properly for this patient? 1 points QUESTION 16 1. The PMHNP is working with a patient who seems dissatisfied with the therapeutic relationship. The PMHNP invites the patient to discuss her feelings regarding the PMHNP openly and honestly. It becomes clear to the PMHNP that they are experiencing an alliance rupture. How does the PMHNP repair the therapeutic alliance? 1 points QUESTION 17 1. The PMHNP is caring for a patient with borderline personality disorder. Using a psychoanalytic psychotherapy approach, the PMHNP attempts to intensify the patient‟s transference to enhance emotional processing by: 1 points A. Eat a heavy meal before bedtime to induce sleepiness B. Maintain a warm bedroom temperature C. Avoid watching television or reading in bed D. Try going to sleep at different times throughout the week to avoid monotony A. Emphasize the past B. Focus on expressions of emotion C. Identify patterns in relationships D. All of the above A. Responding to the patient in a nondefensive manner and accepting responsibility for the PMHNP‟s part in the tension B. Emphasizing with the patient‟s experiences and validating the patient for bringing it up C. Considering changing the goals of the patient‟s treatment D. All of the above A. Developing increased boundaries B. Decreasing supportive psychotherapy 7 1. In your office, you see a 58-year-old patient with PTSD who reports having nightmares, making it impossible for her to sleep. What recommendations based on principles of sleep hygiene will the PMHNP make? NURS-6640 Midterm. lOMoARcPSD| Downloaded by Boom Amor () C. Scaling back contact with the patient D. Increasing the number of sessions per week QUESTION 18 8 1 points NURS-6640 Midterm. lOMoARcPSD| Downloaded by Boom Amor () QUESTION 19 1. The patient is a 56-year-old female patient diagnosed with panic disorder and reports symptoms that include heart palpitations, frequent trembling, and feelings of choking in stressful situations. What special consideration does the PMHNP make? 1 points QUESTION 20 1. A 65-year-old patient has suffered the loss of his wife. He is in a state of hyperarousal with increased sympathetic nervous system arousal. One or more interventions may help the patient to deal with this arousal. To decrease sympathetic nervous system arousal, the PMHNP‟s treatment strategy is . 1 points QUESTION 21 1. The PMHNP is caring for a patient who the PMHNP believes would benefit from a relational psychodynamic approach to therapy. Which action made by the PMHNP demonstrates appropriate use and understanding of the relationship psychodynamic model? 1 points A. “The medication will help you forget the things that trigger your flashbacks.” B. “The medication takes a while to build up in your system and cure you.” C. “The medication may provide symptom relief, but you still need psychotherapy.” D. All of the above. A. Using a special focus on transference as the agent promoting change B. Confronting the emotional significance of the patient‟s symptoms C. Employing psychodynamic therapy combined with pharmacotherapy D. A and B A. mindfulness techniques B. deep breathing exercises C. self-regulation strategies D. all of the above A. Focusing the exploration on making the unconscious 1. The PMHNP is working with a patient who has dissociative disorder and requests pharmacological interventions for dealing with her trauma. What education does the PMHNP provide to the patient regarding NURS-6640 Midterm. lOMoARcPSD| Downloaded by Boom Amor () conscious B. Focusing the exploration on the genetic roots of the patient‟s problem C. Focusing the exploration on here and now D. None of the above