Exam (elaborations) PMHNP Assessment in Psychiatric and Mental Health Nursing

Conrad, a 26-year-old male, is being treated for cuts after being arrested for breaking the windows in the home of his girlfriend, who has just told him that they are through. He has a history of having been physically abused by his father, setting fires as a child, treatment for substance abuse, and arrest for stealing a car. Which of the following personality disorders might the clinician consider? Question 1 options:a) Narcissis tic b) Paranoi d c) Antisocia l d) Histrionic Antisocial 7/13/25, 8:58 PM PMHNP exam prep / 2/140 In a biopsychosocial case formulation, social contributions would be considered to be: a) Genetic influences and adverse circumstances of birth b) Substance use and medical disorders c) Cognitive deficits and dysregulation of emotions d) Religious/cultural factors and living situations Religious/cultural factors and living situations Which of the following criteria would preclude the use of brief dynamic therapy? a) Adequate ego strengths b) Psychological problems in multiple domains c) Use of mature defense mechanisms d) Adequate ability to process information Use of mature defense mechanisms 7/13/25, 8:58 PM PMHNP exam prep / 3/140 In treatment of the acute phase of mania, the focus is on:a) Protecting the patient's biopsychosocial safety b) Educating the patient about social rhythms theory c) Interventions that address impairment of vocational functioning d) Interventions for self management of finance Protecting the patient's biopsychosocial safety During an initial assessment, the relevant features of communication are its ability to: a) Promote a therapeutic alliance and increase understanding. b) Prompt a disclosure of past successes and failures. c) Bring about changes in behavior. d) Educate the patient about what is important to disclose. 7/13/25, 8:58 PM PMHNP exam prep / 4/140 Symptoms of anxiety and panic are associated with a low level of which neurotransmitter? a) Cortiso l b) Dopamin e c) Gamma aminobutyric acid d) Glutamate Gamma-aminobutyric acid Which class of antidepressants has the most anticholinergic side effects? a) Monoamine oxidase inhibitors (MAOIs) b) Selective serotonin reuptake inhibitors (SSRIs) c) Tricyclic antidepressants (TCAs) d) Serotonin norepinephrine reuptake inhibitors (SNRIs) Tricyclic antidepressants (TCAs) 7/13/25, 8:58 PM PMHNP exam prep / 5/140 A 16-year-old male patient is hospitalized for depression after attempting suicide by overdose. Several days later, the patient reports feeling less depressed and having fewer suicidal thoughts, but begins to threaten suicide "if things do not work out." Nursing staff members report feeling resentful and manipulated, but fear for the patient's safety. The adult psychiatric and mental health nurse practitioner's intervention is to a) :assist the staff in developing a treatment plan that limits contact with the patient to one person per shift. b) develop a "no suicide" pact with the patient to decrease his helplessness and increase his feelings of control. c) encourage the patient to express his fears of improving and being abandoned or of leaving the safe environment. d) increase supervision and restrict milieu participation to decrease the secondary gain from manipulation. encourage the patient to express his fears of improving and being abandoned or of leaving the safe environment. 7/13/25, 8:58 PM PMHNP exam prep / 6/140 A female client complains of an intense, overwhelming fear of driving a car. The fear has disrupted all elements of her life. She does not go to the grocery store unless someone transports her, has relinquished her job, and has few social contacts. Her treatment plan includes: assertiveness training. b) biofeedbac k. c) stress management assistance. d) systematic desensitization. A patient with borderline personality disorder experiences intense anxiety when an adult psychiatric and mental health nurse practitioner goes on vacation. The best explanation for this reaction is that the patient: has failed to develop clear ego boundaries. b) has failed to master object constancy. c) is employing primitive idealization. d) is employing projective identification.