WILKES NSG 526 EXAM 2 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% VERIFIED SOLUTIONS |
UPDATED PER LATEST GUIDELINES | GRADED A+...
Question 1
A psychiatric-mental health nurse practitioner is assessing a client who reports persistent feelings of worry,
muscle tension, and restlessness occurring more days than not for the past 8 months. The client states the worry
is difficult to control and interferes with work performance. Which diagnosis is most consistent with these
findings?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Adjustment disorder with anxiety
🟢 Correct Answer:
B. Generalized anxiety disorder
🔴 RATIONALE:
Generalized anxiety disorder is characterized by excessive, difficult-to-control worry occurring more days than
not for at least 6 months, accompanied by symptoms such as restlessness, muscle tension, and impaired
functioning. Panic disorder involves recurrent unexpected panic attacks; social anxiety disorder is specific to
social situations; adjustment disorder is tied to a specific stressor and typically resolves within 6 months.
Question 2
A client with major depressive disorder has been taking fluoxetine 20 mg daily for 4 weeks. The client reports
feeling improved but states, "I still feel tired all the time." What is the most appropriate initial action by the
PMHNP?
,A. Immediately discontinue fluoxetine and switch to a different antidepressant
B. Assess sleep patterns, medication adherence, and potential residual symptoms before changing treatment
C. Add a stimulant medication to address fatigue
D. Increase the fluoxetine dose to 40 mg without further evaluation
🟢 Correct Answer:
B. Assess sleep patterns, medication adherence, and potential residual symptoms before changing treatment
🔴 RATIONALE:
Before altering the treatment plan, the clinician should assess for contributing factors such as poor sleep,
nonadherence, or incomplete symptom resolution. Abrupt discontinuation of fluoxetine is inappropriate; adding
a stimulant or increasing the dose without a thorough evaluation could lead to adverse effects or treatment
failure.
Question 3
Which of the following is a positive symptom of schizophrenia?
A. Avolition
B. Alogia
C. Hallucinations
D. Anhedonia
🟢 Correct Answer:
C. Hallucinations
🔴 RATIONALE:
Positive symptoms of schizophrenia reflect an excess or distortion of normal functions and include
,hallucinations, delusions, disorganized speech, and grossly disorganized behavior. Avolition, alogia, and
anhedonia are negative symptoms, representing a decrease in normal functions.
Question 4
A client with bipolar I disorder is being treated with lithium. Which laboratory value is most important to
monitor to prevent lithium toxicity?
A. Serum sodium
B. Serum lithium level
C. Thyroid-stimulating hormone only
D. Complete blood count
🟢 Correct Answer:
B. Serum lithium level
🔴 RATIONALE:
Lithium has a narrow therapeutic index, and serum lithium levels must be monitored regularly to prevent
toxicity. While thyroid and renal function tests are important during lithium therapy, the serum lithium level is
the most direct indicator of safe dosing.
Question 5
Which medication is most likely to cause a hypertensive crisis if a client consumes foods rich in tyramine?
A. Fluoxetine
B. Sertraline
C. Phenelzine
D. Bupropion
, 🟢 Correct Answer:
C. Phenelzine
🔴 RATIONALE:
Phenelzine is a monoamine oxidase inhibitor (MAOI). MAOIs inhibit the breakdown of tyramine, and
consumption of tyramine-rich foods can lead to a dangerous hypertensive crisis. SSRIs such as fluoxetine and
sertraline and bupropion do not require the same dietary restrictions.
Question 6
A PMHNP is using cognitive-behavioral therapy (CBT) with a client who has panic disorder. Which intervention is
most consistent with this approach?
A. Exploring unconscious conflicts from childhood
B. Identifying and challenging catastrophic interpretations of bodily sensations
C. Providing unconditional positive regard without structured interventions
D. Using free association to uncover repressed memories
🟢 Correct Answer:
B. Identifying and challenging catastrophic interpretations of bodily sensations
🔴 RATIONALE:
CBT for panic disorder focuses on identifying and restructuring maladaptive thoughts, particularly catastrophic
misinterpretations of physical sensations that trigger panic. Exploring unconscious conflicts and free association
are psychodynamic techniques; unconditional positive regard is associated with person-centered therapy.
Question 7
A client with schizophrenia has been taking risperidone for 3 months. The client develops muscle rigidity, fever,
altered mental status, and autonomic instability. Which condition is most likely?
UPDATED PER LATEST GUIDELINES | GRADED A+...
Question 1
A psychiatric-mental health nurse practitioner is assessing a client who reports persistent feelings of worry,
muscle tension, and restlessness occurring more days than not for the past 8 months. The client states the worry
is difficult to control and interferes with work performance. Which diagnosis is most consistent with these
findings?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Adjustment disorder with anxiety
🟢 Correct Answer:
B. Generalized anxiety disorder
🔴 RATIONALE:
Generalized anxiety disorder is characterized by excessive, difficult-to-control worry occurring more days than
not for at least 6 months, accompanied by symptoms such as restlessness, muscle tension, and impaired
functioning. Panic disorder involves recurrent unexpected panic attacks; social anxiety disorder is specific to
social situations; adjustment disorder is tied to a specific stressor and typically resolves within 6 months.
Question 2
A client with major depressive disorder has been taking fluoxetine 20 mg daily for 4 weeks. The client reports
feeling improved but states, "I still feel tired all the time." What is the most appropriate initial action by the
PMHNP?
,A. Immediately discontinue fluoxetine and switch to a different antidepressant
B. Assess sleep patterns, medication adherence, and potential residual symptoms before changing treatment
C. Add a stimulant medication to address fatigue
D. Increase the fluoxetine dose to 40 mg without further evaluation
🟢 Correct Answer:
B. Assess sleep patterns, medication adherence, and potential residual symptoms before changing treatment
🔴 RATIONALE:
Before altering the treatment plan, the clinician should assess for contributing factors such as poor sleep,
nonadherence, or incomplete symptom resolution. Abrupt discontinuation of fluoxetine is inappropriate; adding
a stimulant or increasing the dose without a thorough evaluation could lead to adverse effects or treatment
failure.
Question 3
Which of the following is a positive symptom of schizophrenia?
A. Avolition
B. Alogia
C. Hallucinations
D. Anhedonia
🟢 Correct Answer:
C. Hallucinations
🔴 RATIONALE:
Positive symptoms of schizophrenia reflect an excess or distortion of normal functions and include
,hallucinations, delusions, disorganized speech, and grossly disorganized behavior. Avolition, alogia, and
anhedonia are negative symptoms, representing a decrease in normal functions.
Question 4
A client with bipolar I disorder is being treated with lithium. Which laboratory value is most important to
monitor to prevent lithium toxicity?
A. Serum sodium
B. Serum lithium level
C. Thyroid-stimulating hormone only
D. Complete blood count
🟢 Correct Answer:
B. Serum lithium level
🔴 RATIONALE:
Lithium has a narrow therapeutic index, and serum lithium levels must be monitored regularly to prevent
toxicity. While thyroid and renal function tests are important during lithium therapy, the serum lithium level is
the most direct indicator of safe dosing.
Question 5
Which medication is most likely to cause a hypertensive crisis if a client consumes foods rich in tyramine?
A. Fluoxetine
B. Sertraline
C. Phenelzine
D. Bupropion
, 🟢 Correct Answer:
C. Phenelzine
🔴 RATIONALE:
Phenelzine is a monoamine oxidase inhibitor (MAOI). MAOIs inhibit the breakdown of tyramine, and
consumption of tyramine-rich foods can lead to a dangerous hypertensive crisis. SSRIs such as fluoxetine and
sertraline and bupropion do not require the same dietary restrictions.
Question 6
A PMHNP is using cognitive-behavioral therapy (CBT) with a client who has panic disorder. Which intervention is
most consistent with this approach?
A. Exploring unconscious conflicts from childhood
B. Identifying and challenging catastrophic interpretations of bodily sensations
C. Providing unconditional positive regard without structured interventions
D. Using free association to uncover repressed memories
🟢 Correct Answer:
B. Identifying and challenging catastrophic interpretations of bodily sensations
🔴 RATIONALE:
CBT for panic disorder focuses on identifying and restructuring maladaptive thoughts, particularly catastrophic
misinterpretations of physical sensations that trigger panic. Exploring unconscious conflicts and free association
are psychodynamic techniques; unconditional positive regard is associated with person-centered therapy.
Question 7
A client with schizophrenia has been taking risperidone for 3 months. The client develops muscle rigidity, fever,
altered mental status, and autonomic instability. Which condition is most likely?
