NR 547 Differential Dx Midterm Questions With Complete
Solutions
2 dones and a rone Correct Answer 2 dones and a rone
The dones and rone more potently to the 5HT 2A receptor than
to D2 or bine equally between the 2 receptors. These
medications are less sedating and cause less weight gain, but
have a higher risk for hyperprolactinemia and EPS.
A client has been on clozapine for 9 months. Absolute
neutrophil counts (ANC) have consistently been less than
1500/microliter? At what frequency should a CBC be drawn?
daily
weekly
every 2 weeks (
monthly Correct Answer every 2 weeks (Correct answer)
Rationale: With a normal baseline ANC, the CBC should be
monitored weekly for 6 months; every 2 weeks for months 6-12;
and monthly thereafter (Clozapine REMS, 201).
A commonly used method is the "SNAPPS" method, which
follows a mnemonic consisting of six steps. This method is often
used for client presentations to preceptors. The six steps includ
Correct Answer 1.Summarize the history and findings
2.Narrow the differential diagnosis to two or three possibilities
3.Analyze the differential by comparing and contrasting the
possibilities
,4.Probe the preceptor by asking questions about alternative
approaches or uncertainties
5.Plan the management of the client's health issues
6.Select an issue from the case for self-directed learning
According to NIMH approximately ___% of US adults will
experience GAD in the past year and approximately ____% of
the US adults will experience GAD at some point in their
lifetime Correct Answer 3, 6
Adjustment Disorder with Anxiety Correct Answer The DSM-
5 classifies adjustment disorder as a trauma- and stressor-related
disorder; however, symptoms of adjustment disorder with
anxiety are similar to those found in anxiety disorders.
Adjustment disorder with anxiety presents with nervousness,
worry, or jitteriness.
Adjustment disorder occurs in the presence of a specific and
identifiable stressor. The distress experienced is out of
proportion to the severity of the stressor.
Adjustment Disorder with Anxiety examples Correct Answer
Examples of common stressors include loss of employment,
getting married, a new disability, or a natural disaster.
Affective symptoms of schizophrenia Correct Answer
Depression
Anxiety
Suicidality
,Agoraphobia Correct Answer involves intense fear, anxiety, or
panic out of proportion to the situation that occurs in two or
more of the following specific scenarios:
public transportation (bus)
open spaces (parking lot or bridge)
enclosed spaces (store, theater)
standing in a crowd or line (crowd)
being outside of their home
Alogia Correct Answer A decrease in speech or speech
content; a symptom of schizophrenia. Also known as poverty of
speech.
Amotivation Correct Answer Describes when someone is not
motivated to engage in an activity or behavior.
Anhedonia Correct Answer inability to experience pleasure
Anosognosia Correct Answer A patient's inability to realize
that he or she is ill, which is caused by the illness itself.
Anxiety is usually comorbid with? Correct Answer Depression,
COPD, asthma, and diabetes
Anxiolytic agents? Correct Answer Buspirone
Anxiolytic Pros vs Cons Correct Answer PROS:
↓ adverse effects
↓ drug interactions
CONS
limited effectiveness
, Anxiolytic time to efficacy? Correct Answer 2-4 weeks
Apply the Ask Suicide-Screening Questions (ASQ) Suicide Risk
Screening Tool (Links to an external site.) to the scenario below.
A 52-year-old client presents to the emergency department
following a car accident. The emergency department (ED)
physician is concerned that the client may have intentionally
crashed her car and requests a stat PMHNP consult. In speaking
with the PMHNP, the client describes persistent feelings of
sadness and hopelessness. She states that she often wonders if
her husband would be happier if she wasn't around anymore
since she's never happy and sometimes thinks about what it
would be like to just take a handful of sleeping pills and go to
sleep forever. The client reports a previous suicide attempt when
she was 16 but denies that she is considering killing herself right
now.
Based on the client's ASQ score, what is the most appropriate
response?
A) No action is necessary as the client is not Correct Answer
B)Provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for
a stat full safety and mental health evaluation, the client requires
a brief suicide safety assessment to determine whether a full
mental health evaluation in necessary. It is also important to
notify the client's physician or the clinician responsible for the
client's care.
aripiprazole (Ability) Correct Answer Atypical antipsychotics
Indication: FDA approved for schizophrenia ages 13 and older
Solutions
2 dones and a rone Correct Answer 2 dones and a rone
The dones and rone more potently to the 5HT 2A receptor than
to D2 or bine equally between the 2 receptors. These
medications are less sedating and cause less weight gain, but
have a higher risk for hyperprolactinemia and EPS.
A client has been on clozapine for 9 months. Absolute
neutrophil counts (ANC) have consistently been less than
1500/microliter? At what frequency should a CBC be drawn?
daily
weekly
every 2 weeks (
monthly Correct Answer every 2 weeks (Correct answer)
Rationale: With a normal baseline ANC, the CBC should be
monitored weekly for 6 months; every 2 weeks for months 6-12;
and monthly thereafter (Clozapine REMS, 201).
A commonly used method is the "SNAPPS" method, which
follows a mnemonic consisting of six steps. This method is often
used for client presentations to preceptors. The six steps includ
Correct Answer 1.Summarize the history and findings
2.Narrow the differential diagnosis to two or three possibilities
3.Analyze the differential by comparing and contrasting the
possibilities
,4.Probe the preceptor by asking questions about alternative
approaches or uncertainties
5.Plan the management of the client's health issues
6.Select an issue from the case for self-directed learning
According to NIMH approximately ___% of US adults will
experience GAD in the past year and approximately ____% of
the US adults will experience GAD at some point in their
lifetime Correct Answer 3, 6
Adjustment Disorder with Anxiety Correct Answer The DSM-
5 classifies adjustment disorder as a trauma- and stressor-related
disorder; however, symptoms of adjustment disorder with
anxiety are similar to those found in anxiety disorders.
Adjustment disorder with anxiety presents with nervousness,
worry, or jitteriness.
Adjustment disorder occurs in the presence of a specific and
identifiable stressor. The distress experienced is out of
proportion to the severity of the stressor.
Adjustment Disorder with Anxiety examples Correct Answer
Examples of common stressors include loss of employment,
getting married, a new disability, or a natural disaster.
Affective symptoms of schizophrenia Correct Answer
Depression
Anxiety
Suicidality
,Agoraphobia Correct Answer involves intense fear, anxiety, or
panic out of proportion to the situation that occurs in two or
more of the following specific scenarios:
public transportation (bus)
open spaces (parking lot or bridge)
enclosed spaces (store, theater)
standing in a crowd or line (crowd)
being outside of their home
Alogia Correct Answer A decrease in speech or speech
content; a symptom of schizophrenia. Also known as poverty of
speech.
Amotivation Correct Answer Describes when someone is not
motivated to engage in an activity or behavior.
Anhedonia Correct Answer inability to experience pleasure
Anosognosia Correct Answer A patient's inability to realize
that he or she is ill, which is caused by the illness itself.
Anxiety is usually comorbid with? Correct Answer Depression,
COPD, asthma, and diabetes
Anxiolytic agents? Correct Answer Buspirone
Anxiolytic Pros vs Cons Correct Answer PROS:
↓ adverse effects
↓ drug interactions
CONS
limited effectiveness
, Anxiolytic time to efficacy? Correct Answer 2-4 weeks
Apply the Ask Suicide-Screening Questions (ASQ) Suicide Risk
Screening Tool (Links to an external site.) to the scenario below.
A 52-year-old client presents to the emergency department
following a car accident. The emergency department (ED)
physician is concerned that the client may have intentionally
crashed her car and requests a stat PMHNP consult. In speaking
with the PMHNP, the client describes persistent feelings of
sadness and hopelessness. She states that she often wonders if
her husband would be happier if she wasn't around anymore
since she's never happy and sometimes thinks about what it
would be like to just take a handful of sleeping pills and go to
sleep forever. The client reports a previous suicide attempt when
she was 16 but denies that she is considering killing herself right
now.
Based on the client's ASQ score, what is the most appropriate
response?
A) No action is necessary as the client is not Correct Answer
B)Provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for
a stat full safety and mental health evaluation, the client requires
a brief suicide safety assessment to determine whether a full
mental health evaluation in necessary. It is also important to
notify the client's physician or the clinician responsible for the
client's care.
aripiprazole (Ability) Correct Answer Atypical antipsychotics
Indication: FDA approved for schizophrenia ages 13 and older
