NR547 Midterm Exam Questions With Complete Solutions
5Ps to collect a client's sexual history: Correct Answer Partners
Practices
Protection from STDs
Past History of STDs
Prevention of Pregnancy
*may consider adding another P for pleasure
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?
No action is necessary as the client is not currently considering
suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST Correct Answer 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.
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
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
Adjustment Disorder with Anxiety Correct Answer DSM-5
classifies adjustment disorder as a trauma- and stressor-related
disorder
-presents with nervousness, worry, or jitteriness
-Adjustment disorder occurs in the presence of a specific and
identifiable stressor
• common stressors include loss of employment, getting
married, a new disability, or a natural disaster
• Symptoms begin within three months of the stressor and
typically last no more than six months
,Agoraphobia Correct Answer 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 -decrease in speech or speech content
-symptom of schizophrenia.
-AKA poverty of speech.
American Geriatric Society (AGS) Beers Criteria Correct
Answer Avoid the use of haloperidol, ziprasidone, and
olanzapine due to an increased risk of CVA, cognitive decline,
and death in persons with dementia and with dementia-related
psychosis.
anhedonia Correct Answer inability to experience pleasure
anosognosia Correct Answer inability to realize that he or she
is ill, which is caused by the illness itself.
Antipsychotics: Potency low to high Correct Answer
Chlorpromazine - Low
Mesoridazine - Low
Thioridazine - Low
Thiothixene - Medium
Fluphenazine - Medium
, Haloperidol - High
Anxiety Disorders Correct Answer Generalized Anxiety
Disorder (GAD)
Social Anxiety Disorder
Panic
Phobias
Agoraphobia
Adjustment Disorder with Anxiety
Anxiety is often comorbid with _________________ as well as
medical conditions such as ____________, ___________, and
___________ Correct Answer major depression, COPD,
asthma, diabetes
Anxiety rating scale: GAD-7 Correct Answer General Anxiety
Disorder-7
-answer question with several days (+1), more than half days
(+2), nearly every day (+3)
• Feeling nervous, anxious, or on edge
• Not being able to stop or control worrying
• Worrying too much about different things
• Trouble relaxing
• Being so restless that it's hard to sit still
• Becoming easily annoyed or irritable
• Feeling afraid as if something awful might happen
0-4: No anxiety disorder
5-9: Mild anxiety disorder
10-14: Moderate anxiety disorder
15-21: Severe anxiety disorder
5Ps to collect a client's sexual history: Correct Answer Partners
Practices
Protection from STDs
Past History of STDs
Prevention of Pregnancy
*may consider adding another P for pleasure
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?
No action is necessary as the client is not currently considering
suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST Correct Answer 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.
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
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
Adjustment Disorder with Anxiety Correct Answer DSM-5
classifies adjustment disorder as a trauma- and stressor-related
disorder
-presents with nervousness, worry, or jitteriness
-Adjustment disorder occurs in the presence of a specific and
identifiable stressor
• common stressors include loss of employment, getting
married, a new disability, or a natural disaster
• Symptoms begin within three months of the stressor and
typically last no more than six months
,Agoraphobia Correct Answer 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 -decrease in speech or speech content
-symptom of schizophrenia.
-AKA poverty of speech.
American Geriatric Society (AGS) Beers Criteria Correct
Answer Avoid the use of haloperidol, ziprasidone, and
olanzapine due to an increased risk of CVA, cognitive decline,
and death in persons with dementia and with dementia-related
psychosis.
anhedonia Correct Answer inability to experience pleasure
anosognosia Correct Answer inability to realize that he or she
is ill, which is caused by the illness itself.
Antipsychotics: Potency low to high Correct Answer
Chlorpromazine - Low
Mesoridazine - Low
Thioridazine - Low
Thiothixene - Medium
Fluphenazine - Medium
, Haloperidol - High
Anxiety Disorders Correct Answer Generalized Anxiety
Disorder (GAD)
Social Anxiety Disorder
Panic
Phobias
Agoraphobia
Adjustment Disorder with Anxiety
Anxiety is often comorbid with _________________ as well as
medical conditions such as ____________, ___________, and
___________ Correct Answer major depression, COPD,
asthma, diabetes
Anxiety rating scale: GAD-7 Correct Answer General Anxiety
Disorder-7
-answer question with several days (+1), more than half days
(+2), nearly every day (+3)
• Feeling nervous, anxious, or on edge
• Not being able to stop or control worrying
• Worrying too much about different things
• Trouble relaxing
• Being so restless that it's hard to sit still
• Becoming easily annoyed or irritable
• Feeling afraid as if something awful might happen
0-4: No anxiety disorder
5-9: Mild anxiety disorder
10-14: Moderate anxiety disorder
15-21: Severe anxiety disorder
