NR547 Final Exam complete review. Final exam questions and detailed correct and verified answers.

NR547 Final Exam Questions with Correct and Verified Answers which of the following is a limitation of the Hamilton anxiety rating scale HAMA - Correct Answer it does not identify the "worry" component required for the diagnosis of generalized anxiety disorder which factor determines whether a client presents with symptoms of psychosis or disordered mood? - Correct Answer time frame of psychotic episodes in relation to the mood episodes over the lifetime of the illness. explained: To determine if a clients symptoms point to schizoaffective disorder or a mood disorder with psychotic features, a clinician must carefully assess the timeline and relationship between the psychotic symptoms and mood episodes a client presents with distressing psychological symptoms following a violent confrontation in which she was subjected to racism. this is an example of which facto in mental health and illness. - Correct Answer social determinants of health which of the following are considered essential features of sexual dysfunction - Correct Answer inability to respond to sexual stimulation of the experience of pain during the sexual act which client statement is an example of the most common form of hallucination seen in schizophrenia spectrum and the psychotic disorders - Correct Answer a client hears voices telling them they are stupid and worthless which factor has the strongest evidence as the cause of schizophrenia - Correct Answer gentics which disorder occurs in 10-20% of all men and comprise more than 50% of all men rated for sexual dysfunction - Correct Answer Erectile dysfunction all clients below have a family history of schizophrenia. which client would be most likely to experience symptoms? - Correct Answer 19 year old who just lost his mother which disorder commonly occurs secondary to agoraphobia? - Correct Answer depressive disorder and substance use disorders Which factor would rule out a diagnosis of schizophrenia disorder? - Correct Answer the client experienced symptoms intermittently for only 18 months a 35 year old male presents to the office for a transfer of care. The client has a previous diagnosis of anxiety. during the interview multiple red ________ are noted on his arms. The client denies substance abuse, tactile hallucinations or recent infections. the client states he _________. He tries to stop but find himself picking when he is nervous or bored. what is the client most likely diagnosis? - Correct Answer excoriation disorder A client presents with symptoms of depression. which laboratory test results indicates a possible medical cause - Correct Answer hematocrit of 29 hct level 36-50% which statement is true regarding sleep wake disorders - Correct Answer they share clinical features of nocturnal distress and circadian rhythm disruption an 18 year old presents with symptoms of delusions persecutions feeling low reduced energy and a sense of _______ about her symptoms. what is the primary differential diagnosis? - Correct Answer schizoaffective disorder a client was switch from lurasidone to clozapine two months ago his most recent absolute neutrophils 1154, how often should abc be done - Correct Answer weekly for the first 6 months 6-12 is every 2 weeks after 12 months, monthly which physiological response commonly occurs in clients with anxiety disorders - Correct Answer exaggerated noradrenergic system output explained: in anxiety disorders the noradrenergic system is often overactive meaning minor stressors can trigger exaggerated release of norepinephrine leading to the physical symptoms of anxiety a client presents with symptoms of female sexual interest/arousal disorder. what information collected in the interview may indicate? - Correct Answer client takes lisinopril for hypertension impairs blood flow for arousal or Benadryl remember this when reading the question anticholinergics block the action of acetylcholine a neurotransmitter that plays a role in body functions like sexual arousal and response. a 52 year old man with a history of depression presents to the ... behaving differently than during past episodes - Correct Answer prescribe daily extended release bupropion/welbutrin which are positive sx of psychotic disorder - Correct Answer hearing voices and seeing lights that no one else sees what is the most common breathing sleep disorder - Correct Answer osa a client communicates using short one or two word responses - Correct Answer alogia a client presents to the office requesting refill of adderall, urine drug screen negative what does this mean - Correct Answer has not taken adderall in the past 3 days which statement is true regarding enuresis - Correct Answer episodes awaken clients after a deep sleep all the clients below have a family history of schizophrenia. which client would most likely to experience symptomsq - Correct Answer 19 year old who just lost his mother what disorder commonly occurs secondary to agoraphobia - Correct Answer depressive disorder and substance use disorders they had specific phobias and avoidant personality disorder but these have their own distinct dx and are not secondary conditions. which factor would rule out schizophreniform disorder - Correct Answer the client has experienced symptoms intermittently for 18 months dsm criteria psychosis sx is greater than 1 month but less than 6. no mania or depression sx the psychiatric mental health nurse pracitioner is interviewing a 27 y/o client with reports of anxiety symptoms how long must they be for dx of GAD - Correct Answer 6 months a client presents with symptoms of fatigue which lab test indicates a possible medical clue of symptoms - Correct Answer tsh of 7.1 client taking modafinil what is the most likely reason - Correct Answer narcolepsy the pmhnp is treating a client with anxiety, which social determinant of health can exacerbate her symptoms - Correct Answer the client is a single parent who just lost her job and is being evicted from her apartment why is ruling out medical etiology of symptoms important when developing a psychiatric differential diagnosis - Correct Answer because medical conditions can have complications which result in psychotic symptoms client has excessive daytime sleepiness. falls asleep without warning while laughing or driving. prior to prescribing medication what diagnostic test can be performed to confirm - Correct Answer CSF analysis to dx narcolepsy bc client experiencing cataplexy hypocretin test is via lumbar puncture which medication should the patient take in the morning instead of at night, taking at night and having difficulty sleeping - Correct Answer topiramate take at night to reduce day time sedation fluoxetine is the answer it can have activating side effects which can cause insomnia take in am to avoid or If noticed. a 40 year old client presents after starting a new job. one of the main functions of his role is to present new products to a large group of clients. he expresses that he feels terrified of public speaking and during his first presentation has a racing heart and dry mouth. which medication can be taken as needed? - Correct Answer propranolol which diagnosis presents with minimal spontaneous sexual thinking or minimal desire for sex ahead of sexual experiences? - Correct Answer female sexual interest and arousal disorder characterized by a lack of significantly reduced sexual interest or arousal. which symptom is most likely to be present in a client with catatonia - Correct Answer posturing catatonia is a neuropsychiatric syndrome characterized by abnormalities in motor behavior, movement, and responsiveness. posturing is a hallmark symptom of catatonia. it involves assuming and maintaining bizarre physical postures for extended periods. a client presents with auditory hallucinations. which medication has an adverse effects profile that includes this as a primary symptom - Correct Answer amiodarone prednisone is listed in review as answer however amiodarone crosses the blood brain barrier and affect the central nervous system this can lead to auditory hallucinations, visual hallucinations, confusion and delirium . this was also listen in a module question as an interaction with other medications leading to increased positive symptoms due to its affect on psychotic medications. a 32 year old presents to the psychiatric mental health nurse practitioner following four brief episodes of intense anxiety occurring at home and work of the las two months. he reports the episodes "come out of the blue". during the episodes he experiences dyspnea, heart palpitations, chest pain, tingling in his lips and fingers and sweating. his symptoms are so severe he fears he is going to die. his primary care physician has ruled out medical cause - Correct Answer panic disorder "reports comes out of the blue" which health indicators are important to monitor for clients who are on antipsychotic medication - Correct Answer BMI, fasting glucose, lipid profile due to metabolic risk is highest which is weight gain, elevated blood glucose, dyslipidemia a client presents to the clinic with fatigue, anhedonia, and hyper somnolence. which action is the psychiatric mental health nurse practitioners priority? - Correct Answer order CBC, thyroid stimulation hormone and toxicology screen as many as two thirds of patients with what disorder meet the diagnostic criteria for obsessive compulsive disorder - Correct Answer Tourette disorder is listed body dysmorphic disorder is what is supported on ai meet diagnostic criteria for ocd here's why: both have obsessive compulsive thoughts compulsive behaviors and both related to similar circuits in brain a client presents to the provider with symptoms of obsessive compulsive disorder. in determining whether the clients symptoms are subclinical vs. clinical which factor should the psychiatric mental health nurse practitioner consider? - Correct Answer the patients level of distress and impairment in the function the determining factor for clinical OCD is the presence of significant distress, impairment in functioning, or excessive time consumption due to obsessions and compulsions why are diagnostic instruments and psychiatric rating scales beneficial? - Correct Answer they can help to standardize the information collected across time by various clinicians or researchers explained: these are valuable tools to enhance the consistency and objectivity of mental health assessments, but they should always be used in conjunction with other clinical skills and judgement. a 21 year old presents with symptoms of obsessive compulsive disorder which factor is the best for positive symptoms the client acts on their compulsions - Correct Answer fluoxetine first line tx ssri for compulsions which benzodiazepine is FDA approved with the sole indicator as a treatment of insomnia - Correct Answer temazepam which statement is true regarding old with compulsions/complaints - Correct Answer they are typically performed in response to an obsessive thought a client is referred to the psychiatric pmhnp for eval of anxiety. with complaints of headaches, queasy stomach, insomnia and fatigue - Correct Answer a 22 year old referred from employee assistance program due to complaints of crying and fear she is losing control a client with generalized anxiety disorder reports no relief of symptoms after taking paroxetine 20mg daily for a month. what is the appropriate next step - Correct Answer increase daily dose of paroxetine to 40mg which symptom would most likely be seen during the prodromal phase of schizophrenia - Correct Answer flat affect and decline in grooming habits a 29 year old male pmhnp is scheduled to evaluate a 30 year old single female. which approach is best to ----the sexual history portion of the interview? - Correct Answer provide a welcoming, supportive and inclusive approach using open ended questions a client presents to the clinic with anxiety symptoms. a GAD 7 was completed the score is 10. how does the psychiatric mental health nurse practitioner interpret this score - Correct Answer moderate anxiety select the appropriate treatment modalities for a client with circadian rhythm sleep wake disorder? - Correct Answer melatonin and chronotherapy a client who presents with recurrent episodes of punching and kicking their partner while they are asleep would most likely be diagnosed with which sleep disorder - Correct Answer rem sleep behavior disorder during rem sleep you can physically enact out dreams and nightmares the psychiatric pmhnp is seeing a patient for an initial diagnosis assessment. which factor is most critical in determining whether a physical exam is necessary as part of the assessment - Correct Answer the nature of the clients complaints a client states that she does not have natural vaginal lubrication even when she feels aroused and she often feels pain upon penetration which has led to fear of intercourse. what is most likely the diagnosis for the client - Correct Answer Genito-pelvic pain/penetration disorder The pmhnp is performing an initial interview with a client. which client endorsement is consider a social determinant of health - Correct Answer the client describes growing up in a household where there was abuse and neglect what client has the best prognosis after the diagnosis of schizophrenia - Correct Answer a 22 year old female who works in a downtown office building a client has a BMI of 30..5 and has been diagnosed with schizophrenia. which medication is indicated for this diagnosis and has less effect on BMI? - Correct Answer aripiprazole/ Abilify or lurasidone per ai lurasidone is slightly better in terms of weight loss. anxiety disorders can be differentiated by what? - Correct Answer the presence of worry which factor determines whether a client who presents with symptoms of psychosis and dis---- - Correct Answer the presence of visual or auditory hallucinations which statement is true regarding sleep wake disorders - Correct Answer they share clinical features of nocturnal distress and circadian rhythm dysfunction a client presents with symptoms of chest pain, irritability and ...... - Correct Answer which medication for panic attack sertraline/zoloft