BARKLEY DRT PMHNP Practicum 1
Study online at https://quizlet.com/_hkc8n5
1. Harriet is a well-established busi- Although the patient may be rationalizing her behavior as
ness woman who provides for a righteous act, patients with kleptomania do not commit
her family. She was recently ar- theft to express anger or vengeance. Kleptomania is char-
rested for stealing over $10,000 acterized as failing to resist the impulse to steal, and the
worth of merchandise from the stolen objects are typically not needed. The act of stealing,
mall. When Harriet is asked to which usually is performed alone, gives the person gratifi-
describe her behavior, she says: cation.
"It just comes on me quickly,
and when it's done, I feel re-
ally good." She also describes
how she grew up poor and sees
the theft as a way to "even the
score" against those with "empty
wealth." Which of the following
does not meet the diagnostic cri-
teria for kleptomania?
Harriet views her shoplifting as a
righteous act.
Harriet's stealing is described as
pleasurable.
Harriet is well-off and can sup-
port her family's needs.
Harriet's stealing is described as
impulsive.
2. Tony, a 16-year-old male, has Borderline personality disorder is not considered a dif-
been sent to your clinic for coun- ferential diagnosis for conduct disorder, as indicated by
seling. He has a long record the patient's truancy, defiance of authority figures, fights
of skipping school, talking back with family members, poor academic performance, sexual
to his teachers, and getting promiscuity, running away from home, and "tough guy"
poor grades. His parents say demeanor. Oppositional defiant disorder, bipolar disor-
he has often gotten in fights ders, and adjustment disorders are all considered potential
, BARKLEY DRT PMHNP Practicum 1
Study online at https://quizlet.com/_hkc8n5
with them, has frequently been differential diagnoses for conduct disorder, as are depres-
caught sneaking girls into his sive disorders, attention-deficit/hyperactivity disorder, and
room, and has run away from intermittent explosive disorder.
home on two occasions. During
the session, you notice Tony acts
tough and aloof, not deigning to
speak much. If you suspect con-
duct disorder, which of the fol-
lowing conditions would you be
least likely to include in your dif-
ferential diagnosis?
1. Borderline personality disor-
der
2. Oppositional defiant disorder
3. Adjustment disorder with dis-
turbance of conduct
4. Bipolar disorder
3. Which of these lab findings Depressive symptoms are associated with decreased, not
would be least expected in a pa- increased, levels of somatostatin in cerebrospinal fluid.
tient with depression? Patients with depression may exhibit a decreased thy-
1. Decreased nocturnal growth roid-stimulating hormone response to thyrotropin-releas-
hormone secretion ing hormone, as well as hypersecretion of cortisol. De-
2. Decreased thyroid-stimulating pressive symptoms are also associated with irregularities
hormone response in growth hormone release, such as reduced nocturnal
3. Increased somatostatin in secretion and diurnal hypersecretion.
cerebrospinal fluid
4. Increased secretion of cortisol
4. Jeremy, a suicidal inpatient, is Although ambivalence regarding suicidal intent should be
under close observation. He is taken into account when considering level of observation
able to be observed at all times in a patient, it indicates a moderate risk, not a severe risk.
, BARKLEY DRT PMHNP Practicum 1
Study online at https://quizlet.com/_hkc8n5
by hospital staff during waking Close observation should be employed with patients who
hours and when he sleeps, and is profess suicidal thoughts, are unable to commit to a "No
checked on every 15-30 minutes. Harm" contract, or experience withdrawal.
Which of these reasons would
least indicate the need for this
level of supervision?
1. Jeremy has expressed suicidal
thoughts.
2. Jeremy experiences withdraw-
al from alcohol and cocaine.
3. Jeremy is ambivalent about his
intent to commit suicide.
4. Jeremy was unable to commit
to a "No Harm" contract.
5. Adam, a 23-year-old male, is un- The patient's recent involvement in risky pleasurable activity
dergoing an STD test at your (e.g., unprotected sex), increase in goal-driven activity at
clinic. When you ask him why work, decreased need for sleep, and subjective experience
he is here, he says, "I'm here of racing thoughts all suggest a manic episode; as such,
because I've had this increased bupropion, an antidepressant, would not be considered
craving for sex. I've been picking because the patient has not displayed the diagnostic crite-
up strangers in bars, not caring ria for a major depressive episode. Pharmacologic options
about using protection ... I don't for the treatment of manic episodes include anticonvul-
know what it is. For the last week, sants (carbamazepine), antipsychotics (haloperidol), and
I've just felt really driven. Keep benzodiazepines (lorazepam).
throwing myself into my work,
don't feel much need for sleep,
feel like my thoughts are run-
ning a marathon in my head."
The patient lives a "clean life,"
clarifying that he does not abuse
any substance, "not even coffee
, BARKLEY DRT PMHNP Practicum 1
Study online at https://quizlet.com/_hkc8n5
or cigarettes." He also does not
have a history of mental disor-
ders. Given the most likely di-
agnosis, which of these medica-
tions would you least likely rec-
ommend for Adam?
Lorazepam
Haloperidol
Carbamazepine
Bupropion
6. You have determined that a pa- Lorazepam would not be the first choice to treat delirium in
tient's delirium stems from de- a dehydrated patient because benzodiazepines may cause
hydration. As you begin treat- respiratory depression, especially in debilitated patients.
ment, you realize the patient will Antipsychotics such as haloperidol, quetiapine, and risperi-
require pharmacologic manage- done are considered the mainstay in managing agitation in
ment for his agitation. Which of delirium patients; haloperidol is considered the standard of
these agents would be least ap- care, but newer agents such as quetiapine and risperidone
propriate in this situation? may be preferred due to reduced chance of side effects.
Risperidone
Haloperidol
Quetiapine
Lorazepam
7. Which of the following is true Most inpatients who develop a suicide plan and follow
about suicide among inpatients? it have agreed to a "No Harm" contract. The most com-
Most patients who develop a mon method of suicide among inpatients is hanging,
suicide plan and follow it have not self-inflicted wounds. When "unsolvable" problems at
agreed to a "No Harm" contract. work, school, or home motivate the ideation, inpatients are
Self-inflicted wounds are the most likely to attempt suicide either within the first 5 days
most common means of suicide. at the hospital or shortly after discharge, not after a month.
Inpatients with bipolar disorder The rate of suicide among bipolar patients is relatively low,
Study online at https://quizlet.com/_hkc8n5
1. Harriet is a well-established busi- Although the patient may be rationalizing her behavior as
ness woman who provides for a righteous act, patients with kleptomania do not commit
her family. She was recently ar- theft to express anger or vengeance. Kleptomania is char-
rested for stealing over $10,000 acterized as failing to resist the impulse to steal, and the
worth of merchandise from the stolen objects are typically not needed. The act of stealing,
mall. When Harriet is asked to which usually is performed alone, gives the person gratifi-
describe her behavior, she says: cation.
"It just comes on me quickly,
and when it's done, I feel re-
ally good." She also describes
how she grew up poor and sees
the theft as a way to "even the
score" against those with "empty
wealth." Which of the following
does not meet the diagnostic cri-
teria for kleptomania?
Harriet views her shoplifting as a
righteous act.
Harriet's stealing is described as
pleasurable.
Harriet is well-off and can sup-
port her family's needs.
Harriet's stealing is described as
impulsive.
2. Tony, a 16-year-old male, has Borderline personality disorder is not considered a dif-
been sent to your clinic for coun- ferential diagnosis for conduct disorder, as indicated by
seling. He has a long record the patient's truancy, defiance of authority figures, fights
of skipping school, talking back with family members, poor academic performance, sexual
to his teachers, and getting promiscuity, running away from home, and "tough guy"
poor grades. His parents say demeanor. Oppositional defiant disorder, bipolar disor-
he has often gotten in fights ders, and adjustment disorders are all considered potential
, BARKLEY DRT PMHNP Practicum 1
Study online at https://quizlet.com/_hkc8n5
with them, has frequently been differential diagnoses for conduct disorder, as are depres-
caught sneaking girls into his sive disorders, attention-deficit/hyperactivity disorder, and
room, and has run away from intermittent explosive disorder.
home on two occasions. During
the session, you notice Tony acts
tough and aloof, not deigning to
speak much. If you suspect con-
duct disorder, which of the fol-
lowing conditions would you be
least likely to include in your dif-
ferential diagnosis?
1. Borderline personality disor-
der
2. Oppositional defiant disorder
3. Adjustment disorder with dis-
turbance of conduct
4. Bipolar disorder
3. Which of these lab findings Depressive symptoms are associated with decreased, not
would be least expected in a pa- increased, levels of somatostatin in cerebrospinal fluid.
tient with depression? Patients with depression may exhibit a decreased thy-
1. Decreased nocturnal growth roid-stimulating hormone response to thyrotropin-releas-
hormone secretion ing hormone, as well as hypersecretion of cortisol. De-
2. Decreased thyroid-stimulating pressive symptoms are also associated with irregularities
hormone response in growth hormone release, such as reduced nocturnal
3. Increased somatostatin in secretion and diurnal hypersecretion.
cerebrospinal fluid
4. Increased secretion of cortisol
4. Jeremy, a suicidal inpatient, is Although ambivalence regarding suicidal intent should be
under close observation. He is taken into account when considering level of observation
able to be observed at all times in a patient, it indicates a moderate risk, not a severe risk.
, BARKLEY DRT PMHNP Practicum 1
Study online at https://quizlet.com/_hkc8n5
by hospital staff during waking Close observation should be employed with patients who
hours and when he sleeps, and is profess suicidal thoughts, are unable to commit to a "No
checked on every 15-30 minutes. Harm" contract, or experience withdrawal.
Which of these reasons would
least indicate the need for this
level of supervision?
1. Jeremy has expressed suicidal
thoughts.
2. Jeremy experiences withdraw-
al from alcohol and cocaine.
3. Jeremy is ambivalent about his
intent to commit suicide.
4. Jeremy was unable to commit
to a "No Harm" contract.
5. Adam, a 23-year-old male, is un- The patient's recent involvement in risky pleasurable activity
dergoing an STD test at your (e.g., unprotected sex), increase in goal-driven activity at
clinic. When you ask him why work, decreased need for sleep, and subjective experience
he is here, he says, "I'm here of racing thoughts all suggest a manic episode; as such,
because I've had this increased bupropion, an antidepressant, would not be considered
craving for sex. I've been picking because the patient has not displayed the diagnostic crite-
up strangers in bars, not caring ria for a major depressive episode. Pharmacologic options
about using protection ... I don't for the treatment of manic episodes include anticonvul-
know what it is. For the last week, sants (carbamazepine), antipsychotics (haloperidol), and
I've just felt really driven. Keep benzodiazepines (lorazepam).
throwing myself into my work,
don't feel much need for sleep,
feel like my thoughts are run-
ning a marathon in my head."
The patient lives a "clean life,"
clarifying that he does not abuse
any substance, "not even coffee
, BARKLEY DRT PMHNP Practicum 1
Study online at https://quizlet.com/_hkc8n5
or cigarettes." He also does not
have a history of mental disor-
ders. Given the most likely di-
agnosis, which of these medica-
tions would you least likely rec-
ommend for Adam?
Lorazepam
Haloperidol
Carbamazepine
Bupropion
6. You have determined that a pa- Lorazepam would not be the first choice to treat delirium in
tient's delirium stems from de- a dehydrated patient because benzodiazepines may cause
hydration. As you begin treat- respiratory depression, especially in debilitated patients.
ment, you realize the patient will Antipsychotics such as haloperidol, quetiapine, and risperi-
require pharmacologic manage- done are considered the mainstay in managing agitation in
ment for his agitation. Which of delirium patients; haloperidol is considered the standard of
these agents would be least ap- care, but newer agents such as quetiapine and risperidone
propriate in this situation? may be preferred due to reduced chance of side effects.
Risperidone
Haloperidol
Quetiapine
Lorazepam
7. Which of the following is true Most inpatients who develop a suicide plan and follow
about suicide among inpatients? it have agreed to a "No Harm" contract. The most com-
Most patients who develop a mon method of suicide among inpatients is hanging,
suicide plan and follow it have not self-inflicted wounds. When "unsolvable" problems at
agreed to a "No Harm" contract. work, school, or home motivate the ideation, inpatients are
Self-inflicted wounds are the most likely to attempt suicide either within the first 5 days
most common means of suicide. at the hospital or shortly after discharge, not after a month.
Inpatients with bipolar disorder The rate of suicide among bipolar patients is relatively low,
