NURS 607 Common Adult and Geriatric Disorders Main Exam 2025

NURS 607 Common Adult and Geriatric Disorders Main Exam 2025 Memantine has FDA approval for which of the following in Alzheimer's disease? - Correct Answer-Memantine is approved for use in moderate to severe Alzheimer's disease. Which of the following is true with insomnia disorder? - Correct Answer-Individuals with Insomnia disorder are dissatisfied with sleep quality or quantity. Insomnia is a more prevalent complaint amongst females than males. The first episode is more common in young adulthood compared to childhood. The experience of depersonalization is ego_________ and reality testing is ___________? - Correct Answer-Ego-dysntonic and reality testing is intact. Clients are disturbed by depersonalization and reality testing remains intact. Mikey complains of a new tingling sensation in both of his hands and feels his hands are now "weak". This occurred 4 days after his partner abruptly ended their 5 year relationship. Mikey became very distressed and booked an urgent appointment with his primary care provider. He has no other complaints, rarely calls his primary care provider and denies any recent injury. Upon exam, Mikey has no evidence of a medical condition other than his new sensory function complaint. Given the limited information in this scenario, this is likely an example of what? - Correct Answer-Conversion disorder (Functional Neurological Symptom Disorder). One or more symptoms of altered voluntary motor or sensory function, incompatibility between the symptoms and the exam, not better explained by another medical condition and the deficit causes significant distress. A 15-year-old boy has refused to go to school for the past month. Every morning he has a new symptom or develops one and has to be picked up from school. When he is home, the symptoms disappear. On weekends the symptoms never present. What is the most likely diagnosis? - Correct Answer-Separation anxiety Jeremy is a 62 year old male who attended a family gathering with the assistance of his son. Simon was diagnosed with a major neurocognitive disorder 4 years ago. Jeremy could not remember how he arrived at the party and told several guests that a train brought him. There is no train station within 45 miles of the party location. What else in Jeremy's past medical history would help better explain the above presentation? - Correct Answer-20 years of heavy alcohol use NURS 607 NURS 607 Substance/Medication-induced Major Neurocognitive disorder includes alcohol, amnestic confabulatory type. Heavy, prolonged alcohol consumption may lead to a major neurocognitive disorder in which both amnesia and confabulation are prominent. Confabulation is the creation of false memories in the absence of the intention to deceive. Which of the following are considered vegetative signs of depression? - Correct Answer-The vegetative signs of depression include alterations in activities that support life. For example: sleeping, eating, elimination and sex. Jesse is a 72 year old male with major neurocognitive disorder with Lewy bodies. His family noted that Jesse had a sleep wake disorder which became prominent in his late 60's. Which sleep wake disorder did Jesse likely have - Correct Answer-Over 50% of individuals with REM sleep behavior will go on to develop a neurodegenerative disease. Which of the following are true regarding dissociative amnesia? - Correct Answer-The amnesia is selective for specific events which should be successfully recalled in stored memory and readily remembered. A 26 year old male with a former history of testicular cancer developed low back pain after a flag football game. Over the next year, he focuses continuously on sensations in his back and groin area and repeatedly seeks multiple health care providers for his ongoing symptoms. He checks himself daily for changes in lymph nodes or skin changes. He continues to call on more physicians despite a negative work up for testicular cancer or injury to his spine. Which diagnosis best fits this clinical scenario? - Correct Answer-Somatic symptom disorder. The patient's somatic symptoms are distressing enough to disrupt his daily life. The symptoms are persistent for more than 6 months. He is not concerned with his appearance of his physical features, but rather abnormal focus and appraisal regarding the seriousness of the symptoms. Additionally, his persistent high level of anxiety regarding the symptoms and excessive time and energy devoted to the symptoms help support the diagnosis. A 45-year-old man is reporting chest pressure, difficulty breathing, numbness, and tingling in his hands and lips. He has been seen in the emergency department in which he underwent a negative cardiac workup. He was subsequently triaged to psychiatry for evaluation. The PMHNP asks how he came to the hospital. He states, "I felt awful, my heart was pounding, I was sweating so much, I thought I was going to die. My father had a similar problem, but he died 10 years ago." Which of the following best describes the thought pattern? - Correct Answer-Tangential A 57-year-old man was evaluated in the ED for altered mental status. His head CT scan is negative, white blood cells are 6,000, urinalysis negative for infection with positive ketones, serum glucose is 120 mg/dL, sodium is 148, blood urea nitrogen 22, creatinine 1.8, and cardiac enzymes are negative. Neurology has cleared him for an acute event, and the ED physician has cleared him for psychiatry. The PMHNP evaluating him obtained collateral information that the patient has been in bed for 3 days, and not NURS 607 NURS 607 eating or drinking because the voices tell him the food is bad and the water is contaminated. What should the nurse practitioner do first? - Correct Answer-Order 1 L normal saline at 100 mL/hr The husband of a 68-year-old woman with major depressive episodes is concerned about cognitive decline in his wife. Which of the following statements best addresses his concern regarding this symptom? - Correct Answer-The cognitive decline is reversible once the depression is treated Which of the following symptoms supports the diagnosis of Conversion disorder? - Correct Answer-The diagnostic criteria for Conversion disorder include one or more symptoms of altered voluntary motor or sensory function. The clinical finding are incompatible with neurological or medical conditions. The symptoms are not better explained by another mental or medical disorder. The symptoms cause great distress or impairment in function for the individual. Which type of dementia is characterized by a gradual onset and progressive decline without focal neurological deficits? - Correct Answer-Alzheimer's disease Jaime is a 22 year old male who is accompanied by his brother. His brother is concerned that Jaime "needs mental help". Jaime has no close relationships other than his brother. He has been described as "weird" and "odd" since high school. Jaime is superstitious, but does not have any true delusions or hallucinations. He feels that he can "sense things" and describes himself similar to "a seer". He remains employed at a video game store for the last 5 years, but has no friends at work. On exam, Jaime has old clothes on that do not match, and sports a "reverse mohawk" haircut. His speech at times is metaphorical and his affect is constricted. Jaime has excessive social anxiety that does not diminish with familiarity. Which of the following best explains Jaime's behavior? - Correct Answer-Jaime meets the criteria for Schizotypal personality disorder. He has no true delusions or hallucinations. The "weirdness" and eccentricity are unique to Schizotypal vs Schizoid personality disorder. A 68-year-old man presents with his wife for evaluation of sleep disorder. The wife reports he does not sleep well at night and wanders around the house. He then sleeps much of the day. Which of the following medications is preferred to control this behavior? - Correct Answer-Trazodone An 18-year-old girl was visiting colleges with her family and was involved in a fatal car accident 2 weeks ago. Since that time, she continually has flashbacks, difficulty sleeping, persistent ruminations, and is afraid to drive. She has become apprehensive about her family members driving as well. What is the most appropriate diagnosis? - Correct Answer-Acute stress disorder The PMHNP is evaluating a 32-year-old male who reports social anxiety and depression over his dating prospects. The mental state exam reveals a flat affect, avoidant individual with poor eye contact, and psychomotor agitation. He describes his last NURS 607 NURS 607 relationship in college as one where he just tried to keep the peace. Which of the following areas should the interview focus on to address his concerns? - Correct Answer-Past history of abuse Roberto is a 26 year old male who intentionally punctured his foot with a rusty nail and smothered the wound with dirt. Several days later he sought medical care. He verbalized to his PCP that he must have stepped on something while walking his dog. In the absence of secondary gain, this example best represents which diagnosis? - Correct Answer-The best answer is factitious disorder. In this case scenario there was induction of injury, deceptive behavior in the absence of obvious external rewards. Darko is a 74 year old male who scored a 3/5 on the Mini-Cog with a 1/3 word recall and a normal clock draw (2 points). Which of the following is the best explanation of the findings? - Correct Answer-A total score of 3, 4 or 5 on the mini-cog indicates a lower likelihood of dementia but does not completely rule out cognitive impairment. One cannot speculate as to when Darko could develop Dementia given the information provided. A 50-year-old woman referred from the surgical service is described as a "frequent flyer." She reports vague complaints that have no apparent cause or objective clinical findings. Most recently, she complains of vaginal pain, headache, and stomachache. Upon interview she is tearful, guarded, and withdrawn. What is the most likely psychiatric diagnosis? - Correct Answer-Somatization disorder Regardless of any accompanying symptoms, how many obstructive apneas or hypoapneas found on polysomnography per hour, would qualify one for a diagnosis of Obstructive Sleep Apnea Hypopnea? - Correct Answer-A diagnosis of Obstructive Sleep Apnea Hypopnea can be made when polysomnography shows 15 or more obstructive apneas or hypoapneas in an hour regardless of accompanying symptoms. Jose is a 48-year-old veteran of Operation Iraqi Freedom, during which he sustained a traumatic brain injury that left him unconscious for 7 days. He has progressively regained function and is able to perform his instrumental activities of daily living most days. His wife is worried because he has periods where she does not recognize him as he becomes irritable, fails to remember important dates and events, and gets headaches so bad that he says he wishes he had died in the war. What is the priority action for the PMHNP to take during this office visit? - Correct Answer-Provide anticipatory guidance and coping mechanisms to the patient and his wife Which of the following is false regarding Depersonalization/Derealization disorder? - Correct Answer-During the depersonalization or derealization experiences, reality testing remain intact. According to the DSM-5, which course modifier in bipolar II disorder is associated with a better prognosis? - Correct Answer-According to the DSM-5, individuals of younger age and those with less severe depression are more likely to return to the previous level of NURS 607 NURS 607 social function. A poorer prognosis is associated with a prolonged illness, rapid cycling, single status and less education. A patient is requesting the PMHNP to complete his disability application for schizophrenia because he got fired for disruptive behavior. He states the constant voices ask him questions and interfere with his sleep, so he has started smoking marijuana to help him relax. Which of the following statements is true regarding auditory hallucinations? - Correct Answer-Auditory hallucinations coincide with a delusio Upon awakening, a period of reduced alertness, impaired performance and reduced vigilance associated with Hypersomnolence disorder is better known as what? - Correct Answer-Sleep inertia refers to a groggy period lasting minutes to hours, which includes impaired alertness upon awakening and is specific to hypersomonolence disorder. A 55-year-old man with poorly controlled type 2 diabetes was referred for evaluation of medication noncompliance. Upon evaluation you realize that the patient has increased sleep latency, anhedonia, poor appetite, and persistent depressed mood. In addition, he reports chronic neuropathic pain in the feet unrelieved by analgesics. Which of the following medications may address the patient's symptoms of poor sleep, depressed mood, poor appetite, and neuropathic pain? - Correct Answer-Amitriptyline A patient has been prescribed sertraline 50 mg daily for the past year without adverse effects and remission of symptoms. The patient has missed the last two appointments but leaves a message that he feels "fantastic!" The wife called to reschedule a follow-up appointment, saying he has been giddy lately, emotionally labile, and spending money so frivolously that their account has been overdrawn. During the appointment the patient becomes hostile and tells the PMHNP that he is a phony, and not even a real doctor, and is having an affair with his wife. The patient is uninterruptible, with pressured speech. What pharmacological change is indicated? - Correct Answer-Start valprocic acid, stop sertraline A 25-year-old female presents to the emergency department, having just witnessed an accident. Her speech is pressured. She states, "There were a lot of people in need of care at the scene, and I should know because I have traveled to many Third World countries. I know how bad needs can get. The people were injured, and she was hit by a car before but did not suffer any injuries. There were a lot of police cars and ambulances." The patient was triaged to psychiatry. The PMHNP describes her thought process as - Correct Answer-Circumstantial The most common complaint and reason the acetylcholinsterase inhibitors are sometimes discontinued is what? - Correct Answer-The most common side effects of the cholinesterase inhibitor medications are gastrointestinal. This includes weight lo