NR607 FINAL TEST PREPARATION
QUESTIONS WITH COMPLETE
ANSWERS
BPIOC individuals vs. whites and house owning statistics - Answer- All BIPOC are less
likely than Whites to own their homes regardless of their level of education, income,
location, marital status, and age
Blacks vs whites holding jobs statistics - Answer- Black people are less likely than
Whites to hold jobs that offer retirement savings prioritized by the U.S. tax code. This
creates a persistent wealth gap between White and Black communities where the
median savings of blacks are 21.4 percent of the median savings of whites.
Racism and mental health - Answer- linked to developing or worsening mental health
disorders
-experience higher rates of psychological distress, mental illness, and poor mental
health outcomes
List the symptoms of racial trauma - Answer- -Depression, social anxiety, stress,
substance abuse, agoraphobia, suicidal ideology, psychosis
Intrusion symptoms (e.g., nightmares, flashbacks, physical reactions in the presence of
reminders)
-Avoidance behaviors (e.g., staying away from places that are reminders of racist
experiences)
-Negative changes to thoughts or mood (e.g., feelings of isolation, a belief that the world
is unsafe,
-Decreased interest in previously enjoyable activities)
-Changes in arousal and reactivity
-Cultural paranoia, avoidance of White people (dominant group members), somatic
complaints, and excessive worries about loved ones
Agnieszka has experienced persistent racial discrimination since immigrating to the
United States, which has led to chronic stress, anxiety, depression, and post-traumatic
stress disorder (PTSD), exacerbating her chronic depression - Answer- Discrimination
and racial trauma
Princiana has encountered ongoing barriers to accessing housing and quality
education. Her job insecurity and a lack of housing opportunities have escalated her
feelings of hopelessness, powerlessness, and low self-esteem, detouring her from
timely treatment for her mental health - Answer- Limited access to resources
,Mateo has experienced ongoing racism as a person of color (POC), which has caused
him to mistrust the mental healthcare system, resulting in inadequate care and
treatment for his chronic schizophrenia - Answer- Cultural mistrust and mental
healthcare disparities
Diona is homeless due to substance use disorder and has chronic pain. In the
emergency department, she self-reports a pain rating of 10 out of 10 and does not
receive the same assessment and treatment as her White counterparts - Answer-
Intersections with other social determinants
Perceptions of social beliefs (e.g., stereotypes, prejudice, discrimination) that occur on
the part of the client or provider is what type of stigma? - Answer- Perceived
Perceptions of being a victim of stereotypes, prejudice, or discrimination that occur on
the part of the client is what type of stigma? - Answer- Experienced
Taking inward stereotypes, prejudice, or social discrimination that occur on the part of
the client is what type of stigma? - Answer- Experienced
Expectations of discrimination that occur on the part of the client is what type of stigma?
- Answer- Anticipated
What are the drawbacks of the Race-Based Traumatic Stress Symptom Scale
(RBTSSS)? - Answer- Has a complex scoring system, measures only a single event,
and does not adhere to the DSM-5 framework for diagnosing trauma
Upstream social and community context example - Answer- Level of Intervention
Upstream
Policy Target
National
Example Policy
Equitable access to health care through support of ACA and Medicaid expansion
PMHNP Role
Advocacy, stakeholder engagement, coalition building, and cross-sector partnerships
What do dissociative disorders involve? - Answer- repeated discontinuity or disruption of
the normal integration of consciousness, memory, identity, emotion, perception, body
representation, motor control, and behavior
Define dissociation - Answer- Sense of disconnection or detachment from one's
thoughts, feelings, actions, or sense of self. Dissociation occurs on a continuum from
mild to pathological
,Example of mild dissociation that everyone experiences - Answer- daydreaming, losing
oneself in a book or movie, or being lost in thought and missing an exit while driving
Symptoms of everyday or normal dissociation - Answer- -Daydreaming
-Zoning out
How can dissociation be an adaptive response to trauma? - Answer- the nervous
system seeks an alternative pathway of protection or dorsal vagal response by
immobilizing the body and dissociating the mind from what is occurring
Symptoms of adaptive dissociation - Answer- -Threat or trauma response
-Sense of emotional numbness or detachment
How can dissociation be pathological - Answer- When it leads to co-consciousness or
disassociated states or identities. These symptoms may involve intrusions into
awareness and behavior with a loss in the continuity of subjective experience
Symptoms of Pathological Dissociation: Dissociative Disorders - Answer- -Significant
memory loss for specific times, people, or events
-Out-of-body experiences such as watching oneself from the outside
-Loss of self-identity
-Feeling that the world is distorted or unreal
What are Risk factors for dissociative disorders - Answer- trauma; neglect and physical,
sexual, or emotional abuse; cumulative traumas early in life; or repeated or sustained
trauma or torture associated with captivity
What is the structural dissociation theory? - Answer- premised on the underlying
assumption that no one is born with an integrated personality; the ego typically
integrates into a cohesive personality between the ages of 6-9 years; however, trauma,
especially in childhood, can disrupt the process leaving separate ego states unable to
merge leading to dissociative symptoms
Fancy definition of Structural Dissociation Model - Answer- -Suggests that defense and
attachment are motivational systems with opposing goals: attachment invites closeness
and defense distances
-When these opposing goals are activated, the nervous system becomes dysregulated
as it is biologically incompatible to have opposing aspects activated simultaneously and
structural dissociation occurs.
Basic definition of Structural Dissociation Model - Answer- Defense System: When a
child is abused, their defense system will naturally work to shield them from harm,
BUT...
Attachment System: ...their attachment system will still want to be loved and cared for
by the parent.
, This creates an internal tug-of-war where different motivational systems are working
against each other simultaneously.
This can cause a patient's conflicting parts to separate. That can lead to a split in their
sense of self and a dysregulated nervous system.
Left brain in the structural dissociation model - Answer- The "Going on with Normal Life"
Part of the Self
-This is the rational, present-oriented, and grounded self.
-This self handles daily life - social interaction, attachment, work, play, exploration,
learning, and taking care of physical needs.
Right brain in the structural dissociation model - Answer- Right Brain: The "Traumatized
Child" Part of the Self
-This part contains the trauma.
-This part is often drawn out by reminders of the trauma, and it may not experience
much of everyday life. The survival responses of this self may include Attach/Cry for
Help, Collapse/Submit, Please/Appease, Freeze, along with Fight and Flight
What is the key to recovery in the structural dissociation model - Answer- The key to
recovery is helping a patient have full awareness of all their parts without feeling
overwhelmed.
What is the primary symptom of dissociative amnesia? - Answer- difficulty remembering
autobiographical information to a degree inconsistent with normal forgetting
What can dissosiative amnesia be about? Length of time? - Answer- Commonly relates
to a particular event, such as combat or abuse, memory loss may also include details
about one's identity or life history. Episodes usually involve a sudden onset and may
last minutes, hours, days, or, less commonly, months to years
Do clients notice dissociative amnesia - Answer- Initially unaware of the gaps in
memory until they notice that they do not recall information about their identity or when
circumstances make them aware that autobiographical information is missing
Define localized amnesia - Answer- Inability to recall events related to a circumscribed
period of time
Define selective amnesia - Answer- Ability to remember some, but not all, of the events
occurring during a circumscribed period of time
Define generalized amnesia - Answer- Failure to recall one's entire life
Define continuous amnesia - Answer- Failure to recall successive events as they occur
QUESTIONS WITH COMPLETE
ANSWERS
BPIOC individuals vs. whites and house owning statistics - Answer- All BIPOC are less
likely than Whites to own their homes regardless of their level of education, income,
location, marital status, and age
Blacks vs whites holding jobs statistics - Answer- Black people are less likely than
Whites to hold jobs that offer retirement savings prioritized by the U.S. tax code. This
creates a persistent wealth gap between White and Black communities where the
median savings of blacks are 21.4 percent of the median savings of whites.
Racism and mental health - Answer- linked to developing or worsening mental health
disorders
-experience higher rates of psychological distress, mental illness, and poor mental
health outcomes
List the symptoms of racial trauma - Answer- -Depression, social anxiety, stress,
substance abuse, agoraphobia, suicidal ideology, psychosis
Intrusion symptoms (e.g., nightmares, flashbacks, physical reactions in the presence of
reminders)
-Avoidance behaviors (e.g., staying away from places that are reminders of racist
experiences)
-Negative changes to thoughts or mood (e.g., feelings of isolation, a belief that the world
is unsafe,
-Decreased interest in previously enjoyable activities)
-Changes in arousal and reactivity
-Cultural paranoia, avoidance of White people (dominant group members), somatic
complaints, and excessive worries about loved ones
Agnieszka has experienced persistent racial discrimination since immigrating to the
United States, which has led to chronic stress, anxiety, depression, and post-traumatic
stress disorder (PTSD), exacerbating her chronic depression - Answer- Discrimination
and racial trauma
Princiana has encountered ongoing barriers to accessing housing and quality
education. Her job insecurity and a lack of housing opportunities have escalated her
feelings of hopelessness, powerlessness, and low self-esteem, detouring her from
timely treatment for her mental health - Answer- Limited access to resources
,Mateo has experienced ongoing racism as a person of color (POC), which has caused
him to mistrust the mental healthcare system, resulting in inadequate care and
treatment for his chronic schizophrenia - Answer- Cultural mistrust and mental
healthcare disparities
Diona is homeless due to substance use disorder and has chronic pain. In the
emergency department, she self-reports a pain rating of 10 out of 10 and does not
receive the same assessment and treatment as her White counterparts - Answer-
Intersections with other social determinants
Perceptions of social beliefs (e.g., stereotypes, prejudice, discrimination) that occur on
the part of the client or provider is what type of stigma? - Answer- Perceived
Perceptions of being a victim of stereotypes, prejudice, or discrimination that occur on
the part of the client is what type of stigma? - Answer- Experienced
Taking inward stereotypes, prejudice, or social discrimination that occur on the part of
the client is what type of stigma? - Answer- Experienced
Expectations of discrimination that occur on the part of the client is what type of stigma?
- Answer- Anticipated
What are the drawbacks of the Race-Based Traumatic Stress Symptom Scale
(RBTSSS)? - Answer- Has a complex scoring system, measures only a single event,
and does not adhere to the DSM-5 framework for diagnosing trauma
Upstream social and community context example - Answer- Level of Intervention
Upstream
Policy Target
National
Example Policy
Equitable access to health care through support of ACA and Medicaid expansion
PMHNP Role
Advocacy, stakeholder engagement, coalition building, and cross-sector partnerships
What do dissociative disorders involve? - Answer- repeated discontinuity or disruption of
the normal integration of consciousness, memory, identity, emotion, perception, body
representation, motor control, and behavior
Define dissociation - Answer- Sense of disconnection or detachment from one's
thoughts, feelings, actions, or sense of self. Dissociation occurs on a continuum from
mild to pathological
,Example of mild dissociation that everyone experiences - Answer- daydreaming, losing
oneself in a book or movie, or being lost in thought and missing an exit while driving
Symptoms of everyday or normal dissociation - Answer- -Daydreaming
-Zoning out
How can dissociation be an adaptive response to trauma? - Answer- the nervous
system seeks an alternative pathway of protection or dorsal vagal response by
immobilizing the body and dissociating the mind from what is occurring
Symptoms of adaptive dissociation - Answer- -Threat or trauma response
-Sense of emotional numbness or detachment
How can dissociation be pathological - Answer- When it leads to co-consciousness or
disassociated states or identities. These symptoms may involve intrusions into
awareness and behavior with a loss in the continuity of subjective experience
Symptoms of Pathological Dissociation: Dissociative Disorders - Answer- -Significant
memory loss for specific times, people, or events
-Out-of-body experiences such as watching oneself from the outside
-Loss of self-identity
-Feeling that the world is distorted or unreal
What are Risk factors for dissociative disorders - Answer- trauma; neglect and physical,
sexual, or emotional abuse; cumulative traumas early in life; or repeated or sustained
trauma or torture associated with captivity
What is the structural dissociation theory? - Answer- premised on the underlying
assumption that no one is born with an integrated personality; the ego typically
integrates into a cohesive personality between the ages of 6-9 years; however, trauma,
especially in childhood, can disrupt the process leaving separate ego states unable to
merge leading to dissociative symptoms
Fancy definition of Structural Dissociation Model - Answer- -Suggests that defense and
attachment are motivational systems with opposing goals: attachment invites closeness
and defense distances
-When these opposing goals are activated, the nervous system becomes dysregulated
as it is biologically incompatible to have opposing aspects activated simultaneously and
structural dissociation occurs.
Basic definition of Structural Dissociation Model - Answer- Defense System: When a
child is abused, their defense system will naturally work to shield them from harm,
BUT...
Attachment System: ...their attachment system will still want to be loved and cared for
by the parent.
, This creates an internal tug-of-war where different motivational systems are working
against each other simultaneously.
This can cause a patient's conflicting parts to separate. That can lead to a split in their
sense of self and a dysregulated nervous system.
Left brain in the structural dissociation model - Answer- The "Going on with Normal Life"
Part of the Self
-This is the rational, present-oriented, and grounded self.
-This self handles daily life - social interaction, attachment, work, play, exploration,
learning, and taking care of physical needs.
Right brain in the structural dissociation model - Answer- Right Brain: The "Traumatized
Child" Part of the Self
-This part contains the trauma.
-This part is often drawn out by reminders of the trauma, and it may not experience
much of everyday life. The survival responses of this self may include Attach/Cry for
Help, Collapse/Submit, Please/Appease, Freeze, along with Fight and Flight
What is the key to recovery in the structural dissociation model - Answer- The key to
recovery is helping a patient have full awareness of all their parts without feeling
overwhelmed.
What is the primary symptom of dissociative amnesia? - Answer- difficulty remembering
autobiographical information to a degree inconsistent with normal forgetting
What can dissosiative amnesia be about? Length of time? - Answer- Commonly relates
to a particular event, such as combat or abuse, memory loss may also include details
about one's identity or life history. Episodes usually involve a sudden onset and may
last minutes, hours, days, or, less commonly, months to years
Do clients notice dissociative amnesia - Answer- Initially unaware of the gaps in
memory until they notice that they do not recall information about their identity or when
circumstances make them aware that autobiographical information is missing
Define localized amnesia - Answer- Inability to recall events related to a circumscribed
period of time
Define selective amnesia - Answer- Ability to remember some, but not all, of the events
occurring during a circumscribed period of time
Define generalized amnesia - Answer- Failure to recall one's entire life
Define continuous amnesia - Answer- Failure to recall successive events as they occur
