623 ADULT - PSYCHOSOCIAL - NP CERTIFICATION, FITZGERALD 4TH EDITION
623 Adult - Psychosocial - NP Certification, Fitzgerald 4th edition
Exam Questions & Answers Latest Update.
a 44 y/o man admits to drinking "a few beers now and then" presents for
exam. after obtaining a health hx and performing a PE, you suspect he is a
heavy alcohol user. your next best action is to:
a. obtains liver enzymes
b. administer the CAGE questionnaire
c. confront the pt with your observations
d. advise him abut the hazards of excessive alcohol use - ✔✔✔b. administer
the CAGE questionnaire
which of the following is not a component of the CAGE questionnaire:
a. have you every felt you should cut down on your drinking?
b. have you been annoyed by people criticizing your drinking?
c. have you every felt guilty about your drinking?
d. have you ever engaged in a violent act while drinking? - ✔✔✔d. have you
ever engaged in a violent act while drinking?
which of the following contains the greatest amt of alcohol?
a. 12 oz (360mL) beer (9 proof)
b. 4 oz (120mL wine (22 proof)
c. 3.5 oz (105mL) mixed drink (30 proof)
d. 3 oz (90mL) liquor (80 proof) - ✔✔✔d. 3 oz (90mL) liquor (80 proof)
DSM-5 criteria for a substance use d/o include all of the following except:
a. substance use in larger amts or over longer period than intended
b. substance overuse resulting in hospitalization
c. craving or strong desire to use
®™
1
, 623 ADULT - PSYCHOSOCIAL - NP CERTIFICATION, FITZGERALD 4TH EDITION
d. substance use in potentially hazardous positions - ✔✔✔b. substance
overuse resulting in hospitalization
the DSM5 criteria for substance use tolerance includes:
a. diminished effect with the same amt of substance used
b. desiring to get an amplified effect with higher doses
c. ability to decrease the frequency of substance use
d. absence of withdrawal sxs when substance is not used for a prolonged
period - ✔✔✔a. diminished effect with the same amt of substance used
during an official visit, a 38 y/o woman states "I drink way too much but do
not know what to do to stop". according to Prochaska's change framework,
her statement is most consistent with a person at the stage of:
a. precontemplation
b. contemplation
c. preparation
d. action - ✔✔✔b. contemplation
the NP can consider presenting txment options and support for change after
the pt has moved into which of Prochaska's stages?
a. precontemplation
b. contemplation
c. preparation
d. action - ✔✔✔b. contemplation
lorazepam or oxazepam is the preferred benzodiazepine for txing alcohol
withdrawal sxs when there is a concomitant hx of:
a. seizure d/o
®™
b. folate deficiency anemia
2
, 623 ADULT - PSYCHOSOCIAL - NP CERTIFICATION, FITZGERALD 4TH EDITION
c. multiple substance abuse
d. hepatic dysfunction - ✔✔✔d. hepatic dysfunction
peak sxs of alcohol withdrawal are usually observed how long after alcohol
intake is dc?
a. less than 12 hrs
b. 12 to 24 hrs
c. 24 to 36 hrs
d. more than 36 hrs - ✔✔✔b. 12 to 24 hrs
which of the following is the most helpful approach in the care of pt with
alcoholism?
a. advise the pt to stop drinking in a straight forward manner
b. counsel the pt that alcohol abuse is a treatable disease
c. inform the pt of the long-term health consequences of alcohol abuse
d. refer the pt to Alcoholics Anonymous - ✔✔✔b. counsel the pt that alcohol
abuse is a treatable disease
a 42 y/o man who has a long-standing hx of alcohol abuse presents for
primary care. he admits to drinking 12 to 16 beers daily for 10 yrs. he states
"I really do not feel like the booze is a problem. i get to work every day. your
most appropriate response is:
a. work is usually the last thing to go in alcohol abuse
b. your family has suffered by your drinking
c. i am concerned about your health and safety
d. participating in a support grp can help you understand why you drink -
✔✔✔c. i am concerned about your health and safety
®™
3
, 623 ADULT - PSYCHOSOCIAL - NP CERTIFICATION, FITZGERALD 4TH EDITION
which of the following agents offers an intervention for the control of tremor
and tachycardia associated with alcohol withdrawal?
a. phenobarbital
b. clonidine
c. verapamil
d. naltrexone - ✔✔✔b. clonidine
which of the following is most likely to be noted in a 45 y/o woman with lab
evidence of chronic excessive alcohol ingestion?
a. alanine aminotransferase (ALT) 202 U/L (0 to 31 U/L, mean corpuscular
volume (MCV) 70 fL (80-96)
b. aspartate transaminase (AST) 149 U/L (0 to 31 U/L, mean corpuscular
volume (MCV) 81 fL (80-96)
c. alanine aminotransferase (ALT) 88 U/L (0 to 31 U/L, mean corpuscular
volume (MCV) 140 fL (80-96)
d. AST 80 U/L (0 to 31 U/L, mean corpuscular volume (MCV) 103 fL (80-96) -
✔✔✔d. AST 80 U/L (0 to 31 U/L, mean corpuscular volume (MCV) 103 fL (80-
96)
which of the following is the anticipated clinical effect of acamprosate
(Campral) in the txment of alcohol dependence?
a. modifies intoxicating effects of alcohol
b. causes unpleasant adverse effects of alcohol
c. helps to reduce the urge to drink
d. minimizes alcohol withdrawal sxs - ✔✔✔c. helps to reduce the urge to
drink
when providing primary care for a middle-aged woman with a hx of
prescription benzodiaepine dependence, you consider that:
a. she is unlikely to have a problem with misuse of other drugs or alcohol
®™
4
623 Adult - Psychosocial - NP Certification, Fitzgerald 4th edition
Exam Questions & Answers Latest Update.
a 44 y/o man admits to drinking "a few beers now and then" presents for
exam. after obtaining a health hx and performing a PE, you suspect he is a
heavy alcohol user. your next best action is to:
a. obtains liver enzymes
b. administer the CAGE questionnaire
c. confront the pt with your observations
d. advise him abut the hazards of excessive alcohol use - ✔✔✔b. administer
the CAGE questionnaire
which of the following is not a component of the CAGE questionnaire:
a. have you every felt you should cut down on your drinking?
b. have you been annoyed by people criticizing your drinking?
c. have you every felt guilty about your drinking?
d. have you ever engaged in a violent act while drinking? - ✔✔✔d. have you
ever engaged in a violent act while drinking?
which of the following contains the greatest amt of alcohol?
a. 12 oz (360mL) beer (9 proof)
b. 4 oz (120mL wine (22 proof)
c. 3.5 oz (105mL) mixed drink (30 proof)
d. 3 oz (90mL) liquor (80 proof) - ✔✔✔d. 3 oz (90mL) liquor (80 proof)
DSM-5 criteria for a substance use d/o include all of the following except:
a. substance use in larger amts or over longer period than intended
b. substance overuse resulting in hospitalization
c. craving or strong desire to use
®™
1
, 623 ADULT - PSYCHOSOCIAL - NP CERTIFICATION, FITZGERALD 4TH EDITION
d. substance use in potentially hazardous positions - ✔✔✔b. substance
overuse resulting in hospitalization
the DSM5 criteria for substance use tolerance includes:
a. diminished effect with the same amt of substance used
b. desiring to get an amplified effect with higher doses
c. ability to decrease the frequency of substance use
d. absence of withdrawal sxs when substance is not used for a prolonged
period - ✔✔✔a. diminished effect with the same amt of substance used
during an official visit, a 38 y/o woman states "I drink way too much but do
not know what to do to stop". according to Prochaska's change framework,
her statement is most consistent with a person at the stage of:
a. precontemplation
b. contemplation
c. preparation
d. action - ✔✔✔b. contemplation
the NP can consider presenting txment options and support for change after
the pt has moved into which of Prochaska's stages?
a. precontemplation
b. contemplation
c. preparation
d. action - ✔✔✔b. contemplation
lorazepam or oxazepam is the preferred benzodiazepine for txing alcohol
withdrawal sxs when there is a concomitant hx of:
a. seizure d/o
®™
b. folate deficiency anemia
2
, 623 ADULT - PSYCHOSOCIAL - NP CERTIFICATION, FITZGERALD 4TH EDITION
c. multiple substance abuse
d. hepatic dysfunction - ✔✔✔d. hepatic dysfunction
peak sxs of alcohol withdrawal are usually observed how long after alcohol
intake is dc?
a. less than 12 hrs
b. 12 to 24 hrs
c. 24 to 36 hrs
d. more than 36 hrs - ✔✔✔b. 12 to 24 hrs
which of the following is the most helpful approach in the care of pt with
alcoholism?
a. advise the pt to stop drinking in a straight forward manner
b. counsel the pt that alcohol abuse is a treatable disease
c. inform the pt of the long-term health consequences of alcohol abuse
d. refer the pt to Alcoholics Anonymous - ✔✔✔b. counsel the pt that alcohol
abuse is a treatable disease
a 42 y/o man who has a long-standing hx of alcohol abuse presents for
primary care. he admits to drinking 12 to 16 beers daily for 10 yrs. he states
"I really do not feel like the booze is a problem. i get to work every day. your
most appropriate response is:
a. work is usually the last thing to go in alcohol abuse
b. your family has suffered by your drinking
c. i am concerned about your health and safety
d. participating in a support grp can help you understand why you drink -
✔✔✔c. i am concerned about your health and safety
®™
3
, 623 ADULT - PSYCHOSOCIAL - NP CERTIFICATION, FITZGERALD 4TH EDITION
which of the following agents offers an intervention for the control of tremor
and tachycardia associated with alcohol withdrawal?
a. phenobarbital
b. clonidine
c. verapamil
d. naltrexone - ✔✔✔b. clonidine
which of the following is most likely to be noted in a 45 y/o woman with lab
evidence of chronic excessive alcohol ingestion?
a. alanine aminotransferase (ALT) 202 U/L (0 to 31 U/L, mean corpuscular
volume (MCV) 70 fL (80-96)
b. aspartate transaminase (AST) 149 U/L (0 to 31 U/L, mean corpuscular
volume (MCV) 81 fL (80-96)
c. alanine aminotransferase (ALT) 88 U/L (0 to 31 U/L, mean corpuscular
volume (MCV) 140 fL (80-96)
d. AST 80 U/L (0 to 31 U/L, mean corpuscular volume (MCV) 103 fL (80-96) -
✔✔✔d. AST 80 U/L (0 to 31 U/L, mean corpuscular volume (MCV) 103 fL (80-
96)
which of the following is the anticipated clinical effect of acamprosate
(Campral) in the txment of alcohol dependence?
a. modifies intoxicating effects of alcohol
b. causes unpleasant adverse effects of alcohol
c. helps to reduce the urge to drink
d. minimizes alcohol withdrawal sxs - ✔✔✔c. helps to reduce the urge to
drink
when providing primary care for a middle-aged woman with a hx of
prescription benzodiaepine dependence, you consider that:
a. she is unlikely to have a problem with misuse of other drugs or alcohol
®™
4