Conrad, a 26-year-old male, is being treated for cuts after being arrested for
breaking the windows in the home of his girlfriend, who has just told him that
they are through. He has a history of having been physically abused by his father,
setting fires as a child, treatment for
substance abuse, and arrest for stealing a car. Which of the following personality
disorders might the clinician consider?
Question 1 options:
a) Narcissistic
b) Paranoid
c) Antisocial
d) Histrionic
Antisocial
In a biopsychosocial case formulation, social contributions would be considered
to be:
a)Genetic influences and adverse circumstances of birth
b) Substance use and medical disorders
c) Cognitive deficits and dysregulation of emotions
d) Religious/cultural factors and living situations
Religious/cultural factors and living situations
Which of the following criteria would preclude the use of brief dynamic therapy?
a) Adequate ego strengths
b) Psychological problems in multiple domains
c) Use of mature defense mechanisms
d) Adequate ability to process information
Use of mature defense mechanisms
In treatment of the acute phase of mania, the focus is on:
a) Protecting the patient's biopsychosocial safety
b) Educating the patient about social rhythms theory
c) Interventions that address impairment of vocational functioning
d) Interventions for self-management of finance
Protecting the patient's biopsychosocial safety
During an initial assessment, the relevant features of communication are its
ability to:
a)Promote a therapeutic alliance and increase understanding.
b) Prompt a disclosure of past successes and failures.
1|Page
,c) Bring about changes in behavior.
d) Educate the patient about what is important to disclose.
Symptoms of anxiety and panic are associated with a low level of which
neurotransmitter?
a)Cortisol
b) Dopamine
c) Gamma-aminobutyric acid
d) Glutamate
Gamma-aminobutyric acid
Which class of antidepressants has the most anticholinergic side effects?
a) Monoamine oxidase inhibitors (MAOIs)
b) Selective serotonin reuptake inhibitors (SSRIs)
c) Tricyclic antidepressants (TCAs)
d) Serotonin norepinephrine reuptake inhibitors (SNRIs)
Tricyclic antidepressants (TCAs)
A 16-year-old male patient is hospitalized for depression after attempting suicide
by overdose. Several days later, the patient reports feeling less depressed and
having fewer suicidal thoughts, but begins to threaten suicide "if things do not
work out." Nursing staff members report feeling resentful and manipulated, but
fear for the patient's safety. The adult psychiatric and mental health nurse
practitioner's intervention is to
a) assist the staff in developing a treatment plan that limits contact with the
patient to one person
per shift.
b) develop a "no suicide" pact with the patient to decrease his helplessness and
increase his
feelings of control.
c) encourage the patient to express his fears of improving and being abandoned
or of leaving the
safe environment.
d) increase supervision and restrict milieu participation to decrease the
secondary gain from
manipulation.
encourage the patient to express his fears of improving and being abandoned or of
leaving the
safe environment.
A female client complains of an intense, overwhelming fear of driving a car. The
fear has
disrupted all elements of her life. She does not go to the grocery store unless
someone
transports her, has relinquished her job, and has few social contacts. Her
treatment plan
includes:
a) assertiveness training.
b) biofeedback.
2|Page
,c) stress management assistance.
d) systematic desensitization.
A patient with borderline personality disorder experiences intense anxiety when
an adult psychiatric and mental health nurse practitioner goes on vacation. The
best explanation for this reaction is that the patient:
a. has failed to develop clear ego boundaries.
b) has failed to master object constancy.
c) is employing primitive idealization.
d) is employing projective identification.
An outpatient mental health clinic-based adult psychiatric and mental health
nurse practitioner treats a 32-year-old patient who has diabetes and a major
depressive disorder. The patient reports an improved and stable mood on a trial
of duloxetine (Cymbalta), but experiences continued neuropathic pain. The nurse
practitioner's initial intervention is to:
add gabapentin (Neurontin) to the treatment regimen.
b)
conduct additional diagnostic tests.
c)
contact the patient's endocrinologist.
d)
increase the dosage of duloxetine (Cymbalta).
Among the following statements, which best describes the action of older typical
antipsychotic medications such as Haldol?
They block dopamine receptors in all four dopamine pathways.
b)
They decrease available amounts of serotonin and norepinephrine.
c)
They decrease the metabolism of dopamine in the synaptic cleft.
d)
They selectively block reuptake of dopamine.
3|Page
, Which of the following structures provides for communication between the two
hemispheres
of the brain?
a. lateral ventricle
b. basal ganglia
c. corpus callosum
d. hypothalamus
On evaluation, the patient appears to be having difficulty with working memory,
planning, and insight into his problems. The psychiatric advanced practice nurse
recognizes that these symptoms are associated with problems with the:)
a. frontal lobe
b. temporal lobe
c. parietal lobe
d. occipital lobe
Frontal lobe
In cognitive therapy, therapists focus on patients':
a) Use of immature defense mechanisms
b) Learned behavior of helplessness
c) Automatic negative thoughts
d) Attachment patterns
Automatic negative thoughts
With regard to the biological markers for schizotypal personality disorder, all of
the
following have been reported except:
a) Increased ventricles
b) Increased cerebrospinal fluid
c) impaired smooth pursuit eye movements
d) Impaired of executive functioning
Impaired of executive functioning
Serving as a member on a crisis team, an adult psychiatric and mental health
nurse practitioner provides crisis intervention to the survivors of a plane crash.
Forty-eight hours after the accident, the survivors describe vivid flashbacks,
startle reactions, and disrupted sleep patterns. The nurse practitioner responds
by:
a)advising the survivors to consider using a hypnotic medication for a brief
period.
b) educating the survivors about prodromal symptoms of posttraumatic stress
4|Page
breaking the windows in the home of his girlfriend, who has just told him that
they are through. He has a history of having been physically abused by his father,
setting fires as a child, treatment for
substance abuse, and arrest for stealing a car. Which of the following personality
disorders might the clinician consider?
Question 1 options:
a) Narcissistic
b) Paranoid
c) Antisocial
d) Histrionic
Antisocial
In a biopsychosocial case formulation, social contributions would be considered
to be:
a)Genetic influences and adverse circumstances of birth
b) Substance use and medical disorders
c) Cognitive deficits and dysregulation of emotions
d) Religious/cultural factors and living situations
Religious/cultural factors and living situations
Which of the following criteria would preclude the use of brief dynamic therapy?
a) Adequate ego strengths
b) Psychological problems in multiple domains
c) Use of mature defense mechanisms
d) Adequate ability to process information
Use of mature defense mechanisms
In treatment of the acute phase of mania, the focus is on:
a) Protecting the patient's biopsychosocial safety
b) Educating the patient about social rhythms theory
c) Interventions that address impairment of vocational functioning
d) Interventions for self-management of finance
Protecting the patient's biopsychosocial safety
During an initial assessment, the relevant features of communication are its
ability to:
a)Promote a therapeutic alliance and increase understanding.
b) Prompt a disclosure of past successes and failures.
1|Page
,c) Bring about changes in behavior.
d) Educate the patient about what is important to disclose.
Symptoms of anxiety and panic are associated with a low level of which
neurotransmitter?
a)Cortisol
b) Dopamine
c) Gamma-aminobutyric acid
d) Glutamate
Gamma-aminobutyric acid
Which class of antidepressants has the most anticholinergic side effects?
a) Monoamine oxidase inhibitors (MAOIs)
b) Selective serotonin reuptake inhibitors (SSRIs)
c) Tricyclic antidepressants (TCAs)
d) Serotonin norepinephrine reuptake inhibitors (SNRIs)
Tricyclic antidepressants (TCAs)
A 16-year-old male patient is hospitalized for depression after attempting suicide
by overdose. Several days later, the patient reports feeling less depressed and
having fewer suicidal thoughts, but begins to threaten suicide "if things do not
work out." Nursing staff members report feeling resentful and manipulated, but
fear for the patient's safety. The adult psychiatric and mental health nurse
practitioner's intervention is to
a) assist the staff in developing a treatment plan that limits contact with the
patient to one person
per shift.
b) develop a "no suicide" pact with the patient to decrease his helplessness and
increase his
feelings of control.
c) encourage the patient to express his fears of improving and being abandoned
or of leaving the
safe environment.
d) increase supervision and restrict milieu participation to decrease the
secondary gain from
manipulation.
encourage the patient to express his fears of improving and being abandoned or of
leaving the
safe environment.
A female client complains of an intense, overwhelming fear of driving a car. The
fear has
disrupted all elements of her life. She does not go to the grocery store unless
someone
transports her, has relinquished her job, and has few social contacts. Her
treatment plan
includes:
a) assertiveness training.
b) biofeedback.
2|Page
,c) stress management assistance.
d) systematic desensitization.
A patient with borderline personality disorder experiences intense anxiety when
an adult psychiatric and mental health nurse practitioner goes on vacation. The
best explanation for this reaction is that the patient:
a. has failed to develop clear ego boundaries.
b) has failed to master object constancy.
c) is employing primitive idealization.
d) is employing projective identification.
An outpatient mental health clinic-based adult psychiatric and mental health
nurse practitioner treats a 32-year-old patient who has diabetes and a major
depressive disorder. The patient reports an improved and stable mood on a trial
of duloxetine (Cymbalta), but experiences continued neuropathic pain. The nurse
practitioner's initial intervention is to:
add gabapentin (Neurontin) to the treatment regimen.
b)
conduct additional diagnostic tests.
c)
contact the patient's endocrinologist.
d)
increase the dosage of duloxetine (Cymbalta).
Among the following statements, which best describes the action of older typical
antipsychotic medications such as Haldol?
They block dopamine receptors in all four dopamine pathways.
b)
They decrease available amounts of serotonin and norepinephrine.
c)
They decrease the metabolism of dopamine in the synaptic cleft.
d)
They selectively block reuptake of dopamine.
3|Page
, Which of the following structures provides for communication between the two
hemispheres
of the brain?
a. lateral ventricle
b. basal ganglia
c. corpus callosum
d. hypothalamus
On evaluation, the patient appears to be having difficulty with working memory,
planning, and insight into his problems. The psychiatric advanced practice nurse
recognizes that these symptoms are associated with problems with the:)
a. frontal lobe
b. temporal lobe
c. parietal lobe
d. occipital lobe
Frontal lobe
In cognitive therapy, therapists focus on patients':
a) Use of immature defense mechanisms
b) Learned behavior of helplessness
c) Automatic negative thoughts
d) Attachment patterns
Automatic negative thoughts
With regard to the biological markers for schizotypal personality disorder, all of
the
following have been reported except:
a) Increased ventricles
b) Increased cerebrospinal fluid
c) impaired smooth pursuit eye movements
d) Impaired of executive functioning
Impaired of executive functioning
Serving as a member on a crisis team, an adult psychiatric and mental health
nurse practitioner provides crisis intervention to the survivors of a plane crash.
Forty-eight hours after the accident, the survivors describe vivid flashbacks,
startle reactions, and disrupted sleep patterns. The nurse practitioner responds
by:
a)advising the survivors to consider using a hypnotic medication for a brief
period.
b) educating the survivors about prodromal symptoms of posttraumatic stress
4|Page
