NR547/ NR 547 FINAL EXAM (NEW d d d d d
VERSION) | NEWEST ACTUAL EXAM CO d d d d d
MPLETE QUESTIONS AND VERIFIED AN d d d d
SWERS GRADED A+ | 100% GUARANTE d d d d d
ED PASS | 2025 UPDATE! (BRAND NEW
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)
Kiefer is a 22-year- d d d
old student who presents to the clinic with complaints of a depressed mo
d d d d d d d d d d d d
od that started two weeks ago. He states that he has stopped playing intr
d d d d d d d d d d d d d
amural baseball because of his mood; this is the first time since he was a
d d d d d d d d d d d d d d d
small child that he has not played a season. He endorses insomnia and fa
d d d d d d d d d d d d d
tigue and is having a difficult time concentrating. Kiefer admits to taking
d d d d d d d d d d d d
methylphenidate "on a pretty regular basis." His use caused him to skip cl d d d d d d d d d d d d
asses and lose a few friends who were -
d d d d d d d d
d✔✔✔ Correct Answer > F15.14 Stimulant use disorder, mild
d d d d d d d d
Rationale: Kiefer meets diagnostic criteria for major depressive disorder;
d d d d d d d d d
his depressed mood symptoms started during withdrawal of methylphen
d d d d d d d d
idate. He does not have a history of depressed mood. He meets three crit
d d d d d d d d d d d d d
eria for substance use disorder (social problems related to use, neglectin
d d d d d d d d d d
g major role to use, and repeated attempts to quit). He meets diagnostic
d d d d d d d d d d d d d
criteria for mild methylphenidate use disorder with methylphenidate-
d d d d d d d
induced depressive disorder onset during withdrawal. See DSM criteria d
d d d d d d d d d
oe stimulant use disorder.
d d d
,A client with Alzheimer's dementia is prescribed donepezil. Which of th
d d d d d d d d d d
e following is the most anticipated client outcome?
d d d d d d d
cured Alzheimer's disease
d d
complete return of cognitive function d d d d
prevention of further cognitive and functional decline d d d d d d
improved memory and thinking - d d d d
d✔✔✔ Correct Answer > improved memory and thinking
d d d d d d d
Rationale: The effect of donepezil is to increase the availability of acetylc
d d d d d d d d d d d
holine, which results in enhanced transmission and improved cognition.
d d d d d d d d d
Donepezil does not cure Alzheimer's disease, result in a complete return
d d d d d d d d d d d
of cognitive function, or prevent further decline, although it may slow pr
d d d d d d d d d d d
ogression.
Pete is a 69-year- d d d
old who has been in an inpatient surgical unit for 9 days after a thoracic a
d d d d d d d d d d d d d d d
neurysm replacement. His recovery has been complicated by a history of
d d d d d d d d d d d
chronic obstructive pulmonary disease (COPD). The family nurse practiti
d d d d d d d d
oner (FNP) has been consulted due to changes in his behavior over the pa
d d d d d d d d d d d d d
st two nights. The night shift nurse reported that Pete became disoriente
d d d d d d d d d d d
d to time and place and stated that the mylar balloons in the corner of his
d d d d d d d d d d d d d d d d
room were people standing over him, watchin - ✔✔✔ Correct Answer > F13.221-
d d d d d d d d d d d d
moderate delirium due to sedative
d d d d d
,Rationale: Pete meets diagnostic criteria for medication-
d d d d d d
induced acute hyperactive delirium due to the administration of zolpide
d d d d d d d d d
m.
Kim, an 82-year- d d
old male, presents with his wife and son with complains of memory loss a
d d d d d d d d d d d d d
nd poor hygiene. The client and family report no significant past medical
d d d d d d d d d d d d
history but express a need for assistance in caring for him. Labs and imagi
d d d d d d d d d d d d d
ng are completed to rule out anemia, hypothyroidism, depression, and st
d d d d d d d d d d
roke. All results are negative. A Montreal cognitive assessment (MoCA) yi
d d d d d d d d d d
elds inconclusive results. The client becomes frustrated.
d d d d d d
Which of the following is the most appropriate management str
d d d d d d d d d -d ✔✔✔
Correct Answer > Obtain a complete neuropsychology exam
d d d d d d d
Rationale: A diagnosis has not yet been determined and a cognitive asses
d d d d d d d d d d d
sment screening tool is inconclusive; therefore, a full neurocognitive exa
d d d d d d d d d
m is warranted. A neuropsychological exam will help identify areas of cog
d d d d d d d d d d d
nitive impairment and aid in the creation of a comprehensive manageme
d d d d d d d d d d
nt plan. Note, the first course of action was to eliminate any underlying m
d d d d d d d d d d d d d
edical issues that could explain the concerning behaviors.
d d d d d d d
Chantoya, a 78-year- d d
old female, is being seen for her annual wellness exam. During the exam,
d d d d d d d d d d d d d
she reports that, over the past year, she has had trouble finding her word
d d d d d d d d d d d d d
s and expressing her thoughts and feelings. She worries that this may be i
d d d d d d d d d d d d d
ndicative of a stroke or Alzheimer's disease. Chantoya has a positive medi
d d d d d d d d d d d
cal history for significant coronary artery disease, hypertension, and dysli
d d d d d d d d d
pidemia. She denies recent d d d
, surgeries. Her vital signs and recent lab values are normal. Her physical an
d d d d d d d d d d d d
d neur - ✔✔✔ Correct Answer > Reassurance
d d d d d d d
Rationale: Chantoya's MoCA assessment was negative and her symptom
d d d d d d d d
s align with expressive aphasia which can be attributed to aging. An MRI
d d d d d d d d d d d d d
may be warranted if major cognitive impairment or pathologies were ide
d d d d d d d d d d
ntified in the assessments. If the MoCA assessment indicated impairmen
d d d d d d d d d
t in a specific part of the brain, referral to neurology for follow-
d d d d d d d d d d d d
up interventions would be indicated. Normal aging processes may manif
d d d d d d d d d
est as mild short-
d d d
term memory loss, a slight loss in processing speed, and expressive apha
d d d d d d d d d d d
sia (the inability to find words); No significant loss of function in the cogni
d d d d d d d d d d d d d
tive domains or the activities of daily living are seen.
d d d d d d d d d
Lisa is a 29-year-
d d d
old who admits to using "pills, heroin, and booze" regularly. She lives in a
d d d d d d d d d d d d d d
rural area and is employed part-
d d d d d
time. She has a history of poor compliance with past treatments.
d d d d d d d d d d
prescribe the proper medication: d d d
Methadone Bupren d
orphine
Buprenorphine plus naloxone (Suboxone) Naltrex d d d d
one - ✔✔✔ Correct Answer > Naltrexone
d d d d d d
Naltrexone blocks mu opioid receptors, preventing exogenous opioids fr
d d d d d d d d
om binding there and thus preventing the pleasurable effects of
d d d d d d d d d
VERSION) | NEWEST ACTUAL EXAM CO d d d d d
MPLETE QUESTIONS AND VERIFIED AN d d d d
SWERS GRADED A+ | 100% GUARANTE d d d d d
ED PASS | 2025 UPDATE! (BRAND NEW
d d d d d d
)
Kiefer is a 22-year- d d d
old student who presents to the clinic with complaints of a depressed mo
d d d d d d d d d d d d
od that started two weeks ago. He states that he has stopped playing intr
d d d d d d d d d d d d d
amural baseball because of his mood; this is the first time since he was a
d d d d d d d d d d d d d d d
small child that he has not played a season. He endorses insomnia and fa
d d d d d d d d d d d d d
tigue and is having a difficult time concentrating. Kiefer admits to taking
d d d d d d d d d d d d
methylphenidate "on a pretty regular basis." His use caused him to skip cl d d d d d d d d d d d d
asses and lose a few friends who were -
d d d d d d d d
d✔✔✔ Correct Answer > F15.14 Stimulant use disorder, mild
d d d d d d d d
Rationale: Kiefer meets diagnostic criteria for major depressive disorder;
d d d d d d d d d
his depressed mood symptoms started during withdrawal of methylphen
d d d d d d d d
idate. He does not have a history of depressed mood. He meets three crit
d d d d d d d d d d d d d
eria for substance use disorder (social problems related to use, neglectin
d d d d d d d d d d
g major role to use, and repeated attempts to quit). He meets diagnostic
d d d d d d d d d d d d d
criteria for mild methylphenidate use disorder with methylphenidate-
d d d d d d d
induced depressive disorder onset during withdrawal. See DSM criteria d
d d d d d d d d d
oe stimulant use disorder.
d d d
,A client with Alzheimer's dementia is prescribed donepezil. Which of th
d d d d d d d d d d
e following is the most anticipated client outcome?
d d d d d d d
cured Alzheimer's disease
d d
complete return of cognitive function d d d d
prevention of further cognitive and functional decline d d d d d d
improved memory and thinking - d d d d
d✔✔✔ Correct Answer > improved memory and thinking
d d d d d d d
Rationale: The effect of donepezil is to increase the availability of acetylc
d d d d d d d d d d d
holine, which results in enhanced transmission and improved cognition.
d d d d d d d d d
Donepezil does not cure Alzheimer's disease, result in a complete return
d d d d d d d d d d d
of cognitive function, or prevent further decline, although it may slow pr
d d d d d d d d d d d
ogression.
Pete is a 69-year- d d d
old who has been in an inpatient surgical unit for 9 days after a thoracic a
d d d d d d d d d d d d d d d
neurysm replacement. His recovery has been complicated by a history of
d d d d d d d d d d d
chronic obstructive pulmonary disease (COPD). The family nurse practiti
d d d d d d d d
oner (FNP) has been consulted due to changes in his behavior over the pa
d d d d d d d d d d d d d
st two nights. The night shift nurse reported that Pete became disoriente
d d d d d d d d d d d
d to time and place and stated that the mylar balloons in the corner of his
d d d d d d d d d d d d d d d d
room were people standing over him, watchin - ✔✔✔ Correct Answer > F13.221-
d d d d d d d d d d d d
moderate delirium due to sedative
d d d d d
,Rationale: Pete meets diagnostic criteria for medication-
d d d d d d
induced acute hyperactive delirium due to the administration of zolpide
d d d d d d d d d
m.
Kim, an 82-year- d d
old male, presents with his wife and son with complains of memory loss a
d d d d d d d d d d d d d
nd poor hygiene. The client and family report no significant past medical
d d d d d d d d d d d d
history but express a need for assistance in caring for him. Labs and imagi
d d d d d d d d d d d d d
ng are completed to rule out anemia, hypothyroidism, depression, and st
d d d d d d d d d d
roke. All results are negative. A Montreal cognitive assessment (MoCA) yi
d d d d d d d d d d
elds inconclusive results. The client becomes frustrated.
d d d d d d
Which of the following is the most appropriate management str
d d d d d d d d d -d ✔✔✔
Correct Answer > Obtain a complete neuropsychology exam
d d d d d d d
Rationale: A diagnosis has not yet been determined and a cognitive asses
d d d d d d d d d d d
sment screening tool is inconclusive; therefore, a full neurocognitive exa
d d d d d d d d d
m is warranted. A neuropsychological exam will help identify areas of cog
d d d d d d d d d d d
nitive impairment and aid in the creation of a comprehensive manageme
d d d d d d d d d d
nt plan. Note, the first course of action was to eliminate any underlying m
d d d d d d d d d d d d d
edical issues that could explain the concerning behaviors.
d d d d d d d
Chantoya, a 78-year- d d
old female, is being seen for her annual wellness exam. During the exam,
d d d d d d d d d d d d d
she reports that, over the past year, she has had trouble finding her word
d d d d d d d d d d d d d
s and expressing her thoughts and feelings. She worries that this may be i
d d d d d d d d d d d d d
ndicative of a stroke or Alzheimer's disease. Chantoya has a positive medi
d d d d d d d d d d d
cal history for significant coronary artery disease, hypertension, and dysli
d d d d d d d d d
pidemia. She denies recent d d d
, surgeries. Her vital signs and recent lab values are normal. Her physical an
d d d d d d d d d d d d
d neur - ✔✔✔ Correct Answer > Reassurance
d d d d d d d
Rationale: Chantoya's MoCA assessment was negative and her symptom
d d d d d d d d
s align with expressive aphasia which can be attributed to aging. An MRI
d d d d d d d d d d d d d
may be warranted if major cognitive impairment or pathologies were ide
d d d d d d d d d d
ntified in the assessments. If the MoCA assessment indicated impairmen
d d d d d d d d d
t in a specific part of the brain, referral to neurology for follow-
d d d d d d d d d d d d
up interventions would be indicated. Normal aging processes may manif
d d d d d d d d d
est as mild short-
d d d
term memory loss, a slight loss in processing speed, and expressive apha
d d d d d d d d d d d
sia (the inability to find words); No significant loss of function in the cogni
d d d d d d d d d d d d d
tive domains or the activities of daily living are seen.
d d d d d d d d d
Lisa is a 29-year-
d d d
old who admits to using "pills, heroin, and booze" regularly. She lives in a
d d d d d d d d d d d d d d
rural area and is employed part-
d d d d d
time. She has a history of poor compliance with past treatments.
d d d d d d d d d d
prescribe the proper medication: d d d
Methadone Bupren d
orphine
Buprenorphine plus naloxone (Suboxone) Naltrex d d d d
one - ✔✔✔ Correct Answer > Naltrexone
d d d d d d
Naltrexone blocks mu opioid receptors, preventing exogenous opioids fr
d d d d d d d d
om binding there and thus preventing the pleasurable effects of
d d d d d d d d d
