NRNP 6675 Week 6 Midterm Exam Solution (100% Correct) Walden University

NRNP 6675 Week 6 Midterm Exam Solution (100% Correct) Walden University NB: ANSWER KEY-----page 22 Questions 1. Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply A ...

NRNP 6675 Week 6 Midterm Exam Solution (100% Correct) Walden University NB: ANSWER KEY-----page 22 Questions 1. Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply A. Age B. Rapid dose escalation C. Parental route of administration D. Higher potency typical antipsychotics 2. Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects? A. Reduces negative symptoms B. Increases extra pyramidal symptoms (EPS) C. Causes prolactinemia D. Reduces positive symptoms 3. Phencyclidine (PCP) and Ketamine exert their unique behavioral effects by blocking which of the following receptors? A. GABA type receptors B. Serotonin receptors C. Dopamine receptors D. NMDA type receptors 4. The diagnosis used to describe a syndrome characterized by specific signs and symptoms resulting from recent ingestion or exposure to a substance is known as which of the following? A. Substance intoxication B. Substance withdrawal C. Substance use disorder D. Any of the above 5. Abnormal involuntary movements in a rhythmic pattern affecting face, mouth, tongue, jaw is known as which of the following? A. Akathisia B. Dystonia C. Tardive dyskinesia D. Extrapyramidal side effects 6. A deeply held belief despite evidence to the contrary, lasting at least one month, without prominent hallucinations, with functional impairment that relates to the delusional syste..... A. Schizophrenia B. Delusional disorder C. Brief psychotic disorder D. Schizophreniform disorder 7. Which of the following is true about preoccupation with castration? A. This can be serious and life-threatening if castration is carried out without medical supervision. B. This is consistent with Transvestic Disorder C. This is consistent with other specified paraphilic disorder D. This is consistent with sexual masochism disorder 8. Which of the following is a system that provides a uniform language for describing medical and surgical procedures and diagnostic services rendered by clinicians? A. HIPPA B. DSM-5 C. CPT D. DRG 9. A patient on Chlorpromazine states that his orgasm is dry and afterward he will commonly have milky urine. The ARNP realizes which of the following? A. This is likely a harmless response to the Chlorpromazine B. This is abnormal and needs to be evaluated by a specialist C. It is critical to stop the Chlorpromazine immediately D. This has nothing to do with the Chlorpromazine the patient be referred to his PCP for follow-up 10. A condition which results from absence of second female sex Chromosome (XO) and is associated with web neck, dwarfism, cubitus valgus, and infertility is known as which of the following? A. Hermaphroditism B. Turner's syndrome C. Adrenogenital syndrome D. Androgen insensitivity syndrome 11. Which of the following would be characterized as a negative symptom of schizophrenia? A. Hallucinations and delusions B. Impaired social and occupational functioning C. Isolation and impaired self-care D. B and C only 12. Which of the following are keys to distinguishing OCD from psychosis? A. Patients with OCD can almost always acknowledge the unreasonable nature of their symptoms B. Patients with OCD are better able to control their compulsions. C. Patients with psychosis will have more obsessive thoughts. D. Patients with OCD have less bizarre obsessions. 13. Which of the following is a system that provides a uniform language for describing medical and surgical procedures and diagnostic services rendered by clinicians... A. HIPPA B. DSM-5 C. CPT D. DRG 14. A federal program administered nationally and locally which covers enrolled individuals 65 years and older who pay premiums and disabled individuals.... A. Medicare B. Medicaid C. Both A and B D. None of the above 15. Having an adequate legal description of nurse practitioner (NP) scope of practice according to state law is important for which of the following reasons? A. To avoid any charges of practicing medicine without a license B. To place accountability for both benefits and harm to patients squarely on the NP C. To get reimbursement for physician services when provided by an NP D. All of the above 16. Which of the following is the most widely consumed psychoactive substance? A. Alcohol B. Caffeine C. Heroine D. Cannabis 17. Which of the following is used to treat Tardive Dyskinesia? A. Cogentin (benztropine) B. Artane (trihexyphenidyl) C. Catapress (Clonidine) D. None of the above 18. The APRN consensus model did which of the following? A. Merged adult, gerontology and pediatric foci so that all NPs could truly work across the.... B. Adult and gerontology were merged and identified as primary care or acute care C. Psychiatric mental health foci were stipulated as across the lifespan D. B and C 19. Which of the following behaviors are associated with an alcohol blood level of 0.05 percent? A. Voluntary motor actions usually become perceptibly clumsy B. Thought judgment, and restraint are impaired C. Confusion, stupor D. None of the above 20. According to HIPPA, which of the following must the NP share their NPI with? Check all that apply. Health plans Other providers Any entity that may need it for billing purpose A and C only 21. A patient presents with delusions, disorganized thoughts, and speech with poor self care all of which have persisted for the past 7 months. The APRN this presentation is.......with which of the following diagnosis? Schizophrenia Schizophreniform disorder Brief psychotic disorder Delusional disorder 22. Major neurotransmitters possibly involved in developing substance abuse and substance dependence..... which of the following? Dopamine GABA Serotonin A and B only 23. The Dopamine hypothesis of schizophrenia....which of the following? Schizophrenia results from too much dopaminergic activity Schizophrenia results from a deprivation of dopamine. Schizophrenia is not related to dopamine activity None of the above 24. A patient reports a panic attack several years ago in an elevator and since then has avoided using elevators. This patient meets criteria for which of the following? Social phobia Specific phobia General anxiety disorder unspecified Obsessive-compulsive disorder 25. A patient with a substance abuse disorder who does not meet the clinical criteria for hospitalization but who lacks sufficient social and vocational skills and lack substance-free social supports is ap Residential treatment Partial hospitalizations Outpatient treatment All of the above 26. Obscene phone calling to an unsuspecting partner for sexual arousal is known as which of the following? Telephilia Partialism Telephone scatologia Normal adolescent prank 27. The main psychological difference between fear and anxiety is best described by which of the following statements? Fear is insidious; anxiety is sudden Anxiety is insidious; fear is sudden. There is no difference between fear and anxiety. Both anxiety and fear are alerting signals 28. A diffuse, unpleasant, vague sense of apprehension often accompanied by autonomic symptoms which varies among persons is commonly known as which of the following? Fear Stress Normal anxiety Pathological anxiety 29. If a pregnancy begins while the woman is taking high doses of methadone and withdrawal is desired, during which trimester is this least hazardous? First trimester Second trimester Third trimester Withdrawal from methadone should never be done while the woman is pregnant 30. Neurochemical or neurophysiologic changes in the body that result from the repeated administration of a drug is known as which of the following? Cross-tolerance Neurotransformation Neuroadaptation Neurocognitive adjustment 31. The recurrent and intense sexual arousal from the physical and psychological suffering of another person is known as which of the following? Frotteurism Voyeurism Sexual sadism Sexual masochism 32. Which of the following is not consistent with the onset of OCD? More than half of patients with OCD have a sudden onset of symptoms The onset of symptoms for about 50-70 percent of patients occurs after a stressful event. Most patients keep their symptoms secret initially. The onset of OCD is typically preceded by OCD personality traits. 33. The recurrent urge to expose one's genitals to a stranger is known as which of the following? Fetishism Voyeurism Exhibitionism Paraphilic disorder 34. Which of the following patients would be appropriate for hospitalization for substance use disorder? Select all that apply. Patients who have a substance overdose who cannot be safely treated in an outpatient setting Patients who are at risk for severe or medically complicated withdrawal syndromes Patients who have a history of not benefiting from treatment in a less intensive setting A and B only 35. The nursing practice model recommended for NPs by the National Academy of Medicine and the National Council of State Boards of Nursing is which of the following? Full practice Reduced practice Restricted practice Arbitrary practice 36. Which of the following groups does Medicare cover? Select all that apply. Individuals 65 years and older who have enrolled and pay premiums Disabled individuals who qualify for Social Security Disability payments and benefits Adults who are disabled for one year or less and who qualify on the basis of poverty Mothers and children who qualify on the basis of poverty. 37. Which of the following neurotransmitters increases libido? GABA Serotonin Oxytocin Dopamine 38. Which of the following factors are associated with poor prognosis for patients with OCD? Childhood onset The presence of a precipitating event Co-existing major depressive disorder A and C 39. Which of the following is inconsistent with current knowledge about schizophrenia? Schizophrenia is one of the most common of the serious mental disorders. A diagnosis of schizophrenia is based entirely on the psychiatric history and mental status examination. Dopamine level is a laboratory test that assists in the diagnosis of schizophrenia. Schizophrenia likely comprises a group pf disorders with heterogeneous etiologies and variable presentations. 40. A Chronic disorder characterized by repetitive hair pulling leading to variable hair loss that may be....to others is known as which of the following? Obsessive-Compulsive Disorder Impulse Control Disorder ..... ..... 41. Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply. Age Rapid dose escalation Parental route of administration Higher potency typical antipsychotics 42. Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects? Reduces negative symptoms Increases extrapyramidal symptoms (EPS) Causes prolactinemia Reduces positive symptoms 43. Phencyclidine (PCP) and Ketamine exert their unique behavioral effects by blocking which of the following receptors? GABA type receptors Serotonin receptors Dopamine receptors NMDA type receptors 44. The diagnosis used to describe a syndrome characterized by specific signs and symptoms resulting from recent ingestion or exposure to a substance is known as which of the following? Substance intoxication Substance withdrawal Substance use disorder Any of the above 45. A deeply held belief despite evidence to the contrary, lasting at least one month, without prominent hallucinations with functional impairment that relates to the delusional system... Schizophrenia Delusional disorder Brief psychotic disorder Schizophreniform disorder 46. A method of therapy used to treat individuals with substance abuse based on the fundamental principle of a psychology that reinforced behaviors are likely to be...is known as which of the following? Exposure therapy Contingency management Motivational interviewing Cognitive behavioral therapy 47. The conditions in which people are born, grow, work, live, and age are known as which of the following? Health literacy Health disparities Health vulnerabilities Social determinants of health 48. All the following is consistent with ANCC rules regarding recertification EXCEPT: You are required to have a maximum of 25 credit hours during each certification period You can start the recertification process 1 year before your expiration date, but no later than 3 months before. You must have 1000 clinical practice hours in the clinical specialty within the preceding 5 years. You must have at least 25 contact hours in pharmacotherapy. 49. Risk factors for school violence include which of the following? Select all that apply. Bullying Being bullied Isolation...... Involvement in school organizations. 50. Persons who subordinate their own needs to those of others, get other to assume responsibility for major areas of the lives, lack of self-confidence, and may experience intense discomfort when alone for more than a brief period of time are demonstrating characteristics consistent with which of the following personality disorders? Avoidant personality disorder Passive personality disorder Dependent personality disorder Antisocial personality disorder 51. Generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following lithium levels? 0.8-1.5 mEq/L 1.5-2.0 mEq/L 2.0-2.5 mEq/L >2.5 mEq/L 52. .....form of child abuse in which a patient or character repeatedly fabricates or actually inflicts injury or illness in a child for whom medical intervention is then sought in an emergency setting is known as which of the following? Korsakoff's syndrome Snyder's syndrome Munchausen syndrome Munchausen syndrome by proxy 53. Self-care strategies for the ARNP in preparing for the certification exam include all of the following EXCEPT? Study in a distraction free environment Six to eight hours of sleep is recommended Drink lot of caffeine and eat high concentrated sugars Plan to study for short periods of time over a longer time period. 54. A patient presents with a formal, tense manner. He reluctantly reports a longstanding (since early adulthood) pervasive suspiciousness of others, preoccupied with...trustworthiness of friends, unjustified concerns about others deceiving him, angry about perceived insults and slights, reluctant to confide in the ARNP. The ARNP suspects that the patient likely has which of the following personality disorders? Schizoid personality disorder Paranoid personality disorder Borderline personality disorder Antisocial personality disorder 55. Generalized convulsions, oliguria, and renal failure are symptoms seen with which of the following lithium levels? 0.8-1.5 mEq/L 1.5-2.0 mEq/L 2.0-2.5 mEq/L  2.5 mEq/L 56. A patient with a history of alcohol use presents to the emergency department with oculomotor disturbances, cerebellar ataxia, and confusion.... Symptoms as consistent with which of the following psychiatric emergencies? Akathisia Korsakoff's syndrome Wernicke's encephalopathy Idiosyncratic alcohol intoxication 57. Cluster A personality disorders are more common in biological families of patients with which of the following disorders? Depression Obsessive-compulsive disorder Alcohol use disorders Schizophrenia 58. NP core competencies for INDEPENDENT practice include all of the following EXCEPT: Maintains a collaboration agreement with physician Demonstrates the highest level of accountability for professional practice... Practices independently managing previously diagnosed and undiagnosed patient Practices patient-centered care recognizing culture diversity and the patient or designee as a full partner in decision making 59. Cluster A personality traits consist of which of the following? Schizotypal, schizoid, and paranoid subtypes Narcissistic, borderline, antisocial, and histrionic subtypes Obsessive-compulsive, dependent, and avoidant subtypes Depressive, anxious, hypomanic subtypes 60. The misuse of the charge's funds for personal gain is known as which of the following? Neglect Physical abuse Financial abuse/exploitation Emotional/psychological abuse 61. The ARNP recognizes which of the following as long term effects of sex trafficking on victims? Severe depression Spiritual questions Trauma bonding All of the above 62. In about half of the cases in which suicides occur while parents are on a psychiatric unit, a lawsuit results. Which of the following is not consistent with what courts....related to impatient psychiatric unit suicide events? Courts expect suicides to occur in inpatient settings Courts require zero suicide rates in inpatient setting Periodic patient evaluation for suicide risk Evidence of formulation of a treatment plan with a high level of security 63. Cluster A personality traits consist of which of the following? Schizotypal, schizoid, and paranoid subtypes Narcissistic, borderline, antisocial, and histrionic subtypes Obsessive-compulsive, dependent, and avoidant subtypes Depressive, anxious, hypomanic subtypes 64. Cultural Dimensions Therapy is a framework for cross-cultural communication that describes the effects of a society's culture on the values of its members....by which of the following theorists? Hofstede Leininger Purcell Campinha-Bacote 65. The treatment of choice for patients with paranoid personality disorder includes which of the following? Group therapy Behavioral therapy Psychotherapy B and C 66. The differences in the quality of healthcare across individuals or groups in regard to access, treatment options, and p....following? Racism Health disparities Vulnerable populations Social determinants of health 67. The incidence of suicide is highest for which of the following populations? Older Latino men Older Caucasian men Older Caucasian women Older African American men 68. A patient on lithium with a history of alcohol use disorder presents with dry mouth, ataxia, dizziness, abdominal pain, and slurred speech. The ARNP should do which of the following? The ARNP recognizes this is likely a relapse on alcohol so sends the patient home to sleep it off. The ARNP recognizes these are symptoms of mild to moderate lithium toxicity, decreases the lithium by half, and encourage the patient to drink more fluids The ARNP recognizes these are symptoms of mild to moderate lithium toxicity, discontinues the lithium immediately, orders lithium level, serum electrolytes, and renal function tests The ARNP recognizes these are symptoms of moderate to severe lithium toxicity, discontinues the lithium and tells the patient hemodialysis will most probably be needed. 69. An ARNP takes a position in which a specific amount is paid according to a set job description. This type of pay structure is known as which of the following? Straight salary Average percentage of net receipts Base salary plus percentage Hourly rate 70. A personality disorder characterized by emotional constriction, orderliness, perseverance, stubbornness, indecisiveness, a.....inflexibility as which of the following? Depressive personality disorder Borderline personality disorder Dependent personality disorder Obsessive-compulsive personality disorder 71. Which of the following is consistent with what is known about the epidemiology of anxiety? Men have a higher lifetime prevalence of anxiety than women. Women have a higher lifetime prevalence of anxiety than men Men and women have equal lifetime prevalence. The lifetime prevalence of anxiety is not gender specific 72. Which of the following is consistent with NP practice parameters when prescribing buprenorphine? NPs with full practice authority can prescribe and administer buprenorphine under their state NP license. As a qualified practitioner the NP simply needs to notify SAMHSA prior to prescribing or administering buprenorphine The NP can provide buprenorphine to 300 patients per month The NP is required to complete specific training to prescribe and dispense buprenorphine 73. Which of the following are consistent with current data related to the prevalence of drinking alcohol? Men and women with higher education and income are less likely to drink alcohol. Men and women with higher education and income are more likely to drink alcohol Men and women with lower education and higher income are more likely to drink alcohol. Education and income are not a factor in prevalence of drinking alcohol. 74. A patient with history of hypoglycemia reports feelings of fear, worry, and restlessness that has persisted over the past 6 months. The patient states these feelings are worse when glucose is low. The ARNP suspects the patient has which of the following diagnoses? Generalized anxiety disorder attributable to another medical condition Panic attacks attributable to another medical condition Hypoglycemia with anxiety None of the above 75. Which of the following is not consistent with benzodiazepine withdrawal? Benzodiazepine withdrawal can continue to develop for several weeks The best way to proceed with benzodiazepine withdrawal is to stop it immediately and treat withdrawal symptoms It may be helpful to switch to a long-acting benzodiazepine for withdrawal If patient is on a therapeutic benzodiazepine dose, initiate 10-25 percent dose reduction and evaluate response. 76. Which of the following is true about the legal practice of the psychiatric-mental health nurse practitioner? All have some degree of prescriptive privileges in all states and the District of Columbia. All are considered primary providers in all states and the District of Columbia. All have the ability to manage patients medically within their scope of practice without a collaborative practice agreement. A and B only 77. Flashbacks in which the individual may act and feel as if the trauma were reoccurring represent which of the following clinical features of PTSD? Intrusion symptom Symptom of avoidance Symptom of increased autonomic arousal Derealization 78. In which ways are nurse practitioners (NPs) and physician's assistants (Pas) different? NPs differ from PAs in legal definition, scope of practice, licensure, and independence of practice. NPs practice under their own license and independent of the physician, PAs always work under the supervision of a physician. There is essentially no difference functionally between an NP and a PA. A and B 79. Which of the following initials would a psychiatric-mental health nurse practitioner use to designate appropriate credentials? ANP-C CPNP CPNP-AC PMHNP-BC 80. Variations from norms in gender role behavior such as toy preferences, rough-and-tumble play, aggression, or playmate gender is known as which of the following? Gender discordance Gender role behavior Gender identity variance Childhood gender non-conformity 81. The three major neurotransmitters associated with anxiety, based on animal studies and response to drug treatment include which of the following? Glutamate, Norepinephrine, Serotonin GABA, Norepinephrine, Serotonin GABA, Dopamine, Glutamate Dopamine, Norepinephrine, Serotonin 82. Which of the following is consistent with the epidemiology of schizophrenia in the United States? The lifetime prevalence of schizophrenia is about 50 percent Schizophrenia is more prevalent in children than in adolescents. Peak age of onset in men is 10 to 25 years of age Onset of schizophrenia before the age of 25 is extremely rare. 83. Clinical findings that may indicate abuse include which of the following? Select all that apply. Delay between onset of injury and seeking treatment Explanation by the patient which is inconsistent with the type of injury Psychological distress such as depression, anxiety, suicidal ideations and/or sleep disorder Explanation by the patient which is inconsistent with the type of injury 84. According to the American Psychiatric Association (APA) which of the following is consistent with the evidence base practice for telepsychiatry? There are few studies exploring the evidence for telepsychiatry. In populations with severe anxiety, telepsychiatry is preferred. The effectiveness is comparable to in-person care in terms of therapeutic engagement, quality of care, validity and reliability of assessment, and clinical outcomes The evidence base for children and adolescents is very weak. 85. Which of the following is consistent with literature regarding the term psychosexual? Psychosexual is used to describe personality development and functioning Psychosexual is synonymous with libido in the Freudian sense Psychosexual basically refers only to sexual feelings and behavior None of the above 86. Bleuler identified four fundamental symptoms of schizophrenia known as the 4 As, which include which of the following symptoms? Associations, affect, autism and ambivalence Associations, alogia, abstraction, anxiety. Affect, apraxia, anhedonia, audible thoughts. Autism, apperception, amotivation, automatism. 87. The fear of or anxiety regarding places from which escape might be difficult is known as which of the following? Depression Panic disorder Agoraphobia Generalized anxiety disorder 88. All of the following are one of the five major categories of third-party payers EXCEPT: Medicre/Medicaid Managed-care organizations (MCOs) Indemnity insurance companies Only A and B 89. Discrepancy between anatomical sex and gender identity is known as which of the following? Gender role behavior Gender discordance Gender nonconformity Internalized sexual prejudice 90. Which of the following is not a common physical effect of cannabis? Mild tachycardia Mild bradycardia Orthostatic hypotension Dilation of the conjunctival blood vessels 91. A conscious standardized recurrent behavior such as counting, checking, avoiding that interferes significantly with the person's normal routine and functioning is known as which of the following? A compulsion An obsession Obsessive-Compulsive Disorder Obsessive-Compulsive Personality Disorder 92. Most everyone has a firm conviction that they are male or female by which age range?  years of age 2-3 years of age 4-5 years of age 6-7 years of age 93. A patient who presents absent movement with difficulty starting activities flat affect, and avolition would be assessed as having which of the following? Dystona Akathisia Akinesia Pseudo-Parkinson's 94. Which of the following is consistent with current epidemiology literature about gender and Obsessive-Compulsive Disorder (OCD)? Adult men are more likely to have OCD than adult women. Adult women are more likely to have OCD than adult men Adolescent girls are more likely to have OCD than adolescent boys. Adult men and adult women are equally likely to have OCD. 95. A type of schizophrenia in which the individual has a marked disturbance in motor function and may involve stupor, negativism, rigidity, excitement or posturing or mutism is Residual Type Catatonic Type Disorganized Type Undifferentiated Type 96. A patient who presents with the inability to remain still, with motor restlessness, would be assessed to have which of the following? Dystonia Akathisia Akinesia Tardive dyskinesia 97. A method of therapy used to treat individuals with substance abuse based on the fundamental principle of a psychology that reinforced behaviors are likely to be....is known as which of the following? Exposure therapy Contingency management Motivational interviewing Cognitive behavioral therapy