nrnp6675 midterm exam 2022

Question # 00639937
Course Code : NRNP6675
Subject: Health Care
Due on: 10/25/2022
Posted On: 10/04/2022 11:12 AM
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NRNP 6675-15 Week 6 Midterm Exam 2022

 

 

 

 

 

(100% Correct Answers)

 

 

 

 

 

 

1.            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

 

 

 

 

2.            Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects?

 

Reduces negative symptoms

 

Increases extra pyramidal symptoms (EPS)

 

Causes prolactinemia

 

Reduces positive symptoms

 

 

 

 

 

 

3.            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

 

 

 

 

 

 

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?

 

Substance intoxication

 

Substance withdrawal

 

Substance use disorder

 

Any of the above

 

 

 

 

 

 

5.            Abnormal involuntary movements in a rhythmic pattern affecting face, mouth, tongue, jaw is known as which of the following?

 

Akathisia

 

Dystonia

 

Tardive dyskinesia

 

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.....

 

Schizophrenia

 

Delusional disorder

 

Brief psychotic disorder

 

Schizophreniform disorder

 

 

 

7. Which of the following is true about preoccupation with castration?

 

This can be serious and life-threatening if castration is carried out without medical supervision.

 

This is consistent with Transvestic Disorder

 

This is consistent with other specified paraphilic disorder

 

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?

 

HIPPA

 

DSM-5

 

CPT

 

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?

 

This is likely a harmless response to the Chlorpromazine

 

This is abnormal and needs to be evaluated by a specialist

 

It is critical to stop the Chlorpromazine immediately

 

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?

 

Hermaphroditism

 

Turner's syndrome

 

Adrenogenital syndrome

 

Androgen insensitivity syndrome

 

 

 

 

 

 

11.         Which of the following would be characterized as a negative symptom of schizophrenia? Hallucinations and delusions

 

Impaired social and occupational functioning Isolation and impaired self-care

 

B and C only

 

 

 

 

 

 

Which of the following are keys to distinguishing OCD from psychosis? Patients with OCD can almost always acknowledge the unreasonable nature of their symptoms

 

 

Patients with OCD are better able to control their compulsions.

 

Patients with psychosis will have more obsessive thoughts.

 

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...

 

HIPPA

 

B.            DSM-5

 

CPT DRG

 

 

 

 

A federal program administered nationally and locally which covers enrolled individuals 65 years and

 

older who pay premiums and disabled individuals....

 

Medicare

 

Medicaid

 

Both A and B

 

None of the above

 

 

 

 

 

 

Having an adequate legal description of nurse practitioner (NP) scope of practice according to state law is important for which of the following reasons?

 

To avoid any charges of practicing medicine without a license

 

To place accountability for both benefits and harm to patients squarely on the NP

 

To get reimbursement for physician services when provided by an NP

 

All of the above

 

 

 

 

 

 

Which of the following is the most widely consumed psychoactive substance?

 

Alcohol

 

Caffeine

 

Heroine

 

Cannabis

 

 

 

 

 

 

Which of the following is used to treat Tardive Dyskinesia?

 

Cogentin (benztropine)

 

Artane (trihexyphenidyl)

 

Catapress (Clonidine)

 

None of the above

 

 

 

 

 

 

The APRN consensus model did which of the following?

 

Merged adult, gerontology and pediatric foci so that all NPs could truly work across the....

 

Adult and gerontology were merged and identified as primary care or acute care Psychiatric mental health foci were stipulated as across the lifespan B and C

 

 

 

 

 

 

 

 

 

Which of the following behaviors are associated with an alcohol blood level of 0.05 percent?

 

Voluntary motor actions usually become perceptibly clumsy

 

Thought judgment, and restraint are impaired

 

Confusion, stupor

 

None of the above

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

Major neurotransmitters possibly involved in developing substance abuse and substance dependence.....

 

which of the following?

 

Dopamine

 

GABA

 

Serotonin

 

A and B only

 

 

 

 

 

 

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

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

Obscene phone calling to an unsuspecting partner for sexual arousal is known as which of the following?

 

Telephilia

 

Partialism

 

Telephone scatologia

 

Normal adolescent prank

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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.

 

 

 

 

 

 

The recurrent urge to expose one's genitals to a stranger is known as which of the following? Fetishism

 

Voyeurism

 

Exhibitionism

 

Paraphilic disorder

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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.

 

 

 

 

 

 

Which of the following neurotransmitters increases libido?

 

GABA

 

Serotonin

 

Oxytocin

 

Dopamine

 

 

 

 

 

 

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

 

 

 

 

 

 

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.

 

 

 

 

 

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

 

..... Trichotillomania

 

.....

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

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

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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.

 

 

 

 

 

 

Risk factors for school violence include which of the following? Select all that apply.

 

Bullying

 

Being bullied

 

Isolation......

 

Involvement in school organizations.

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

.....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

 

 

 

 

 

 

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.

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

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

 

 

 

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

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

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

 

 

 

 

 

 

The treatment of choice for patients with paranoid personality disorder includes which of the following?

 

Group therapy

 

Behavioral therapy

 

Psychotherapy

 

B and C

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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.

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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.

 

 

 

 

 

 

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

 

 

 

 

 

 

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.

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

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

 

 

 

 

 

 

Which of the following initials would a psychiatric-mental health nurse practitioner use to designate appropriate credentials?

 

ANP-C

 

CPNP

 

CPNP-AC

 

PMHNP-BC

 

 

 

 

 

 

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

 

 

 

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

 

 

 

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

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Grantham University Second World War Questions DISCUSSION 1: Frankl argues, based on his experience of the concentration camp, that camp inmates could choose to keep their “spiritual freed …