NR 668 CEA Final
A 10-yr-vintage boy is referred with the aid of the faculty nurse because of persistent
stomachache every morning in school. In evaluating the boy, the PMHNP learned that he
does not like to move to highschool and insists on coming domestic right now, and that he
sleeps in his determine's mattress at night. His scientific description is maximum
characteristic of which of the subsequent conditions?
A. Separation tension
b. Social phobia
c. PTSD
d. Reactive attachment disease - ANS-a. Separation tension
A 10-yr-old girl is referred for evaluation of behavioral difficulties. Her teachers record that
she is easily distracted and fails to finish any elegance paintings, and regularly stares off into
space or tries to chat with her neighbor. Her mother reports that mornings are the maximum
difficult because of her general disorganization and forgetfulness. Otherwise she is socially
engaged and enjoys many activities. Which of the following is the maximum likely diagnosis?
A. Disruptive behavior
b. Conduct disorder
c. Attention deficit disease
d. Oppositional defiant disorder - ANS-c. Attention deficit sickness
A 15-year-vintage boy has refused to head to school for the beyond month. Every morning
he has a new symptom or develops one and has to be picked up from faculty. When he is
domestic, the signs and symptoms disappear. On weekends the signs and symptoms in no
way gift. What is the most possibly analysis?
A. Panic disease
b. Social anxiety
c. Separation tension
d. Agoraphobia - ANS-c. Separation anxiety
A 16 year antique patron Jamie affords on your workplace and starts offevolved with "I might
be transgender". You reply, My name is James, and my pronouns are he/him. How do you
Jamie, describe your gender identity? What are your selected pronouns? Jamie answers,
"My pronouns are "They". As a PMHNP you understand that Jamie...
A. Identifies as cisgender
b. Identifies as none of these
c. Identifies as gender binary
d. Identifies as non-binary - ANS-d. Identifies as non-binary
Some people do no longer identify with a specific gender. Persons whose gender isn't
always female or male may additionally use numerous phrases to describe themselves
including "non-binary" as one in all them.
A 16-yr-vintage boy is being evaluated for emotional lability, hypervigilance, issue dozing,
and irritability. During the interview he reports that his first sexual stumble upon became
,along with his teacher 1 yr in the past and he continues to have sex with her sometimes. He
states that his courting is consensual. What must the PMHNP do with this data?
A. Screen for neurosyphilis
b. Instruct the boy within the proper use of condoms
c. Prescribe a selective serotonin reuptake inhibitor (SSRI) for posttraumatic stress disorder
(PTSD)
d. Report the incident to toddler protective services - ANS-d. Report the incident to infant
shielding offerings
A 16-yr-old boy with a records of substance use sickness reviews fatigue, apathy, and
anhedonia almost each day and his mom reviews increasing irritability and raging behavior.
The boy says he smokes marijuana daily simply to experience exact and is unwilling to give
it up. The mother wants some kind of medication to assist him sense higher so that he stops
smoking marijuana. The PMHNP consents to prescribe fluoxetine 20 mg day by day. What is
the maximum common aspect effect related to this medication?
A. Weight grain
b. Sedation
c. Nausea
d. Hypotension - ANS-c. Nausea
A 16-yr-old girl and not using a beyond medical records became referred through her
number one care company who noticed her for a sports activities physical because she
stated she became depressed. During the interview the woman found out that she has been
feeling worn-out, unhappy, is crying effortlessly, and has issue falling asleep. She reviews
that she has additionally been consuming a lot extra and to hold from gaining weight she has
been taking laxatives and sometimes makes herself vomit. She has dropped out of the
yearbook committee and she or he isn't always sure she wants to go to university anymore.
Which nonpharmacologic intervention is most appropriate?
A. Psychoanalysis
b. Group remedy
c. Cognitive behavioral remedy
d. Family remedy - ANS-c. Cognitive behavioral therapy
A sixteen-yr-antique male is being evaluated in a partial sanatorium software for teenagers
for principal depressive ailment. In addressing safety making plans with the boy and his
parents, they raised the query of feasible suicidality with using selective serotonin reuptake
inhibitors (SSRIs). What query should the PMHNP ask concerning the maximum
commonplace method of suicide and early life?
A. Can all of the knives be secured?
B. Are there firearms inside the domestic?
C. Does the house include ligature dangers?
D. Is the medicine cabinet locked? - ANS-b. Are there firearms within the home?
A sixteen-year-old male with a records of smoking cigarettes and marijuana is being
evaluated on the request of the school and mother and father. The child states that the
purpose he smokes is it "helps calm me down" as he is hectic all the time. Which of the
subsequent medications would be the exceptional choice?
A. Citalopram 5mg dailly
,b. Vortioxetine 20mg day by day
c. Fluoxetine 20mg day by day
d. Clonazepam zero.5mg day by day - ANS-c. Fluoxetine 20mg day by day
A 17-yr-vintage woman with fundamental depressive disorder single episode and bulimia
nervosa is not able to actively participate in psychotherapy due to the fact she says she feels
too sleepy in the course of the day because she is not able to sleep at night time. In addition,
she is inattentive, irritable, reveals it hard to pay attention, and has no preference to do some
thing. Which pharmacological agent is desired for monotherapy?
A. Selective serotonin reuptake inhibitor
b. Atypical antipsychotic
c. Mood stabilizer
d. Tricyclic antidepressant - ANS-a. Selective serotonin reuptake inhibitor
A 19-year-old lady is being visible at a disaster pregnancy middle for an unplanned being
pregnant. She feels compelled by way of her boyfriend to get an abortion, but it is going in
opposition to her deeply held religious ideals. Which of the subsequent reduces her hazard
of being the sufferer of domestic violence?
A. Financial independence
b. Fear of isolation
c. Poor social support
d. Pregnancy - ANS-a. Financial independence
A 19-year-old male is attending his submit health center discharge appointment where he
changed into diagnosed with psychosis. He has been taking risperidone 4 mg by means of
mouth twice every day. Which of the subsequent is the pinnacle precedence at some point of
this first encounter with the PMHNP?
A. Establish a therapeutic alliance
b. Baseline EKG, weight, hemoglobin A1c
c. Administer a long-appearing injectable
d. Draw a prolactin degree - ANS-a. Establish a healing alliance
A 19-year-antique male is mentioned the PMHNP by means of the pupil health workplace for
alcohol use ailment. The patient states that on one event he handed out a lot sooner than he
generally might with a long way much less than he could normally drink. Upon further
interview, the affected person famous the time he surpassed out became in the course of a
fraternity hazing in which he was butt-chugging (receiving a lager and vodka enema). What
pharmacokinetic process turned into bypassed with the aid of this rectal administration
course?
A. Distribution
b. Absorption
c. Excretion
d. First-pass impact - ANS-d. First-skip impact
A 21-yr-vintage man had his first drink at his celebration with friends final night. He supplied
the subsequent morning to the emergency branch with psychomotor agitation, cognitive
impairment, depressed mood, flat have an effect on, and anhedonia. His heart charge is 110,
his blood stress is 90/60, and he complains of belly pain. He received 2 L of normal saline IV
, and is mentioned psychiatry for evaluation of mood disorder. Which of the following checks
should the consulting PMHNP order given those symptoms?
A. Urinary porphobilinogen
b. Acetaminophen level
c. Urinalysis
d. Blood alcohol stage - ANS-a. Urinary porphobilinogen
A 22-year-old male has been referred with the aid of the employee assistance application at
his activity for negative work performance. The affected person reviews that regardless of
how much coffee he drinks he stays sleepy for the duration of the day and could nod off at
conferences. He notes that he's going to regularly unsleeping when his head hits the lower
back of his chair whilst at a assembly. On occasion he has dropped his cup of espresso in
front of everybody and now he feels he's below regular scrutiny and thinks humans are
speculating he is the use of pills. What is the maximum probable diagnosis?
A. Narcolepsy
b. Hypnagogic hallucinations
c. Hypnopompic hallucinations
d. Primary hypersomnia - ANS-a. Narcolepsy
A 22-year-vintage man is stated the psychiatric emergency branch for suicidal ideation.
Upon interview the patient states that he isn't seeking to kill himself, and he virtually can fly if
most effective people might allow him. The affected person is emphatic that he isn't manic
because he is "the first-rate sleeper inside the international." The affected person has a vivid
reactive affect and is forced at times. Which of the subsequent first-class describes his
situation?
A. Hallucinations
b. Erotomaniac delusions
c. Grandiose delusions
d. Persecutory delusions - ANS-c. Grandiose delusions
A 24-month-old girl is referred to psychiatry for an expressive language disease. The mother
reports that the child has not but spoken a clean word, unevenly follows commands, and
does not play with her older brother of four years. In addition, the mom reviews that the kid
has started making repetitive motions together with her fingers and appears to be clumsy
with growing issue strolling. These medical findings are suggestive of a pervasive
developmental disease, most likely:
a. Cerebral palsy
b. Autism spectrum disease
c. Intellectual incapacity
d. Rett syndrome - ANS-d. Rett syndrome
A 25 12 months antique male stated a surprising choking sensation at work which brought
about a few issue breathing. He felt dizzy, sweaty, sick to his belly and could not swallow. He
had a fear at first that he was demise. He attributed his signs to an undiagnosed infection or
a recent infection that he wasn't over. He in no way sought medical remedy. He struggled for
the next three weeks out of situation these symptoms may come returned. The signs
recurred 4 weeks later, at the same time as sitting alone in his automobile after leaving a
supermarket. He drove to the nearest emergency room and no on the spot reason was
A 10-yr-vintage boy is referred with the aid of the faculty nurse because of persistent
stomachache every morning in school. In evaluating the boy, the PMHNP learned that he
does not like to move to highschool and insists on coming domestic right now, and that he
sleeps in his determine's mattress at night. His scientific description is maximum
characteristic of which of the subsequent conditions?
A. Separation tension
b. Social phobia
c. PTSD
d. Reactive attachment disease - ANS-a. Separation tension
A 10-yr-old girl is referred for evaluation of behavioral difficulties. Her teachers record that
she is easily distracted and fails to finish any elegance paintings, and regularly stares off into
space or tries to chat with her neighbor. Her mother reports that mornings are the maximum
difficult because of her general disorganization and forgetfulness. Otherwise she is socially
engaged and enjoys many activities. Which of the following is the maximum likely diagnosis?
A. Disruptive behavior
b. Conduct disorder
c. Attention deficit disease
d. Oppositional defiant disorder - ANS-c. Attention deficit sickness
A 15-year-vintage boy has refused to head to school for the beyond month. Every morning
he has a new symptom or develops one and has to be picked up from faculty. When he is
domestic, the signs and symptoms disappear. On weekends the signs and symptoms in no
way gift. What is the most possibly analysis?
A. Panic disease
b. Social anxiety
c. Separation tension
d. Agoraphobia - ANS-c. Separation anxiety
A 16 year antique patron Jamie affords on your workplace and starts offevolved with "I might
be transgender". You reply, My name is James, and my pronouns are he/him. How do you
Jamie, describe your gender identity? What are your selected pronouns? Jamie answers,
"My pronouns are "They". As a PMHNP you understand that Jamie...
A. Identifies as cisgender
b. Identifies as none of these
c. Identifies as gender binary
d. Identifies as non-binary - ANS-d. Identifies as non-binary
Some people do no longer identify with a specific gender. Persons whose gender isn't
always female or male may additionally use numerous phrases to describe themselves
including "non-binary" as one in all them.
A 16-yr-vintage boy is being evaluated for emotional lability, hypervigilance, issue dozing,
and irritability. During the interview he reports that his first sexual stumble upon became
,along with his teacher 1 yr in the past and he continues to have sex with her sometimes. He
states that his courting is consensual. What must the PMHNP do with this data?
A. Screen for neurosyphilis
b. Instruct the boy within the proper use of condoms
c. Prescribe a selective serotonin reuptake inhibitor (SSRI) for posttraumatic stress disorder
(PTSD)
d. Report the incident to toddler protective services - ANS-d. Report the incident to infant
shielding offerings
A 16-yr-old boy with a records of substance use sickness reviews fatigue, apathy, and
anhedonia almost each day and his mom reviews increasing irritability and raging behavior.
The boy says he smokes marijuana daily simply to experience exact and is unwilling to give
it up. The mother wants some kind of medication to assist him sense higher so that he stops
smoking marijuana. The PMHNP consents to prescribe fluoxetine 20 mg day by day. What is
the maximum common aspect effect related to this medication?
A. Weight grain
b. Sedation
c. Nausea
d. Hypotension - ANS-c. Nausea
A 16-yr-old girl and not using a beyond medical records became referred through her
number one care company who noticed her for a sports activities physical because she
stated she became depressed. During the interview the woman found out that she has been
feeling worn-out, unhappy, is crying effortlessly, and has issue falling asleep. She reviews
that she has additionally been consuming a lot extra and to hold from gaining weight she has
been taking laxatives and sometimes makes herself vomit. She has dropped out of the
yearbook committee and she or he isn't always sure she wants to go to university anymore.
Which nonpharmacologic intervention is most appropriate?
A. Psychoanalysis
b. Group remedy
c. Cognitive behavioral remedy
d. Family remedy - ANS-c. Cognitive behavioral therapy
A sixteen-yr-antique male is being evaluated in a partial sanatorium software for teenagers
for principal depressive ailment. In addressing safety making plans with the boy and his
parents, they raised the query of feasible suicidality with using selective serotonin reuptake
inhibitors (SSRIs). What query should the PMHNP ask concerning the maximum
commonplace method of suicide and early life?
A. Can all of the knives be secured?
B. Are there firearms inside the domestic?
C. Does the house include ligature dangers?
D. Is the medicine cabinet locked? - ANS-b. Are there firearms within the home?
A sixteen-year-old male with a records of smoking cigarettes and marijuana is being
evaluated on the request of the school and mother and father. The child states that the
purpose he smokes is it "helps calm me down" as he is hectic all the time. Which of the
subsequent medications would be the exceptional choice?
A. Citalopram 5mg dailly
,b. Vortioxetine 20mg day by day
c. Fluoxetine 20mg day by day
d. Clonazepam zero.5mg day by day - ANS-c. Fluoxetine 20mg day by day
A 17-yr-vintage woman with fundamental depressive disorder single episode and bulimia
nervosa is not able to actively participate in psychotherapy due to the fact she says she feels
too sleepy in the course of the day because she is not able to sleep at night time. In addition,
she is inattentive, irritable, reveals it hard to pay attention, and has no preference to do some
thing. Which pharmacological agent is desired for monotherapy?
A. Selective serotonin reuptake inhibitor
b. Atypical antipsychotic
c. Mood stabilizer
d. Tricyclic antidepressant - ANS-a. Selective serotonin reuptake inhibitor
A 19-year-old lady is being visible at a disaster pregnancy middle for an unplanned being
pregnant. She feels compelled by way of her boyfriend to get an abortion, but it is going in
opposition to her deeply held religious ideals. Which of the subsequent reduces her hazard
of being the sufferer of domestic violence?
A. Financial independence
b. Fear of isolation
c. Poor social support
d. Pregnancy - ANS-a. Financial independence
A 19-year-old male is attending his submit health center discharge appointment where he
changed into diagnosed with psychosis. He has been taking risperidone 4 mg by means of
mouth twice every day. Which of the subsequent is the pinnacle precedence at some point of
this first encounter with the PMHNP?
A. Establish a therapeutic alliance
b. Baseline EKG, weight, hemoglobin A1c
c. Administer a long-appearing injectable
d. Draw a prolactin degree - ANS-a. Establish a healing alliance
A 19-year-antique male is mentioned the PMHNP by means of the pupil health workplace for
alcohol use ailment. The patient states that on one event he handed out a lot sooner than he
generally might with a long way much less than he could normally drink. Upon further
interview, the affected person famous the time he surpassed out became in the course of a
fraternity hazing in which he was butt-chugging (receiving a lager and vodka enema). What
pharmacokinetic process turned into bypassed with the aid of this rectal administration
course?
A. Distribution
b. Absorption
c. Excretion
d. First-pass impact - ANS-d. First-skip impact
A 21-yr-vintage man had his first drink at his celebration with friends final night. He supplied
the subsequent morning to the emergency branch with psychomotor agitation, cognitive
impairment, depressed mood, flat have an effect on, and anhedonia. His heart charge is 110,
his blood stress is 90/60, and he complains of belly pain. He received 2 L of normal saline IV
, and is mentioned psychiatry for evaluation of mood disorder. Which of the following checks
should the consulting PMHNP order given those symptoms?
A. Urinary porphobilinogen
b. Acetaminophen level
c. Urinalysis
d. Blood alcohol stage - ANS-a. Urinary porphobilinogen
A 22-year-old male has been referred with the aid of the employee assistance application at
his activity for negative work performance. The affected person reviews that regardless of
how much coffee he drinks he stays sleepy for the duration of the day and could nod off at
conferences. He notes that he's going to regularly unsleeping when his head hits the lower
back of his chair whilst at a assembly. On occasion he has dropped his cup of espresso in
front of everybody and now he feels he's below regular scrutiny and thinks humans are
speculating he is the use of pills. What is the maximum probable diagnosis?
A. Narcolepsy
b. Hypnagogic hallucinations
c. Hypnopompic hallucinations
d. Primary hypersomnia - ANS-a. Narcolepsy
A 22-year-vintage man is stated the psychiatric emergency branch for suicidal ideation.
Upon interview the patient states that he isn't seeking to kill himself, and he virtually can fly if
most effective people might allow him. The affected person is emphatic that he isn't manic
because he is "the first-rate sleeper inside the international." The affected person has a vivid
reactive affect and is forced at times. Which of the subsequent first-class describes his
situation?
A. Hallucinations
b. Erotomaniac delusions
c. Grandiose delusions
d. Persecutory delusions - ANS-c. Grandiose delusions
A 24-month-old girl is referred to psychiatry for an expressive language disease. The mother
reports that the child has not but spoken a clean word, unevenly follows commands, and
does not play with her older brother of four years. In addition, the mom reviews that the kid
has started making repetitive motions together with her fingers and appears to be clumsy
with growing issue strolling. These medical findings are suggestive of a pervasive
developmental disease, most likely:
a. Cerebral palsy
b. Autism spectrum disease
c. Intellectual incapacity
d. Rett syndrome - ANS-d. Rett syndrome
A 25 12 months antique male stated a surprising choking sensation at work which brought
about a few issue breathing. He felt dizzy, sweaty, sick to his belly and could not swallow. He
had a fear at first that he was demise. He attributed his signs to an undiagnosed infection or
a recent infection that he wasn't over. He in no way sought medical remedy. He struggled for
the next three weeks out of situation these symptoms may come returned. The signs
recurred 4 weeks later, at the same time as sitting alone in his automobile after leaving a
supermarket. He drove to the nearest emergency room and no on the spot reason was
