NURS 6670 MIDTERM EXAM QUESTIONS WITH
CORRECT ANSWERS HIGHLIGHED LATEST
EXAM UPDATE
Question 11 i
Mr. iKendall iis ia i47-year iold imale iwho iis ipresented ito icare iby ihis iyounger isister, iMegan. iMr. iKendall ihas ispent ihis
ientire iadult ilife iliving iin ian iapartment ithat iwas iattached ito ihis iparents’ ihome. iHis imother idied ia ifew iweeks iago,
iand ithe iproperty iis ilisted ifor isale. iMr. iKendall iwill ihave ito imove, iand iwhile idiscussing ithis iwith ihim, iMegan
ibecame ivery iconcerned. iHe ihas iapparently ibeen iconsidered iodd iall ihis ilife, ihas inever imarried ior ieven idated ias ifar
ias iMegan iknows, ibut ishe ihad ino iidea ihow iodd ihe iwas. iWhen ihis imother idied, ihe iseemed idisconnected ifrom
ireality iand ihad episodes iof italking ito ipeople iwho iweren’t ipresent. iMegan isays ithat isometimes ishe idoes inot ieven
iunderstand iwhat ihe iis italking iabout. iHe iseems ito ithink ihe ihas ipsychic ipowers, iand ithat ihe idoesn’t ineed ito imove
ibecause ihe iknows ithe ihouse iwill inot ibe isold. iWhen iconsidering ia idiagnosis iof ischizotypal idisorder, ithe iPMHNP
iexpects iwhich iof ithe
A ihistory iof ischizophrenia iof ia ifirst-degree irelative
Sustained ipsychosis ipredating ihis imother’s ideath
Comorbid iAsperger’s isyndrome
Apparent ifrank ithought idisorder
Question 12 i
i Which iof ithe ifollowing iis ia itrue istatement iwith irespect ito ithe itreatment iof inarcissistic ipersonalitydisorder? i
Psychoanalytic ipsychotherapy ihas istrong iempiric isupport
Both iserotonergic idrugs iand ilithium iare iuseful
Group itherapy iis irarely ihelpful
1
, Immobilized ipatients i(hospitalized ior iincarcerated) ihave ithe ibest
i outcomes
Question 13 i
While ipreparing ia iclass ion ipersonality idisorders ifor ia iclass iof iPMHNP istudents, ithe iinstructor iis ipresenting icase
istudies iof ipatients iwith icluster iA ipersonalities. iOne iof ithese icases iis iClark iM., ia i41-year-old iman iwho iis idescribed
ias ia ilife-long i―loner.‖ iIn ihigh ischool iand icollege, ihe ikept ito ihimself, iexcelling iin ihis istudies iin ithe isciences.
Currently idescribed ias ia ibrilliant icomputer iprogrammer, ihe iclearly iprefers isolitary ipursuits iand ithe icompany iof
ihis icat iover ipeople. iHe iknows ihe iis isocially iisolated, ibut ihe iis ijust imore icomfortable ithis iway. iThis idescription iis
Schizoid ipersonality idisorder
Schizotypal ipersonality idisorder
Paranoid ipersonality idisorder
Delusional idisorder
Question 14 i
Darius iis ia i26-year-old imale iwho ipresents ifor icare ias ipart iof icouple itherapy iwith ihis iwife, iwho iis ibeing iseen ifor
idependency iissues. iDarius ihimself iseems ivery ianxious ito i―do ithe iright ithing‖ iand iappears ito iwant ito iplease ithe
therapist. iDuring ithe ievaluation, iDarius iis iimpeccably idressed, ivery iformal iin ihis ipresentation iand iinteraction, iand
iis iwatchful iof itime ibecause ihe ihas ian iappointment iafter ithe iinterview iand istates iseveral itimes ithat ihe icannot ibe ilate.
The iPMHNP iconsiders ithat iDarius imay ihave iobsessive icompulsive ipersonality idisorder i(OCPD). iIn idifferentiating
ithis ifrom iobsessive icompulsive idisorder i(OCD), ishe iexplores ihis ihistory ifurther ifor:
A ihistory iof iracing ithoughts
Difficulty iinteracting iwith iothers
Extremely ihigh iexpectations iof iself
Significant iimpairment iat iwork
2
,Question 15 i
Hugo iis ia i39-year-old imale iwho ihas iencouraged ihis iwife ito icome ito icounseling ibecause ihe iis iworried iabout iher
iwine idrinking. iHugo isays ithat ihe iand ihis iwife ihave ishared ia ibottle iof iwine iwith idinner imost inights ifor ithe ilast
icouple iof iyears, ibut iin ithe ilast ifew imonths ihe ihas ibecome iworried ithat ishe idrinks itoo imuch. iThey iboth iagree ithat
ishe inever ireally ibecomes iintoxicated, ibut ihe idoes inot ilike ithe ifact ithat ievening iwine ihas ibecome ithe imost iimportant
ipart iof iher imeal. iIf ihe iwants ito igo iout, ishe iwill ionly igo ito ia iplace ithat ihas ia iwine ishe ilikes. iLast imonth ithey iwent
ion ia iweek-long ivacation, iand ishe iinsisted ion ipacking ienough iof iher iwine ito ilast ithe iwhole itime. iIf ithey igo ito ia
irestaurant ithat idoes inot ihave ia iwine ishe ilikes, ishe iwill itake iher iown iin ia idisposable icoffee icup. iIt iseems ilike ifor ithe
ilast ifew imonths, ishe ihas ibeen idrinking imore iand imore, ioccasionally ifinishing ithe ibottle ialone iwhen ihe idoesn’t
iwant iany. iBoth ipartners iagree ithat ithere iis ino iinterference iwith iwork ior iany iactivities ior iresponsibilities, ibut iit iis
icausing isome itension iin itheir imarriage. iWhen iconsidering ia idiagnosis iof isubstance iuse idisorder, ithe
i Hugo’s iwife imeets idiagnostic icriteria ifor ithis idisorder
A itrial iperiod iwith ino iwine iingestion iis inecessary ito iassess ifor iwithdrawal isymptoms
The ifamily ihistory ishould ibe iassessed ifor igenetic itendency
Hugo imay ihave iunreasonable
i expectations
Question 16 i
When ideveloping ia ipharmacologic itreatment iplan ifor ithe imanagement iof imajor idepressive idisorder, ithe iPMHNP
icounsels ithe ipatient ithat ithe imedication iwill ibe ititrated iup ito ithe iappropriate idose iand ithen icontinued ifor ia
iminimum iof i3 imonths; imedication imust inot ibe istopped iabruptly ior iwithout iprovider isupervision. iThis iis ibecause
ithe iphysiologic iconsequence iof iabrupt icessation iis ilikely ito iresult iin:
Antidepressant idiscontinuation isyndrome
Rebound idepressive isymptoms
A imanic ior ihypomanic iepisode
Unresponsiveness ito imedication iwith ifuture iepisodes
3
, Question 17 i
i Which iof ithe ifollowing iis ia itrue istatement iwith iregard ito ithe ietiology iof isubstanceabuse? i
Neurotransmitters ior ireceptors ihave ibeen iidentified iwith imost isubstances iof iabuse iexcept ifor ialcohol
Twin iand isibling istudies ido inot isupport ia igenetic icomponent iwith irespect ito ithe ietiology iof isubstance iabuse
Substances iof iabuse idecrease iactivity iin ithe iamygdala iand ianterior icingulate
The iWHO ischematic iof idrug iuse iand idependence iidentifies iimmediate iantecedents ias ithe icentral ielement iof
iabuse
Question 18 i
i Assessment iof ithe imanic istate iin ia ipatient iwith ibipolar idisorder iis ilikely ito iinclude iall ithe ifollowingexcept: i
Mood-congruent idelusions iof igrandeur
Suicidal ior ihomicidal iideation
Impaired ijudgment iwith ino iinsight
Unrestrained iflow iof iideas
Question 19 i
When iperforming ia ipsychiatric iassessment iof ian ielderly ipatient iwith iAlzheimer’s idementia, ithe iPMHNP irecognizes
ithat:
An iimportant ipart iof ithe ihistory iwill icome ifrom ithe icaregiver
The ipatient imust ialso ibe iinterviewed ialone ito ipreserve iprivacy iof ithe irelationship
A isexual ihistory iis inot inecessary iin ipatients iwho iare inot isexually iactive
4
CORRECT ANSWERS HIGHLIGHED LATEST
EXAM UPDATE
Question 11 i
Mr. iKendall iis ia i47-year iold imale iwho iis ipresented ito icare iby ihis iyounger isister, iMegan. iMr. iKendall ihas ispent ihis
ientire iadult ilife iliving iin ian iapartment ithat iwas iattached ito ihis iparents’ ihome. iHis imother idied ia ifew iweeks iago,
iand ithe iproperty iis ilisted ifor isale. iMr. iKendall iwill ihave ito imove, iand iwhile idiscussing ithis iwith ihim, iMegan
ibecame ivery iconcerned. iHe ihas iapparently ibeen iconsidered iodd iall ihis ilife, ihas inever imarried ior ieven idated ias ifar
ias iMegan iknows, ibut ishe ihad ino iidea ihow iodd ihe iwas. iWhen ihis imother idied, ihe iseemed idisconnected ifrom
ireality iand ihad episodes iof italking ito ipeople iwho iweren’t ipresent. iMegan isays ithat isometimes ishe idoes inot ieven
iunderstand iwhat ihe iis italking iabout. iHe iseems ito ithink ihe ihas ipsychic ipowers, iand ithat ihe idoesn’t ineed ito imove
ibecause ihe iknows ithe ihouse iwill inot ibe isold. iWhen iconsidering ia idiagnosis iof ischizotypal idisorder, ithe iPMHNP
iexpects iwhich iof ithe
A ihistory iof ischizophrenia iof ia ifirst-degree irelative
Sustained ipsychosis ipredating ihis imother’s ideath
Comorbid iAsperger’s isyndrome
Apparent ifrank ithought idisorder
Question 12 i
i Which iof ithe ifollowing iis ia itrue istatement iwith irespect ito ithe itreatment iof inarcissistic ipersonalitydisorder? i
Psychoanalytic ipsychotherapy ihas istrong iempiric isupport
Both iserotonergic idrugs iand ilithium iare iuseful
Group itherapy iis irarely ihelpful
1
, Immobilized ipatients i(hospitalized ior iincarcerated) ihave ithe ibest
i outcomes
Question 13 i
While ipreparing ia iclass ion ipersonality idisorders ifor ia iclass iof iPMHNP istudents, ithe iinstructor iis ipresenting icase
istudies iof ipatients iwith icluster iA ipersonalities. iOne iof ithese icases iis iClark iM., ia i41-year-old iman iwho iis idescribed
ias ia ilife-long i―loner.‖ iIn ihigh ischool iand icollege, ihe ikept ito ihimself, iexcelling iin ihis istudies iin ithe isciences.
Currently idescribed ias ia ibrilliant icomputer iprogrammer, ihe iclearly iprefers isolitary ipursuits iand ithe icompany iof
ihis icat iover ipeople. iHe iknows ihe iis isocially iisolated, ibut ihe iis ijust imore icomfortable ithis iway. iThis idescription iis
Schizoid ipersonality idisorder
Schizotypal ipersonality idisorder
Paranoid ipersonality idisorder
Delusional idisorder
Question 14 i
Darius iis ia i26-year-old imale iwho ipresents ifor icare ias ipart iof icouple itherapy iwith ihis iwife, iwho iis ibeing iseen ifor
idependency iissues. iDarius ihimself iseems ivery ianxious ito i―do ithe iright ithing‖ iand iappears ito iwant ito iplease ithe
therapist. iDuring ithe ievaluation, iDarius iis iimpeccably idressed, ivery iformal iin ihis ipresentation iand iinteraction, iand
iis iwatchful iof itime ibecause ihe ihas ian iappointment iafter ithe iinterview iand istates iseveral itimes ithat ihe icannot ibe ilate.
The iPMHNP iconsiders ithat iDarius imay ihave iobsessive icompulsive ipersonality idisorder i(OCPD). iIn idifferentiating
ithis ifrom iobsessive icompulsive idisorder i(OCD), ishe iexplores ihis ihistory ifurther ifor:
A ihistory iof iracing ithoughts
Difficulty iinteracting iwith iothers
Extremely ihigh iexpectations iof iself
Significant iimpairment iat iwork
2
,Question 15 i
Hugo iis ia i39-year-old imale iwho ihas iencouraged ihis iwife ito icome ito icounseling ibecause ihe iis iworried iabout iher
iwine idrinking. iHugo isays ithat ihe iand ihis iwife ihave ishared ia ibottle iof iwine iwith idinner imost inights ifor ithe ilast
icouple iof iyears, ibut iin ithe ilast ifew imonths ihe ihas ibecome iworried ithat ishe idrinks itoo imuch. iThey iboth iagree ithat
ishe inever ireally ibecomes iintoxicated, ibut ihe idoes inot ilike ithe ifact ithat ievening iwine ihas ibecome ithe imost iimportant
ipart iof iher imeal. iIf ihe iwants ito igo iout, ishe iwill ionly igo ito ia iplace ithat ihas ia iwine ishe ilikes. iLast imonth ithey iwent
ion ia iweek-long ivacation, iand ishe iinsisted ion ipacking ienough iof iher iwine ito ilast ithe iwhole itime. iIf ithey igo ito ia
irestaurant ithat idoes inot ihave ia iwine ishe ilikes, ishe iwill itake iher iown iin ia idisposable icoffee icup. iIt iseems ilike ifor ithe
ilast ifew imonths, ishe ihas ibeen idrinking imore iand imore, ioccasionally ifinishing ithe ibottle ialone iwhen ihe idoesn’t
iwant iany. iBoth ipartners iagree ithat ithere iis ino iinterference iwith iwork ior iany iactivities ior iresponsibilities, ibut iit iis
icausing isome itension iin itheir imarriage. iWhen iconsidering ia idiagnosis iof isubstance iuse idisorder, ithe
i Hugo’s iwife imeets idiagnostic icriteria ifor ithis idisorder
A itrial iperiod iwith ino iwine iingestion iis inecessary ito iassess ifor iwithdrawal isymptoms
The ifamily ihistory ishould ibe iassessed ifor igenetic itendency
Hugo imay ihave iunreasonable
i expectations
Question 16 i
When ideveloping ia ipharmacologic itreatment iplan ifor ithe imanagement iof imajor idepressive idisorder, ithe iPMHNP
icounsels ithe ipatient ithat ithe imedication iwill ibe ititrated iup ito ithe iappropriate idose iand ithen icontinued ifor ia
iminimum iof i3 imonths; imedication imust inot ibe istopped iabruptly ior iwithout iprovider isupervision. iThis iis ibecause
ithe iphysiologic iconsequence iof iabrupt icessation iis ilikely ito iresult iin:
Antidepressant idiscontinuation isyndrome
Rebound idepressive isymptoms
A imanic ior ihypomanic iepisode
Unresponsiveness ito imedication iwith ifuture iepisodes
3
, Question 17 i
i Which iof ithe ifollowing iis ia itrue istatement iwith iregard ito ithe ietiology iof isubstanceabuse? i
Neurotransmitters ior ireceptors ihave ibeen iidentified iwith imost isubstances iof iabuse iexcept ifor ialcohol
Twin iand isibling istudies ido inot isupport ia igenetic icomponent iwith irespect ito ithe ietiology iof isubstance iabuse
Substances iof iabuse idecrease iactivity iin ithe iamygdala iand ianterior icingulate
The iWHO ischematic iof idrug iuse iand idependence iidentifies iimmediate iantecedents ias ithe icentral ielement iof
iabuse
Question 18 i
i Assessment iof ithe imanic istate iin ia ipatient iwith ibipolar idisorder iis ilikely ito iinclude iall ithe ifollowingexcept: i
Mood-congruent idelusions iof igrandeur
Suicidal ior ihomicidal iideation
Impaired ijudgment iwith ino iinsight
Unrestrained iflow iof iideas
Question 19 i
When iperforming ia ipsychiatric iassessment iof ian ielderly ipatient iwith iAlzheimer’s idementia, ithe iPMHNP irecognizes
ithat:
An iimportant ipart iof ithe ihistory iwill icome ifrom ithe icaregiver
The ipatient imust ialso ibe iinterviewed ialone ito ipreserve iprivacy iof ithe irelationship
A isexual ihistory iis inot inecessary iin ipatients iwho iare inot isexually iactive
4
