NR607 Exam 2 Actual Exam Style V3 | NR
607 Diagnosis & Management in
Psychiatric-Mental Health III Practicum |
Chamberlain
1. A 72-year-old female presents with acute onset of fluctuating consciousness, inattention,
and visual hallucinations over the last 48 hours. Her family notes she was fine three days ago.
Which of the following is the most likely diagnosis?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Lewy Body Dementia
D. Delirium
Correct Answer: D
Expert Explanation: Delirium is characterized by an acute onset and a fluctuating course
of symptoms. In contrast, dementias typically involve a slow, progressive decline in
cognitive function over years. The presence of visual hallucinations and inattention in an
elderly patient with rapid onset strongly points toward delirium, often caused by an
underlying medical condition.
2. When prescribing Clozapine (Clozaril), the PMHNP must monitor the Absolute Neutrophil
Count (ANC). What ANC level requires immediate discontinuation of the medication?
A. Less than 2000/mm3
,B. Less than 1500/mm3
C. Less than 1000/mm3
D. Less than 500/mm3
Correct Answer: C
Expert Explanation: According to the FDA Clozapine REMS program, an ANC less than
1000/mm3 is categorized as severe neutropenia. This level necessitates the immediate
cessation of Clozapine to prevent life-threatening infections. Monitoring ensures that the
potential for agranulocytosis is managed safely through frequent blood draws.
3. A patient with a history of chronic alcohol use presents with ataxia, ophthalmoplegia, and
confusion. The PMHNP suspects Wernicke’s Encephalopathy. What is the immediate
treatment priority?
A. Intravenous Thiamine
B. Intravenous Glucose
C. Oral Multivitamin
D. Lorazepam (Ativan)
Correct Answer: A
Expert Explanation: Wernicke’s Encephalopathy is a medical emergency caused by
thiamine (vitamin B1) deficiency. It is critical to administer thiamine before or
, concurrently with glucose to avoid worsening the neurological symptoms. Failure to treat
this condition promptly can lead to permanent brain damage or death.
4. In Dialectical Behavior Therapy (DBT), which module is specifically designed to help
patients tolerate painful emotions without acting on them impulsively?
A. Distress Tolerance
B. Interpersonal Effectiveness
C. Mindfulness
D. Emotion Regulation
Correct Answer: A
Expert Explanation: Distress tolerance focuses on developing skills to survive crises
without making the situation worse. It teaches patients how to accept reality as it is when
they cannot immediately change it. This module is a core component of DBT, particularly
for individuals with Borderline Personality Disorder.
5. A 25-year-old male exhibits a pervasive pattern of disregard for and violation of the rights
of others, occurring since age 15. He shows a lack of remorse after hurting others. Which
diagnosis is most appropriate?
A. Borderline Personality Disorder
B. Antisocial Personality Disorder
C. Narcissistic Personality Disorder
607 Diagnosis & Management in
Psychiatric-Mental Health III Practicum |
Chamberlain
1. A 72-year-old female presents with acute onset of fluctuating consciousness, inattention,
and visual hallucinations over the last 48 hours. Her family notes she was fine three days ago.
Which of the following is the most likely diagnosis?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Lewy Body Dementia
D. Delirium
Correct Answer: D
Expert Explanation: Delirium is characterized by an acute onset and a fluctuating course
of symptoms. In contrast, dementias typically involve a slow, progressive decline in
cognitive function over years. The presence of visual hallucinations and inattention in an
elderly patient with rapid onset strongly points toward delirium, often caused by an
underlying medical condition.
2. When prescribing Clozapine (Clozaril), the PMHNP must monitor the Absolute Neutrophil
Count (ANC). What ANC level requires immediate discontinuation of the medication?
A. Less than 2000/mm3
,B. Less than 1500/mm3
C. Less than 1000/mm3
D. Less than 500/mm3
Correct Answer: C
Expert Explanation: According to the FDA Clozapine REMS program, an ANC less than
1000/mm3 is categorized as severe neutropenia. This level necessitates the immediate
cessation of Clozapine to prevent life-threatening infections. Monitoring ensures that the
potential for agranulocytosis is managed safely through frequent blood draws.
3. A patient with a history of chronic alcohol use presents with ataxia, ophthalmoplegia, and
confusion. The PMHNP suspects Wernicke’s Encephalopathy. What is the immediate
treatment priority?
A. Intravenous Thiamine
B. Intravenous Glucose
C. Oral Multivitamin
D. Lorazepam (Ativan)
Correct Answer: A
Expert Explanation: Wernicke’s Encephalopathy is a medical emergency caused by
thiamine (vitamin B1) deficiency. It is critical to administer thiamine before or
, concurrently with glucose to avoid worsening the neurological symptoms. Failure to treat
this condition promptly can lead to permanent brain damage or death.
4. In Dialectical Behavior Therapy (DBT), which module is specifically designed to help
patients tolerate painful emotions without acting on them impulsively?
A. Distress Tolerance
B. Interpersonal Effectiveness
C. Mindfulness
D. Emotion Regulation
Correct Answer: A
Expert Explanation: Distress tolerance focuses on developing skills to survive crises
without making the situation worse. It teaches patients how to accept reality as it is when
they cannot immediately change it. This module is a core component of DBT, particularly
for individuals with Borderline Personality Disorder.
5. A 25-year-old male exhibits a pervasive pattern of disregard for and violation of the rights
of others, occurring since age 15. He shows a lack of remorse after hurting others. Which
diagnosis is most appropriate?
A. Borderline Personality Disorder
B. Antisocial Personality Disorder
C. Narcissistic Personality Disorder
