6670 FINAL EXAM
QUESTION 1
1. Collette is a 23-year-old female who presented for emergency care with her mother
because her behavior has become increasingly erratic and caused her to lose her job. Her
mother reports that she had never done anything like this in the past, but about 3 months
ago, her boyfriend of 3 years broke up with her, and Collette began to express unrealistic
beliefs that her boyfriend wanted to drive her crazy and hurt her. A gentleman trying to hail
a taxi accidentally bumped into her this morning, and she started screaming that her ex-
boyfriend had hired the man to throw her into the street under a car. Collette is on a 2-week
suspension from her job as a restaurant server because she was combative to a customer—
she accused him of colluding with her ex-boyfriend to get her fired. After this morning’s
incident, her mother was so worried she brought her to the emergency room. Her
appearance is disheveled, she is clearly hyperalert and is crying that her boyfriend must
have converted her mother to work against her. Head imaging, screening lab, and a
toxicology screen are negative. A leading differential for Collette is:
Bipolar disorder
Acute psychotic episode
Schizophreniform disorder
Post-traumatic stress disorder
1 points
QUESTION 2
1. Jake and Laurie are a young married couple who have been referred to mental health
counseling because Jake is having disturbing sleep events. Laurie reports that on more than
one occasion she has awakened to find Jake having what appears to be a panic attack, but
he doesn’t seem to realize it. When he finally wakes up, he is confused and doesn’t really
understand what happened, although he does have a sense of intense fear. This has
happened twice in the last 2 weeks, and the last time Laurie heard him screaming. Jake is
now a bit afraid to go to sleep and as a result does not feel well the next day. The PMHNP
recognizes that sleep terrors in adults:
Are often associated with trauma or
psychiatric problems
Represent a disorder of REM sleep
QUESTION 1
1. Collette is a 23-year-old female who presented for emergency care with her mother
because her behavior has become increasingly erratic and caused her to lose her job. Her
mother reports that she had never done anything like this in the past, but about 3 months
ago, her boyfriend of 3 years broke up with her, and Collette began to express unrealistic
beliefs that her boyfriend wanted to drive her crazy and hurt her. A gentleman trying to hail
a taxi accidentally bumped into her this morning, and she started screaming that her ex-
boyfriend had hired the man to throw her into the street under a car. Collette is on a 2-week
suspension from her job as a restaurant server because she was combative to a customer—
she accused him of colluding with her ex-boyfriend to get her fired. After this morning’s
incident, her mother was so worried she brought her to the emergency room. Her
appearance is disheveled, she is clearly hyperalert and is crying that her boyfriend must
have converted her mother to work against her. Head imaging, screening lab, and a
toxicology screen are negative. A leading differential for Collette is:
Bipolar disorder
Acute psychotic episode
Schizophreniform disorder
Post-traumatic stress disorder
1 points
QUESTION 2
1. Jake and Laurie are a young married couple who have been referred to mental health
counseling because Jake is having disturbing sleep events. Laurie reports that on more than
one occasion she has awakened to find Jake having what appears to be a panic attack, but
he doesn’t seem to realize it. When he finally wakes up, he is confused and doesn’t really
understand what happened, although he does have a sense of intense fear. This has
happened twice in the last 2 weeks, and the last time Laurie heard him screaming. Jake is
now a bit afraid to go to sleep and as a result does not feel well the next day. The PMHNP
recognizes that sleep terrors in adults:
Are often associated with trauma or
psychiatric problems
Represent a disorder of REM sleep
