NURS 6640 MIDTERM EXAM 5 – QUESTION AND ANSWERS

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NURS 6640 MIDTERM EXAM 5 – QUESTION AND
ANSWERS
QUESTION 1
1. The PMHNP understands that anxiety and depression are two disorders in
which their symptoms may overlap. When discussing this, you explain that
the autonomic nervous system is activated and further helps distinguish
anxiety symptoms by making the following points:
2. A “You may experience an elevated heart rate, constant
.
worrying, and diarrhea.”
B “You may experience fear, sweating, and muscle tension.”
.
C “You may experience an elevated heart rate, the need to
.
urinate, and fear.”
D “You may experience sleepiness, decreased blood pressure,
.
and fear.”

1 points
QUESTION 2
1. The PMHNP is working with a school-aged child who has been diagnosed with
depression. The child has attended several sessions with the PMNHP, but
recently presents with avoidant behavior by showing increased distress and
being late to sessions. What approach does the PMHNP need to employ with
the child to continue making therapeutic progress?
D All of the
.
above
1 points
QUESTION 3
1. After informing a prospective patient about limits of confidentiality, the
patient consents to the “conditions” of confidentiality and signs an informed
consent form. Several weeks later, a lawyer representing the patient’s
spouse for a court case, asks the PMHNP for the disclosure of information
about the patient. The PMHNP should:
2.

C Limit disclosure to the extent legally
.
possible


1 points
QUESTION 4

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1. In your office, you see a 58-year-old patient with PTSD who reports having
nightmares, making it impossible for her to sleep. What recommendations
based on principles of sleep hygiene will the PMHNP make?
C Avoid watching television or
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reading in bed


1 points
QUESTION 5
1. An 11-year-old patient has been exhibiting low self-esteem at school and
acting out. According to Maslow’s hierarchy of needs, which of the following
questions would best be addressed first by the PMHNP?
2.

C “Is Joel getting enough sleep at
.
home?”


1 points
QUESTION 6
1. A patient named Steve is seeking therapy to get help with his home
situation, stating that he has been stressed since his mother-in-law moved
into the house. What can the PMHNP do to assist the patient in constructing
a narrative?
2.
B Elicit details so Steve becomes more self-disclosing and
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self-examining
1 points
QUESTION 7
1. A new patient has been informed of the limits of confidentiality, and has
signed informed consent forms. No consent, however, has been obtained for
voluntary “Release of Information.” The patient is 20 years old and still lives
at home with his parents. He is being treated for depression, which he
attributes to the trouble he’s had finding employment.
True or false: If the patient’s mother calls the PMHNP to check up on her son
to see how he is doing, the therapist is required to protect patient
confidentiality and not disclose information.
True

1 points
QUESTION 8
1. The PMHNP is caring for a patient with borderline personality disorder. Using
a psychoanalytic psychotherapy approach, the PMHNP attempts to intensify
the patient’s transference to enhance emotional processing by:

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2. A Developing increased boundaries
.
B Decreasing supportive
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psychotherapy
C Scaling back contact with the
.
patient
D Increasing the number of sessions
.
per week
1 points
QUESTION 9
1. True or false: A PMHNP may ask his patient to describe her relationship with
her father, both as a child and now, in order to assess interpersonal style.
True
False

1 points
QUESTION 10
1. The PMHNP has a session with a patient who was injured and traumatized
from an explosion at the industrial plant where he used to work. During the
session, an outside noise startles the patient and he experiences a flashback
of the loud boom from the explosion. The PMHNP witnesses the patient
present with anxiety and belabored breathing. What is the appropriate action
of the PMHNP?
2. A Telling the patient there is no reason to be startled
.
B Avoiding interrupting the flashback as it occurs
.
C Asking the patient to describe the flashbacks
.
D Have the patient use the relaxation response (take a deep breath, exhale
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long, and slow down)
1 points
QUESTION 11
1. The PMHNP is working with a veteran who has posttraumatic stress disorder
(PTSD). The PMHNP believes that dual awareness will be beneficial in
allowing the patient to focus on the here and now. What strategies can the
PMHNP use to develop dual awareness in the patient?
2. A Asking the patient to recall a recent and mildly disturbing event
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B Having the patient focus on details of the room, such as how hot or
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cold it is
C Telling the patient to rate the level of disturbance he feels from a
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mildly disturbing event
D All of the above
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