NURS 6635 MIDTERM-PMHNP Newly Updated Exam Elaborations Questions with Answers Explanations 2021

NURS 6635 MIDTERM-PMHNP Newly Updated Exam Elaborations Questions with Answers Explanations 2021 . QUESTION 1 1. Select the neurotransmitter involved in obsessive-compulsive disorder (OCD) in children and adolescents based on the common comorbidity of tic disorders. Midterm 6635 PMHNP Walden University Exam Year 2021 Opioid analgesics are drugs that function on opioid receptors that are used to alleviate pain. Weak opioid analgesics are often used to describe compound analgesics that combine acetaminophen with low levels of codeine or tramadol. Opioid analgesics, which include oxycodone, hydrocodone, and codeine, can be used to relieve mild to extreme acute pain. Opioids are medications that are chemically similar to, but more potent than, the body's own pain relievers (endorphins). They operate by binding to receptors on cells, primarily in the brain, spinal cord, and gastrointestinal tract. Step-by-Step explanation References Andrieu, G., Amrouni, H., Robin, E., Carnaille, B., Wattier, J. M., Pattou, F., ... & Lebuffe, G. (2017). Analgesic efficacy of bilateral superficial cervical plexus block administered before thyroid surgery under general anaesthesia. British journal of anaesthesia, 99(4), 561-566. Mangione, M. P., & Crowley-Matoka, M. (2018). Improving pain management communication: how patients understand the terms "opioid" and "narcotic". Journal of general internal medicine, 23(9), 1336. 1 points QUESTION 3 1. Select the most commonly occurring eating disorder. Answer: A Anorexia . nervosa B Bulimia . nervosa C Purging . D Binge . A. Anorexia Nervosa Step-by-Step explanation Anorexia nervosa is one eating disorder that most people have heard of. People with anorexia often starve themselves in order to achieve an unattainable ideal of thinness. This condition, like many eating disorders, tends to affect more women than men. 1 points QUESTION 4 1. Select the disorder in which inflicting injury to self or others is common. A Pain . Midterm 6635 PMHNP Walden University Exam Year 2021 1 points 1 points B Conversion . C Somatic . symptom D Factitious . Factitious disorder is a serious mental disorder in which someone deceives others by appearing sick, by purposely getting sick or by self-injury. QUESTION 5 1. Select two imaging methods used to study anxiety disorders. A CT . B TM . S C MRI . D EKG . QUESTION 6 1. Select the two factors that do not cause dissociative amnesia. A Sexual . abuse B Substance . abuse C Surgical pain . D Partner . betrayal Answer: A . Step-by-Step explanation The correct answer is; A. Sexual abuse D. Partner betrayal Substance abuse and surgical pain can cause dissociative amnesia. Dissociative amnesia is a disorder in which a person loses track of vital details from their past. This forgetfulness can be limited to a few key areas (thematic), or it might encompass a large portion of a person's life history and/or identity (general). Drug and alcohol usage not only raises the risk of having a co-occurring or comorbid substance use disorder, but it can also intensify dissociative amnesia symptoms. Dissociative disorders are essential to the pain physician because persistent pain can be Reference accompanied with dissociative symptoms. A disruption in the integrated functions of consciousness, memory, identity, or perception characterizes dissociative disorders. Midterm 6635 PMHNP Walden University Exam Year 2021 1 points 1 points 1 points QUESTION 9 1. Select the greatest impediment to treating anorexia nervosa patients. Wagener, D. (2019, September 5). Treatment for dissociative amnesia and substance abuse. American Addiction Centers. QUESTION 7 1. Select the correct epidemiologic fact about major depression in children and adolescents. A There is a 20% incidence by age 18 . B The incidence is equal in adolescent females and males . C There is a decreased incidence after 20 . D The incidence is five- to ten-fold greater in children with a parent or sibling . with major depression Answer:  A. There is 20% incidence by age of 18 years. Step-by-Step explanation Depression takes place at an estimated rate of around two percent during childhood and from four to around seven percent in time of the adolescence stage. This mental illness is a top cause of health impairment called the morbidity and death also known as mortality which is increasing rapidly every time. Depression is common in time of teenage years, having impacts on about 20% of adolescents by the time they reach adulthood, that is the age of 18. Reference. Jacobs, R. H., Reinecke, M. A., Gollan, J. K., & Kane, P. (2008). Empirical evidence of cognitive vulnerability for depression among children and adolescents: A cognitive science and developmental perspective. Clinical psychology review, 28(5), 759-782. QUESTION 8 1. Select the brain region that is most implicated in the function of memory. A Hippocampu . s B Temporal . lobe C Amygdala . D Corpus . callosum Midterm 6635 PMHNP Walden University Exam Year 2021 1 points A Drug adverse effects . B Variability of family . therapy C Patient resistance . D Noncompliance with . therapy Answer; C) Patient resistance Step-by-Step explanation Anorexia nervosa (AN) is a chronic illness in which sufferers experience a slew of negative consequences in a variety of areas of their lives as a result of their low weight and restrictive food intake. Given these negative consequences, which are visible in physical, emotional, and social dimensions, it can be tempting to dismiss the condition entirely. As a result, AN sufferers' inability to pursue, continue, or participate in care may also be perplexing from an outsider's perspective. This ego-syntonic perspective is most prevalent in anorexia nervosa. When an eating disorder is experienced as ego-syntonic, there is little to no desire to alter the habits, resulting in high levels of medication resistance that worsens over time. The egosyntonic aspect of the disease, in which individuals with anorexia nervosa esteem their condition, is a major issue for clinicians treating the illness. This hinders encouragement for rehabilitation and involvement with care. The aim of this review article is to explain the essence of egosyntonicity in anorexia nervosa by examining both qualitative and quantitative studies on the topic, and, more importantly, to present strategies for overcoming this impediment to recovery in anorexia nervosa care. Therefore, we can conclude that, the greatest impediment to treating anorexia nervosa patients is option C, Patient resistance. References The Egosyntonic nature of anorexia: An impediment to recovery in anorexia nervosa treatment. (2019, January 14). PubMed Central (PMC). Retrieved April 6, 2021, from Patient resistance in eating disorders. (2014, September 24). Psychiatric Times. Retrieved April 6, 2021, from Perplexities of treatment resistence in eating disorders. (2013, November 7). BMC Psychiatry. Retrieved April 6, 2021, from QUESTION 10 1. Select the most common sleep disorder. A Parasomni . a B Hypersom . nia C Insomnia . D Apnea Midterm 6635 PMHNP Walden University Exam Year 2021 1 points . Answer: c. Insomnia Step-by-Step explanation Insomnia refers to the inability to stay asleep and fall asleep. It the most common sleeping disease. Markedly, narcolepsy triggers extreme sleepiness during the daytime, while hypersomnia involves the inability to remain awake in the day. The others are severe but less common than insomnia. For instance, apnea affects frequent breathing when one is sleeping. Parasomnia leads to unusual behavior when sleeping that can happen at any stage and time of sleep. It may include the transition from sleeping to wakefulness, talking, moving around, and doing abnormal things while asleep. Reference; Morin, C. M., Drake, C. L., Harvey, A. G., Krystal, A. D., Manber, R., Riemann, D., & Spiegelhalder, K. (2015). Insomnia disorder. Nature Reviews Disease Primers, 1(1), 1-18. QUESTION 11 1. Select the percentage of untreated PTSD patients who recover after one year. A 10 . % B 20 . % C 30 . % D 50 . % Answer: PTSD Data compiled by the U.S. Department of Veterans Affairs' National Center for PTSD indicate that roughly half of all American women and more than half of all American men will experience traumatic situations associated with the later onset of post-traumatic stress disorder. However, much smaller numbers of men and women will actually develop the disorder. Specific traumas linked to the condition include combat participation, being present in a combat zone, adult exposure to physical or sexual attacks, childhood exposure to physical or sexual abuse, exposure to severe floods or other national disasters, exposure to lifethreatening accidents and exposure to life-threatening physical illness. For a number of reasons, a woman exposed to severe mental/emotional trauma has higher chances of developing PTSD than a man exposed to such trauma. Doctors can't diagnose PTSD in a person who has undergone a highly traumatic experience within a period of 30 days. Instead, they diagnose the condition in people who continue to experience symptoms after 30 days or only show the first signs of a damaging stress reaction after 30 days. Specific symptoms of the condition include nightmares or flashbacks that involuntarily recall a traumatic situation, an excessive state of mental arousal stemming from an overactive "fight-or-flight" response, avoidance of anything that serves as a trauma reminder and an ongoing or recurring negative outlook that impairs dayto-day functionality. Step-by-Step explanation How Often Do Adults Recover? In the study review published in Clinical Psychology Review, researchers from the Netherlands' University of Amsterdam and Tilburg University and the United Kingdom's Queen Mary University Midterm 6635 PMHNP Walden University Exam Year 2021 1 points of London used data gathered from 42 previously conducted studies to determine how often people diagnosed with PTSD recover 10 months or more after receiving their initial diagnosis if they don't receive treatment geared toward their condition. The studies under consideration included 81,642 adults diagnosed with the disorder. On average, the studies looked at the outcomes for untreated PTSD patients over the course of 40 months. The researchers looked at the numbers of people who no longer had diagnosable cases of PTSD; they considered cases of "spontaneous" remission rather than cases of remission stemming from PTSD-specific treatment. At the low end, the recovery rate for the participants of one study was just 8 percent; at the high end, the recovery rate for the participants of another study was 89 percent. All told, 44 percent of the participants in all of the studies recovered from their condition and no longer qualified for a PTSD diagnosis. The study's authors note that the highest rates of spontaneous recovery apparently occur among people exposed to natural disaster-related trauma; conversely, the lowest rates of recovery apparently occur among people exposed to physical illness-related trauma. They also note that people diagnosed with PTSD fairly soon after developing their symptoms typically have higher chances of recovering spontaneously than people diagnosed after exhibiting symptoms for extended amounts of time. The authors believe their findings contribute considerably to the understanding of PTSD recovery, as well as the understanding of the lasting effects of specific sources of PTSD. It's critically important to point out that no one can tell who will naturally recover from the condition; for this reason, all affected individuals should seek prompt treatment from qualified mental health professionals. Significance Trauma disorders are a common and costly problem in the United States. An estimated 5.2 million American adults ages 18 to 54, or approximately 3.6 percent of people in this age group in a given year, have PTSD. In 1990, anxiety disorders cost the U.S. an estimated $46.6 billion. Untreated PTSD from any trauma is unlikely to disappear and can contribute to chronic pain, depression, drug and alcohol abuse and sleep problems that impede a person's ability to work and interact with others. According to psychologist R.C. Kessler's findings from The National Cormorbidity Survey Report (NCS) that examined over 8,000 individuals between the ages of 15 to 54, almost 8 % of adult Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely to be victims as men (5%). QUESTION 12 1. Select the factor that is required to cause PTSD from a stressor. A Intense horror . B Isolated experience . C Concurrent substance . abuse D Survivor’s guilt . Answer is A, Intense horror. Step-by-Step explanation Midterm 6635 PMHNP Walden University Exam Year 2021 1 points 1 points Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. Horror films are designed to elicit certain emotions such as tension, fear, stress, and shock. These can cause the release of the hormones in the body such as norepinephrine, cortisol, and adrenaline from the autonomic nervous system hence causing PTSD. Guyton, et al. 2012 QUESTION 13 1. Select two causes of dissociative amnesia. A Sexual . abuse B Substance . abuse C Surgical pain . D Partner . betrayal Answer: A . Step-by-Step explanation A and D Sexual abuse and Partner betrayal are the two causes of dissociate amnesia. Usually, overwhelming stress has been attributed to dissociative amnesia, which can be brought on by traumatic events such as injuries, war, violence, or natural disasters. The person may have been directly affected by the trauma or may have just witnessed it. There appears to be a hereditary link in dissociative amnesia, as close relatives often acquire the condition. In this case, sexual abuse and partner betrayal and directly related to emotional abuse. In multivariate hierarchical tests, emotional violence, like the sexual abuse, was the strongest and most direct indicator of dissociation, confounding the influence of other trauma forms. the degree to which one is abused by a caregiver or close relationship may have an impact on the essence of trauma and how one responds to it. According to BTT, this is closely related to psychogenic amnesia or other dissociative processes that arise as a way of maintaining a connection with the caregiver and promoting survival. References QUESTION 14 1. Select the population in which rumination disorder occurs most frequently. A Male infants aged 3 to 12 . months B Female infants 6 to 18 . months C Children aged 2 to 5 years . Midterm 6635 PMHNP Walden University Exam Year 2021 1 points 1 points Answer: A . D Adolescents aged 13 to 15 . years Step-by-Step explanation According to studies, the prevalence of rumination disorder most often occurs in infants and very young children between 3 and 12 months and in children with intellectual disabilities. Typically, It is rare in older children, adolescents and adults. It may also occur slightly more often in boys than in girls but few studies of the disorder exist to confirm this. Thus, choice A with male infants aged 3- 12 months is the correct answer. Reference:   QUESTION 15 1. Select the symptom that is least associated with manic and hypomanic episodes. A Suicidal . ideation B Inflated self- . esteem C Distractibility . D Pressured . speech Answer: A . Step-by-Step explanation Hypomania and mania are periods of over-active and excited behaviour that can have a significant impact on day-to-day life. Both are symptom of bipolar disorder.The main difference between mania and hypomania is the intensity of the symptoms. Symptoms of mania are much more intense than those of hypomania. Among the given options, suicidal ideation is the least associated symptom. It can happen yes, but the 3 other choices are most common in hypomania and manic patients. QUESTION 16 1. Select the two comorbid disorders with which Pica occurs most commonly. A Enuresis . B Encopresis . C Autism . Midterm 6635 PMHNP Walden University January 2021 1 points 1 points D Intellectual . disability Answer: C . and D . Step-by-Step explanation Answer: C and D - Autism and Intellectual disability According to the DSM-5, disorders most commonly comorbid with pica are disorders with impaired in functioning such as Autism Spectrum Disorder and Intellectual Disability, and to a lesser extent, schizophrenia and obsessive-compulsive disorder. Some other lesser known comorbidities are:  Trichotillomania/hair-pulling disorder  Excoriation/skin-picking disorder  avoidant-restrictive food intake disorder source:  American Psychiatric Association. (2013). Feeding and Easting disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).  QUESTION 17 1. Select the third most commonly reported psychiatric symptom. A Depression . B Anxiety . C Psychosis . D Depersonaliza . tion Answer: C . Step-by-Step explanation Psychosis is a condition that affects the way your brain processes information. It causes you to lose touch with reality. You might see, hear, or believe things that aren't real. Common psychotic experiences include hallucinations (hearing, seeing or feeling things that are not there) and delusions (fixed false beliefs or suspicions that are firmly held even when there is evidence to the contrary). QUESTION 18 1. Select the characteristic in long sleepers (more than 9 hours) that is absent in short sleepers (less than 6 hours). A Mildly . depressed Midterm 6635 PMHNP Walden University January 2021 1 points 1 points B Ambitious . C Socially . adept D Efficient . QUESTION 19 1. Select the two most common peripheral symptoms of anxiety. A Bradycar . dia B Dizziness . C Constipati . on D Tremors . Answer: C . Step-by-Step explanation The two most common peripheral symptoms of anxiety are (1) Dizziness and (2) Constipation. It actually has a lot of distressing symptoms, but the above two are the most common among the choices provided. If you are experiencing anxiey, you will feel dizzy, would faint or you are unsteady. You will also eventually experience digestive discomfort like constipation or other digistive problems. QUESTION 20 1. Select the two methods to treat dissociative amnesia. A Antipsychotic . drugs B Cognitive . therapy C Hypnosis . D Psychoanalysis . Answer: For detailed solution Please see explanation part. If there is anything that I can help you please let me know in comments. Rating the answer helpful, is always appreciated. Thanks Correct Answer is Option B & Option C Midterm 6635 PMHNP Walden University January 2021 1 points 1 points Step-by-Step explanation Treatment of dissociative amnesia (disorder) usually consists of psychotherapy, with the goal of helping the person integrate different identities, and to gain control over the dissociative process and symptoms. Therapy can be long and difficult, as it involves remembering and learning to deal with past trauma. Cognitive (that is, dealing with a patient's conscious intellectual activity) behavioral therapy has been found to be effective. Hypnosis may be another helpful treatment. A newer therapy called Eye Movement Desensitization and Reprocessing (EMDR) focuses specifically on the role that disturbing memories play in the development of mental disorders. QUESTION 21 1. Select the theorist who is credited with establishing the area of psychosomatic medicine. A Freud . B Abraha . m C Grodde . ck D Ferencz . i Answer: D . Step-by-Step explanation Franz Gabriel Alexander (January 22, 1891 - March 8, 1964) was a Hungarian-American psychotherapist and physician who is credited with founding psychosomatic medicine and psychoanalytic criminology. Reference Lacan, J. (1950). A theoretical introduction to the functions of psychoanalysis in criminology. Écrits: The first complete edition in English, 103-122. QUESTION 22 1. Select the disorder in children and adolescents that is described by depressed or irritable mood for most of the day for a majority of days in at least one year. A Major . depression B Cyclothymia . C Bereavement . D Persistent . depression Correct Answer is Option B & Option C Midterm 6635 PMHNP Walden University January 2021 1 points Answer: D . Step-by-Step explanation Persistent depression disorder is an irritable mood that lasts for most of the day form more days than not for about one year. It leads to poor appetite or overeating. Insomnia or hypersomnia. It causes low energy or fatigue. It leads to low self- esteem, poor concentration and feelings of hopelessness. If one has persistent depression, he or she may find it hard to be upbeat even on happy occasions. They may have a gloomy personality, constantly complaining or incapable of having fun. It is usually not as severe as major depression, the depressed mood may be mild, moderate or severe. QUESTION 23 1. Select the type of dissociative amnesia described by inability to recall any events in a particular lifespan period. A Selective . B Localized . C Generaliz . ed D Continuo . us Answer: C . Step-by-Step explanation The correct answer would be letter C. Generalized Because in this type of dissociative amnesia, a person has inability to recall encompasses the person's entire life. This type of amnesia is rare and is characterized by total loss of memories related to one's past and identity. A person may not remember anything about life before a certain point, including where they have been, what they have done or said, or who they were with. A person may even may loss information about the world, history, or previously-held skills. Persons have a complete loss of memory of their entire life history like their own identity. Those who experience this type of amnesia deficits in both semantic and procedural knowledge. This means that people have no common knowledge of the world like cannot identify songs, the current president, or names of colors nor do they have the ability to engage in learned skills like typing shoes and driving car. The onset of generalized amnesia is typically acute. Reference: Leong S, Waits W, Diebold C (January 2006). "Dissociative Amnesia and DSM-IV-TR Cluster C Personality Traits". Psychiatry (Edgmont). 3 (1): 51-5. PMC . PMID Midterm 6635 PMHNP Walden University January 2021 1 points QUESTION 24 1. Select the frequency range of heritability of bipolar disorder. A 60%- . 90% B 50%- . 80% C 30%- . 60% D10%-40% Answer: A. 60%-90% Step-by-Step explanation Bipolar disorders are 80% to greater than 90% heritable. Therefore, from the choices given 60% - 90% is the appropriate range. 1 points QUESTION 25 1. Select the two symptoms that result from prolonged sleep deprivation. A Ambition . B Hallucinati . ons C Contented . ness D Irritability . QUESTION 26 1. Select the most likely stressor to cause an adjustment disorder. A Medical . illness B Natural . disaster C Vehicle . accident D Substance 1 points Midterm 6635 PMHNP Walden University January 2021 1 points 1 points . abuse Answer: A. Medical Illness Adjustment disorders are usually caused by significant stressors i one's life and I believe amongst the choices is an ongoing stress therefore has a higher chance to cause the adjustment disorder. QUESTION 27 1. Select the medical condition that must be excluded as a cause of somatic symptom disorder or hypochondriasis. A Angina . pectoris B Asthma . C Diabetes . D Multiple . sclerosis QUESTION 28 1. Select the function that is most affected by conversion disorder. A Voluntary . motor B Hearing . C Involuntary . motor D Smelling . Answer: A . Step-by-Step explanation Conversion disorder is a mental disorder illness in which the brain and nerves of the body will be unable to properly send and receive information. The therapy focuses heavily on brain retraining. The following criteria are used to make a diagnosis of conversion disorder. The patient is suffering from: One or more illnesses that cause changes in voluntary motor or sensory function, affecting the five senses: vision, hearing, touch, taste, smell. There were no physical discoveries that may justify the illness. Reference O'Neal, M. A., & Baslet, G. (2018). Treatment for patients with a functional neurological disorder (conversion disorder): An integrated approach. American Journal of Psychiatry, 175(4), 307-314. Midterm 6635 PMHNP Walden University January 2021 1 points QUESTION 29 1. Select the therapy for insomnia that can be effective at up to three years after discontinuation. A Cognitive- . behavioral B Sedating . antihistamines C Benzodiazepines . D Paradoxical . intention Answer: A . Step-by-Step explanation CBT have been found to be more effective even after discontinuation as it changes your way of thinking and behavior, while medicinal drugs can only aid to help sleep, you can become dependent on them and effects will wear off when you stop taking them. More on CBT on sleep disorders here: QUESTION 30 1. Select the mental health model that is most associated with human interpersonal connection. A Maturity . B Resilienc . e C Spiritual . D Well- . Being Answer: D . Step-by-Step explanation Maintaining healhy interpersonal relationships with oher people has been found to improve psychological health and well-being. Poor social connections and support from others have been associated with stress and affect mental health negatively. Source: s_of_mental_health 1 points Midterm 6635 PMHNP Walden University January 2021 1 points QUESTION 31 1. Select the behavior that best describes early onset bipolar disorder in children and adolescents. A Aggressi . on B Withdra . wal C Panic . D Exhibitio . n Answer: B . Step-by-Step explanation Bipolar disorder is a chronic mental health condition commonly known as manic-depressive disease or bipolar affective disorder. Bipolar disorder is diagnosed when a youngster goes through episodes of extreme moods, ranging from bursting with so much activity that he can't sleep or sit still to crushing depression that leaves him unhappy and withdrawn. Reference Biederman, J., Mick, E., Wozniak, J., Aleardi, M., Spencer, T., & Faraone, S. V. (2015). An open- label trial of risperidone in children and adolescents with bipolar disorder. Journal of Child & Adolescent Psychopharmacology, 15(2), 311-317. QUESTION 32 1. Select the two medical conditions in which derealization and depersonalization are common. A Anorexia . B Migraine . C Parkinso . n’s D Seizures . Answer: A . and D . Step-by-Step explanation Options A and D are the correct answers. In seizure and anorexia, derealization and depersonalization. Depersonalization and or derealization disorder is a form of dissociative illness characterized by chronic or repeated experiences of being disconnected (dissociated) from one's body or mental processes, sometimes accompanied by a sense of being an outside observer of 1 points Midterm 6635 PMHNP Walden University January 2021 one's life (depersonalization) or being disconnected from one's surroundings (derealization) is common. This type of disorder is often triggered by severe stress. In anorexia, a disorder characterized by abnormal low body weight and an intense fear of gaining weight with distorted perception about weight, often cause severe stress due to constant worries about food and weight leading to anxiety, depression, and low self-esteem level. In seizure, both ictal (period from the first symptoms to the end of the seizure activity) or postictal (begins when a seizure subsides and ends when the patient returns to normal), areas of the brain responsible for emotions and responding to stress are greatly affected. Patients with ictal depersonalization- like symptoms have impaired self-identification with their bodies and usually have frontal lobe epilepsy with the epileptogenic zone in the dorsal premotor cortex, whereas patients with derealization-like symptoms have temporal lobe epilepsy with the epileptogenic zone in the temporal lobe. ***Both options B and C are incorrect because there is no substantial evidence that derealization and depersonalization are common in migraine and Parkinson's disease. Reference: 1.Spiegel, D. (2021, March) Depersonalization/Derealization Disorder - Psychiatric Disorders. MSD Manual Professional Edition. Retrieved on May 27, 2021, from 20detached%20from%20one's 2. Heydrich, L., Marillier, G., Evans, N., Seeck, M., & Blanke, O. (2019, August 22) Depersonalization- and derealization-like phenomena of epileptic origin. NCBI. Retrieved on May 27, 2021, from 1 points QUESTION 33 1. Select the age stage of life in which identity crisis typically emerges. A Childhood . B Adolescen . ce C Middle . adult D Elderly . adult Answer: B . Step-by-Step explanation The answer is B. Adolescence. Adolescents are children who are transitioning to be adults. It is at this age that people have to commit to certain life-changing choices such as choosing a career path, dating potential lifetime partners, and sometimes, even moving out of their own homes. Thus, a lot of adolescents end up experiencing identity crisis, as they still do not have enough knowledge and experience to make big decisions on their own. "What career would suit me the best?", "What type of person should I Midterm 6635 PMHNP Walden University January 2021 date?", "Who do I want to be in the future?"--these are just some of the questions that plague the minds of adolescents. 1 points QUESTION 34 1. Select the two most important factors that guide the decision to prescribe benzodiazepines to treat generalized anxiety. A Specific target symptoms . B Patient insistence on a . benzodiazepine C History of substance abuse . D Duration of therapy . Answer: C . and D . Step-by-Step explanation Guidelines for Responsible Prescription  APA and NICE. The APA guideline for the treatment of panic disorder10 and the NICE guideline11 on the management of panic disorder and GAD recommend SSRIs and not BDZs as the best choice of medication, alongside CBT and self-help based on CBT principles. BDZs are associated with a less good outcome in the long term and should not be prescribed beyond 2 to 4 weeks in GAD and are not recommended for panic disorder. BDZs, Compared With non-BDZ Antianxiety Medication and CBT. Non- BDZ antianxiety medication and CBT often take weeks before there is any beneficial effect, thus the short-term prescription of high-potency BDZs may remain an option when patients express an urgent need for the reduction of high levels of anticipatory anxiety and the reduction in the severity of panic attacks. BDZs with slower onset and longer action may be safer than fast-acting agents.  Regular monitoring for signs of abuse or dependence as well as concurrent abuse of alcohol or other drugs.  Screening for sedative-hypnotic use through a nonthreatening personal and family history and possibly urine toxicology. Therefor, given these facts the answer is C and D ideas from 1 points QUESTION 35 1. Select age after which encopresis may be correctly diagnosed. A 2 Midterm 6635 PMHNP Walden University January 2021 1 points 1 points . B 3 . C 4 . D 6 . Answer: A . Step-by-Step explanation The correct answer is C not A. Diagnosis of encopresis is done when the child is at least 4 years and is experiencing repeated leakage or passing of faeces in inappropriate places. QUESTION 36 1. Select the mg/dL blood alcohol level range that is associated with causing impaired judgment and coordination. A 20 to 40 . B 50 to . 100 C 100 to . 130 D 140 to . 190 Answer: B . Step-by-Step explanation The blood alcohol range that the researches have found to be associated with causing impaired judgment and coordination is 50 to 100mg/dl. After that, i.e., from 100-130mg/dl, the condition becomes even more severe and the person also starts exhibiting symptoms of slurred speech, disorientation and loss of control over voluntary muscles. Therefore, the answer is B. 50 to 100 mg/dL Source: Monico, N. (2020). Blood Alcohol Level & Effects on the Body. American Addiction Centres. QUESTION 37 1. Select the minimum treatment time to assess the effectiveness of antidepressant drug therapy. A 1-2 . weeks Midterm 6635 PMHNP Walden University January 2021 1 points 1 points B 3-4 . weeks C 6-8 . weeks D 10-14 . weeks Answer: C Step-by-Step explanation When it comes to antidepressant drug therapy, it usually takes 6-8 weeks before the effects of the drugs are realized. This means that it will take an individual at least six weeks before they start experiencing the benefits of antidepressant drug therapy. For other individuals, it can take up to eight weeks before they can start seeing the benefits of antidepressants. Therefore, anything along the timelines of 6-8 weeks is ideal for a person to start realizing the effects of the drugs. QUESTION 38 1. Select the exposure to violence that is excluded as a DSM-5 diagnostic criterion for PTSD in children and adolescents. A Electronic media . B Directly witnessed . C Report of family . member D Repeated natural . disaster Answer: A . Step-by-Step explanation The answer is A. Electronic Media PTSD--post-traumatic stress disorder--is characterized by exposure to traumatic experiences, hence, the name. Among these experiences, included are: directly experiencing actual or threatened death, serious injury, or sexual violence. PTSD can also be diagnosed if the person experienced the aforementioned events vicariously, either by witnessing it in person or by learning that a loved one went through such experiences. Lastly, repeated exposure to aversive details of the traumatic events can also be considered as a qualifier for a PTSD diagnosis. Among the choices, only option A. Electronic Media is not included in the DSM-V criteria. It is also specifically mentioned in the DSM-V that: "Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related." QUESTION 39 1. Select the psychiatric disorder for which drug and nondrug treatments are least effective. A Dissociative Midterm 6635 PMHNP Walden University January 2021 1 points 1 points . amnesia B Major . depression C Depersonalizatio . n D Dissociative . identity Answer: C . Step-by-Step explanation No known medication for depersonalization derealization disorder, however treatment can minimize distressing symptoms and also lead to full remission of the condition. This ailment is a dissociative infection which was not well understood initially. Reference: Rumschlag, K. E. (2017). Teacher burnout: A quantitative analysis of emotional exhaustion, personal accomplishment, and depersonalization. International management review, 13(1), 22- 36. QUESTION 40 1. Select the life stage at which emotional and social behavior begin. A Toddler . B Infancy . C Middle . years D Preschool . Answer: B . Step-by-Step explanation The social-emotional development begins with parental bonding to the child. This bonding allows the mother to respond to the child's needs timely and soothe their newborn. The consistent availability of the caregiver results in the development of "basic trust" and confidence in the infant for the caregiver during the first year of life. The infant to seek for parents or the caregiver during times of stress, known as the attachment. QUESTION 41 1. Select two events that are excluded as causes of dissociative trance disorder. A Natural disaster . B Substance abuse . C Experienced . violence Midterm 6635 PMHNP Walden University January 2021 1 points D Appropriate drug . therapy Answer: B . and D . Step-by-Step explanation The answer would be B) substance abuse and D) appropriate drug therapy this is because dissociative trance disorder is caused by children being subjected to emotional abuse or frightening home environments and can be even caused by stress of war or natural disasters. QUESTION 42 A Family . B Psychoanal . ytic C Cognitive . D Behavior . Answer: C . Step-by-Step explanation Cognitive therapy is a treatment process that helps patients correct false self-beliefs that lead to certain moods and behaviors. The fundamental principle behind cognitive therapy is that a thought precedes a mood, and that both are interrelated with a person's environment, physical reaction, and subsequent behavior. 1 points QUESTION 43 1. Select the theorist who developed the eight stages of psychosocial life cycle. A Bowlb . y B Perls . C Erikso . n D Roger . s Answer: C . Step-by-Step explanation C. Erik Erickson 1. Select the nondrug therapy with the greatest evidence of effectiveness in treating major depressive disorder. Midterm 6635 PMHNP Walden University January 2021 Erik Erikson developed the 8 stages of Psychosocial Development 1 points QUESTION 44 1. Select the two common characteristics of illness anxiety disorder. A Avoidance of provider . evaluation B Few or lack of somatic . symptoms C Frequent provider visits . D Presence of a fixed . delusion Answer: B . and C . Step-by-Step explanation Illness anxiety disorder (formerly known by its derogatory meaning as hypochondriasis) more commonly starts early in adulthoods and seems to happen similarly in males and females. The worries of a patient might result through misconstruing the physical effects or typical body functioning . It is characterized by an excessive worry of a catastrophic physical issue while having little or no signs. Individuals with IAD see many doctors for signs that they feel are associated with a health concern or that clinical signs are much more significant than what they are. Although there is no medical problem, the worries people experiencing IAD are very significant and the worry they feel can create major disturbances in routine dayto-day operations. Following medical examination and lab testing, a disease anxiety disorder is often identified with normal results, however the person stays concerned and worried over underlying medical conditions. IAD treatment is made on the indications, medical records, test findings and symptoms associated of mental health, such as serious anxiety. The reality that persons with this illness are not comforted by regular tests or lab tests may confound diagnosis and thus ignore their physician's conclusions and look for a different provider. One person must look like the following in order to be diagnosed with illness anxiety disorder: Excessive concern for a critical or existence disease Lack or minor somatic signs, Severe health concerns and anxieties and Frequent illness checks and even illness signs. Individuals with illness anxiety disorder are just so worried that they really are or may become ill that worry affects the functionality of today 's society or causes severe discomfort. Individuals may have physical ailments, or may not, however, if they do, they are more concerned with the probable symptoms than with the symptoms. Several individuals constantly examine themselves . New physical feelings are quickly frightened. Some people often see doctors (kind of treatment); others seldom seek medical care. A person monitors the health status constantly or skips visits to the doctor and institutions maladaptively. No or mild somatic symptoms are present in the patient. 1 points QUESTION 45 1. Select the serum assessment that is required when prescribing drugs to treat psychiatric disorders in psychosomatic patients. A Potassium . Midterm 6635 PMHNP Walden University January 2021 1 points 1 points B White blood . cells C Liver enzymes . D Blood urea . nitrogen Answer: A . Step-by-Step explanation The serum assessment that is required when prescribing drugs to treat psychiatric disorders in psychomatic patients is potassium. QUESTION 46 1. Select the alternate name for persistent depressive disorder. A Cyclothy . mia B Bipolar I . C Bipolar II . D Dysthymi . a Answer: D . Step-by-Step explanation Dysthymia. QUESTION 47 1. Select the serum substance that should be measured to aid the diagnosis of restless leg syndrome. A Potassiu . m B Ferritin . C Magnesi . um D Albumin . Answer: C . Midterm 6635 PMHNP Walden University January 2021 1 points 1 points Step-by-Step explanation Magnesium This is because deficiency of magnesium causes restless leg syndrome. QUESTION 48 1. Select the scientist who is most associated with the development of learning theory. A Piaget . B Ainswor . th C Bowlby . D Pavlov . Answer: A . Step-by-Step explanation From the set of choices given, the scientist who is most associated with the development of learning theory is option (a) which is Piaget. Jean Piaget is mostly associated with the theory of learning due to his development of theory of cognitive development in children. His theory focuses on studying two key aspects that promote learning. These aspects are; how little children acquire knowledge and comprehending the nature of intelligence in children. Piaget presents his theory of cognitive development in four stages which are the sensorimotor, the preoperational, the concrete operational stage and the formal operational stage. A Head trauma . B Substance . abuse C Partner . betrayal D Unplanned . travel Answer: D Step-by-Step explanation Dissociative fugue is a reversible kind of amnesia that affects one's personality, memories, and sense of self. Temporary amnesia can continue for hours, days, weeks, months, or even longer. It QUESTION 49 1. Select the event most associated with the occurrence of dissociative fugue. Midterm 6635 PMHNP Walden University January 2021 entails a person's wandering or unplanned trip, during which they may form a new identity in a new area that is considerably different from their previous existence. Adults are more likely to have dissociative fugue, which generally happens during the second and fourth decades of life. While males appear to be afflicted at the same rate as women, the number of males suffering from dissociative fugue increases during wartime. Reference Coons, P. M. (1998). The dissociative disorders: Rarely considered and underdiagnosed. Psychiatric Clinics of North America, 21(3), 637-648. 1 points QUESTION 50 1. Select the drug proven most effective in treating PTSD. A Buspiro . ne B Paroxeti . ne C Trazodo . ne D Clonidin . e Answer: B . Step-by-Step explanation Correct answer: B. Paroxetine Hello student, there is not option B so I answered E, but the correct answer is B. Paroxetine. Along with Paroxetine, Sertraline are the only drugs that are approved to treat PTSD. 1 points QUESTION 51 1. Select the percentage that most accurately represents the rate of heritability of major depression. A 1 . 5 B 3 . 0 C 4 . 5 D 6 . 0 Answer: C Step-by-Step explanation Midterm 6635 PMHNP Walden University January 2021 1 points According to research that was done and published by Stanford University, the rate of heritability of major depression is between 40%-50%(F. Levinson and E. Nichols, n.d.). The research even goes on to say that the percentages could be higher in that genetics could play a part in 50% of the cases, whereas other factors could play a part in the rest of the cases(F. Levinson and E. Nichols, n.d.). Therefore, based on the percentages that have been expressed above, I believe that 45% falls between the ranges that have been given in the study, which means that choice C is most likely the correct answer. Reference F. Levinson, D. and E. Nichols, W., n.d. Major Depression and Genetics. [online] Genetics of Brain Function. Available at: May 2021]. 1 points QUESTION 52 1. Select two neurotransmitters associated with anxiety. A Dopami . ne B Glutam . ate C Serotoni . n D GABA . Dopamine and Serotonin and other nuerotrasmitters like norepinephrine, and gamma-aminobutyric acid (GABA) neurotransmitters are in charge of regulating various bodily and mental functions QUESTION 53 1. Select the drug with the most rapid onset of action to treat acute mania. A Lithium . B Clonazep . am C Lamotrigi . ne D Valproate . Answer: D . Step-by-Step explanation Unlike Lithium, Valporate has a rapid onset of action producing significant results in clinical trials within the span of 1 week and is effective as well in treating mixed and classic mania.