6670 FINAL EXAM QUESTION
PAPER
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
, May be a symptom of temporal lobe epilepsy
Is treated with a cycle of sleep deprivation
1 points
QUESTION 3
1.Jack is a 27-year-old male who has a history of paranoid schizophrenia that first became apparent approximately 10 ye
Increased dopamine activity in the
mesolimbic pathway
Increased dopamine activity in the
mesocortical pathway
Increased glutamate in the prefrontal cortex
Increased glutamate in the hippocampus
1 points
QUESTION 4
1.Johanne is a 22-year-old female who is being treated for narcolepsy. She is attempting to implement a regimen of forc
Suicidality
Depressio
n
Hyperpha
gia
Disinhibiti
on
1 points
QUESTION 5
1.The PMHNP is asked to prepare a presentation for non-nursing health care workers in a local long-term care facility on
Perceptual
disturbances
Rapid onset
, Agitation
Abnormal sleep
patterns
1 points
QUESTION 6
1.Valerie is a 27-year-old woman who has been referred by her primary care provider. She was initially diagnosed with m
The patient has tried unsuccessfully to suppress the urge to repeatedly check
locks
The compulsive activities are time-consuming to the extent that at least 1 hour
daily is spent on them
The disturbance is not better explained as the symptoms of another mental
disorder
The patient has good or fair insight with respect to the appropriateness of her
behaviors
1 points
QUESTION 7
1.Michael is an 18-year-old male who is presented to care at the urging of his parents. He has never had any significant
Narcolepsy
Mood
disorder
Hypersexua
lity
Alcohol
PAPER
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
, May be a symptom of temporal lobe epilepsy
Is treated with a cycle of sleep deprivation
1 points
QUESTION 3
1.Jack is a 27-year-old male who has a history of paranoid schizophrenia that first became apparent approximately 10 ye
Increased dopamine activity in the
mesolimbic pathway
Increased dopamine activity in the
mesocortical pathway
Increased glutamate in the prefrontal cortex
Increased glutamate in the hippocampus
1 points
QUESTION 4
1.Johanne is a 22-year-old female who is being treated for narcolepsy. She is attempting to implement a regimen of forc
Suicidality
Depressio
n
Hyperpha
gia
Disinhibiti
on
1 points
QUESTION 5
1.The PMHNP is asked to prepare a presentation for non-nursing health care workers in a local long-term care facility on
Perceptual
disturbances
Rapid onset
, Agitation
Abnormal sleep
patterns
1 points
QUESTION 6
1.Valerie is a 27-year-old woman who has been referred by her primary care provider. She was initially diagnosed with m
The patient has tried unsuccessfully to suppress the urge to repeatedly check
locks
The compulsive activities are time-consuming to the extent that at least 1 hour
daily is spent on them
The disturbance is not better explained as the symptoms of another mental
disorder
The patient has good or fair insight with respect to the appropriateness of her
behaviors
1 points
QUESTION 7
1.Michael is an 18-year-old male who is presented to care at the urging of his parents. He has never had any significant
Narcolepsy
Mood
disorder
Hypersexua
lity
Alcohol
