6670 AA111 FINAL EXAM PRACTICE QUESTIONS
ANSWERS 2022/2023 UPDATE
Question 1
Fletcher is a 29-year-old male referred for court-ordered counseling. He has a long history of repeated
offenses including DUI, domestic violence, battery, and other violent acts that fortunately have not yet
caused any serious injury or death to the recipients. An interview with his wife reveals that he has lied
about almost everything for the
,last few years; he is able to get hired for jobs because he is very engaging and likeable, and then
invariably he gets fired because he misses work and doesn’t do his job properly when he is there.
According to the wife, they have known each other since high school, where Fletcher was very happy and
well-adjusted. He was on the soccer team, liked by teachers, and never demonstrated the tendencies he
does now. Apparently in college he got involved with a fraternity that was notorious for alcohol and drug
abuse, and he started drinking heavily; it was ―all downhill from there.‖ The PMHNP considers that:
History and symptoms are most consistent with antisocial personality disorder
Fletcher needs a neurological workup to include an EEG and assessment for neurological soft
signs
Consistent with his symptoms, Fletcher will likely respond well to a stress interview
It is likely that substance abuse is the underlying cause of symptoms and should be explored
further
Question 2
Anne is a 32-year-old female who presented to care after a random drug screening at work was positive for cocaine.
She was initially resistant to therapy, maintaining that her use is not a problem and she could stop at any time. Upon
further discussion in session, it appears that she uses cocaine every day at work, sometimes 2–3 times, other days
more. She also uses it occasionally at home and most weekends. During her third session, she admitted that it is a
financial burden, and she basically cannot afford any other form of recreation. She understands that if she uses again
she will lose her job, and she admits that she loves her job and that cocaine is not worth losing it. When counseling
her about cessation strategies, the PMHNP advises all the following except:
The physiologic symptoms of withdrawal may require a short-term hospitalization
Unlike other substances of abuse, there are no medications to help reduce the intensity of
withdrawal
She will need to be monitored for depression
Overcoming the intense craving for cocaine is the biggest issue
Question 3
Clare’s history of personal relationships is characterized by complete intolerance of being alone.
Whether it is an
1
, intimate-partner relationship or a close friend, Clare appears to always need someone in her
life. She had a live- in boyfriend of 3 years, and while they were together, he took care of
everything. The PMHNP expects all of the following to be additional features of Clare’s
history except:
Has disproportionate anger toward an abusive spouse
Question 4
The PMHNP is conducting an initial interview with a patient whose history is consistent with avoidant personality disorder. The
Clothing
Speech pattern
Anger
Anxiet
y
Question 5
Alexa is a 27-year-old female who has come to group therapy while she is in the city jail. She was arrested
for vagrancy because she was sleeping in her car in a parking lot at a local shopping center. She could not
post bail, so she is sentenced to 14 days in jail. During group, she contributes that none of this is her fault.
Her mother is totally evil because she would not let Alexa stay in the family home. She has some other
family. but they are all jerks because they won’t help her. Alexa’s friend Melanie is the absolute best
person in the world, but she can’t help because her boss fired her for no reason. Alexa has a history of
arrests for buying illegal drugs and prostitution. The last time she was in jail, her sentence was extended
for 30 days because she got into a fight with another inmate and beat her up so badly she had to be
admitted to the hospital for 6 days. The PMHNP considers which of the following personality disorders?
Histrionic
Narcissistic
, Borderli
ne
Schizoid
Question 6
A PMHNP student is reviewing his notes from his clinical experience over the past week to prepare his first required case present
A 27-year-old female with a 1-month history of social withdrawal, anorexia,
hypersomnia, unprovoked outbursts of anger, and a strong family history of
endogenous depression
A 41-year-old male with a history of childhood sexual abuse, loss of interest in both his
professional and personal life, an unplanned 10 lb. weight loss in the last 3 months, and
perceptual disturbances
A 65-year-old male whose wife died 2 months ago and he reports a 3-week history of generally
depressed
mood, guilt about his wife’s death, insomnia, difficulty focusing on daily tasks, with
increasing thoughts of dying
A 72-year-old female who just relocated across country to live with her adult son and
daughter-in-law who is despondent about leaving her home and reports forgetfulness, loss
of appetite, new onset bowel problems, and extreme loss of energy
Question 7
A variety of pharmacologic agents have demonstrated effectiveness in the treatment of post-traumatic stress disorder. Which of th
SSRIs
TCAs
Antiadrenerg
ics
ANSWERS 2022/2023 UPDATE
Question 1
Fletcher is a 29-year-old male referred for court-ordered counseling. He has a long history of repeated
offenses including DUI, domestic violence, battery, and other violent acts that fortunately have not yet
caused any serious injury or death to the recipients. An interview with his wife reveals that he has lied
about almost everything for the
,last few years; he is able to get hired for jobs because he is very engaging and likeable, and then
invariably he gets fired because he misses work and doesn’t do his job properly when he is there.
According to the wife, they have known each other since high school, where Fletcher was very happy and
well-adjusted. He was on the soccer team, liked by teachers, and never demonstrated the tendencies he
does now. Apparently in college he got involved with a fraternity that was notorious for alcohol and drug
abuse, and he started drinking heavily; it was ―all downhill from there.‖ The PMHNP considers that:
History and symptoms are most consistent with antisocial personality disorder
Fletcher needs a neurological workup to include an EEG and assessment for neurological soft
signs
Consistent with his symptoms, Fletcher will likely respond well to a stress interview
It is likely that substance abuse is the underlying cause of symptoms and should be explored
further
Question 2
Anne is a 32-year-old female who presented to care after a random drug screening at work was positive for cocaine.
She was initially resistant to therapy, maintaining that her use is not a problem and she could stop at any time. Upon
further discussion in session, it appears that she uses cocaine every day at work, sometimes 2–3 times, other days
more. She also uses it occasionally at home and most weekends. During her third session, she admitted that it is a
financial burden, and she basically cannot afford any other form of recreation. She understands that if she uses again
she will lose her job, and she admits that she loves her job and that cocaine is not worth losing it. When counseling
her about cessation strategies, the PMHNP advises all the following except:
The physiologic symptoms of withdrawal may require a short-term hospitalization
Unlike other substances of abuse, there are no medications to help reduce the intensity of
withdrawal
She will need to be monitored for depression
Overcoming the intense craving for cocaine is the biggest issue
Question 3
Clare’s history of personal relationships is characterized by complete intolerance of being alone.
Whether it is an
1
, intimate-partner relationship or a close friend, Clare appears to always need someone in her
life. She had a live- in boyfriend of 3 years, and while they were together, he took care of
everything. The PMHNP expects all of the following to be additional features of Clare’s
history except:
Has disproportionate anger toward an abusive spouse
Question 4
The PMHNP is conducting an initial interview with a patient whose history is consistent with avoidant personality disorder. The
Clothing
Speech pattern
Anger
Anxiet
y
Question 5
Alexa is a 27-year-old female who has come to group therapy while she is in the city jail. She was arrested
for vagrancy because she was sleeping in her car in a parking lot at a local shopping center. She could not
post bail, so she is sentenced to 14 days in jail. During group, she contributes that none of this is her fault.
Her mother is totally evil because she would not let Alexa stay in the family home. She has some other
family. but they are all jerks because they won’t help her. Alexa’s friend Melanie is the absolute best
person in the world, but she can’t help because her boss fired her for no reason. Alexa has a history of
arrests for buying illegal drugs and prostitution. The last time she was in jail, her sentence was extended
for 30 days because she got into a fight with another inmate and beat her up so badly she had to be
admitted to the hospital for 6 days. The PMHNP considers which of the following personality disorders?
Histrionic
Narcissistic
, Borderli
ne
Schizoid
Question 6
A PMHNP student is reviewing his notes from his clinical experience over the past week to prepare his first required case present
A 27-year-old female with a 1-month history of social withdrawal, anorexia,
hypersomnia, unprovoked outbursts of anger, and a strong family history of
endogenous depression
A 41-year-old male with a history of childhood sexual abuse, loss of interest in both his
professional and personal life, an unplanned 10 lb. weight loss in the last 3 months, and
perceptual disturbances
A 65-year-old male whose wife died 2 months ago and he reports a 3-week history of generally
depressed
mood, guilt about his wife’s death, insomnia, difficulty focusing on daily tasks, with
increasing thoughts of dying
A 72-year-old female who just relocated across country to live with her adult son and
daughter-in-law who is despondent about leaving her home and reports forgetfulness, loss
of appetite, new onset bowel problems, and extreme loss of energy
Question 7
A variety of pharmacologic agents have demonstrated effectiveness in the treatment of post-traumatic stress disorder. Which of th
SSRIs
TCAs
Antiadrenerg
ics
