NR 607 Questions and Accurate Answers (100% Correct) 2025 Latet version.

NR 607 Questions and Accurate Answers (100% Correct) 2025 Latet version. Being loyal and keeping promises is an example of what? Fidelity- Fidelity is faithfulness to one's duties, promise keeping or the commitment to obligations. Which statistical test identifies a relationship between two variables? Pearson's r correlation A patient who is refusing psychiatric treatment has their case adjudicated. The judge orders treatment over objection for the good of the patient. Which ethical principle is trumped? Autonomy Which statistical test identifies if the means of two groups are statistically different from each other? t-test The process of integrating the best research evidence with clinical expertise and client needs and values is known as: Evidence-based practice Use the following scenario to answer question regarding the Health Belief Model (HBM). A PMHNP is leading a recovery group for at-risk teens who have been mandated to attend meetings as part of their addiction treatment. A member of the group states that his problem is not that bad and he can stop anytime he chooses. Using on occasion is just a way to have fun with friends. Which concepts of the Health Belief Model best describes the group member's readiness to change? Percieved severity and perceived barriers During a psychiatric evaluation, the client reveals to the PMHNP a transgender identity. The client indicates a preference for personal pronouns like he and him. What is the biological sex of the client? Female The learned beliefs and behaviors common among all members of a group defines: Culture A cultural explanation of distress including fatigue, weakness, weight loss, somatic complaints, depressed mood and impotence thought to be related to semen loss is otherwise known as dhat in this region of the world. Where is a client most likely from given the specific complaint of dhat? India and Pakistan -Dhat syndrome is a syndrome of distress thought related to a loss of semen. Related symptoms thought caused from dhat include depressed mood, fatigue, weight loss, anxiety, somatic complaints and impotence. Andika, a 26 year old male from Indonesia swung a sword at a doctor shortly after the sudden death of his father. He lost consciousness, collapsing to the floor after the violent attempt to hurt the doctor. Which culture bound syndrome best describes Andika's behavior? Amok is mostly found amongst males in Malaysia and Indonesia. Sudden violent behavior that is often followed by amnesia best describes this dissociative episode. A patient who is considering electroconvulsive therapy (ECT) for resistant depression inquires as to the number of sessions she would likely require. Based on the best evidence currently available what is the best response? 10 In observing the appearance of the patient with depression and a history of systemic lupus erythematosus, the PMHNP notices a lesion on the neck of the patient about the size of a pencil eraser, flush with the skin, uniformly colored, with discrete borders, and consistent texture. The PMHNP should: Watch and wait A 26-year-old man has been on an antipsychotic. He requires further titration for control of symptoms. Which of the following tests should be repeated? EKG A systematic inquiry that elaborates on the chief complaint while eliciting pertinent positive and pertinent negative factors from the history is known as: Review of systems Your client Jamie asks you about a mole of her forearm. You refer her to dermatology. As an APRN, you recognize that cancerous moles can be detected on exam. Which of the following would not be of concern? Recall the ABCDE acronym. Concerning moles are asymmetric, have irregular borders, have color variation, a diameter 6mm and elevated moles. A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that he had felt a lump on his left testicle. He is concerned he has not had a physical exam in 10 years. What is the best action by the PMHNP? Explore the reason for not having had a physical in so long A 26-year-old female is diagnosed with psychosis not otherwise specified (NOS) and substance use disorder. Which of the following lab tests should be ordered prior to starting antipsychotic medications? Hemoglobin A1C, lipid profile, EKG A 68-year-old man with no past psychiatric history but with a history of poly substance use disorder is admitted for psychosis (disorganized thoughts, rapid pressured speech, persistent rumination, paranoid delusions, and apathy). Which of the following tests would be most important in determining the etiology of his new onset symptoms? HIV testing Which of the following is true regarding the influenza vaccination? All of the statements are true about the influenza vaccine (CDC). When evaluating a 78-year-old man, the PMHNP notices the patient frequently leans in with the right side of his head and frequently asks for things to be repeated. His daughter is very worried that he has dementia or depression because he has also become increasingly isolated, as well as increasingly irritable as he believes people are yelling at him out of frustration of not being heard. The daughter is tearful, anxious, and frustrated. What should the PMHNP do first? Examine the patient's ear canals A 38-year-old investment banker reveals that on weekends he visits the Delightful Dungeon and pays a dominatrix to tie him up, humiliate him, and whip him. He finds these sessions painful but very sexually arousing. He is able to become aroused and climax without this experience but finds this activity novel and has no desire to stop. Which of the following diagnosis is most likely? No diagnosis A 44 year old female presents with a heart rate of 101, nervousness, insomnia and weight loss, brittle hair. Which test would be most helpful given the findings? TSH-Hyperthyroidism can present with nervousness, irritability, increased heart rate, palpitations, sweating, tremors, weight loss, exophthalmos and insomnia. Pam is 22 yr old female who lives alone and has Bipolar disorder documented as F31.2 (Manic, Severe with psychotic features). Pam stopped taking her Quetiapine and Lithium medications. Pam's delusions are worsening and she has been awake for 36 hours. Does the PMHNP have the right to share this information with Pam's mother who lives in a neighboring state? Yes, Pam does not currently have the capacity to make decisions given her chief complaint, presentation and history of a serious mental illness.-If the PMHNP believes that the client does not have the capacity to agree or object to the sharing information at that critical time and the sharing of the information would be in the clients best interest, the provider may discuss the pertinent information only to the family member who can possibly help with the clients immediate care concerns. 45 CFR 164.510(b) When conducting a community outreach educational session regarding domestic violence, which of the following points should the PMHNP emphasize? The most dangerous time for victims is when they try to leave the abuser. After a motor vehicle accident, Nancy was unresponsive and required surgery for multiple leg fractures. In an emergency situation where one cannot weigh the risks and benefits of a procedure, what is assumed? Informed consent-In a life saving situation with a patient who lacks decision making capacity and no patient surrogate is available, the healthcare team may initiate treatment. This is known as assuming informed consent. A 16-year-old girl with no past medical history was referred by her primary care provider who saw her for a sports physical because she said she was depressed. During the interview the girl revealed that she has been feeling tired, sad, is crying easily, and has difficulty falling asleep. She reports that she has also been eating a lot more and to keep from gaining weight she has been taking laxatives and on occasion makes herself vomit. She has dropped out of the yearbook committee and she is not sure she wants to go to college anymore. Which nonpharmacologic intervention is most appropriate? Cognitive behavioral therapy A 70-year-old retired male with a history of hypertension controlled with amlodipine, metoprolol, valsartan, and furosemide has been referred from his primary care provider for depression. Formerly an avid reader, the patient has lost interest in reading and has become increasingly isolative as he has been spilling things during his lunch club meetings and finds this embarrassing, which makes him feel self-conscious and anxious. In which portion of the mental status exam would the PMHNP expect to find a deficit? Intersecting pentagon A 45-year-old man presents for a follow-up visit after starting on an SSRI 2 weeks ago for major depressive disorder. Which assessment tool would be the best indicator of progress? Quick Inventory of Depressive Symptomatology The mental status exam includes all of the following except: Cranial nerves and reflexes Jake described his brother's death stemming from a horrific car accident with minimal discomfort in his expression. Jake's affect would best be described as? Restricted Affect - Jake displayed little emotion describing the accident which would be considered a restricted or constricted affect. The next best answer would be flat affect. However, a flat affect describes a complete lack of emotional expression. Penelope is a 27-year old female with schizophrenia. She has been treated with Ripseridone. She is experiencing galactorrhea. You recognize that this side effect of Risperidone is a result of D2 blockade in the what? When the D2 receptors are blocked in the Tuberoinundibular pathway, hyperprolactinemia may result. Which cerebral lobe houses the receptive area for touch and spatial orientation? The Parietal lobe houses the receptive area for touch and spatial orientation. A patient appears internally preoccupied and responding to auditory hallucination. This patient may have a pathology affecting which lobe of the brain? Temporal lobe Expressive aphasia may occur with damage in which brain location? Damage to Broca's area located within the frontal lobe may result in expressive aphasia. Which of the following receives messages and conducts impulses to the soma? Dendrite Theodore is a 44 year old male with a history of traumatic brain injury (TBI). Today, he presents to you with his caregiver, Beverly. He has difficulty determining whether you are happy or angry. Which area of the brain is most likely impacted secondary to his TBI? Damage to the right hemisphere may impair the ability to interpret when a speaker is angry, sad, happy or other. The physiological process in which structural changes occur in the brain, increasing the likelihood of addiction over time and increasing the risk of relapse after a period of sobriety, is called: Neuroadaptation What is the fatty layer that prevents interference and increases the speed of impulse transmission along the axon? Myelin sheath Layla checks on her curling iron to ensure it has been shut off upwards of 8 times per day. Layla suffers from obsessive thinking. Layla likely has an overly active what? The Caudate Nucleus is thought to be dysfunctional in persons with OCD. This lobe of the brain empowers one to know the difference in how one should act at a church service vs. at a football game? The Frontal lobe is involved with personality and modifying emotions to fit what is considered socially acceptable. Which is the key laboratory parameter for monitoring patients for clozapine-induced neutropenia? The ANC or Absolute Neutrophil count is the key laboratory parameter for monitoring patients for clozapine-induced neutropenia. Which of the following is not related to the Black Box warning for Valproate? Acute dystonia is not an adverse effect of Valproate. The Black box warning for Depakote includes Hepatotoxicity, Pancreatitis, Teratogenicity and Thrombocytopenia. A 19-year-old male is referred to the PMHNP by the student health office for alcohol use disorder. The patient states that on one occasion he passed out much sooner than he usually would with far less than he would usually drink. Upon further interview, the patient reveals the time he passed out was during a fraternity hazing in which he was butt-chugging (receiving a beer and vodka enema). What pharmacokinetic process was bypassed by this rectal administration route? First-pass effect An uninsured patient who was discharged from the hospital on haloperidol 10 mg twice daily presents to the PMHNP for a 2-week follow-up medication check visit. On exam the patient has tachypnea, tachycardia, and tremors, the skin is hot to the touch, and is overall very rigid. What should the PMHNP do first? Call 911 for transfer to the emergency department Which of the following adverse drug effects is usually temporary? Nausea is often a time limited side effect during the initiation of SSRI treatment. Gabe receives psychotherapy for performance anxiety. He has a rare request for a medication to help with sleep. He is required to travel for work and is requesting help. He has no trouble with sleep latency, but wants 6 hours of sleep. Which of the following best fits Gabe's needs? Eszopiclone (Lunesta) may help with short term insomnia related to sleep maintenance issues. Which of the following is true about a drug with a narrow therapeutic index? The plasma concentration required for a therapeutic effect is near the concentration that results in toxic effects. Sunny is a 50-year -old female who presents to the clinic with a recent ECG tracing. Her QTC is recorded at 327 ms. Mary is on Citalopram 40 mg daily x 3 years secondary to generalized anxiety disorder. Given this information, you decide to do what? Do nothing. A QTC of 388 ms is considered normal. Persons over 60 are limited to a daily dose of Citaloprma 20mg given the potential risk of prolonged QTC. Pharmacodynamics describe which of the following? Pharmacodynamics describe how the drug effects the body. The PMHNP in the ED is evaluating a 68-year-old woman who was recently diagnosed with mild cognitive impairment and cannot remember the name of the medication that she has recently started 1 week ago. The patient is complaining of increased heart rate, sweating, and muscle spasms progressively worsening for the last 3 days. Which neurotransmitter is associated with this adverse effect? Acetylcholine A 15-year-old boy has refused to go to school for the past month. Every morning he has a new symptom or develops one and has to be picked up from school. When he is home, the symptoms disappear. On weekends the symptoms never present. What is the most likely diagnosis? Separation anxiety The cognitive processes that allows us to organize, plan, sequence and initiate tasks are collectively know as what? Executive functions allow us to pay attention, organize, plan, prioritize, sequence, begin tasks, regulate emotions, self monitor and comprehend different view points. Executive functions are sometimes referred to as the the CEO of the brain. A 55-year-old female recently accepted a severance package for early retirement from her job as a fashion buyer for a major retail store. Over the past 6 months she has increasingly become isolated, neglecting her self-care, and collecting various things of no real value. Her appearance is unkempt, and her affect is flat. Before being called back to the consultation room the PMHNP notices that the patient seems to be talking to herself audibly. During the consultation the patient makes poor eye contact and wants frequent reassurance that no one is listening in. Which of the following would be the best action for the PMHNP to take? Speak in a clam reassuring voice and evaluate for comorbid conditions According to the DSM-5, an incongruence between one's natal gender and one's experienced or expressed gender is better known as what? Gender Dysphoria describes the marked incongruence between an individual's gender assigned at birth and their expressed or experienced gender. Jerry, a 37 year old male presents to you after agreeing with his partner's request to obtain help. He notes that he collects comic books and feels strongly that this growing collection is an investment in the future. He offers that he never sells the comic books and "cannot part with them". He admits that the condominium is running out of walkable hallway space to store all of the comics. Despite this, he continues to purchase more comic books each week. His partner is concerned about both the cost of the comic books and the remaining space left in their home to store these items. What is the best diagnosis? Hoarding disorder, excessive acquisition type. The comic book collecting becomes pathological hoarding once the diagnostic criteria are met. In this case, the patient has difficulty discarding the comic books, feels he needs to save them (not selling any), has accumulated comic books that congest the living space and yet continues to purchase more despite third party opinion. Shirley is a 20-year-old female on oral contraceptives. Which of the following is most likely to interact with her oral contraceptive? All of the above may decrease the efficacy of oral contraceptives. Roberto is a 26 year old male who intentionally punctured his foot with a rusty nail and smothered the wound with dirt. Several days later he sought medical care. He verbalized to his PCP that he must have stepped on something while walking his dog. In the absence of secondary gain, this example best represents which diagnosis? The best answer is factitious disorder. In this case scenario there was induction of injury, deceptive behavior in the absence of obvious external rewards. A 32-year-old man presents to the emergency department with acute onset disorganization, paranoid delusions, and visual hallucinations of flying bugs, which he tries to crush because he thinks they contain listening devices. The patient is accompanied by the police, who were called because the man was smashing things in a store. Which of the following can the PMHNP diagnose during the initial encounter? Brief psychotic disorder A 25-year-old woman reports frequently falling asleep during the day for the last 6 months. This has been affecting her work as a computer help desk agent, noting she sometimes nods off during calls but also during times of high volume. When her head hits the back of the chair she wakes up and realizes what has happened. She insists she consistently sleeps 8 hours each night. This is most consistent with which of the following? Narcolepsy Which of the following would meet the diagnostic criterion A for the diagnosis of Acute Stress disorder? Being in the close vicinity of a drive by shooting while walking to work- The Criterion A for Acute Stress Disorder include traumatic events that are experienced directly such as exposure to war, threatened or actual violent assault, natural or manmade disasters and severe accidents. A 10-year-old boy is referred by the school nurse because of persistent stomachache every morning in school. In evaluating the boy, the PMHNP learned that he does not like to go to school and insists on coming home immediately, and that he sleeps in his parent's bed at night. His clinical description is most characteristic of which of the following conditions? Separation anxiety The PMHNP is performing primary prevention in the high school regarding mental illness. The most common psychiatric emergency in children and adolescents is: Suicidal behavior Shawna is a 3 year old female who, at times, bites her own hand. She has no other concerning behaviors or developmental delays. Which of the following would be the best intervention? No treatment is required for stereotypic movement disorder when not associated with other symptoms. This behavior should fade by 4 years of age. A 4-year-old boy is brought to the pediatric emergency department kicking and screaming while trying to run away from the sharks he fears are going to eat him. Which of the following diagnostic tests would be most appropriate? Urine toxicology Which of the following regarding Rett syndrome is false? Rett syndrome is a rare disorder that mostly occurs in males is false. This neurodevelopmental disorder affects girls almost exclusively. In terms of the management of Bipolar disorder in pregnancy, one should avoid Lithium, Valproic acid and Carbamazepine, especially in which trimester? First-Lithium, Valproic acid and Carbamazepine have been associated with fetal harm, with the greatest risk occurring in the first trimester Which of the following developmental milestones should a 2-year-old child be able to accomplish? Copy a circle Luanne is a 19-year-old single mother of a 3-year-old boy. She works during the day and attends classes for her high school equivalency exam several evenings per week. Her son is in daycare and an after-school program from 8 a.m. to 7 p.m. 5 days per week. She reports feeling so tired that she sometimes loses her patience with her son and gives him Benadryl to help calm him down and sleep through the night. Which of the following actions should the PMHNP take? Report the mother to child protective services Ella is trying to help her 3-year-old son sleep through the night but reports recently he has had three episodes of waking up within 3 hours of falling asleep with inconsolable screaming and crying. He then falls back asleep on his own and has no memory of what happened. What would be the best intervention? Create and maintain bedtime routine and reduce stimuli The school psychologist refers a 7-year-old girl with difficulty reading, distractibility, and writing avoidance behaviors. The child has no diagnosed conditions, takes no medications, and met all of her developmental milestones. She loves arts and crafts and physical education. Prior to diagnosing a learning disorder, which of the following screening tests must be performed? Vision and hearing A 30-year-old male who was started on sertraline for generalized anxiety disorder was also started on lorazepam 1 mg for sleep during the first 2 weeks as he was adjusting to the medication. At the 2-week follow-up visit his psychiatrist increased the sertraline, but the dose of lorazepam does not seem to be helping with sleep and the patient is requesting a higher dose. Which of the following best describes the patient's condition? Tolerance A 60-year-old man with alcohol use disorder in remission presents to the psychiatric ED and is very distraught. He tells the PMHNP that he was at his daughter's wedding and called upon to make a toast. The waiter had handed him the champagne glass, and he took a sip of alcohol for the first time in 10 years. He tells the PMHNP that he is concerned he may relapse and go back to his old ways. What is the best response by the PMHNP? "How have you been able to maintain your sobriety for so long?" A patient who has been drinking a six-pack of beer each night to relax after work has been having trouble staying asleep through the night. When she wakes up at 2 a.m. she takes diphenhydramine 25 mg to help her fall back asleep, but this makes her sleep through the alarm clock and late for work. She also reports having a headache through midmorning until she gets her second cup of coffee. She thinks this is related to her alcohol use and has unsuccessfully tried to cut down several times in the past year. Which of the following disorders best describes this patient's condition? Alcohol use disorder A patient who has been stable on his long-acting injectable medication tells the PMHNP that he would like to quit smoking. What is the best response? "Let us make an appointment as your medication dose may need to be lowered." A 29-year-old man presents to the emergency department stating he is very anxious and feels his heart is going to beat out of his chest. He is diaphoretic, with pressured speech and unable to be calmed. A psychiatric consult was called because the patient seems uncooperative and a proper history cannot be obtained. Which of the following conditions must be excluded first? Cocaine-induced mood disorder Which of the following substances would be most likely to cause withdrawal symptoms? Alprazolam A patient presents for a follow-up visit and has a dual diagnosis of substance use disorder and major depressive disorder. He reports that he has been feeling increasingly anxious, having difficulty sleeping. He continues to attend his Alcoholics Anonymous meetings regularly, but reports he had two beers 3 days ago and feels very guilty. Which of the following best describes this patient's situation? Lapse A 49-year-old female is on Fentanyl patch at 25 mcg/hr. In the last week the patient's valproate was increased from 750mg po BID to 1000mg po BID. In the last 4 days the patient was placed on clarithromycin for strep throat and started cepacol lozenges. This morning she was resuscitated with Naloxone and she returned to baseline mantation. Which medication likely contributed to her unresponsive episode? All of these contributed to this episode.-The patient was on Fentanyl and recently started a strong CYP3A4 inhibitor (Macrolide antibiotics include clarithromycin). This led to a REDUCTION in the clearance of the opioid resulting in sedation. Individuals with a history of prenatal alcohol exposure are at increased risk for what disorder? The risk for all of these disorders is increased. Individuals with a history of prenatal alcohol exposure are at increased risk for ADHD, bipolar, depressive disorders, ODD, conduct disorders, alcohol use disorder and substance use disorders. A 38-year-old male presents for follow up chronic back pain and spasm. Four years earlier, he sustained a motorcycle accident. He has been taking morphine extended release 40mg PO BID and Hydrocodone 10mg IR Qd PRN. Today he complains that the medication is no longer effective. He notes diarrhea and restlessness when he skips a dose. He continues to be employed and has not missed any work days. He has been filling the prescription 1 day early each month and visited an urgent care twice this summer requesting additional pain control. The are no changes on exam today and no focal deficits. Which of the following do you recommend for this patient? Evaluate for Opioid use disorder, recommend a slow taper off full opioid agonists and then start buprenorphine. -This patient has signs of OUD. This is little evidence supporting opioids for chronic pain syndromes. The patient remains functional at work so no need for acute hospitalization. Benzodiazepines and opioids should not be combined given the increase risk of death when used together. A 62-year-old woman formerly employed as a receptionist reports progressive word-finding difficulty over the past 6 months that caused her so much anxiety she quit her job. Her daughter has become increasingly impatient waiting for her to finish her sentences but she has now become depressed due to the relational strain. She denies any other behavioral problems. Which of the following diagnostic tests would be most appropriate? Brain MRI with and without contrast A middle-school girl who is timid to take any risks, prefers solitary activities, and does not ask questions of her teachers for fear that she is bothering them likely did not master which developmental stage? Initiative versus Guilt The S2 heart sound is a result of what? Closure of the semilunar valves- The closure of the semilunar valves results in the second heart sound. The semilunar valves are the aortic and pulmonary valves. A 36-year-old Korean male who has recently started attending graduate school complains of persistent abdominal pain despite an extensive gastrointestinal work-up including an upper and lower gastroscopy. Which of the following defense mechanisms is employed? Conversion A 16 year old client Jamie presents to your office and begins with "I might be transgender". You respond, My name is James, and my pronouns are he/him. How do you Jamie, describe your gender identity? What are your preferred pronouns? Jamie answers, "My pronouns are "They". As a PMHNP you recognize that Jamie... Identifies as non-binary A 35-year-old female victim of sexual assault is fearful of getting into any more relationships but expresses dissatisfaction at the prospect of being alone forever. What therapeutic technique would be most appropriate for this patient? Cognitive behavioral therapy Teddy is a 6 year old male who is frustrated that he cannot learn as quickly as his peers. What Erikson stage of Psychosocial development does this best describe? Industry vs. Inferiority begins at age 6 -11, school aged children. Competence is developed, and the child now compares himself/herself to others and can appreciate disparities in ability.