NRNP 6665 FINAL EXAM
Actual Questions and Answers
Expert-Verified Explanation
This Exam contains:
❖ The Exam has passing score of 90%
❖ 100 Questions and Answers
❖ format set of multiple-choice
❖ Expert-Verified explanation
❖ Verified with trusted textbooks
,**Question 1:**
The Confusion Assessment Method instrument (CAMI) is a standardized
assessment tool for which of the following disorders?
A. Depression
B. Anxiety
C. Delirium
D. Schizophrenia
**Answer:** C. Delirium
**Explanation:**
The Confusion Assessment Method (CAM) is a widely recognized tool used to
identify delirium in patients. Delirium is an acute neuropsychiatric syndrome
characterized by sudden changes in attention, awareness, and cognition. CAM
assesses key features such as the acute onset and fluctuating course, inattention,
disorganized thinking, and altered level of consciousness. Accurate identification
of delirium is crucial as it is associated with increased morbidity and mortality,
especially in hospitalized and elderly patients. Early diagnosis using CAM allows
for timely intervention and management of the underlying causes, thereby
improving patient outcomes.
---
**Question 2:**
Which of the following is a common sensory deficit of conversion disorder? (Check
all that apply)
A. Blindness
B. Deafness
C. Loss of limb
D. Paralysis
**Answer:**
A. Blindness
B. Deafness
**Explanation:**
Conversion disorder, now known as Functional Neurological Symptom Disorder in
the DSM-5, involves neurological symptoms that are not explained by medical
evaluation. Common sensory deficits include blindness and deafness, which occur
without any organic cause. These deficits are psychological in origin and often
,serve as a manifestation of underlying stress or trauma. While loss of a limb
(anosognosia) and paralysis can also be present in conversion disorders, the
primary sensory deficits typically involve the senses of sight and hearing.
---
**Question 3:**
Delirium is an example of which type of clinical problem in psychosomatic
medicine?
A. Primary psychiatric disorder
B. Psychiatric symptoms secondary to a medical condition
C. Behavioral disorder
D. Developmental disorder
**Answer:** B. Psychiatric symptoms secondary to a medical condition
**Explanation:**
Delirium is classified as psychiatric symptoms secondary to a medical condition
within psychosomatic medicine. It arises as a result of an underlying physiological
cause, such as infection, medication side effects, or metabolic disturbances. Unlike
primary psychiatric disorders, which originate in the absence of another medical
condition, delirium is directly attributable to an acute medical issue. Recognizing
delirium as secondary to a medical condition is essential for appropriate
treatment, which focuses on addressing the underlying medical cause rather than
solely managing the psychiatric symptoms.
---
**Question 4:**
All of the following medications are used in the treatment of Parkinson’s disease
dementia/psychosis except for:
A. Rivastigmine
B. Olanzapine
C. Memantine
D. Pimavanserin
**Answer:** C. Memantine
**Explanation:**
Memantine is primarily used to treat moderate to severe Alzheimer's disease and is
not typically used for Parkinson’s disease dementia or psychosis. In contrast,
,Rivastigmine, a cholinesterase inhibitor, is approved for managing dementia
symptoms in Parkinson’s disease. Pimavanserin is specifically approved for
treating psychosis associated with Parkinson’s disease, and Olanzapine, an atypical
antipsychotic, may sometimes be used off-label with caution to manage psychosis
without exacerbating motor symptoms. Thus, Memantine is the exception among
the listed medications.
---
**Question 5:**
Indicators of imitative dissociative identity disorder include which of the following
symptoms?
A. Persistent mood swings
B. Confusion and symptoms related to stress
C. Recurrent hearing voices
D. Impaired memory for personal information
**Answer:** B. Confusion and symptoms related to stress
**Explanation:**
Dissociative Identity Disorder (DID) is characterized by the presence of two or
more distinct personality states. Indicators include significant confusion, memory
gaps, and symptoms that appear related to external stressors. Patients often
experience alterations in identity and behavior that seem imitative or influenced
by their environment or experiences. While impaired memory is also a feature of
DID, the key indicators specifically relate to confusion and stress-related
symptoms, distinguishing it from other disorders that might involve mood swings
or auditory hallucinations.
---
**Question 6:**
Which of the following can lower a person's resistance to control impulses?
A. Fatigue
B. Incessant stimulation
C. Psychic trauma
D. All of the above
**Answer:** D. All of the above
**Explanation:**
,Fatigue, incessant stimulation, and psychic trauma are all factors that can impair
an individual's ability to control impulses. Fatigue affects cognitive function and
decision-making, making it harder to resist impulses. Constant stimulation, such as
noise or information overload, can overwhelm the brain's capacity to regulate
responses effectively. Psychic trauma can disrupt emotional regulation and
executive functioning, further weakening impulse control. Therefore, all the listed
factors contribute to lowered resistance to controlling impulses.
---
**Question 7:**
Schizophrenia in a patient with end-stage renal disease is an example of which type
of clinical problem in psychosomatic medicine?
A. Primary psychiatric disorder
B. Psychiatric symptoms secondary to a medical condition
C. Behavioral problem
D. Developmental disorder
**Answer:** B. Psychiatric symptoms secondary to a medical condition
**Explanation:**
When schizophrenia occurs in the context of a significant medical condition such
as end-stage renal disease (ESRD), it is considered a psychiatric symptom
secondary to a medical condition. The physiological and psychological stressors
associated with ESRD, including electrolyte imbalances and the psychosocial
impact of chronic illness, can exacerbate or contribute to psychiatric symptoms
like those seen in schizophrenia. This classification emphasizes the need to
address both the medical and psychiatric aspects of the patient's health in
treatment planning.
---
**Question 8:**
A patient expresses feelings of unreality or detachment from their environment,
describing the perception of the outside world as unreal, dreamlike, and visually
distorted. The ARNP recognizes this as which of the following?
A. Depersonalization
B. Derealization
C. Hallucination
D. Delusion
,**Answer:** B. Derealization
**Explanation:**
Derealization involves a persistent or recurrent feeling of detachment from the
surrounding environment, where the external world appears unreal, dreamlike, or
visually distorted. This contrasts with depersonalization, which involves
detachment from oneself. Hallucinations are sensory experiences without external
stimuli, and delusions are firmly held false beliefs. The patient's description
specifically aligns with derealization, as it pertains to the perception of the
external environment rather than the self.
---
**Question 9:**
A patient presents with persistent feelings of detachment from oneself, like
watching one's life in a movie. The ARNP recognizes this as which of the following?
A. Derealization
B. Depersonalization
C. Schizophrenia
D. Mania
**Answer:** B. Depersonalization
**Explanation:**
Depersonalization is characterized by persistent or recurrent feelings of
detachment from one's own body or mental processes, as if observing oneself from
an external perspective. This can manifest as feeling like a passive observer of
one's actions or life events, akin to watching a movie. Derealization, on the other
hand, involves detachment from the external world. Schizophrenia and mania
involve broader psychiatric symptoms that are not limited to self-detachment.
---
**Question 10:**
An acute onset, short-term confusion with changes in cognition and level of
awareness due to a physiological cause is known as which of the following?
A. Dementia
B. Delirium
C. Depression
D. Anxiety
,**Answer:** B. Delirium
**Explanation:**
Delirium is an acute neurocognitive disorder characterized by sudden confusion,
disturbances in attention and awareness, and fluctuating levels of consciousness.
It typically arises from a physiological cause, such as infection, medication side
effects, or metabolic imbalances. Unlike dementia, which is a chronic and
progressive decline in cognitive function, delirium has a rapid onset and is often
reversible with appropriate treatment of the underlying cause. Depression and
anxiety primarily affect mood and do not present with acute confusion or altered
consciousness.
---
**Question 11:**
Which of the following is recommended in the treatment of pyromania?
A. Medication therapy
B. Cognitive therapy
C. Electroconvulsive therapy
D. Exposure therapy
**Answer:** B. Cognitive therapy
**Explanation:**
Pyromania is an impulse control disorder characterized by an obsession with fire
and deliberate, purposeful setting of fires. Cognitive therapy is recommended as it
helps individuals understand and modify the thought patterns and behaviors that
lead to fire-setting. This form of psychotherapy focuses on addressing the
underlying psychological factors, developing better coping mechanisms, and
reducing the impulsive drive to commit arson. Medication therapy and other forms
of therapy may be adjunctive but are not the primary recommended treatments for
pyromania.
---
**Question 12:**
Which of the following biological factors have been associated with kleptomania?
(Check all that apply)
A. Brain disease
B. Cortical atrophy
C. Enlarged lateral ventricles
,D. Dopamine dysregulation
**Answer:**
A. Brain disease
B. Cortical atrophy
C. Enlarged lateral ventricles
**Explanation:**
Kleptomania has been linked to various biological factors, including brain diseases
that affect impulse control, cortical atrophy which may impair executive functions,
and enlarged lateral ventricles indicating possible structural brain changes. These
biological abnormalities can disrupt the neural pathways involved in self-
regulation and impulse control, contributing to the compulsive behavior seen in
kleptomania. While dopamine dysregulation is implicated in many impulse control
disorders, it was not specifically listed in the original answer options provided.
---
**Question 13:**
A neurodevelopmental disorder characterized by impairment confined to a specific
area of academic achievement (e.g., reading, writing, spelling) without deficits in
intellectual and adaptive behaviors is known as which of the following?
A. Attention-Deficit/Hyperactivity Disorder (ADHD)
B. Specific Learning Disability
C. Autism Spectrum Disorder
D. Intellectual Disability
**Answer:** B. Specific Learning Disability
**Explanation:**
A Specific Learning Disability (SLD) is characterized by significant difficulties in
specific academic areas such as reading (dyslexia), writing (dysgraphia), or
mathematics (dyscalculia), despite having normal intelligence and adequate
educational opportunities. Individuals with SLD do not exhibit broad deficits in
adaptive behaviors or intellectual functioning, which distinguishes it from
disorders like Autism Spectrum Disorder or Intellectual Disability, where multiple
areas of functioning are affected.
---
**Question 14:**
, Which of the following approaches/treatments are recommended in working with
patients with a conversion disorder?
A. Recommend psychotherapy to focus on issues of stress and coping
B. Prescribe anti-anxiety medications
C. Initiate cognitive-behavioral therapy
D. Suggest physical therapy
**Answer:** A. Recommend psychotherapy to focus on issues of stress and coping
**Explanation:**
Conversion disorder, or Functional Neurological Symptom Disorder, involves
neurological symptoms such as paralysis, blindness, or seizures that are not
explained by medical evaluation. The recommended treatment approach focuses
on psychotherapy aimed at addressing the underlying psychological stressors and
improving coping mechanisms. By exploring and resolving emotional conflicts or
stress, psychotherapy can help alleviate the conversion symptoms. While
cognitive-behavioral therapy can be a component, the primary recommendation is
targeted psychotherapy addressing stress and coping strategies.
---
**Question 15:**
Experiences of depersonalization and derealization are common in which of the
following patients?
A. Patient that uses marijuana
B. Patient suffering from Parkinson’s disease
C. Patient with Major Depressive Disorder
D. Patient with Generalized Anxiety Disorder
**Answer:** A. Patient that uses marijuana
**Explanation:**
Depersonalization and derealization are dissociative symptoms where individuals
feel detached from themselves or perceive the external world as unreal. These
experiences are commonly reported among individuals who use marijuana,
especially with high-potency strains or frequent use. Marijuana can alter
perception, leading to feelings of detachment and unreality. While
depersonalization and derealization can also occur in conditions like Major
Depressive Disorder and Generalized Anxiety Disorder, they are notably prevalent
in the context of marijuana use.
Actual Questions and Answers
Expert-Verified Explanation
This Exam contains:
❖ The Exam has passing score of 90%
❖ 100 Questions and Answers
❖ format set of multiple-choice
❖ Expert-Verified explanation
❖ Verified with trusted textbooks
,**Question 1:**
The Confusion Assessment Method instrument (CAMI) is a standardized
assessment tool for which of the following disorders?
A. Depression
B. Anxiety
C. Delirium
D. Schizophrenia
**Answer:** C. Delirium
**Explanation:**
The Confusion Assessment Method (CAM) is a widely recognized tool used to
identify delirium in patients. Delirium is an acute neuropsychiatric syndrome
characterized by sudden changes in attention, awareness, and cognition. CAM
assesses key features such as the acute onset and fluctuating course, inattention,
disorganized thinking, and altered level of consciousness. Accurate identification
of delirium is crucial as it is associated with increased morbidity and mortality,
especially in hospitalized and elderly patients. Early diagnosis using CAM allows
for timely intervention and management of the underlying causes, thereby
improving patient outcomes.
---
**Question 2:**
Which of the following is a common sensory deficit of conversion disorder? (Check
all that apply)
A. Blindness
B. Deafness
C. Loss of limb
D. Paralysis
**Answer:**
A. Blindness
B. Deafness
**Explanation:**
Conversion disorder, now known as Functional Neurological Symptom Disorder in
the DSM-5, involves neurological symptoms that are not explained by medical
evaluation. Common sensory deficits include blindness and deafness, which occur
without any organic cause. These deficits are psychological in origin and often
,serve as a manifestation of underlying stress or trauma. While loss of a limb
(anosognosia) and paralysis can also be present in conversion disorders, the
primary sensory deficits typically involve the senses of sight and hearing.
---
**Question 3:**
Delirium is an example of which type of clinical problem in psychosomatic
medicine?
A. Primary psychiatric disorder
B. Psychiatric symptoms secondary to a medical condition
C. Behavioral disorder
D. Developmental disorder
**Answer:** B. Psychiatric symptoms secondary to a medical condition
**Explanation:**
Delirium is classified as psychiatric symptoms secondary to a medical condition
within psychosomatic medicine. It arises as a result of an underlying physiological
cause, such as infection, medication side effects, or metabolic disturbances. Unlike
primary psychiatric disorders, which originate in the absence of another medical
condition, delirium is directly attributable to an acute medical issue. Recognizing
delirium as secondary to a medical condition is essential for appropriate
treatment, which focuses on addressing the underlying medical cause rather than
solely managing the psychiatric symptoms.
---
**Question 4:**
All of the following medications are used in the treatment of Parkinson’s disease
dementia/psychosis except for:
A. Rivastigmine
B. Olanzapine
C. Memantine
D. Pimavanserin
**Answer:** C. Memantine
**Explanation:**
Memantine is primarily used to treat moderate to severe Alzheimer's disease and is
not typically used for Parkinson’s disease dementia or psychosis. In contrast,
,Rivastigmine, a cholinesterase inhibitor, is approved for managing dementia
symptoms in Parkinson’s disease. Pimavanserin is specifically approved for
treating psychosis associated with Parkinson’s disease, and Olanzapine, an atypical
antipsychotic, may sometimes be used off-label with caution to manage psychosis
without exacerbating motor symptoms. Thus, Memantine is the exception among
the listed medications.
---
**Question 5:**
Indicators of imitative dissociative identity disorder include which of the following
symptoms?
A. Persistent mood swings
B. Confusion and symptoms related to stress
C. Recurrent hearing voices
D. Impaired memory for personal information
**Answer:** B. Confusion and symptoms related to stress
**Explanation:**
Dissociative Identity Disorder (DID) is characterized by the presence of two or
more distinct personality states. Indicators include significant confusion, memory
gaps, and symptoms that appear related to external stressors. Patients often
experience alterations in identity and behavior that seem imitative or influenced
by their environment or experiences. While impaired memory is also a feature of
DID, the key indicators specifically relate to confusion and stress-related
symptoms, distinguishing it from other disorders that might involve mood swings
or auditory hallucinations.
---
**Question 6:**
Which of the following can lower a person's resistance to control impulses?
A. Fatigue
B. Incessant stimulation
C. Psychic trauma
D. All of the above
**Answer:** D. All of the above
**Explanation:**
,Fatigue, incessant stimulation, and psychic trauma are all factors that can impair
an individual's ability to control impulses. Fatigue affects cognitive function and
decision-making, making it harder to resist impulses. Constant stimulation, such as
noise or information overload, can overwhelm the brain's capacity to regulate
responses effectively. Psychic trauma can disrupt emotional regulation and
executive functioning, further weakening impulse control. Therefore, all the listed
factors contribute to lowered resistance to controlling impulses.
---
**Question 7:**
Schizophrenia in a patient with end-stage renal disease is an example of which type
of clinical problem in psychosomatic medicine?
A. Primary psychiatric disorder
B. Psychiatric symptoms secondary to a medical condition
C. Behavioral problem
D. Developmental disorder
**Answer:** B. Psychiatric symptoms secondary to a medical condition
**Explanation:**
When schizophrenia occurs in the context of a significant medical condition such
as end-stage renal disease (ESRD), it is considered a psychiatric symptom
secondary to a medical condition. The physiological and psychological stressors
associated with ESRD, including electrolyte imbalances and the psychosocial
impact of chronic illness, can exacerbate or contribute to psychiatric symptoms
like those seen in schizophrenia. This classification emphasizes the need to
address both the medical and psychiatric aspects of the patient's health in
treatment planning.
---
**Question 8:**
A patient expresses feelings of unreality or detachment from their environment,
describing the perception of the outside world as unreal, dreamlike, and visually
distorted. The ARNP recognizes this as which of the following?
A. Depersonalization
B. Derealization
C. Hallucination
D. Delusion
,**Answer:** B. Derealization
**Explanation:**
Derealization involves a persistent or recurrent feeling of detachment from the
surrounding environment, where the external world appears unreal, dreamlike, or
visually distorted. This contrasts with depersonalization, which involves
detachment from oneself. Hallucinations are sensory experiences without external
stimuli, and delusions are firmly held false beliefs. The patient's description
specifically aligns with derealization, as it pertains to the perception of the
external environment rather than the self.
---
**Question 9:**
A patient presents with persistent feelings of detachment from oneself, like
watching one's life in a movie. The ARNP recognizes this as which of the following?
A. Derealization
B. Depersonalization
C. Schizophrenia
D. Mania
**Answer:** B. Depersonalization
**Explanation:**
Depersonalization is characterized by persistent or recurrent feelings of
detachment from one's own body or mental processes, as if observing oneself from
an external perspective. This can manifest as feeling like a passive observer of
one's actions or life events, akin to watching a movie. Derealization, on the other
hand, involves detachment from the external world. Schizophrenia and mania
involve broader psychiatric symptoms that are not limited to self-detachment.
---
**Question 10:**
An acute onset, short-term confusion with changes in cognition and level of
awareness due to a physiological cause is known as which of the following?
A. Dementia
B. Delirium
C. Depression
D. Anxiety
,**Answer:** B. Delirium
**Explanation:**
Delirium is an acute neurocognitive disorder characterized by sudden confusion,
disturbances in attention and awareness, and fluctuating levels of consciousness.
It typically arises from a physiological cause, such as infection, medication side
effects, or metabolic imbalances. Unlike dementia, which is a chronic and
progressive decline in cognitive function, delirium has a rapid onset and is often
reversible with appropriate treatment of the underlying cause. Depression and
anxiety primarily affect mood and do not present with acute confusion or altered
consciousness.
---
**Question 11:**
Which of the following is recommended in the treatment of pyromania?
A. Medication therapy
B. Cognitive therapy
C. Electroconvulsive therapy
D. Exposure therapy
**Answer:** B. Cognitive therapy
**Explanation:**
Pyromania is an impulse control disorder characterized by an obsession with fire
and deliberate, purposeful setting of fires. Cognitive therapy is recommended as it
helps individuals understand and modify the thought patterns and behaviors that
lead to fire-setting. This form of psychotherapy focuses on addressing the
underlying psychological factors, developing better coping mechanisms, and
reducing the impulsive drive to commit arson. Medication therapy and other forms
of therapy may be adjunctive but are not the primary recommended treatments for
pyromania.
---
**Question 12:**
Which of the following biological factors have been associated with kleptomania?
(Check all that apply)
A. Brain disease
B. Cortical atrophy
C. Enlarged lateral ventricles
,D. Dopamine dysregulation
**Answer:**
A. Brain disease
B. Cortical atrophy
C. Enlarged lateral ventricles
**Explanation:**
Kleptomania has been linked to various biological factors, including brain diseases
that affect impulse control, cortical atrophy which may impair executive functions,
and enlarged lateral ventricles indicating possible structural brain changes. These
biological abnormalities can disrupt the neural pathways involved in self-
regulation and impulse control, contributing to the compulsive behavior seen in
kleptomania. While dopamine dysregulation is implicated in many impulse control
disorders, it was not specifically listed in the original answer options provided.
---
**Question 13:**
A neurodevelopmental disorder characterized by impairment confined to a specific
area of academic achievement (e.g., reading, writing, spelling) without deficits in
intellectual and adaptive behaviors is known as which of the following?
A. Attention-Deficit/Hyperactivity Disorder (ADHD)
B. Specific Learning Disability
C. Autism Spectrum Disorder
D. Intellectual Disability
**Answer:** B. Specific Learning Disability
**Explanation:**
A Specific Learning Disability (SLD) is characterized by significant difficulties in
specific academic areas such as reading (dyslexia), writing (dysgraphia), or
mathematics (dyscalculia), despite having normal intelligence and adequate
educational opportunities. Individuals with SLD do not exhibit broad deficits in
adaptive behaviors or intellectual functioning, which distinguishes it from
disorders like Autism Spectrum Disorder or Intellectual Disability, where multiple
areas of functioning are affected.
---
**Question 14:**
, Which of the following approaches/treatments are recommended in working with
patients with a conversion disorder?
A. Recommend psychotherapy to focus on issues of stress and coping
B. Prescribe anti-anxiety medications
C. Initiate cognitive-behavioral therapy
D. Suggest physical therapy
**Answer:** A. Recommend psychotherapy to focus on issues of stress and coping
**Explanation:**
Conversion disorder, or Functional Neurological Symptom Disorder, involves
neurological symptoms such as paralysis, blindness, or seizures that are not
explained by medical evaluation. The recommended treatment approach focuses
on psychotherapy aimed at addressing the underlying psychological stressors and
improving coping mechanisms. By exploring and resolving emotional conflicts or
stress, psychotherapy can help alleviate the conversion symptoms. While
cognitive-behavioral therapy can be a component, the primary recommendation is
targeted psychotherapy addressing stress and coping strategies.
---
**Question 15:**
Experiences of depersonalization and derealization are common in which of the
following patients?
A. Patient that uses marijuana
B. Patient suffering from Parkinson’s disease
C. Patient with Major Depressive Disorder
D. Patient with Generalized Anxiety Disorder
**Answer:** A. Patient that uses marijuana
**Explanation:**
Depersonalization and derealization are dissociative symptoms where individuals
feel detached from themselves or perceive the external world as unreal. These
experiences are commonly reported among individuals who use marijuana,
especially with high-potency strains or frequent use. Marijuana can alter
perception, leading to feelings of detachment and unreality. While
depersonalization and derealization can also occur in conditions like Major
Depressive Disorder and Generalized Anxiety Disorder, they are notably prevalent
in the context of marijuana use.
