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NR606 Week 4 Midterm Exam

Question 1

Which diagnostic criterion of obsessive compulsive disorder is not required for a diagnosis in a child?

Answers:

1. Attempts to ignore, suppress, or neutralize persistent thoughts
2. Time spent on behaviors is more than one hour per day

🟩 C. Recognition of excessive or unreasonable thoughts or behaviors

1. Recurrent and persistent thoughts or behaviors

Question 2

Which pregnant client is at greatest risk for postpartum psychosis?

Answers:

1. A 28-year-old client with poorly managed obsessive-compulsive disorder
2. A 40-year-old client diagnosed with anxiety with peripartum onset
3. A 24-year-old client with a history of one episode of major depressive disorder

🟩 D. A 32-year-old client with a history of well-managed bipolar II disorder

Question 3

Which client diagnosed with Tourette syndrome is displaying a complex vocal tic?

Answers:

1. A child who frequently shrugs shoulders
2. A child who barks while playing with others

🟩 C. A child who repeats the last word spoken by someone else

1. A child who grunts frequently

Question 4

For which client would breastfeeding most likely be contraindicated?

Answers:

1. A client who takes diazepam
2. A client who takes quetiapine
3. A client who takes valproic acid

🟩 D. A client who takes lithium

Question 5

A client who started taking an SSRI for depressive symptoms presents with increased irritability. What additional information would help the clinician determine that the client is experiencing activation?

Answers:

1. The client has insomnia.
2. The client’s appetite has decreased.

🟩 C. Symptoms began two days after taking the first dose of SSRI.

1. Symptoms began two weeks after taking the first dose of SSRI.

Question 6

Under what circumstances may a provider withhold a child’s mental health treatment records from a parent or guardian?

Answers:

1. When the insurance company requests that the provider withhold records.
2. When the child requests that the provider withhold records.
3. When the client is 16 or older.

🟩 D. When there is concern of parental neglect.

Question 7

For which client would breastfeeding most likely be contraindicated?

Answers:

1. A client who takes alprazolam
2. A client who takes fluoxetine
3. A client who takes quetiapine

🟩 D. A client who takes clozapine

Question 8

A 17-year-old is prescribed a new stimulant medication. Which is the best approach to client education?

Answers:

1. “Think of your brain as a car. This medicine will help it run faster and smoother.”
2. “This medicine is required so you can succeed in school.”
3. “Your parents can explain why you need this medication.”

🟩 D. “This medicine has risks and benefits; let’s explore those together.”

Question 9

A client who takes lithium for bipolar disorder becomes pregnant. Which is the most appropriate initial action?

Answers:

1. Reduce the dose of lithium.
2. Discontinue lithium.

🟩 C. Switch the client to lamotrigine.

1. Have the client continue taking the prescribed dose of lithium.

Question 10

A client who has delivered her first child endorses loss of appetite, mood swings, and difficulty sleeping. What additional information would help the provider differentiate between “baby blues” and maternal depression?

Answers:

1. Whether she delivered via vaginal or Cesarean birth.
2. Whether she is successfully breastfeeding.
3. Whether she has assistance in the home.

🟩 D. Length of time since the delivery.

Question 11

A client with bipolar disorder is prescribed divalproex sodium for mania. What diagnostic tests should be monitored?

Answers:

1. ECG
2. Toxicology screen

🟩 C. Liver function test and CBC

1. Blood glucose and lipids

Question 12

What movement pattern is characteristic of Tourette syndrome?

Answers:

1. Abrupt, recurrent movements of the hands, arms, or shoulders
2. Rhythmic movements of the neck or head

🟩 C. Abrupt, recurrent movements of the neck or head

1. Rhythmic movements of the hands, arms, or shoulders

Question 13

What symptom is most common in clients with childhood-onset schizophrenia?

Answers:

1. Delusions
2. Apathy

🟩 C. Auditory hallucinations

1. Visual hallucinations

Question 14

A client who delivered her first child 3 weeks ago completes the Edinburgh Postnatal Depression Scale. What score would indicate the need for additional follow-up?

Answers:

1. 4
2. 10
3. 8

🟩 D. 14

Question 15

A client who delivered her firstborn infant two weeks ago is referred to the PMHNP by her OBGYN. Her partner reports that the client appears withdrawn, detached, and “in a daze” since the hospital discharge. The client avoids interacting with the infant, leading to bottle-feeding instead of the planned breastfeeding. The infant was born prematurely at 36 weeks and required a NICU stay prior to discharge. The client reports frequent flashbacks of the delivery, feelings of guilt, and difficulty concentrating. Which is the most likely diagnosis for this client?

Answers:

1. Generalized anxiety disorder with peripartum onset
2. Major depressive disorder with peripartum onset
3. Baby Blues

🟩 D. Post-traumatic stress disorder

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Related: (Complete) NR606 Week 8 Final Exam