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NR547 Week 4 Midterm Exam

Which statement is true regarding obsessive-compulsive disorder related compulsions?

Answers: A – D

1. they are typically performed in response to an obsessive thought ✅
   B. they are usually infrequent and not severe
   C. they are separate and unrelated to obsessions
   D. the purpose of the compulsion is to help the patient avoid the obsessive thought

Which symptom is most likely to be present in a client who has catatonia?

Answers: A – D

1. posturing ✅
   B. irritability
   C. tangential speech
   D. anhedonia

Which diagnosis presents with minimal spontaneous sexual thinking or minimal desire for sex ahead of sexual experiences?

Answers: A – D

1. male sexual interest/arousal disorder
   B. male hypoactive sexual desire disorder ✅
   C. female sexual interest/arousal disorder
   D. female orgasmic disorder

A client presents with distressing psychological symptoms following a violent confrontation in which she was subjected to racism. This is an example of which factor in mental health and illness?

Answers: A – D

1. social determinant of health ✅
   B. neurobiological factor
   C. medical cause for psychiatric symptoms
   D. genetic factor

Which symptom is most likely to accompany a panic attack?

Answers: A – D

1. negative thinking
   B. hallucinations
   C. tics
   D. syncopal episode ✅

As many as two thirds of patients with what disorder also meet the diagnostic criteria for obsessive-compulsive disorder?

Answers: A – D

1. Tourette disorder. ✅
   B. panic disorder
   C. generalized anxiety disorder
   D. body dysmorphic disorder

A client was switched from lurasidone to clozapine two months ago. His most recent absolute neutrophil count was 1654/mcL. How often should the psychiatric mental health nurse practitioner order complete blood counts for the client?

Answers: A – D

1. weekly ✅
   B. daily
   C. monthly
   D. every 2 weeks

The psychiatric mental health nurse practitioner is interviewing a 21-year-old client with reports of anxiety symptoms. How long must symptoms be present for a diagnosis of generalized anxiety disorder (GAD)?

Answers: A – D

1. two months
   B. three months
   C. one month
   D. six months ✅

A 17-year-old boy is brought to the mental health clinic by his parents due to their concerns about his lack of motivation, odd behaviors, verbal aggression, and social isolation. The parents report the client has had few friends since middle school. Over the last nine months, he has gradually withdrawn from family and refuses to eat meals with them. He is experiencing increased academic difficulties. His parents are concerned about drug use, but the client reports he has only used alcohol a few times and tried marijuana one time. The client has no previous medical history and is not on any prescribed medications. The client has no past psychiatric history. While meeting privately with the psychiatric mental health nurse practitioner, the client reports that his family is out to get him, and they have been poisoning his food with a chemical substance his father obtained from a terrorist organization. His mental status exam is significant for a clear sensorium, restricted affect, tangential speech, and poor insight. Laboratory testing is normal, and urine drug screen is negative. Which is the most likely diagnosis?

Answers: A – D

1. schizophrenia ✅
   B. schizophreniform disorder
   C. schizoaffective disorder
   D. schizoid personality disorder

Which criteria is included for both a DSM 5 and an ICD-10 diagnosis of panic disorder?

Answers: A – D

1. the presence of at least four panic symptoms ✅
   B. one month of worry after one panic attack
   C. avoidance behaviors to prevent another attack
   D. dizziness and palpitations

Which client statement is an example of the most common form of hallucination seen in schizophrenia spectrum and other psychotic disorders?

Answers: A – D

1. a client hears voices telling them they are stupid and worthless ✅
   B. the client smells a foul odor in the absence of a stimulus
   C. the client sees flashes of light that are not visible to anyone else
   D. a client feels invisible insects crawling on their skin

A client who presents with recurrent episodes of punching and kicking their partner while they are asleep would most likely be diagnosed with which sleep disorder?

Answers: A – D

1. REM sleep behavior disorder ✅
   B. circadian rhythm sleep-wake disorder
   C. restless legs syndrome
   D. NREM-related parasomnia

A 32-year-old presents to the psychiatric mental health nurse practitioner following four brief episodes of intense anxiety occurring at home and work over the last two months. He reports the episodes “come out of the blue.” During the episodes, he experiences dyspnea, heart palpitations, chest pain, tingling in his lips and fingers, and sweating. His symptoms are so severe he fears he is going to die. His primary care physician has ruled out a medical cause for the episodes. He has cancelled several work meetings out of fear that he might have another attack. The client meets DSM criteria for which listed diagnosis?

Answers: A – D

1. panic disorder. ✅
   B. social anxiety disorder.
   C. panic disorder and specific phobia.
   D. panic disorder with agoraphobia.

Which medication is appropriate to prescribe for a 68-year-old client with schizophrenia?

Answers: A – D

1. aripiprazole ✅
   B. ziprasidone.
   C. olanzapine
   D. haloperidol

A client presents to the clinic with anxiety symptoms. A GAD-7 was completed, the score is 10. How does the psychiatric mental health nurse practitioner interpret this score?

Answers: A – D

1. moderate anxiety ✅
   B. severe anxiety
   C. mild anxiety
   D. minimal anxiety

In which situation would the use of a brief screening tool be least appropriate?

Answers: A – D

1. completing a psychiatric history for a new counseling client ✅
   B. assessing the severity of a client’s anxiety
   C. evaluating the efficacy of a client’s antipsychotic medication
   D. assessing a client’s suicide risk in the emergency department

Which response includes all the stages of sleep?

Answers: A – D

1. delta wave stage, REM, stages 1-4, wakefulness.
   B. wakefulness, NREM, stages 1-4, REM. ✅
   C. REM, NREM, stage 1-3, wakefulness
   D. NREM, wakefulness and REM

 

The psychiatric mental health nurse practitioner is seeing a client for an initial diagnostic assessment. Which factor is most critical in determining whether a physical exam is necessary as part of the assessment?

Answers: A – D

1. the nature of the client’s complaints ✅
   B. the complexity of the client’s past medical history
   C. the number of medications the client takes
   D. the amount of time that has elapsed since the client’s last complete physical exam

Which of the following are common comorbidities in clients who present with sleepwalking?

Answers: A – D

1. major depressive disorder and obsessive-compulsive disorder ✅
   B. narcolepsy and coronary artery disease
   C. bipolar disorder and anxiety disorder
   D. neurodegenerative disorders and personality disorders
2. 

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Related:(Completed) NR548 Week 4 Exam Guide