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NR547 Week 8 Final exam

Question 1

A 21-year-old client presents to the emergency department after initiating a physical fight with a coworker. The client states, “The guy disparaged my work. I do the best work of anyone in the whole company; in fact, my productivity has increased so much in the last 2 weeks. I don’t really need to sleep anymore! My thoughts just race right through my head and come out on paper. It’s amazing!” Based on the client’s initial presentation, what is the priority differential diagnosis?

1. Narcissistic personality disorder
2. Schizotypal personality disorder
3. Bipolar I disorder
4. Bipolar II disorder

Question 2

Which medication is most likely to be used to treat symptoms of psychosis in a client with delirium?

1. clozapine
2. haloperidol ✅
3. risperidone
4. ziprasidone

Question 3

An inpatient client has a CIWA-Ar score of 12. What is the most appropriate action by the nurse practitioner?

1. prescribe STAT dose of oral lorazepam and reassess CIWA-Ar every hour ✅
2. prescribe oral lorazepam every 4 hours and reassess CIWA-Ar every hour
3. prescribe STAT dose of oral diazepam and reassess CIWA-Ar every 4 hours
4. reassess CIWA-Ar every 4 hours; do not prescribe medication at this time

Question 4

A client is started on lamotrigine for bipolar disorder and presents with blistering skin and mouth sores shortly after an increase in dose. Labs indicate normal renal and liver function. What is the most likely cause of the symptoms?

1. DRESS syndrome
2. atopic dermatitis
3. Steven-Johnson syndrome ✅
4. serotonin syndrome

Question 5

Which description best describes cluster A personality disorders?

1. characterized by anxious, fearful thinking or behavior
2. characterized by odd, eccentric thinking or behavior. ✅
3. characterized by dramatic, overly emotional, or unpredictable thinking or behavior
4. characterized by oppositional or sadistic behavior

Question 6

A client diagnosed with a personality disorder states that he does not trust any of his work colleagues because they constantly “spy on” his work and “verbally attack” him during meetings. He also states that he doesn’t trust his wife because she is probably cheating on him with the Amazon deliveryman and is more loyal to their children than to him. Which is the most likely diagnosis?

1. schizoid personality disorder
2. paranoid personality disorder ✅
3. schizotypal personality disorder
4. histrionic personality disorder

Question 7

Which action should be included in a treatment plan for a client with borderline personality disorder?

1. coping strategies for self-harm behaviors ✅
2. strategies to reduce the risk of physical harm to others
3. benzodiazepines for anxiety
4. electroconvulsive therapy

 

Question 8

A 66-year-old client presents with complaints of insomnia, low mood, and feelings of guilt. His Geriatric Depression Scale score is 10. What is the client’s most likely diagnosis?

1. mild depression ✅
2. no depression
3. moderate depression
4. severe depression

Question 9

A client is admitted to an inpatient unit for major depressive disorder. The client endorses daily alcohol consumption. Which nurse practitioner action is the most appropriate?

1. order CIWA-Ar to be administered every 6 hours for 24 hours
2. complete a CAGE questionnaire ✅
3. prescribe chlordiazepoxide every 8 hours
4. transfer the client to a medical unit for observation

Question 10

A client is concerned that he won’t pass a urine drug screen at his new job because he used marijuana three days ago. What is the most appropriate response by the psychiatric mental health nurse practitioner?

1. Marijuana can only be detected in the urine for 8 hours.
2. Marijuana is a short-acting drug that can only be detected in the urine for 24 hours.
3. Marijuana can only be detected by taking a serum drug level.
4. Marijuana can be detected in the urine for up to 7 days. ✅

Question 11

Which drug class is most likely to be prescribed upon diagnosis of Alzheimer’s disease?

1. atypical antipsychotic
2. cholinesterase inhibitor ✅
3. anxiolytic
4. anticholinergic

 

Question 12

A 44-year-old client presents with depressed mood and anhedonia. He states that he has always felt low for the past 10 years, but sometimes his depression gets particularly bad. Right now, he is considering ending his life. What is the most appropriate diagnosis for the client?

1. bipolar II disorder
2. major depressive disorder
3. persistent depressive disorder with intermittent major depressive episodes, with current episode ✅
4. adjustment disorder with depressed mood

 

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Related:(Completed) NR547 Week 4 Midterm Exam