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    Exam Review

    1. A 23-year-old woman presents to the PMHNP with a chief complaint of "nervous tension." After a full evaluation and the administration of the Hamilton Anxiety Scale (HAM-A), the PMHNP diagnoses her with generalized anxiety disorder. He plans to use today's HAM-A score as a baseline and then readminister the scale at every follow-up appointment to monitor treatment. Her score today is 20. What does this score indicate?
      A)Mild anxiety
      B)Minimal anxiety
      C)Moderate anxiety
      D)Severe anxiety
    2. A 41-year-old male client has just been diagnosed with nephrogenic diabetes insipidus (NDI) and asks the nurse practitioner for more information about the disorder. Which one of the following statements is NOT correct?
      A)"NDI occurs as a result of partial or absolute lack of antidiuretic hormone."
      B)"NDI has been associated with a genetic (sex-linked) predilection in men."
      C)"NDI is associated with normal antidiuretic hormone production and secretion."
      D)"In NDI, large volumes of dilute urine are produced."
    3. A 29-year-old pregnant woman presents to her nurse practitioner (NP) for a prenatal visit. The NP advises her to receive vaccination against whooping cough and influenza. Which of the following, besides the flu shot, will she receive?
      A)Measles, mumps, and rubella (MMR) vaccine
      B)Varicella (VAR) vaccine
      C)Meningococcal B (MenB) vaccine
      D)Diphtheria, tetanus, and pertussis (Tdap) vaccine or tetanus diphtheria (Td) vaccine
    4. The father of an 18-year-old girl who is being treated for generalized anxiety disorder with panic attacks calls the PMHNP with questions about the medications she was prescribed. He demands the information because the patient lives in his home and is on his health insurance plan. What should the nurse practitioner do?
      A)Give the father limited information in order to appease him.
      B)Do not give the father any information without the patient's consent.
      C)Answer all of the father's questions because she is on his health insurance plan.
      D)Tell the father to make an appointment for an evaluation.
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    Exam Review

    1. A mother presents to the nurse practitioner with her 14-year-old son for a wellness check and a flu shot. The mother inquires about a sign she saw in the waiting room regarding human immunodeficiency virus (HIV) testing. She is surprised that adolescents need to be tested for HIV. The NP’s most appropriate response is:
      A)"He might be sexually active and you aren't aware."
      B)"We would never test an adolescent unless they are sexually active."
      C)"The CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once."
      D)"Don't worry, it's just routine."
    2. A 49-year-old man with a history of a liver transplant presents with painless purplish spots on his face and mouth. The nurse practitioner suspects which of the following?
      A)Tinea versicolor
      B)Squamous cell carcinoma
      C)Kaposi's sarcoma
      D)Addison disease
    3. The PMHNP is evaluating a 27-year-old woman who has been diagnosed with posttraumatic stress disorder due to a childhood history of sexual trauma. Today she has brought her husband with her. He reports that he sometimes feels he has "two wives who have different likes and dislikes, different tastes in food, clothing, and entertainment, and even talk in different voices." The patient says she has periods in which she has no memory of what took place. As an example, she says she may be dining out with her husband and have no recollection of how she got there. The PMHNP will evaluate for which of the following disorders?
      A)Dissociative identity disorder (DID)
      B)Adjustment disorder
      C)Schizotypal personality disorder
      D)Malingering
    4. A 31-year-old woman with a history of intellectual disability and congenital heart defects presents to the nurse practitioner with new onset neurologic deficits. Magnetic resonance imaging is contraindicated in patients with a history of which of the following?
      A)Claustrophobia
      B)Essential hypertension
      C)Implanted defibrillator
      D)Intrauterine device
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    Exam Review

    1. The psychiatric-mental health nurse practitioner is treating a 26-year-old woman diagnosed with bipolar I disorder who has exhibited a partial response to Lamictal 200 mg PO BID. The PMHNP wants to augment the Lamictal with valproate (Depakote). To do so, how must she change the dose of Lamictal?
      A)She does not need to change the dose of Lamictal
      B)She must double the dose
      C)She must decrease the dose by half
      D)She must discontinue the dose of Lamictal because the two medications are contraindicated
    2. A patient calls the PMHNP with a question about her newborn. "She has a shrill, high-pitched cry I have never heard before." The PMHNP advises her to do which of the following?
      A)Go directly to the nearest emergency department.
      B)Change the baby’s diaper.
      C)Feed the baby.
      D)Do nothing; this is normal.
    3. A nurse practitioner has just diagnosed a 14-year-old boy with Klinefelter syndrome. What is the most appropriate treatment?
      A)Estrogen
      B)Testosterone
      C)None
      D)Progesterone
    4. The PMHNP primarily works with older adult patients who frequently present with cognitive issues. He knows many people with Lewy body dementia are misdiagnosed or do not receive diagnosis for 18 months or more. Which of the following assessment tools does the PMHNP use to discriminate between Lewy body dementia (LBD), Parkinson's disease dementia (PDD), and mild cognitive impairment (MCI) due to Lewy body disease from other forms of cognitive impairment?
      A)Eight-item Informant Interview to Differentiate Aging and Dementia (AD8)
      B)Mini-Cog
      C)Lewy Body Composite Risk Score
      D)Informant Questionnaire on Cognitive Decline in the Elderly
    Page 3 of 5

    Exam Review

    1. A 36-year-old woman of Chinese descent presents to the PMHNP after a referral from her primary care physician, who has worked up her physical complaints. These physical complaints include headaches, dizziness, and abdominal pain. The patient says she also experiences insomnia, difficulty concentrating, anxiety, and fatigue. These symptoms started approximately 6 months ago, after her husband had an affair, which he ended. She is also under stress at work, since she just received a promotion. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?
      A)Shenjing Shuairuo
      B)Susto
      C)Kufungisisa
      D)Khayal
    2. During an initial psychiatric evaluation on a 65-year-old man who is new to the practice, the patient expresses concern about his left foot "shaking." One of the differential diagnoses for dementia of Alzheimer’s type is Parkinson's disease. Which physical exam finding would be expected?
      A)No tremor is evident when the patient is asked to kick his leg.
      B)Tremor is present when resting and when moving the leg.
      C)Tremor is only present when the patient is moving his leg.
      D)Tremor is worse when the patient is moving, but it is present when resting.
    3. A 19-year-old girl sustained multiple long bone fractures as a result of a motor vehicle crash and now is at risk for fat embolism. Which of the following signs and symptoms strongly suggest fat embolism?
      A)Bradypnea, bradycardia, decreased temperature, shortness of breath
      B)Bradypnea, bradycardia, confusion, shortness of breath
      C)Tachypnea, tachycardia, restlessness, petechial rash
      D)Tachypnea, tachycardia, decreased temperature, petechial rash
    4. A 63-year-old White man presents with bowing deformity of his legs, gait abnormality, and tingling and weakness in his left leg. He is diagnosed with Paget’s disease of bone and asks the NP about his treatment options. Which of the following therapies is considered first line?
      A)Bisphosphonates
      B)Calcitonin
      C)Vitamin D
      D)NSAIDs
    Page 4 of 5

    Exam Review

    1. Kelly is a 22-year-old woman who was involved in a motor vehicle accident (MVA) 1 year ago. She now presents to the mental health clinic with her mother, who complains that Kelly's personality has changed drastically in the past year. Upon thorough examination, Kelly most likely has experienced an injury to which part of her brain?
      A)Occipital lobe
      B)Frontal lobe
      C)Parietal lobe
      D)Temporal lobe
    2. A 26-year-old woman with bipolar disorder explains to the PMHNP that she stopped taking her medication during a manic episode, but she now wants to start again. Prior to re-initiating lithium (Eskalith) for mood stabilization, which of the following labs are appropriate to obtain for this patient?
      A)Thyroid function test, creatinine, liver function test
      B)Thyroid function test, liver function test, pregnancy test
      C)Thyroid function test, creatinine, complete blood count
      D)Thyroid function test, creatinine, pregnancy test
    3. The PMHNP is evaluating a 7-year-old boy who is brought in by his grandmother. The child has epicanthal skin folds, a short nose, a small head circumference, and a smooth, indistinct philtrum. What is the most likely diagnosis?
      A)Rhett syndrome
      B)Intracranial pressure
      C)Fetal alcohol syndrome
      D)Global developmental delay
    4. The major characteristic that differentiates between delirium and dementia of Alzheimer’s type (DAT) is:
      A)A steadily progressive, gradual decline in cognition without extended plateaus in dementia of Alzheimer’s type.
      B)A steadily progressive, gradual decline in cognition without extended plateaus in delirium.
      C)Dementia of Alzheimer’s type (DAT) is often associated with a disturbance in the sleep-wake cycle.
      D)The majority of people with dementia experience a full recovery with or without treatment.
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