, NURS 6670 MIDTERM EXAM
Question 1
Alexa is a 27-year-old female who has come to group therapy while she
is in the city jail. She was arrested for vagrancy because she was sleeping
in her car in a parking lot at a local shopping center. She could not post
bail, so she is sentenced to 14 days in jail. During group, she contributes
that none of this is her fault. Her mother is totally evil because she would
not let Alexa stay in the family home. She has some other family. but
they are all jerks because they won’t help her. Alexa’s friend Melanie is
the absolute best person in the world, but she can’t help because her boss
fired her for no reason. Alexa has a history of arrests for buying illegal
drugs and prostitution. The last time she was in jail, her sentence was
extended for 30 days because she got into a fight with another inmate and
beat her up so badly she had to be admitted to the hospital for 6 days. The
PMHNP considers which of the following personality disorders?
Histrionic
Narcissistic
Borderline
Schizoid
Question 2
Anne is a 32-year-old female who presented to care after a random drug
screening at work was positive for cocaine. She was initially resistant to
therapy, maintaining that her use is not a problem and she could stop at
, any time. Upon further discussion in session, it appears that she uses
cocaine every day at work, sometimes 2–3 times, other days more. She
also uses it occasionally at home and most weekends. During her third
session, she admitted that it is a financial burden, and she basically
cannot afford any other form of recreation. She understands that if she
uses again she will lose her job, and she admits that she loves her job and
that cocaine is not worth losing it. When counseling her about cessation
strategies, the PMHNP advises all the following except:
The physiologic symptoms of withdrawal may require a short-term
hospitalization
Unlike other substances of abuse, there are no medications to help
reduce the intensity of withdrawal
She will need to be monitored for depression
Overcoming the intense craving for cocaine is the biggest issue
Question 3
Clare’s history of personal relationships is characterized by complete
intolerance of being alone. Whether it is an intimate-partner relationship
or a close friend, Clare appears to always need someone in her life. She had
a livein boyfriend of 3 years, and while they were together, he took care of
everything. The PMHNP expects all of the following to be additional
features of Clare’s history except:
Has disproportionate anger toward an abusive spouse
, Question 4
The PMHNP is conducting an initial interview with a patient whose
history is consistent with avoidant personality disorder. The PMHNP
understands that one of the most striking features of this interview is
likely to be centered upon the patient’s:
Clothing
Speech pattern
Anger
Anxiety
Question 5
A PMHNP student is reviewing his notes from his clinical experience
over the past week to prepare his first required case presentation on a
patient suffering a major depressive episode. Which of the following
patients best represents the DSM-5 criteria for major depressive episode?
A 27outbursts of anger, and a strong family history of endogenous
depression-year-old female with a 1-month history of social
withdrawal, anorexia, hypersomnia, unprovoked
A 41personal life, an unplanned 10 lb. weight loss in the last 3
months, and perceptual disturbances-year-old male with a history of
childhood sexual abuse, loss of interest in both his professional and
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