NURS 6670 / NURS 6670N FINAL EXAM.
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Question1.
Collette is a 23-year-old female who presented for
emergency care with her mother because her behavior
has become increasingly erratic and caused her to lose
her job. Her mother reports that she had never d...
nurs 6670 nurs 6670n final exam questions and answers with explanations question1 collette is a 23 year old female who presented for emergency care with her mother because her behavior has become
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NURS 6670 / NURS 6670N FINAL EXAM.
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Question1.
Collette is a 23-year-old female who presented for
emergency care with her mother because her behavior
has become increasingly erratic and caused her to lose
her job. Her motherreports that she had never done
anything like this in the past, but about 3 months ago,
her boyfriend of 3 years broke up with her, and
Collette began to express unrealistic beliefs thather
boyfriend wanted to drive her crazy and hurt her. A
gentleman trying to hail a taxi accidentally bumped
into her this morning, and she started screaming that
her ex-boyfriendhad hired the man to throw her into
the street under a car.
Collette is on a 2-week suspension from her job as a
restaurant server because she was combative to a
customer— she accused him of colluding with her ex-
boyfriend to get her fired. After this morning's
incident, her mother was so worriedshe brought her to
the emergency room. Her appearance is disheveled, she
is clearly hyperalert and is crying that
her boyfriend must have converted her mother to work
againsther. Head imaging, screening lab, and a
toxicology screen are negative. A leading differential
for Collette is:
Acute psychotic episode
Rationale:
Collette's differential diagnosis is an acute psychotic
episode,this disorder causes abnormal ideas and
perceptions. Two of the main symptoms are delusions
and hallucinations.
Delusions are false beliefs, such as that someone is
againstthem and hallucinations are false perceptions,
such as listening, or feeling something that does not
exist.
,Question 2.
Jake and Laurie are a young married couple who have
been referred to mental health counseling because Jake
is having disturbing sleep events. Laurie reports that
on more than one occasion she has awakened to find
Jake having what appears to be a panic attack, but he
doesn't seem to realize it. When he finally wakes up,
he is confused and doesn't really understand what
happened, although he does have a sense ofintense
fear. This has happened twice in the last 2 weeks, and
the last time Laurie heard him screaming. Jake is now a
bit afraid to go to sleep and as a result does not feel
well the next day. The PMHNP recognizes that sleep
terrors in adults:
Are often associated with trauma or psychiatric problems
Question 3.
Jack is a 27-year-old male who has a history of
paranoid schizophrenia that first became apparent
approximately 10 years ago. He developed paranoid
delusions and eventually decompensated to the point
that he required inpatient stabilization. At the time, he
was started on conventional antipsychotics, but due to
intolerable adverse effects he was switched to
haloperidol. It worked well, but whenever he stopped
taking it, symptoms would recur. After several
hospitalizations, he was stabilized. The
neurophysiologic theory of schizophrenia suggests
that Jack's symptoms were aresult of:
Increased dopamine activity in the mesolimbic pathway
Question 4.
Johanne is a 22-year-old female who is being treated
for narcolepsy. She is attempting to implement a
regimen of forced daytime naps in an effort to manage
her condition without pharmacotherapy as she is
generally averse to takingmedications. While
,following Johanne, the PMHNP should be alert to
signs and symptoms of
Depression
Question 5.
Narcolepsy
A sleep disorder characterized by uncontrollable sleep
attacks. The sufferer may lapse directly into REM
sleep, oftenat inopportune times.
Question 6.
The PMHNP is asked to prepare a presentation for
non- nursing health care workers in a local long-
term care facility on the various causes of cognitive
impairment in the elderly. A case presentation
approach is used to reinforce principles of
identifying delirium, which needs tobe reported to
the patient's attending provider right away. The
case should emphasizewhich of the following
features as being closely correlated with delirium?
Rapid onset
Question 7.
Valerie is a 27-year-old woman who has been referred
by her primary care provider. She was initially
diagnosed with major depressive episode following a
breakup with her boyfriend of 7 years. They moved
into a house together 1 year ago, but within a few
months the boyfriend moved out. Valerie was
unresponsive to medication for depression and was
referred to the mental health clinic. During this initial
psychiatric evaluation, the PMHNP learns that a
primary reason for the breakup was that Valerie had an
extensive routine every nightof repeatedly checking
every door and window in the home to ensure that they
were locked.
, Valerie's nighttime routine is exhaustive and involves
checking every door and window at least four times.
She hasa remote history of being attacked in her home
while alone and states that she is unable to go to bed
until she is certainthat every door and window is
locked. When considering diagnostic criteria for OCD,
the PMHNP needs further assessment to ascertain
which diagnostic criteria?
The patient has good or fair insight with respect to the
appropriateness of her behaviors
Question 8.
Michael is an 18-year-old male who is presented to care
at theurging of his parents. He has never had any
significant medical or psychiatric problems in the past,
but during his first semester at college he has
developed a very alarming pattern of excess sleep. He
is missing classes and is in dangerof losing a
scholarship. He is sleeping normally at night but
apparently is having these very long episodes of
napping and sleeping during the day. When he is
awake, he tends to be rather withdrawn. His parents
have taken him to their family practitioner as they
thought he might be using drugs. A full exam,
laboratory assessment, and toxicology screen are all
normal, and there is no apparent cause for this
sleepiness.
While very rare, the PMHNP considers Kleine-Levin
syndromeand further assesses for coincident onset of:
Hypersexuality
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