NRNP 6665 PSYCHIATRIC MENTAL HEALTH NURSE
PRACTITIONER CARE NEWEST EXAM 2024-2025 WITH
QUESTIONS AND ANSWERS/ ALREADY GRADED A++
Signs and symptoms according to the DSM-5-TR - ANSWER Deficits in intellectual
functioning and adaptive functioning (Lee et al., 2023)
Occurring before the age of 22 (Lee et al., 2023)
Differential diagnoses - ANSWER Child abuse, debilitating medical diseases, cerebral
palsy, sensory disability, and speech disorder (Lee et al., 2023)
Incidence - ANSWER Peaks between 10 and 14 years old (Lee et al., 2023)
1.5x more prevalent in males versus females (Lee et al., 2023)
Etiology - ANSWER Genetic- Phenylketonuria, Lesch-Nyhan syndrome, Fragile X
syndrome, and Rett syndrome are all inborn errors of metabolism that can cause
neurodevelopmental defects or neurodegeneration (Lee et al., 2023)
Environmental- Toxic substances (alcohol, illicit drugs), infectious agents (rubella, HIV),
and uncontrolled maternal medical conditions (hypertension, asthma, urinary tract
infection, pre-pregnancy obesity, or pre-pregnancy diabetes) (Lee et al., 2023)
Prognosis - ANSWER Deficits seen in intellectual disability are permanent (Lee et al.,
2023)
With adequate interventions those with; Mild intellectual disability might achieve
adequate language and social skills to function independently (Lee et al., 2023)
Moderate intellectual disability might achieve a second-grade level of language and
social skills (Lee et al., 2023) Severe intellectual disability might not be able to
communicate orally (Lee et al., 2023)
Considerations related to culture, gender, age - ANSWER Age, development, and
language need to be taken into consideration when educating those about intellectual
disability
Pharmacological treatments, including any side effects - ANSWER Aggression and
self-injurious behaviors- Risperidone and aripiprazole
Side effects: weight gain, sedation, insomnia, tardive dyskinesia, akathisia, change in
cholesterol, change in QT interval (Pillinger et al., 2023)
Depression- Fluoxetine, paroxetine, and sertraline
,Side effects: nausea and vomiting, dizziness, headache, sedation, insomnia, dry mouth,
constipation, sweating, weight gain, sexual dysfunction (Pillinger et al., 2023)
Involuntary movements- Reportedly, antipsychotics and SSRIs mentioned above
Nonpharmacological treatments - ANSWER Educational support- special education
programs in schools, academic modifications, and transition planning to aid in self-
sufficiency from childhood to adulthood (Lee et al., 2023)
Behavioral intervention- behavioral therapy and cognitive therapy are used to manage
undesirable behaviors (Lee et al., 2023)
Vocational training- with a social worker, occupational therapist, teacher, counselor,
and/or psychologist helps adolescents and young adults learn ADLs and responsibilities
to become self-sufficient (Lee et al., 2023)
Family education- helps families understand the condition leading to better planning and
lower amounts of stress (Lee et al., 2023)
Government resources- social security income, housing, and food delivery services are
offered to those with intellectual disability (Lee et al., 2023)
Diagnostics and labs - ANSWER IQ tests can be done to rate the severity of
intellectual disability and genetic testing can be done to assess for the cause of
intellectual disability (Boat et al., 2015)
Comorbidities - ANSWER Attention-deficit/hyperactivity disorder (ADHD), depression,
and movement disorders (Lee et al., 2023)
Legal and ethical considerations - ANSWER Intellectual disability causes an unclear
decisional capacity, so informed consent might not be able to be obtained (Chepkirui et
al., 2023)
Exploitation can occur if involved in research (Chepkirui et al., 2023)
Disparities between caregivers (Chepkirui et al., 2023)
Pertinent patient education considerations - ANSWER Inclusion to help avoid social
isolation
Family therapy to resolve any feelings of guilt, despair, or anger (Lee et al., 2023).
Professional role responsibilities - ANSWER Confidentiality, HIPAA, HITECH,
telegraphy, informed consent, ethics
,intellectual disability age of onset - ANSWER infancy usually evident at birth
ADHD age of onset - ANSWER early childhood by age 12
schizophrenia age of onset - ANSWER 18-25 for men
25-35 for women
major depression age of onset - ANSWER late adolescence to young adulthood
dementia age of onset - ANSWER most common after age 65
2 types of normal drives - ANSWER sexual drives (libido)
aggressive drives
psychosexual stages of development - ANSWER show age related behaviors
commonly used for discharging drives and obtaining gratification
normally different actions or behaviors are used at different ages to discharge tension
from drives and seek gratification
oral stage - ANSWER Freud's first stage of psychosexual development during which
pleasure is centered in the mouth
0-18 months
sucking chewing feeding and crying
psychiatric disorder linked to failure of oral stage - ANSWER schizophrenia
substance abuse
paranoia
anal stage - ANSWER Freud's second stage of psychosexual development where the
primary sexual focus is on the elimination or holding onto feces. The stage is often
thought of as representing a child's ability to control his or her own world.
18 months- 3 years
sphincter control, activities of expulsion and retension
psychiatric disorder linked to failure of anal stage - ANSWER depressive disorders
phallic stage - ANSWER Freud's third stage of psychosexual development pleasure is
gained from self-stimulation of the sexual organs
3-6 years
exhibitionism, masturbation with focus on Oedipal conflict, castration anxiety, and
female fear of lost maternal love
psychiatric disorder linked to phallic stage - ANSWER sexual identity disorders
latency stage - ANSWER Freud's fourth stage of psychosexual development when the
sex drive goes underground
, 6 years-puberty
peer relationships, learning, motor skills development, socialization
psychiatric disorders linked to latency phase - ANSWER inability to form social
relationships
genital stage - ANSWER Freud's stage of psychosexual development when adult
sexuality is prominent
puberty forward
integration and synthesis of behaviors from early stages, primary genital based
sexuality
psychiatric disorders linked to failure of the genital stage - ANSWER sexual
perversion disorders
3 primary psychic structures - ANSWER the id
the ego
the superego
the ID - ANSWER contains primary drives or instances, urges (hunger, sex, or
aggression), or fantasies
drives are largely unconscious, sexual, or aggressive in content, and infantile in nature
operates on the pleasure principle; seeks immediate satisfaction
present at birth and motivated early infantile actions.
the Ego - ANSWER contains concept of external reality
rational mind; responsible for logical and abstract thinking
functions in adaptation
mediates between demands of drivesand environmental realities
operates on reality principle
begins to develop at birth as infant struggles to deal with environment
responsible for use of defense mechanisms
the superego - ANSWER is the ego-ideal
contains sense of conscience or right versus wrong
also contains aspirations, ideals, and moral values
regulated by guilt and shame
