NRNP 6640 Midterm Exam

QUESTION 1

1. The PMHNP understands that anxiety and depression are two disorders in which their symptoms

may overlap. When discussing this, you explain that the autonomic nervous system is activated

and further helps distinguish anxiety symptoms by making the following points:

2. A. “You may experience an elevated heart rate, constant worrying, and diarrhea.”

B. “You may experience fear, sweating, and muscle tension.”

C. “You may experience an elevated heart rate, the need to urinate, and fear.”

D. “You may experience sleepiness, decreased blood pressure, and fear.”

1 points

QUESTION 2

1. The PMHNP is working with a school-aged child who has been diagnosed with depression. The

child has attended several sessions with the PMNHP, but recently presents with avoidant

behavior by showing increased distress and being late to sessions. What approach does the

PMHNP need to employ with the child to continue making therapeutic progress?

2. A.Remaining quiet until the child is ready to talk

B. Using communication techniques that are expressive

C. Inviting the child’s parents to speak on behalf of the child

D.All of the above

1 points

QUESTION 3

1. After informing a prospective patient about limits of confidentiality, the patient consents to the

“conditions” of confidentiality and signs an informed consent form. Several weeks later, a

lawyer representing the patient’s spouse for a court case, asks the PMHNP for the disclosure of

information about the patient. The PMHNP should:

2. A.Disclose all patient information as requested

B. Refuse to disclose any confidential information

C. Limit disclosure to the extent legally possible

D.Ignore the request based on ethical reasons

1 points

QUESTION 4

1. In your office, you see a 58-year-old patient with PTSD who reports having nightmares, making

it impossible for her to sleep. What recommendations based on principles of sleep hygiene will

the PMHNP make?

2. A.Eat a heavy meal before bedtime to induce sleepiness

B. Maintain a warm bedroom temperature

C. Avoid watching television or reading in bed

D.Try going to sleep at different times throughout the week to avoid monotony

1 points

QUESTION 5

1. An 11-year-old patient has been exhibiting low self-esteem at school and acting out. According

to Maslow’s hierarchy of needs, which of the following questions would best be addressed first

by the PMHNP?

2. A. “Are Joel’s peers including him at recess?”

B. “Does Joel feel safe and secure at school?”

C. “Is Joel getting enough sleep at home?”

D. “How can Joel feel that he is loved?”

1 points

QUESTION 6

1. A patient named Steve is seeking therapy to get help with his home situation, stating that he has

been stressed since his mother-in-law moved into the house. What can the PMHNP do to assist

the patient in constructing a narrative?

2. A.Share a personal story about her home situation and family members

B. Elicit details so Steve becomes more self-disclosing and self-examining

C. Guide Steve through imagery exercises so he can decrease his stress

D.None of the above

1 points

QUESTION 7

1. A new patient has been informed of the limits of confidentiality, and has signed informed

consent forms. No consent, however, has been obtained for voluntary “Release of Information.”

The patient is 20 years old and still lives at home with his parents. He is being treated for

depression, which he attributes to the trouble he’s had finding employment.

True or false: If the patient’s mother calls the PMHNP to check up on her son to see how he is

doing, the therapist is required to protect patient confidentiality and not disclose information.

True

False

1 points

QUESTION 8

1. The PMHNP is caring for a patient with borderline personality disorder. Using a psychoanalytic

psychotherapy approach, the PMHNP attempts to intensify the patient’s transference to enhance

emotional processing by:

2. A.Developing increased boundaries

B. Decreasing supportive psychotherapy

C. Scaling back contact with the patient

D.Increasing the number of sessions per week

1 points

QUESTION 9

1. True or false: A PMHNP may ask his patient to describe her relationship with her father, both as

a child and now, in order to assess interpersonal style.

True

False

1 points

QUESTION 10

1. The PMHNP has a session with a patient who was injured and traumatized from an explosion at

the industrial plant where he used to work. During the session, an outside noise startles the

patient and he experiences a flashback of the loud boom from the explosion. The PMHNP

witnesses the patient present with anxiety and belabored breathing. What is the appropriate

action of the PMHNP?

2. A.Telling the patient there is no reason to be startled

B. Avoiding interrupting the flashback as it occurs

C. Asking the patient to describe the flashbacks

D.Have the patient use the relaxation response (take a deep breath, exhale long, and slow down)

1 points

QUESTION 11

1. The PMHNP is working with a veteran who has posttraumatic stress disorder (PTSD). The

PMHNP believes that dual awareness will be beneficial in allowing the patient to focus on the

here and now. What strategies can the PMHNP use to develop dual awareness in the patient?

2. A.Asking the patient to recall a recent and mildly disturbing event

B. Having the patient focus on details of the room, such as how hot or cold it is

C. Telling the patient to rate the level of disturbance he feels from a mildly disturbing event

D.All of the above

1 points

QUESTION 12

1. Your patient is a 65-year-old male who has a strained relationship with his son and daughter. His

children refuse to participate in a family session. The PMHNP asks the patient to draw his family

genogram as a next step to _______________.

2. A. assess the patient’s mental health status and functioning

B. explore the interpersonal styles of each family member

C. provide background information for the patient’s family structure

D.measure the patient’s quality of well-being and productivity

1 points

QUESTION 13

1. You are seeing a 29-year-old widow whose husband recently died overseas while serving his

country in the military. She has been mourning the loss of her husband for several months, and

continues to grieve. She refuses to go to group grieving sessions, but reports that she is still able

to go to work and her fitness classes sometimes, and even makes attempts to stay social. She

says, “Sometimes it’s like he’s not even gone. Other times it feels like it’s been an eternity since

I’ve seen him. It’s hard to talk about this type of stuff with my girlfriends, especially since all of

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