NUR7375900 PMHNP Acute and chronic management of adult with Psych
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Free NUR7375900 PMHNP Acute and chronic management of adult with Psych Questions
What are long term anxiolytics?
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Benzodiazepines
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Select serotonin reuptake inhibitors and Select serotonin-norepinephrine reuptake inhibitors
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Neuroleptics
Explanation
Correct Answer: (B) Select serotonin reuptake inhibitors and Select serotonin-norepinephrine reuptake inhibitors
SSRIs and SNRIs are the first-line long-term treatments for anxiety disorders. They work by modulating serotonin and norepinephrine levels over time, requiring several weeks to achieve therapeutic effects. Their favorable safety profile and low dependence potential make them ideal for sustained anxiety management.
Why Other Options are Incorrect:
A. Benzodiazepines — These are short-term anxiolytics due to their risk of dependence, tolerance, and withdrawal with prolonged use.
C. Neuroleptics — Antipsychotics are not standard long-term anxiolytics. While some may be used adjunctively in treatment-resistant cases, they are not first-line agents for anxiety disorders.
According to research, individuals with bipolar affective disorder, ______ % of manic patients are the most significant risk for verbal threatening or assault?
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25%
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50%
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75%
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85%
Explanation
Correct Answer: (C) 75%
Research indicates that approximately 75% of manic patients with bipolar affective disorder are at significant risk for verbal threatening or assault. During manic episodes, patients may experience severe irritability, impulsivity, and grandiosity, which substantially elevates the risk of aggressive verbal and physical behavior, making safety assessment a critical component of clinical management.
Why Other Options are Incorrect:
A. 25% — This significantly underestimates the risk of verbal threatening or assault in manic patients with bipolar disorder.
B. 50% — While closer, this figure still underrepresents the documented risk percentage associated with manic episodes and aggression.
D. 85% — This overestimates the documented percentage cited in research regarding this specific risk in manic patients.
Which example best illustrates the defense mechanism "rationalization"?
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A man who is passed over for a promotion says he didn't really want the job anyway because it had too much responsibility.
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A woman who dislikes her neighbor believes the neighbor dislikes her instead.
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A teenager channels aggressive impulses into sports.
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A person who recently quit smoking continues to crave cigarettes but insists they never really enjoyed smoking.
Explanation
Correct Answer: A) A man who is passed over for a promotion says he didn't really want the job anyway because it had too much responsibility.
Rationalization is a defense mechanism in which a person constructs a logical-sounding justification for an outcome or behavior to avoid confronting the true, more painful reason. In this example, the man avoids acknowledging feelings of rejection or inadequacy by reframing the situation — convincing himself he never truly wanted the promotion, thereby protecting his self-esteem. Option B describes projection, where one's own feelings are attributed to another person. Option C describes sublimation, where unacceptable impulses are redirected into socially acceptable activities. Option D more closely resembles reaction formation or denial, where the person contradicts their true internal experience.
What is an example of the defense mechanism "denial"?
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A person drinks heavily every night but insists they do not have a drinking problem.
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A worker who dislikes their boss takes their anger out on a coworker.
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A teenager justifies cheating on a test by saying, "Everyone else was doing it."
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A man redirects feelings of guilt by volunteering excessively.
Explanation
Correct Answer: A) A person drinks heavily every night but insists they do not have a drinking problem.
Denial is a defense mechanism in which a person refuses to acknowledge a painful or threatening reality, despite clear evidence to the contrary. The individual continues destructive behavior while consciously rejecting the existence of a problem, thereby avoiding the anxiety and discomfort that would come with acknowledging it.
Denial is commonly seen in substance use disorders and is a significant barrier to treatment-seeking. Option B describes displacement, redirecting emotions onto a less threatening target. Option C describes rationalization, using justifications to excuse unacceptable behavior.
Option D describes reaction formation or undoing, where guilt is managed through compensatory prosocial behavior.
How many days/nights of duration of mood symptoms is diagnostic along with other DSM-5-TR symptoms indicative of hypomania?
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4 days/nights
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5 days/nights
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6 days/nights
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7 days/nights
Explanation
Explanation:
Correct Answer: (A) 4 days/nights
According to the DSM-5-TR, a hypomanic episode requires a distinct period of abnormally elevated, expansive, or irritable mood and increased energy or goal-directed activity lasting a minimum of 4 consecutive days. This duration criterion is a critical distinguishing feature between hypomania and a full manic episode, which requires at least 7 days or hospitalization due to severity.
Why Other Options are Incorrect:
B. 5 days/nights — This exceeds the minimum required duration for a hypomanic episode as specified in the DSM-5-TR.
C. 6 days/nights — Similarly, 6 days surpasses the minimum diagnostic threshold for hypomania without reaching the 7-day criterion for mania.
D. 7 days/nights — Seven consecutive days is the minimum duration criterion for a manic episode in bipolar 1 disorder, not a hypomanic episode.
What is the DSM-5 criterion for the diagnosis of major depressive disorder?
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Sad mood, sleep changes, guilt
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Depressive mood, sleep changes, guilt
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Depressive or sad mood with sleep changes, guilt that lasts two weeks or more, that impacts daily life
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Depressive or sad mood with sleep changes, guilt that lasts one week or more, that impacts daily life
Explanation
Explanation
The DSM-5 requires that at least five depressive symptoms be present during the same two-week period, representing a change from previous functioning. At least one symptom must be either depressed mood or loss of interest/pleasure. Symptoms must include combinations such as sleep disturbances, feelings of worthlessness or guilt, fatigue, concentration difficulties, and must cause clinically significant distress or functional impairment in daily life. Option D incorrectly states one week — the DSM-5 requires a minimum of two weeks. Options A and B are incomplete as they omit the critical duration and functional impairment criteria required for a formal MDD diagnosis.
The neurotransmitters implicated in Alzheimer's disease are _______ and _______.
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Serotonin and norepinephrine
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Acetylcholine and norepinephrine
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Dopamine and norepinephrine
Explanation
Correct Answer: (B) Acetylcholine and norepinephrine Alzheimer's disease is primarily associated with a deficiency of acetylcholine and norepinephrine in the brain. The cholinergic hypothesis of Alzheimer's disease proposes that the degeneration of cholinergic neurons in the basal forebrain, particularly in the nucleus basalis of Meynert, leads to significant reductions in acetylcholine, which is critical for memory and cognitive function. This is why cholinesterase inhibitors such as donepezil, rivastigmine, and galantamine are used as first-line treatments to slow cognitive decline by preventing the breakdown of acetylcholine.
Why Other Options are Incorrect:
A. Serotonin and norepinephrine — Serotonin and norepinephrine deficiencies are primarily associated with major depressive disorder and anxiety disorders, not Alzheimer's disease. While serotonin changes can occur in Alzheimer's, they are not the primary neurotransmitters implicated in its pathophysiology.
C. Dopamine and norepinephrine — Dopamine deficiency is the primary neurotransmitter implicated in Parkinson's disease and schizophrenia. While some dopaminergic changes occur in Alzheimer's disease, dopamine is not the primary neurotransmitter implicated in its core cognitive pathology.
The PMHNP is assessing a 56 y/o male with schizophrenia. The student nurse asks what is positive symptoms. The PMHNP responds the positive symptoms are: (Answer with the best choice below)
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Alogia, poverty of speech and avolition
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Bright affect, bizarre delusions and anxiety
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Auditory and visual hallucinations
Explanation
Correct Answer: (C) Auditory and visual hallucinations Positive symptoms of schizophrenia represent an excess or distortion of normal functions — things that are added to the person's experience that should not be present. Auditory and visual hallucinations are classic positive symptoms, along with delusions, disorganized speech, and disorganized or catatonic behavior. Auditory hallucinations, particularly hearing voices, are the most common positive symptom in schizophrenia.
Why Other Options are Incorrect:
A. Alogia, poverty of speech and avolition — These are negative symptoms of schizophrenia, representing a decrease or absence of normal functions. They reflect a loss of normal behavior rather than an addition of abnormal experiences.
B. Bright affect, bizarre delusions and anxiety — While bizarre delusions are indeed positive symptoms, bright affect is not a recognized positive symptom of schizophrenia. Schizophrenia is more commonly associated with flat or blunted affect. Anxiety alone is not classified as a positive symptom of schizophrenia.
Borderline personality disorder stands on the premise of _______ and _______.
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Neurosis and psychosis
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Borders and anxiety
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Anxiety and neurosis
Explanation
Correct Answer: (A) Neurosis and psychosis Borderline personality disorder (BPD) is conceptualized as standing on the border between neurosis and psychosis. The term "borderline" was historically coined to describe clients whose symptoms were considered to be on the boundary between neurotic conditions (such as anxiety and depression) and psychotic conditions (such as brief breaks from reality). This is reflected in BPD's characteristic features of emotional instability, identity disturbance, and transient stress-related paranoid ideation.
Why Other Options are Incorrect:
B. Borders and anxiety — This option is not a clinically recognized premise of borderline personality disorder. "Borders" alone does not accurately describe the theoretical foundation of the disorder.
C. Anxiety and neurosis — While anxiety is a component of many personality disorders including BPD, anxiety and neurosis together do not define the foundational premise of borderline personality disorder. The correct pairing is neurosis and psychosis.
What common defense mechanism is used in alcohol use disorder?
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Denial
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Repression
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Suppression
Explanation
Correct Answer: (A) Denial Denial is the most characteristic and commonly observed defense mechanism in alcohol use disorder. Clients with alcohol use disorder frequently refuse to acknowledge the existence or severity of their drinking problem, minimizing its impact on their health, relationships, and daily functioning. Denial is a major barrier to treatment-seeking and is a hallmark feature recognized in the assessment and treatment of alcohol use disorder.
Why Other Options are Incorrect:
B. Repression — Repression involves unconsciously blocking distressing thoughts or memories from conscious awareness. While repression can occur in various psychiatric conditions, it is not the defining or most commonly identified defense mechanism specifically associated with alcohol use disorder.
C. Suppression — Suppression is a conscious and deliberate effort to push unwanted thoughts or feelings out of awareness. Unlike denial, which is unconscious, suppression involves intentional avoidance. Suppression is not the primary defense mechanism characteristically associated with alcohol use disorder.
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