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
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
Correct Answer: A) 4 days/nights
According to the DSM-5-TR, a hypomanic episode requires a distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased goal-directed activity or energy lasting at least 4 consecutive days. This duration criterion helps distinguish hypomania from normal mood variation and from a full manic episode, which requires at least 7 days or is of any duration if hospitalization is required. 5, 6, and 7 days exceed the minimum threshold for hypomania and move toward the duration criteria for a manic episode. The 4-day minimum is the specific DSM-5-TR threshold that must be met for a hypomanic diagnosis.
Joey is a 25-year-old male who presents to the clinic for treatment of major depressive disorder (unipolar depression), recurrent. The PHQ-9 score is 19. Which specifier would the PMHNP give as the diagnosis severity to drive treatment?
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Mild
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Moderate
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Moderately Severe
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Severe
Explanation
Correct Answer: C) Moderately Severe
A PHQ-9 score of 19 falls within the 15–19 range, which corresponds to Moderately Severe depression. At this level, the PMHNP would typically initiate or intensify pharmacological treatment, consider psychotherapy, and closely monitor for safety given the elevated symptom burden.
Which of the following is an example of the defense mechanism "projection" as described by Freud?
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A student who forgets an exam date insists the teacher never announced it.
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A person who is angry at their boss insists that their boss is actually angry at them.
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After being scolded by a parent, a child begins sucking their thumb again.
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A person refuses to accept that their partner has ended the relationship.
Explanation
Explanation:
Correct Answer: (B) A person who is angry at their boss insists that their boss is actually angry at them.
Projection is a defense mechanism in which an individual attributes their own unacceptable thoughts, feelings, or impulses to another person. In this example, the person who feels anger toward their boss cannot consciously accept this feeling, so they project it outward — perceiving the boss as the one who is angry, rather than themselves.
Why Other Options are Incorrect:
A. A student who forgets an exam date insists the teacher never announced it — This describes rationalization or denial, where the student creates a justification to avoid personal responsibility.
C. After being scolded by a parent, a child begins sucking their thumb again — This describes regression, where an individual reverts to earlier, more childlike behaviors in response to stress.
D. A person refuses to accept that their partner has ended the relationship — This describes denial, where an individual refuses to acknowledge a painful reality.
Which scenario best represents the defense mechanism "displacement"?
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After a stressful day at work, a man comes home and yells at his children for making noise.
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A woman who feels attracted to her friend's husband convinces herself that he is flirting with her.
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A student who is anxious about exam results starts biting their nails.
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A person who loses a loved one insists they are fine and shows no emotion.
Explanation
Explanation:
Correct Answer: (A) After a stressful day at work, a man comes home and yells at his children for making noise.
Displacement is a defense mechanism in which an individual redirects emotions — typically anger or frustration — from the original threatening or unacceptable target to a safer, less threatening substitute. The man cannot express his frustration at work (the true source), so he displaces that anger onto his children, who represent a less threatening outlet.
Why Other Options are Incorrect:
B. A woman who feels attracted to her friend's husband convinces herself he is flirting with her — This describes projection, where one's own unacceptable feelings are attributed to another person.
C. A student anxious about exam results starts biting their nails — This describes a behavioral anxiety response or regression, not displacement, as the emotion is not redirected toward a different target.
D. A person who loses a loved one insists they are fine and shows no emotion — This describes denial, where an individual refuses to acknowledge or experience painful feelings associated with a distressing reality.
Bipolar affective disorder is a mood disorder generally first diagnosed as major depressive disorder. The PMHNP knows that the DSM-5-TR differentiates between major depressive unipolar versus bipolar 1 disorder by criterion of timeframes and mood fluctuations. One of the main criteria is the quantity of sleep or insomnia triggering either hypomania or mania. The PMHNP knows that with bipolar 1 disorder, the client will experience insomnia that may last for ____ hours per night, and the client will report they "do not miss the sleep, with good energy or high energy." This may be the beginning of a hypo or manic episode. How many hours of sleep is indicated for "poor sleep 4 to 7 nights in a row?" Choose the best answer below.
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5 hours
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8 hours
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3 hours
Explanation
Correct Answer: C) 3 hours
In bipolar 1 disorder, a hallmark feature of an emerging manic or hypomanic episode is a decreased need for sleep — typically as little as 3 hours per night — without the individual feeling tired or fatigued. This is distinct from insomnia, where the person wants to sleep but cannot. The patient instead reports feeling energized and functional despite minimal sleep. When this pattern occurs for 4 to 7 nights in a row, it is a significant clinical warning sign of an impending manic episode. 5 hours and 8 hours do not reflect the characteristically reduced sleep threshold associated with mania. 8 hours represents normal sleep duration, and 5 hours, while reduced, does not capture the extreme sleep reduction seen in manic episodes.
Which of the following best describes the clinical presentation of someone experiencing their first true manic episode?
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A mildly elevated mood with occasional irritability that lasts only a few hours, resolved without impairment.
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A week or more of abnormally elevated or irritable mood and increased energy/activity, with symptoms such as decreased need for sleep, grandiosity, pressured speech, racing thoughts, distractibility, and risky behavior or causing marked impairment or hospitalization.
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Persistent depression followed by brief moments of euphoria, without changes in behavior or energy.
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A seasonal pattern of mood swings tied only to external stressors, without psychotic or impulsive episodes.
Explanation
Correct Answer: B) A week or more of abnormally elevated or irritable mood and increased energy/activity, with symptoms such as decreased need for sleep, grandiosity, pressured speech, racing thoughts, distractibility, and risky behavior or causing marked impairment or hospitalization.
According to the DSM-5, a manic episode requires a distinct period of abnormally elevated, expansive, or irritable mood and increased goal-directed activity or energy lasting at least seven days, present most of the day nearly every day. At least three additional symptoms must be present, and the episode must be severe enough to cause marked functional impairment or necessitate hospitalization.
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.
Hannah is a 35-year-old female who presents to the clinic for treatment of major depressive disorder (unipolar depression), recurrent. The patient health questionnaire 9 (PHQ-9) score is 9. Which specifier would the PMHNP give as the diagnosis severity to drive treatment?
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Mild
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Moderate
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Moderately Severe
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Severe
Explanation
Correct Answer: B) Moderate
The PHQ-9 uses standardized score ranges to classify depression severity. A score of 9 falls within the range of 5–9 for mild and... actually, the PHQ-9 scoring is: 5–9 = Mild, 10–14 = Moderate, 15–19 = Moderately Severe, 20–27 = Severe. A score of 9 would be classified as Mild. However, based on standard scoring, the correct answer here is Mild — a score of 9 sits at the upper boundary of the mild range (5–9).
According to Erik Erikson's theory of psychosocial development, which of the following best describes the primary psychosocial challenge faced by individuals around age 60?
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Achieving a sense of trust in others
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Developing a sense of personal identity
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Reflecting on one's life and achieving a sense of integrity
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Establishing intimate relationships
Explanation
Correct Answer: C) Reflecting on one's life and achieving a sense of integrity
According to Erikson's eighth and final stage of psychosocial development — Ego Integrity vs. Despair — individuals in late adulthood (approximately age 60 and beyond) face the challenge of looking back on their lives and evaluating whether they have lived meaningfully. Those who feel a sense of fulfillment and acceptance achieve ego integrity, while those who experience regret and feel their life lacked purpose may develop despair. This stage is central to healthy aging and end-of-life psychological well-being.
What theory is specifically connected to the depressive phenomena of experiences built on uncontrollable sequences?
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Cognitive theory
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Learned helplessness theory
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Neuroplasticity theory
Explanation
Correct Answer: (B) Learned helplessness theory
Learned helplessness theory, developed by Martin Seligman, directly explains depression as a result of repeated exposure to uncontrollable and inescapable negative events. When individuals repeatedly experience situations where their actions have no effect on outcomes, they develop a sense of helplessness that generalizes to other areas of life, leading to depressive symptoms.
Why Other Options are Incorrect:
A. Cognitive theory — Cognitive theory of depression, associated with Aaron Beck, focuses on negative thought patterns and cognitive distortions rather than the experience of uncontrollable sequences of events.
C. Neuroplasticity theory — This theory addresses the brain's ability to change and adapt structurally and functionally, and while relevant to understanding depression biologically, it does not specifically explain the depressive phenomena arising from uncontrollable experiences.
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