8003 FINAL items + lecture Flashcards
A diagnosis of Schizophrenia is associated with a reduction in life expectancy by as much as 20 percent. What is the number one cause of premature death among individuals diagnosed with schizophrenia?
a. Cardiovascular disease
b. Suicide
c. Type II Diabetes Mellitus
d. Human Immunodeficiency Virus (HIV/AIDS)
b
Several studies have shown that over the 5 to 10-year period after the first psychiatric hospitalization for schizophrenia, only about 10 to 20 percent of patients can be described as having a good outcome. Which of the following indicates a positive prognostic factor in the treatment of schizophrenia?
a. Positive symptoms
b. Negative symptoms
c. Childhood or adolescent onset
d. Insidious onset
a
Serotonin is widely recognized as a modulator of neural activity and its receptors are broadly targeted in a variety of psychiatric drugs. In what area of the neuron is the biogenic amine serotonin synthesized?
a. Dendrite
b. Soma
c. Node of Ranvier
d. Axon terminal
d
Studies have shown that pubertal development was significantly related to structural maturation of all six regions of the brain in both sexes. Which of the following statements is most accurate regarding teenage brain development?
a. THC can retard developing portions of the brain including impairing the ability of the prefrontal cortex to fully develop.
b. The prefrontal cortex appears to shrink prior to puberty.
c. Sedentary lifestyle and high screen time during age of 13-18 years old has shown a 5% loss of grey matter.
d. There is a loss of synapse formation during puberty.
a
Studies have shown that pubertal development was significantly related to structural maturation of all six regions of the brain in both sexes. Which of the following statements is most accurate regarding teenage brain development?
a. THC can retard developing portions of the brain including impairing the ability of the prefrontal cortex to fully develop.
b. The prefrontal cortex appears to shrink prior to puberty.
c. Sedentary lifestyle and high screen time during age of 13-18 years old has shown a 5% loss of grey matter.
d. There is a loss of synapse formation during puberty.
a
Eric Erikson believed that people move through a series of several psychosocial stages throughout the lifespan. According to Erikson’s psychosocial stages theory, what stage would a 13-year-old be entering?
a. Initiative vs. Guilt
b. Intimacy vs. Isolation
c. Identity vs. Role Confusion
d. Industry vs. Inferiority
c
Which of the following medications requires routine blood level monitoring?
a. Nortriptyline (Pamelor)
b. Sertraline (Zoloft)
c. Venlafaxine (Effexor)
d. Bupropion XL (Wellbutrin XL)
a
Which of the following most accurately describes clinical aspects of bipolar disorder?
a. Bipolar disorder is a chronic illness and will require consistent medication management throughout the lifetime to prevent relapse of symptoms
b. Bipolar illness is not a chronic illness and can go into remission after one year of medication management where patients can stop all medications
c. Bipolar illness presents with manic episodes, but no more than 5 manic episodes in a lifetime
d. Bipolar illness presents with depressive episodes, but no more than 5 depressive episodes in a lifetime
a
Which of the following most accurately describes the prognosis for Bipolar II as compared to Bipolar I?
a. Bipolar II is a less chronic course of illness compared to bipolar I
b. Bipolar II has an increased risk for suicide compared to bipolar I
c. Bipolar II has longer periods of time between depressive episodes compared to bipolar I
d. Bipolar II patients spend the majority of time in hypomanic episodes
b
Which of the following is the most effective treatment for people with mood disorders?
a. Physical Activity
b. Psychotherapy Alone
c. Pharmacotherapy Alone
d. Psychotherapy & Pharmacotherapy
d
Which of the following is the best indicator when assessing for risk of suicide?
a. Family support structure
b. Being unemployed
c. Past suicide attempt
d. Currently on psychiatric medication
Past suicide attempt is the correct answer. Past suicide attempts are the best indicator for risk (Tyson, 2023).
c
Which of the following is the most accurate assessment scale to predict risk of suicide?
a. beck anxiety inventory (BAI)
b. the Adult ADHD Self-Report Scale (ASRS)
c. mood disorder questionnaire (MDQ)
d. The Columbia – Suicide Severity Rating Scale (C-SSRS)
d
Which of the following most accurately describes a static factor in evaluating Dissociative Identity Disorder (DID)?
a. past history of trauma
b. difficulty getting along with others
c. experiencing memory loss
d. switching between personalities
a
It is well known that somatic symptom disorder presents more often in females. What other feature is most accurate in the prevalence of somatic symptom disorder (SSD)?
a. SSD has not been shown to be impacted by a person’s cultural background
b. SSD is inversely related to social position and occurs most often with persons with little education and low incomes
c. There is no difference in SSD’s prevalence across different countries
d. SSD consists of four subtypes
b
Which most accurately describes the prevalence of separation anxiety in the US population?
a. separation anxiety is most prevalent in adults age 21-30 years old
b. separation anxiety is most prevalent in adolescents age 13-16 years old.
c. separation anxiety is most prevalent in adults age 30-40 years old.
d. separation anxiety is most prevalent in children younger than age 12 years old.
d
Which of the following is the most accurate in the development and course of selective mutism?
a. selective mutism is more prevalent in males
b. selective mutism usually develops before 5 years of age
c. selective mutism is never found with comorbid anxiety disorders
d. selective mutism usually develops after 10 years of age
b
How many types of personality disorders are currently listed in the DSM 5?
a. 3
b. 10
c. 5
d. 2
b
Which of the following most accurately describes cluster B antisocial personality disorder?
a. often unstable personal relationships, impulsive behavior, chronic emptiness, chronic fears of abandonment, reckless behavior and suicidality, Attention seeking behavior, and splitting.
b. often strives to be the center of attention, attention seeking in socially inappropriate situations, provocative interactions, theatrical expressions, false sense of intimacy, and very superficial
c. strong sense of entitlement, extremely negative reactions to criticism, elevated sense of self-importance, have difficulty showing empathy or remorse, preoccupation with grandiosity or success.
d. general disregard and violation of rights of others, high prevalence in the prison population, deceptive, focus on personal gain, disregard for the law, and little or no remorse.
d
Which of the following diseases is clinically similar to Alzheimer disease, but presents with hallucinations, parkinsonian features, capgras syndrome, and extrapyramidal signs?
a. frontotemporal dementia
b. huntington disease
c. lewy body disease
d. binswanger disease
c
There are two separate classifications for the diagnosis of cognitive impairments; mild and severe. Which of the following most accurately describes how to select the correct classification when diagnosing?
a. slight decline in decision-making alone is classified as major
b. slight decline in 1 daily function is considered major
c. Delirium is classified as mild cognitive impairment
d. determined by the degree to which the condition affects their level of independence.
d
What is considered the most complex organ in the entire human body?
a. Heart
b. Kidney
c. Brain
d. Liver
c
Which lobe of the brain is primarily responsible for motor skills, higher cognition and expressive language?
a. Frontal Lobe
b. Parietal Lobe
c. Temporal Lobe
d. Occipital Lobe
a
Which region of the brain is considered the “thermostat of the body”?i
a. Hypothalamus
b. Thalamus
c. Cerebellum
d. Basal Ganglia
a
Which system of the brain is responsible for emotional responses?
a. Sensory
b. Somatosensory
c. Motor
d. Limbic
d
In what part of the neuron is Serotonin synthesized?
a. Axon Terminal
b. Soma
c. Dendrite
d. Nucleus
a
What is the precursor amino acid for Serotonin?
a. Histamine
b. Tryptophan
c. Acetylcholine
d. Glutamate
b
Which of the following is considered a Peptide Neurotransmitter?
a. Substance Y
b. Neuropeptide P
c. Corticotropin-Releasing Factor
d. GABA
c
What changes are noted in the teenage brain in the 2002 landmark study conducted by Giedd, et. al?
a. Prefrontal cortex appears to grow right before puberty
b. There is a 2nd wave of synapse formation noted around ages 11-12
c. Between 13-18 years of age, the teenage brain loses approximately 1% gray matter
d. All of the above
d
Regarding the female versus the male brain during development over the teenage years, which one of the following statements is true?
a. The female brain is 10% larger than the male brain
b. Male brains mature earlier than female brains
c. The basal ganglia is larger in teenage females than in teenage males
d. The basal ganglia is smaller in teenage females than in teenage males
c
Regarding the neurogenetics of Schizophrenia, if a patient has a first degree relative with Schizophrenia, what is their chance of developing the disease?
a. 1%
b. 5%
c. 10%
d. 25%
c
Select the statement that is FALSE:
Pruning is the process of removing and decreasing brain structures such as axons, synapses, and neurons from the number present at birth.
Pruning causes deactivation of certain brain structures once they have performed their designated functions such as production of neurotrophic and growth factors
In utero fetal brains have more neurons than will be needed once adulthood is reached
There are approximately twice as many synapses present at birth in the cerebral cortex than early and mid-life.
b
Which rooting reflex is present at birth according to Boland and Verduin (2022)?
The glabellar reflex (Myerson’s Sign)
The palmomental reflex
The Babinski reflex
The Huntington’s reflex
c
Warning signs of school violence include:
Social withdrawal
Uncontrolled anger
Drug and alcohol use
All of the above
d
Bradykinesia is
An inability to initiate movements
Quick and repetitive movements
Clonic movements of the arms and legs
Slow, flapping movements of the arms
a
Language comprehension is processed at three levels. These are:
Phonologic, cortical and Wernicke processing centers
Lexical, Broca and vestibular processing centers
Phonologic, lexical and semantic processing centers
Cochlear, semantic and Wernicke’s processes centers
c
Where is serotonin found in the body?
The majority of serotonin is found in the spinal cord but can also be found in platelets, mast cells and enterochromaffin cells.
Less than 2% is found in the body and more than 80% is found in the gut.
Because serotonin cannot cross the Blood Brain Barrier (BBB) it gets trapped in this space.
It is synthesized by the amino acid tyrosine and taken up to the brain using active transport.
b
According to Jean Piaget the stages of cognitive development, in order, are:
Formal operations, concrete operations, preoperational thought, then formal thought
Preoperational thought, sensorimotor, concrete operations, then formal operations.
Sensorimotor, concrete operations, formal operations, then preoperational thought.
Sensorimotor, preoperational thought, concrete operations, then formal operations.
d
Mary Ainsworth was a developmental psychologist from Canada that describes the three main insecure attachment types as insecure-avoidant, insecure-ambivalent and:
Insecure-disorganized
Insecure-organized
Insecure-detachment
Insecure-indecisive
a
Which statement is FALSE about the history of the DSM?
According to Halter, Rolin-Kenny, and Grund (2013) the 1840 US Census was the first attempt to capture data on mental illness.
Epilepsy was once considered a psychiatric disorder.
The International Statistical Classification of Disease (ICD) was developed and suggested to be updated annually
Military and Veterans Affairs created their own version of classifying mental disorders to include anxiety and stress reactions. This was known as The Medical 203.
c
The Model of Mental Health as Maturity defines mental health as:
Most people would be included in normality while a smaller portion would be considered abnormal; people fall somewhere on the continuum.
The human brain takes a lifetime to develop and leads to mental health as opposed to other organs that are healthier earlier in life.
The analgram of positive emotions that bind us all together.
Emotional intelligence is the defining piece to this model and is a subjective experience.
a
nconsistency among a person’s beliefs, knowledge, and behavior is known as what theory?
A. Social learning theory
B. Attribution theory
C. Avoidance theory
D. Cognitive dissonance
d
The focus on how a person perceives the causes of behavior is known as what theory?
A. Avoidance theory
B. Cognitive dissonance
C. Attribution theory
D. Social learning theory
c
Which part of the brain is responsible for learning?
A. Occipital lobe
B. Medulla and pons
C. Hippocampus and cerebellum
D. Frontal lobe
c
Broca and Wernicke have identified areas of the brain involved in what?
A. Habituation and sensitization
B. Speech and language
C. Aggression and competition
D. Circadian rhythm and sleep
b
Symptoms of cannabis withdrawal have been what?
A. Restless leg syndrome, disruptive mood, binge eating disorder.
B. Increased appetite, sleep disturbance, agitation
C. Nightmares, imagining being stoned, cravings.
D. Sleep-related hypoventilation, excoriation, disinhibited social engagement disorder.
c
Who was responsible for first proposing mental illness is a disease of the brain?
A. Erik Kraepelin
B. Hippocrates
C. John Bowlby
D. Jean Piaget
b
What is the component of one’s personality that is responsible for dealing with reality according to Sigmund Freud?
A. Conscious
B. Superego
C. ID
D. Ego
d
The act of taking out feelings/impulses etc. on those that won’t result in a true threat is what?
A. Repression
B. Denial
C. Displacement
D. Reaction Formation
c
Erikson believed that people move through a series of how many psychosocial changes throughout their lifespan?
A. Four
B. Twelve
C. Ten
D. Eight
d
Treating someone who you dislike as someone you really like to hide your true feelings is an example of what?
A. Displacement
B. Reaction Formation
C. Denial
D. Repression
b
What age group is Dominique-R designed for?
Ages 6-11
Ages 4-6
Ages 12-17
Ages 2-3
a
Prolactin levels can sometimes be elevated in antipsychotic and mood stabilizing medications. Which medication is Prolactin commonly elevated in?
Lithium
Carbamazepine
Risperdal
Nortriptyline
c
An overdose of these medications can be lethal.
Tricyclics
FGA
SGA
Benzodiazepines
a
Who first proposed Mental illness a disease of the brain?
Eric Kraeplin
Hippocrates
Evelyn Hooker
Jean Piaget
b
Who was a British psychoanalyst and originated attachment theory?
Eric Kraeplin
Hippocrates
Evelyn Hooker
John Boldy
d
What is not a role of culture?
Note the individuals cultural reference group
Assess the degree of involvement with identified cultural group
If immigrant, pay particular attention to the pre-immigration experience
Where the Patient was last weekend
d
What is an example of lifetime prevelance?
Number of persons who have disorder at a specified point
Number of persons who have disorder at some time during their life which is measured as specific point in time
Number of persons being treated for a disorder obtained by counting those in a defined geographic area
Number of person who have disorder at a specified period
b
What part of Freud’s system provides guidelines for making judgments and emerges at around 5 years?
A. Ego
B. ID
Unconscious
D. Superego
d
What genetic term is an inherited characteristic?
A. Genome
B. Proband
C. Traito
D. Allele
d
What is the peak ages that men develop Schizophrenia?
5-10
25-35
10-25
35-45
c
What mental health disorder is most associated with disruption of the biological rhythms?
a. Anxiety
b. Depression
c. Anorexia
d. Dementia
b
When dopamine levels are elevated classic symptoms of what disorder are seen?
a. ADHD
b. Bipolar Disorder
c. Schizophrenia
d. Obsessive Compulsive Disorder
c
Where is serotonin synthesized?
a. Axon hillock
b. Soma
c. Dendrite
d. Axon terminal
d
Prenatal exposure to all below prescribed medications can results in abnormalities in the newborn EXCEPT:
a. Minocycline
b. Warfarin
c. Valproate
d. Clindamycin
d
The Rorschach Test is one of the common assessment instruments used by clinicians. What does the Rorschach test?
a. Intelligence
b. Memory
c. Personality
d. Cognition
c
Defense mechanism is a tactic used to safeguard the mind against feelings and thoughts that are too difficult for the conscious mind to deal with. George Vaillant used a classification system to catalog the four types: Narcissistic Defenses, Immature Defenses, Neurotic Defenses and Mature Defense. Which one of these four defense systems is most likely when an individual shows signs of altruism?
a. Narcissistic Defense
b. Immature Defense
c. Neurotic Defense
d. Mature Defense
d
Examples of medical conditions that more commonly present with neuropsychiatric symptoms that must be ruled out before moving forward with a mental health disorder diagnosis include all the following except:
a. Vitamin B12 deficiency
b. Systemic Lupus Erythematous
c. Primary Sjogren’s Syndrome
d. Hypothyroidism
c
Mental health issues that present with audiovisual hallucinations or paranoid delusions, like schizophrenia, signify a dysregulation or chemical imbalance in which system?
a. Somatosensory System
b. Limbic System
c. Motor System
d. Sensory System
b
A child completes all his assignments on time every day for one week as asked. The consequence of this behavior is letting the child skip chores at home for 2 days. Taking into consideration The Law of Effect in Operant Learning. Which is taking place in the above example?
a. Positive Reinforcement
b. Negative Reinforcement
c. Positive Punishment
d. Negative Punishment
b
Lucy had her first schizophrenic episode during her freshman year in college. She was not diagnosed with schizophrenia until 1 year after her first episode. Her treating doctor understands this to be an important time in the disease progression because the most effective time to prevent brain tissue loss as well as other effects of schizophrenia are in:
a. The first two years after the first psychotic break.
b. The first year after a confirmed diagnosis.
c. The first year after the first psychotic break.
d. The first two years after a confirmed diagnosis.
a
To meet criteria in DSM-5 for major Depressive Disorder, 5 or more symptoms MUST be present in the same 2 week period. At least 1 of the criteria must include which of the following?
A. Insomnia or hypersomnia nearly everyday
B. Fatigue or loss of energy
C. Loss of interest or pleasure
D. Psychomotor agitation or retardation
c
SY is a 9 year old male who presents for an initial interview. He is accompanied by his mother, who provides some background information. Her main concerns include, falling asleep at school, excessive mood swings, anger outbursts, inappropriate laughter, especially during instruction at school, difficulty concentrating and difficulty sleeping. After obtaining background information, which assessment would be lease likely to be administ3ered at this time?
A. K-SADS
B. CAPA
C. CIPS
D. PHQ-9
d
Pathologically, the definition of mental disorder or disability does Not meet criteria if which of the following are NOT present?
A. Clinically significant occupational distress
B. Anhedonia
C. Fatigue
D. Incongruent mood
a
Prior to DSM-5 criteria, Bluelers 4 A’s helped delineate symptmos of schizophrenia. Which of the following is NOT one of the 4 A’s?
A. Association
B. Affective
C. Ambivalence
D. Aggression
d
What is the number one cause of premature death in Schizophrenia?
A. Heart Attack
B. Suicide
C. Accidental drug overdose
D. Infection
b
In treatment of mood disorders, it is recommended to use the following :
A. ECT only
B. Medication alone
C. Psychotherapy only
D. Medication and psychotherapy together
d
Which class of medications used to treat major depressive disorder causes significant increased need to monitor dietary intake due to medical contraindications?
A. SSRI’s
B. MAOI’s
C. Tricyclic Antidepressants
D. Mood stabilizers
c
Which of the antipsychotics are most beneficial in treating anger/rage?
A. Risperdal
B. Fluoxetine
C. Lurasidone
D. Latuda
a
Which of the following would NOT be considered part of Bipolar Manic episode?
A. Spending increased amounts of money they do not have
B. Increased/hypersexuality
C. Anhedonia
D. God-like complelx
c
When someone is in a full-blown manic episode, which of the following is the most important consideration?
A. Start medications right away
B. Give individual referral for therapy
C. Make sure the patient is safe from harm
D. Wait for a 2nd episode to start treatment.
c
SA, a 21-year-old male reports hearing voices that others can’t hear, and he often believes that people are conspiring against him. A neuroimaging scan reveals abnormalities in the Brain.
Which component of the Brain is unlikely to be affected in SA case and is not relevant to the symptoms of schizophrenia?
A) Third ventricle & Lateral ventricle
B) Prefrontal cortex & Thalamus
C) Adrenal cortex & medulla
D) Hippocampus &Amygdala
c
The following statement describes one of the Neurotic defense mechanisms “The management of unacceptable impulses by permitting expression of the impulse in antithetical form” (Boland et al., 2022). Which one is correct?
A) Repression
B) Reaction formation
C) Inhibition
D) Displacement
b
Select the correct order of the 4 Cognitive Development Stages created by Jean Piaget, who had significant interactions with children in both educational and clinical contexts, as mentioned in (Boland et al., 2022).
A) Sensorimotor, preoperational thought, concrete operations, and formal operations.
B) Preoperational thought, Sensorimotor, concrete operations, and formal operations.
C) Somatosensory, concrete operations, preoperational thought, and formal operations.
D) Sensorimotor, preoperational thought, formal operations, and concrete operations.
a
When you ask a child, “Who is guiltier, the person who breaks one dish on purpose or the person who breaks ten dishes by accident?” the child’s answer will be the person who breaks more dishes is guilty. According to Stages of Intellectual Development Nominated by Piaget (Boland et al., 2022), which stage is mentioned above?
A) Formal operations
B) Sensorimotor
C) Preoperational thought
D) Concrete operations
c
This learning theory is centered on homeostasis. What is the name of this theory?
A) Hull drive reduction theory
B) Kandel habituation & sensitization
C) Pavlov classic conditioning
D) Skinner operant conditioning
a
Fifteen new disorders were added to the DSM 5. Which of the following are included within the fifteen disorders?
A) Central Sleep Apnea and Sleep-Related Hypoventilation.
B) Bipolar disorder unspecified
C) Cocaine withdrawal
D) Insomnia Disorder
a
Which of the following statements are true regarding the limbic system’s involvement in neuro-pathologic studies of schizophrenia and Eugen Bleuler’s four A’s? (Boland et al., 2022).
A) Loss of association, social awkwardness, altruism, and flat affect.
B) Affect, associations, ambivalence, and autism.
C) Mixed feelings, appropriate affect, decreased eye contact, and psychomotor agitation.
D) Euthymic, loss of association, ambivalence, and flat affect.
b
All the following statements are correct except one concerning schizophreniform disorder. Which statement is false?
A) Schizophreniform disorder symptoms are short-term and lasting at least 1 month but less than 6 months.
B) Schizophreniform disorder is an acute psychotic disorder with a rapid onset and lacks a long prodromal phase.
C) If the duration of the symptoms in schizophreniform disorder exceeds 1 year, then schizoaffective should be considered.
D) Schizophreniform disorder is unlikely to report a progressive decline in social and occupational functioning.
c
One of the mature defense mechanisms is where the person has a “gratification of an impulse whose aim is changed from socially objectable one to socially valued one.” Which one of the following is correct?
A) Altruism
B) Anticipation
C) Humor
D) Sublimation
d
Which one of the following is the primary characteristic of Cyclothymia. Cyclothymia is one of the mood disorders?
A) Prolonged periods of severe mania
B) Recurrent episodes of full-blown major depression
C) Frequent mood swings between hypomania and mild depression
D) Complete absence of mood disturbances
c
Who emphasized how children think and acquire knowledge?
a. Sigmoid Freud
b. Mary Ainsworth
c. Piaget
d. John Bolbie
c
Attachment theory created between 1979-1990. The theory studied infant attachment and separation, Attachment developers gradually resulting in infants wanting to be with a preferred person, who it perceives as the person who is wiser, stronger and the person who reduces his/her anxiety or distress (Boland, Verdiun, & Ruiz, 2022, p. 1011). Who is the creator of the attachment theory?
a. Sigmoid Freud
b. John Bolwlby
c. Piaget
d. Gerber
b
Pick the statement that is True.
a. Suicide is the third leading cause of death among adolescents worldwide (Centers for diease control and Prevention, 2023).
b.Drug overdose is the leading cause of death among adolescents.
c.Covid is the leading cause of death worldwide among young adults.
d.All of the above
a
When evaluating a patient with psychotic symptoms. You should evaluate for other causes of those symptoms. What other diseases processes can mimic psychotic symptoms?
a.Neurosyphilis, AID, and Epilepsy
b.Dm, HTN, and CHF
c.Dementia
d.Traumatic brain injury (TBI), substance use, and elevated ammonia levels.
Answer A- Neurosyphilis, AID, and Epilepsy
a
True or False. A mental disorder is a syndrome characterized by clinically significant disturbances in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental process underlying mental functioning?
a.True
b.False
a
Patients with untreated schizophrenia often exhibit violent behavior. What are risk factors for that increase patient risk of violence?
a. Persecutory delusions
b. Hx of violence
c. Neurological deficits
d. All of the above
d
The symptoms of schizophrenia can be divided into 3 categories, positive symptoms, negative symptoms, and cognitive symptoms. Positive symptoms are considered abnormal behaviors. Negative symptoms are the absence of normal behavior, and cognitive symptoms are impairments in normal cognitive function. Hallucination, delusions, bizarre behavior, and positive formal thought disorder. Are examples of which category of symptoms related to schizophrenia (Boland, Verdiun, & Ruiz, 2022).
a.Cognitive symptoms
b.Negative symptoms
c.Positive symptoms
d.None of the above
e.All of the above
c
Catatonic type of schizophrenia involves marked disturbance in motor function, this disturbance may involve stupor, negativism, rigidity, excitement, or posturing (Boland, Verdiun, & Ruiz, 2022). True or false
a.True
c.False
a
.In patients diagnosed with bipolar disorder with manic episodes, what percentage of patients have delusions?
a. 100
b. 75
c. 50
d. 25
b
What is the minimum duration of treatment is acute phase of schizophrenia? (Boland, Verdiun, & Ruiz, 2022, p. 351)
a. 4-8 weeks
b. 3-9 weeks
c. 12-24 weeks
d. No specific time frames
a
Where is serotonin made?
Axon terminal
Schwann cell
Cell body
Axon Hillock
a
Abe struggles with depression and has a PMH of chronic pain, type 2 diabetes, and migraines, he takes fluoxetine 40 mg daily, trazodone 150mg daily, tryptophan supplement, a multivitamin, and l-theanine 400mg daily and occasionally 50mg sumatriptan and 50mg tramadol. After Thanksgiving day, Abe starts to feel very restless and anxious. Abe states, “I feel like I can’t stop moving”. What is most likely starting to happen to Abe?
Serotonin syndrome
Hyperglycemia, concerns for DKA (Diabetic Ketoacidosis) or HHS (hyperosmolar hyperglycemic state).
He has been misdiagnosed and actually as ADHD.
He is beginning to have a panic attack.
a
You are concerned about Pick’s disease in our patient. What are the initial symptoms you should be assessing for?
Personality and behavioral changes
Recurrent visual hallucinations
Memory loss
Loss of language comprehension
a
According to Erickson’s development theory, Which stage would a person be most likely to begin to struggle with gender dysphoria?
Identity vs role confusion
Intimacy vs isolation
Autonomy vs shame and doubt
Industry vs inferiority
a
According to Erikson, why would someone in the above stage of development most likely start to struggle with gender dysphoria?
People are more concerned about how they appear to others and wanting to fit in.
People continue to be focused on fantasies and childhood roles.
People have a stable identity.
People develop a virtue of fidelity.
a
Which of the following symptoms are pediatric patients most likely to complain of with depression?
social withdrawal, isolation
Loss of motivation
Loss of interest in hobbies
Eating too much or too little
a
In schizophrenia, which is the most commonly occurring substance being abused?
nicotine
methamphetamine
cocaine
LSD
a
You work in an outpatient clinic and are establishing care for a 13-year-old girl who was discharged 2 weeks ago from an inpatient facility for an overdose attempt with SI. Since the patient has been home, she has been complaining of insomnia due to, “not being tired”. Which medication should you heed caution about prescribing?
Amitriptyline
doxepin
trazodone
Hydroxyzine (Atarax)
a
You are working in the emergency department, and you have a patient who comes in with mental status changes, xerosis, headache, and visual changes. The patient takes no medications besides Accutane and endorses a diet of animal products, including dairy and liver. Which lab value will you check?
Vitamin A
Vitamin D
Blood glucose
TSH
a
You are treating an established patient with bipolar 2 disorder with depression who is currently on aripiprazole. The patient is complaining of ongoing irritability, anger, aggression and rage. Which medication would you consider changing the patient to?
Risperdal (risperidone)
Buproprion (Wellbutrin)
Lithium
Valproate (Depakene)
a
You are taking care of a patient with a history of depression who has tried various antidepressants with adequate dosing and time on each medication and also had a negative experience with an antipsychotic and is refusing to try another antipsychotic. You are considering starting the patient on Phenelzine (Nardil). What is the most critical information you can give the patient about this medication?
Diet must remain free of fermented, aged foods, including: alcohol, cheese, and cured meats.
Must be taken with food, at least 350 calories
Should be taken at night to assist with sleep.
Serum levels should be monitored monthly.
a
A male client has been taking his antipsychotic medication routinely and now has developed gynecomastia and also noticed some discharge. What labs would be elevated?
A. AST/ALP
B. Prolactin
C. White blood count
D. Fasting plasma glucose concentration
b
A female client just had routine labs from her PCP. Her PCP noticed that her BUN 50, creatinine 2 and TSH 1.5 elevated from her baseline labs 6 months ago. Her PCP reviews her medication list: Atorvastatin 20mg po daily, Metformin 500mg po BID, Lisinopril 10 mg po daily, Zoloft 50mg po at bedtime and Lithium 600mg po BID. Her last visit with her PMHNP was 1 month ago. The PCP refers her to see her PMHNP. What medication would cause these labs to increase?
A. Atorvastatin
B. Metformin
C. Lisinopril
D. Lithium
d
A client presents to the office for follow up Mental Health visit with complaint of difficulty standing, walking and aphasia. What lobe of the brain is responsible for her symptoms?
A. Parietal
B. Temporal
C. Frontal
D. Occipital
c
Which medication can cause Qt interval prolongation and should have a baseline EKG?
A. Geodon
B. Risperdal
C. Clozapine
D, Quetiapine
a
What neurotransmitter is synthesized in the axon terminal?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
b
Mom brings in her 11-year-old son to be evaluated for behavioral issues at school. Teachers reports inability to focus and sit during lessons causing distracting behaviors for the rest of the class. What neuropsychiatric exam would be initiated?
A. K-SADS
B. CAPA
C. MDQ
D. PHQ-9
b
What part of the brain is associated with an emotional response causing positive symptoms such as hallucinations, agitation, and delusions?
A. Cerebellum
B. Hypothalamus
C. Cerebral cortex
D. Limbic system
d
17 -year old client presents to clinic for initial mental health evaluation. His mother is present at visit. Mother states his behavior has changed in the last month. She reports he has been hearing voices when no one else is in the room. What would the NP diagnosis?
A. Schizophreniform
B. Schizoaffective
C. Bipolar
D. Schizophrenia
a
This mental disorder is more prevalent in women with a later onset. It is defined with bipolar type with major depressive or manic episodes.
A. Bipolar 1
B. Schizophreniform
C. Schizoaffective disorder
D. Schizophrenia
c
Bleuler was well-known for 4 A’s of Schizophrenia?
A. Autonomy, Affective, Appropriate, Autoimmune
B. Ambivalence, Alogia, Anhedonia, Avolition).
C. Affective, Alogia, Anhedonia, Autonomy
D. Association, Affective, Ambivalence, Autism
d
10 y/o Ashton presents to your office with his mother. While processing behavioral issues, Ashton states, “I’m sorry mom, I see how much it worries you when I don’t come home from my friends house on time.” Ashton is in what period of Piaget’s cognitive development?
a) Concrete Operational
b) Formal operational
c) Pre-operational
d) None of the above
a
In John Bowlby’s Attachment Theory, which of the below statement/s are true
a) Infants become more attached to caregivers that reduce anxiety and stress
b) Time spent with the infant is more important than activities enjoyed together
c) Attachment is developed at first sight
d) A and B
a
Suzie has her phone taken away for 24 hours because she came home 1 hour after curfew. By what method is Suzie learning?
a) Classical conditioning
b) Operant conditioning
c) Behavioral conditioning
d) None of the above
b
A good example of Cognitive Dissonance is?
a) Leslie smokes even though she knows it causes cancer
b) John was asked to file papers at his clerical job
c) Jill Johnson PMHNP prescribed Lithium for mood swings
d) B & C
a
Mike displays a hatred for homosexual men because deep inside he is attracted to men. What type of defense mechanism is Mike displaying?
a) Distortion
b) Repression
c) Displacement
d) Reaction Formation
d
Which one of the characteristics below is NOT one of Bleuler’s 4 As?
a) Attentiveness: ability to follow tasks
b) Associations: looseness of thoughts
c) Affect disturbances
d) Autism: social awkwardness
e) Ambivalence: emotionally neutral
a
Antipsychotics are an effective treatment of various types of Schizophrenia. What mechanism of action do they perform?
a) Selective serotonin reuptake inhibitor
b) Prevents dopamine build-up in the brain
c) Serotonin-norepinephrine reuptake inhibitor
d) Both A & C
b
Which side effects below are positive side effects for schizophrenia?
A) Volitional impairment
B) Anhedonia
C) Audio/visual hallucinations
D) Alogia
c
What is the hallmark sign of mania/manic episode?
A) Pressured speech
B) Elevated, expansive, irritable mood
C) Impaired judgement
D) All the above
d
When choosing an anticonvulsant to treat Acute Bipolar Depression, as a PMHNP, you know the best choice is?
A) Levetiracetam
B) Lithium
C) Lamotrigine
D) All are effective anticonvulsant agents for Acute Bipolar Depression
c
Damage to what lobe would cause difficulties recognizing objects?
Frontal
Occipital
Parietal
Temporal
b
Degeneration of neurons in what area of the brain are associated with Parkinson’s disease?
Medulla
Pons
Red nucleus
Substantia Nigra
d
What neurotransmitter is most closely related to anxiety?
Dopamine
GABA
Glutamate
Serotonin
b
Repression is an example of what defense mechanism?
-Immature
-Mature
-Narcissistic
-Neurotic
d
What laboratory test may be helpful to explain symptoms of depression?
-ammonia
-Prolactin
-renal function
-TSH
d
Which of the following is an example of a semi structured assessment tool that does NOT require specific training?
CAPA
CAS
DIS
K-SADS
d
What symptom of schizophrenia is most likely to be associated with a good prognosis?
-avolition
-young onset
-catatonia
-hallucinations
d
Who would be the most at risk to attempt and complete a suicide a major depressive episode in the United States?
-a 10-year-old male
-a 16-year-old female
-a 25-year-old male
-a 45-year-old female
c
What medication should be avoided in patients in an alcohol detox program?
-Celexa
-Nardil
-Paxil
-Wellbutrin
d
What antipsychotic is most closely related to elevated prolactin levels that could
lead to lactation or gynecomastia?
Clozapine
Ziprasidone
quetiapine
risperidone
d
According to the American Psychiatric Association, which of the following is typically a symptom of schizophrenia? Select All: a) Delusions b) Increased energy c) Hallucinations d) Disorganized thinking
a
c
d
Which of the following factors is considered a risk factor for schizophrenia according to the APA? a) Alcohol addiction b) Obesity c) Consuming a high-fat diet d) Having a family history of the disorder
d
Which organization publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)? a) World Health Organization b) National Institute of Mental Health c) American Psychological Association d) American Psychiatric Association
d
What is the primary purpose of the DSM-5 according to the APA? a) To provide psychotherapy techniques b) To classify and diagnose mental disorders c) To outline treatment modalities for all known diseases d) To guide research in psychology
b
Which of the following statements is true regarding the distinction between Schizophrenia and Schizophreniform Disorder? a) Schizophreniform Disorder involves more severe symptoms than Schizophrenia. b) Schizophrenia has a shorter duration of symptoms than Schizophreniform Disorder. c) The primary distinction between the two is the duration of symptoms. d) Schizophreniform Disorder always transitions into Schizophrenia.
c
According to DSM-5 criteria, which of the following is required for a diagnosis of Schizophreniform Disorder? Select All: a) Hallucinations b) Major depressive episode c) Delusions d) Disorganized speech
a
c
d
Which of the following mood episodes can be present in Schizoaffective Disorder? a) Depressive b) Manic c) Hypomanic d) All of the above
d
Which factor differentiates Schizophrenia from Schizoaffective Disorder? a) The presence of hallucinations b) The severity of delusions c) The presence of a major mood episode d) The presence of disorganized speech
c
The gap between two neurons where communication occurs is known as: a) Neurotransmitter b) Vesicle c) Synapse d) Receptor
c
Which of the following structures of a neuron receives incoming signals from other neurons? a) Axon b) Dendrites c) Myelin sheath d) Synaptic vesicles
b
Which of the following is an example of a “positive symptom” of schizophrenia?
A.) Absence of affect
B.) Absence of attention
C.) Delusions
D.) Social inattentiveness
c
Which disorder is defined as a psychotic condition that involves the sudden onset of psychotic symptoms which lasts 1 day or more but less than 1 month with full remission and the individual returns to the premorbid level of functioning?
A.) Delusional disorder
B.) Brief psychotic disorder
C.) Bipolar I Disorder
D.) Bipolar II Disorder
b
What is considered a “hallmark” of mania?
A.) Poor concentration
B.) Grandiose thoughts
C.) Distractibility
D.) Pressured speech
d
Sarah has Bipolar I disorder for which she takes Lithium carbonate. Which of the following lithium levels indicate that Sarah is within a therapeutic range?
A.) 1.6 mEq/L
B.) 0.4 mEq/L
C.) 0.8 mEq/L
D.) 1.8 mEq/L
c
Which statement made by a patient would distinguish dysthymia from major depressive disorder?
A.) “I have always been depressed.”
B.) “I have a hard time sleeping.”
C.) “I feel hopeless.”
D.) “I have no energy and just feel depressed.”
a
Nate is an adolescent with autism spectrum disorder who has been exhibiting severe irritability despite behavioral therapy. Which of the following medications is considered the first line of medication treatment for children and adolescents with autism spectrum disorder who exhibit severe irritability and may be a good option for Nate?
A.) Haloperidol
B.) Risperidone
C.) Ziprasidone
D.) Quetiapine
b
Which antipsychotic is considered the most effective for treatment the of schizophrenia, particularly in patients who have been unresponsive to other treatments but is a challenging drug to administer due to its risk of both severe side effects?
A.) Cariprazine B.) Aripiprazole C.) Olanzapine D.) Clozapine
d
8.) What is the single leading cause of premature death among people with schizophrenia?
A) Drug Overdose
B) Suicide
C.) Heart disease
D.) Stroke
b
A patient is prescribed a second-generation antipsychotic. All the following should be monitored except:
A.) BMI B.) Fasting blood glucose C.) Lipid profile D.) Liver enzymes
d
What is the first choice of agents for pharmacologic treatment of ADHD?
A.) CNS stimulants B.) Antipsychotics C.) SSRIs D.) Benzodiazepines
a
Delusions occur in what percentage of manic bipolar disorder patients?
50%
75%
60%
80%
b
Which of the following are types of short-term psychotherapies?
A. Interpersonal
B. Cognitive
C. Behavioral
D. All of the above
d
DSM-5 classifies the severity levels of intellectual disability into what four categories?
Mild , average, above average, profound
Low, minor, major, critical
Mild, moderate, severe, profound
Minor, moderate, major, critical
c
Symptoms of schizophrenia are divided into what three groupings?
Positive, negative, cognitive
Mild, moderate, severe
Minor, major, critical
None of the above
a
Nondeclarative memory includes which of the following?
Skills and habits
Priming
Nonassociative learning
All of the above
d
What term was coined in 1975 by Edward Obsbone Wilson, an American biologist, whose book emphasized the role of evolution in shaping behavior?
Ethology
Sociobiology
Phenology
Ecology
b
There are four major stages that lead to the capacity for adult thought. What is the third stage of this capacity?
Formal operations
Preoperational thought
Sensorimotor
Concrete Operations
d
Memory consists of various subtypes, however, amnesia affects only one kind of memory. What memory does amnesia affect?
Declarative memory
Cognitive memory
Nondeclarative memory
None of the above
a
The human brain contains approximately 85 billion glial cells. Of these types of glial cells, which one is the most common?
Microglia
Dendrites
Oligodendrocytes
Astrocytes
d
Body muscle movements are controlled by what neurons?
Upper motor neurons
Basal ganglia
Lower motor neurons
Cerebellum
c
What is the best treatment option for mood disorders?
a. Medications
b. Psychotherapy
c. Socialization
d. Medications in combination with psychotherapy
d
When is Electroconvulsive Therapy (ECT) contraindicated for a patient with a mood disorder?
a. The patients illness is severe, the patient is suicidal and was just started on a Selective Serotonin reuptake inhibitor (SSRI) 3 days ago.
b. The patient is pregnant.
c. The patient has a brain tumor.
d. The patient has had medication trials which have been unsuccessful.
c
Lithium is processed by the kidneys and has a narrow therapeutic range. Due to risk of toxicity, what maintenance range should Lithium be kept?
a. 0.5-1.3 mEq/L
b. 1.2-2.6 mEq/L
c. 0.6-1.2 mEq/L
d. 0.8-1.5 mEq/L
c
During childhood, when it comes to psychological disorders, which is more common in girls than boys?
a. ADHD
b. Autism
c. Tourette syndrome
d. Anorexia Nervosa
d
There is a theory in psychology that suggests that cannabis can have a detrimental effect on the brain of a teenager, this is due to the brain sometimes not being fully developed until what age?
a. 30
b. 6
c. 25
d. 10
c
What do most antipsychotic mediations do to help with symptoms of schizophrenia?
a. Block dopamine build up in the brain
b. Increase the amount of dopamine found in the brain
c. Increase Serotonin found in the brain
d. Decrease gamma-aminobutyric acid (GABA) found in the gut.
a
Who originated work in the Attachment Theory?
a. Freud
b. John Bowlby
c. Carl Rogers
d. Jean Piaget
b
Which of these Assessment Instruments is used to test cognition?
a. Rorschach Test
b. Mini Mental Status Exam
c. Wechsler Memory Test
d. Minnesota Multiphasic Personality Inventory (MMPI)
b
According to Freud, the ego functions in the _____?
a. Conscious, pre-conscious and the unconscious mind
b. The conscious mind only
c. The unconscious mind only
d. The superego
a
When it comes to the prevalence and incidence of depression, which of the following is true?
a. Depression is found in more men than women.
b. The mean onset for major depression disorder (MDD) is age 40.
c. Depression is found more in those who have higher economic status than those with lower economic status.
d. Caucasian Americans have a higher incidence of depression than African Americans and Asian Americans.
b
What is described as the foundational paradigm from which all biology arises and it’s also described as any change in the genetic makeup of a population?
a. Reproduction
b. Evolution
c. Biology
d. Competition
b
Culture shapes how psychiatric symptoms are expressed. What should be a component of every complete psychiatric assessment?
a. Cultural assessment
b. Food aversions
c. Social media
d. Temperament
a
Manic patients are excited, talkative, sometimes amusing, and frequently hyperactive. Which type of speech is considered a hallmark of mania?
a. Manic speech
b. Hyperactive speech
c. Depressed speech
d. Pressured speech
d
Selective serotonin reuptake inhibitors (SSRI’s) are believed to exert their therapeutic effects through serotonin reuptake inhibition. All of these are SSRI’s except
a. Celexa b. Venlafaxine c. Prozac d. Paxil
b
The most common clinical mistake leading to an unsuccessful trial of antidepressant is the use of too low a dosage for too short a time. How many weeks should an antidepressant be raised at a maximum level and maintained at that level before a drug trial is considered unsuccessful?
a. 4 to 5 weeks
b. 10 days
c. 2 or 3 weeks
d. 8 to 10 weeks.
a
In contrast to major depressive disorder, Which disorder has a roughly equal prevalence among men and women?
a. Depression
b. Manic episodes
c. Bipolar 1 disorder
d. Bipolar 2 disorder
c
This hormone is a posterior hormone involved in osmoregulation, it also has been used experimentally in autistic children to increase socialization, what is it called?
a. Melatonin
b. Prolactin
c. Oxytocin
d. Insulin
c
What is the name one of the boundaries of the limbic system, which is a critically important gate through which internal and external stimuli are generated?
a. Septum
b. Basal forebrain
c. Amygdala
d. Orbito-frontal complex
c
Part of the basal ganglia, the caudate nucleus acts as a gatekeeper to allow the motor system to perform acts that are goal directed. When the caudate nucleus fails to perform, all of these may happen except?
a. Tourette’s
b. OCD
c. Bradykinesia
d. All the above
d
Substance use is related to a variety of behaviors. Adolescents with inadequate social skills may use a substance as a modality to join a peer group. Which substance with an abrupt cessation used heavily by adolescents can result in insomnia, irritability, restlessness, drug craving and depressed mood followed by anxiety?
a. Marijuana
b. Alcohol
c. Cocaine
d. LSD
a
What parts of the brain make up the limbic system?
a. hypocampus and amygdala
b. cerebellum and thalmus
c. hypothalmus
d. cerebral cortex
a
The limbic system is responsible for what symptoms in schizophrenia?
a. alogia
b social inattentiveness
c. affective flattening
d. auditory hallucinations
d
New disorders identified in the DSM5 included:
a. hoarding
b cannibus withdrawal
c. central sleep apnea
d. all of the above
d
A patient presents with major depressive disorder and his predominate symptom is rage. Which medication would be best for treating this patient?
a. Prozac
b.Wellbutrin
c. Risperdal
d. Celexa
c
The difference in prognosis/severity of Bipolar 1 and Bipolar II is:
a. type 1 is more severe because it has more manic episodes and requires a lifetime of medications
b. type 2 because it has shorter periods of time between episodes
c. type 1 because it starts with depression
d. type 2 because there is an increased risk of suicide
a
Differential diagnosis for mania include:
a. AIDS/HIV, substance abuse, hyperthyrodism
b. hypothyroidism, measles, alcohol withdrawal
c.coxsakies virus, rheumatic fever, hypotension
d. AIDS/HIV, rubella, hepatitis C
a
Serotonin originates in the
a. axon terminal
b. cerebral cortex
c. pituitary gland
d. tyrosine vessel
a
The 4 A’s of Schizophrenia identified by Blueler include: association, affective disturbances, autism, and ambivalance. The patient exhibiting inappropriate social cues is displaying:
a. association
b. autism
c. ambivalence
d.affective disturbances
b
Attachment theory was originated by John Bowlby in early 1900 and he defined attachment as:
a. change in behavior resulting from repeated practice
b. emotional tone between children and their caregivers
c. the ability of a parent to care for a child
d. the theory of a child becoming attached to a material object
b
When therapists present drugs and psychotherapy as complementary to a client they are practicing which theory:
a. attribution theory
b. attachment theory
c. learning theory
d.operant conditioning theory
a
The hypothalamus is the part of the limbic system located in the cerebrum. As a driver of the autonomic system, the hypothalamus helps to regulate all of the following EXCEPT:
a. Appetite
b. Body temperature
c. Libido
d. Maintain balance
d
Sexual Maturity Rating (SMR) or Tanner Stages classifies the physical development of primary and secondary sex characteristics in children, adolescents, and adults. As a PMHNP, you are conducting a physical exam of a girl. The following results are which SMR or Tanner stage? The Female examined identified enlargement of the breast and areola but no separation in contour. The pubic hair is coarser, darker, curlier, and sparsely spread over the junctions of pubes.
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
e. Stage 5
c
Neuroimaging measures brain structures, areas of function, and chemistry. All of the following are examples of neuroimaging EXCEPT:
a. Computer Tomography (CT)
b. Electroencephalogram (EEG)
c. Magnetic Resonance Imaging (MRI)
d. Positron Computer Tomography (PET)
e. Single Photon Emission Tomography (SPECT)
b
What neuropsychological assessment instrument would a Psychiatric Mental Health Nurse Practitioner (PMHNP) utilize to evaluate an adult patient’s memory, including immediate recall and delayed retention?
a. Mini Mental Status Exam
b. Minnesota Multiphasic Personality Inventory (MMPI)
c. Rorschach Test
d. Wechsler Adult Intelligence Scale (WAIS)
e. Weschler Memory Scale
e
Epidemiologic surveys have identified up to two-thirds of intellectually disabled children and adults have coexisting psychopathy. This is an example of _____________ prevalence.
a. Lifetime prevalence
b. Period prevalence
c. Point prevalence
d. Treated prevalence
a
Julie is an 18-year Freshman at UC who presents to the clinic for her first evaluation. Julie indicates she is struggling with sexual attraction towards another female classmate. She is concerned there is something wrong with her for not being attracted to males. As a PMHNP, you know Julie should be in which stage of Erik Erikson’s psychosocial development.
a. Autonomy vs. shame and doubt
b. Generativity vs. stagnation
c. Intimacy vs. isolation
d. Identity vs. role confusion
e. Trust vs. mistrust
d
PMHNPs frequently utilize the Therapeutic Nurse-Client Relationship Theory or Intrapersonal Theory. This theory implements the orientation, working, and termination phases. Which nursing theorist is credited with developing the therapeutic nurse-client relationship theory?
a. Madeline Leininger
b. Dorothy Orem
c. Hildegard Peplau
d. Jean Watson
c
Joseph is a 22-year-old with a history of schizophrenia and was admitted to the inpatient psychiatric mental health unit. In reviewing Joseph’s medical history and assessment, including information from his parents, the PMHPNP identifies which of the following is a negative symptom.
a. Hearing voices from the radio telling him to sell all his clothes.
b. Threaten the mailperson when they deliver mail to the house.
c. Absent from school and work for over two weeks.
d. Speaking incoherent sentences.
c
In assuring a patient has been correctly diagnosed with schizophrenia disorder, the PHMNP recognizes which of the following as a DSM-5 requirement?
a. Auditory hallucinations and grandiose delusions must be present consecutively for at least six months.
b. The patient is keenly aware of the severity and nature of other symptoms.
c. Poor hygiene and grooming.
d. Hallucinogen intoxication detected on a urine drug screen.
a
Jane, a 15-year-old girl, has been diagnosed with major depressive disorder and started on fluoxetine (Prozac) 10 mg daily. The PHMNP can effectively monitor for therapeutic effectiveness by implementing which of the following?
a. Urine drug screening to evaluate for compliance in taking the medication daily.
b. Daily weights to ensure appetite is good.
c. Hamilton Depression Rating Scale (HDRS)
d. Sleep study
c
What is the primary reason that many clinicians avoid prescribing Monoamine Oxidase Inhibitors (MAOIs) to their patients suffering from depression?
a. Those who take MAOIs would need to follow strict dietary guidelines that are difficult to adhere to and noncompliance may result in hypertensive crisis
b. The waiting period for efficacy is too long for many patients
c. They are not an effective group of medications to treat depression
d. They lower the seizure threshold
a
Which of the following patients would Wellbutrin be an appropriate choice for?
a. A patient suffering from depression with a history of an eating disorder
b. A patient suffering from depression with a history of a seizure disorder
c. A patient with anxiety who is trying to attempt their chronic daily alcohol use
d. A patient in a depressive episode and a concurrent diagnosis of ADHD
d
Lithium is known as the gold standard for the treatment of Bipolar Disorder. What is the caveat when it comes to Lithium related to suicidality?
a. Lithium toxicity is associated with suicidality
b. Though Lithium is deadly in overdose it can also diminish suicidal ideation in patients who are therapeutic
c. It’s narrow therapeutic index makes it difficult too monitor and therefore is not worth the risk
d. Lithium therapy masks the risks for suicidality in the patient assessment
b
Substance use disorders (SUD) are very common in patients with Schizophrenia. What explanation could explain the association?
a. Those who are considered biologically vulnerable and encounter an external stressor such as the use of a substance may be more prone to the development of a mental health disorder such as schizophrenia
b. Substances are used to mask the symptoms of schizophrenia and/or side effects of their treatment regimen
c. SUD and schizophrenia are similar when it comes to the process of disorder development in an individual
d. All of the above
d
Why is bipolar disorder commonly a missed diagnosis?
a. There are no labs that help clinicians with diagnosis
b. The patients offer suffer with treatment resistant, chronic depression for several years before ever having their first manic episode
c. Substance use is typically the main focus of treatment
d. There are limited screening tools available for the diagnosis of mood disorders
b
What is the risk that a clinician should be aware of when starting a patient on an antidepressant or using ECT?
a. The possibility of the patient experiencing their first manic episode
b. Excessive weight gain
c. The patient becoming violent or threatening
d. The patient experiencing a traumatic experience during ECT
a
Which of the following is not more specific to children when it comes to the signs and symptoms of Bipolar Disorder?
a. Their symptoms are similar to ADHD and they are sometimes misdiagnosed
b. They often have somatic complaints such as a stomach ache or headache that is not improved with typical treatment
c. The cycles are slower and more drawn out than adults suffering from Bipolar Disorder
d. They often appear more irritable than adults when functioning in a manic episode
c
Extrapyramidal side effects (EPS) are a risk with the initiation of certain antipsychotics. They should be treated with anticholinergic and/or the offending medication should be discontinued. If treatment is not initiated in a timely manner, what can the patient then suffer from chronically that may be irreversible?
a. Tardive Dyskinesia
b. Sedation
c. Hypotension
d. Gynecomastia and lactation due to elevated prolactin levels
a
The child’s brain undergoes pruning or the loss of grey matter. Which of the following is false concerning the pruning process?
a. Around 5% of grey matter is lost between the ages of 13-18
b. It is just as important as growth when it comes to brain development
c. Adolescents consolidate learning by pruning away some synapses while simultaneously strengthening other connections
d. Cannabis use may be harmful to the development of the brain during this sensitive time period
a
Social defeat such as bullying or a failure to connect with peers socially in adolescence can have what impact on the developing brain?
a. Deficits in language and communication
b. Deficits in long term memory
c. Slowed puberty and physical development
d. Cognitive deficits including a decrease in function of working memory due to dopamine’s role in the medial prefrontal cortex
d
Which of the following is a pictorial diagnostic instrument used for 6-11 year olds?
A. Children’s Interview for Psychiatric Syndromes
B. Diagnostic Interview Schedule (DIS)
C. Dominic-R
D. The Child Assessment Schedule (CAS)
c
The NP knows that monitoring patients for gynecomastia is most important with administration of which antipsychotic medication?
A. Aripiprazole
B. Clozapine
C. Quetiapine
D. Risperidone
d
With administration of which medication is it most important to obtain a baseline EKG?
A. Aripiprazole (Abilify)
B. Lurasidone (Latuda)
C. Sertraline (Zoloft)
D. Ziprasidone (Geodon)
d
Schizophrenia is thought to be primarily related to dysregulation of which neurotransmitter?
A. Acetylcholine
B. Dopamine
C. Norepinephrine
D. Serotonin
b
Antipsychotic drugs work primarily on which receptor?
A. 5HT2A
B. H1
C. M3
D. D2
d
What is the number one cause of premature death in people with schizophrenia?
A. Cardiovascular disease
B. Homocide
C. Lung Cancer
D. Suicide
d
Which of the following is indicative of poor long-term prognosis in schizophrenia?
A. Married
B. Support system
C. Positive symptoms
D. Young onset
d
In which of the following patients would electroconvulsive therapy (ECT) be contraindicated?
A. 18-year-old with treatment resistant depression
B. 25-year-old pregnant patient
C. 50-year-old with suicidal ideation
D. 65-year-old with a brain tumor
d
Which medication has the added benefit of eliminating suicidal ideation?
A. Elavil
B. Gabapentin
C. Lithium
D. Paroxetine
c
When prescribing Lamotrigine (Lamictal) it is important that the clinician does which of the following?
A. Educate the patient on possible side effects such as priapism
B. Monitor liver function
C. Obtain baseline EKG
D. Titrate slowly to minimize the risk for rash development.
d
A 29-year-old patient presents to the emergency department with complaints of A 29-year-old female presents to the emergency department with complaints of abdominal pain, nausea, vomiting, and bloody stools. Despite an extensive evaluation, no underlying cause for her symptoms can be identified and her lab work is within normal limits. The patient gets frustrated, insisting there is something physically wrong with her. Which of the following best describes her condition?
Jealous delusion
Persecutory delusion
Somatic delusion
Grandiose delusion
c
A 22-year-old male presents to the emergency department accompanied by police who were called because the patient was shouting at imaginary figures, displaying bizarre behavior, and appearing disoriented. The patient has acute onset delusions, believing he has special powers to communicate with aliens and is on a mission to save the world. He continues to exhibit disorganized speech and aggressive behavior. Which of the following can the PMHNP diagnose during the initial encounter?
Schizoaffective disorder
Schizophrenia
Brief psychotic disorder
Schizophreniform disorder
c
Which of the following best describes the essential feature of Bipolar I Disorder?
At least one manic episode lasting for at least one week
Alternating episodes of major depression and hypomania
A pattern of depressive symptoms lasting for at least two years
Frequent mood swings between extreme highs and lows
a
A patient is unable to acknowledge that his mental illness is perpetuated by his substance use disorder and is insisting that his mother’s genes are to blame. Which defense mechanism is employed?
Neurotic
Immature
Mature
Narcissistic
d
Which type of bipolar disorder is characterized by recurrent major depressive episodes alternating with hypomanic episodes, but never reaching full-blown manic episodes?
Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder
Rapid-Cycling Bipolar Disorder
b
Which type of delusion involves the belief that one has extraordinary powers, abilities, or importance?
Jealous delusion
Persecutory delusion
Somatic delusion
Grandiose delusion
d
What disorder is characterized by the presence of both mood disorder episodes (e.g., major depressive or manic episodes) and psychotic symptoms (delusions or hallucinations)?
Schizophrenia
Schizophreniform Disorder
Bipolar I Disorder
Schizoaffective Disorder
d
Which of the following is a common symptom of catatonia, commonly associated with schizophrenia?
Rapid, excessive speech
Frequent mood shifts
Immobility and muteness
Excessive worrying
c
What is the leading cause of premature death in people with schizophrenia?
Diabetes mellitus
Substance use disorder
Cardiovascular disease
Suicide
d
When evaluating a new 44-year-old patient complaining of fatigue, irritability, dry skin, and poor sleep quality for a mood disorder, which of the following diagnostic tests should be ordered to aid in formulating a diagnosis?
Thyroid-stimulating hormone (TSH)
EKG
Urine pregnancy test
Hemoglobin A1c
a
Which of the brain functions served by the limbic system is NOT one of Eugen Bleuler’s well-known four A’s of schizophrenia :
A) Autism
B)Associations
C) Affect
D) Attention
d
Recently, amino acids have been recognized as neurotransmitters. Which are the two major ones when considering neurobiology causes of schizophrenia?
A) Endocannabinoids and Neurotrophic factors
B) Nucleotides and Sigma receptors
C) GABA and Glutamate
D) Eucsanoids and Substance P
c
Harry Harlow’s work in Ethological studies with monkeys demonstrated the emotions and behavioral effects of isolating monkeys from birth. Which theory of psychopathology was his work most applicable to?
A) Social Learning Theory
B) Cognitive Learning Theory
C) Operant Conditioning
D) Attachment Theory
d
The Drive Reduction Theory is described as a state of tension arousal caused by biological or physiological needs. All motivation arises as a result of biological needs. Which behaviorist(s) developed this theory? (Cherry, 2023)
A) Broca and Wernicke
B) Eric Kandel
C) Clark Hull
D) Mary Ainsworth
c
The Rorschach Test is a common assessment instrument to evaluate:
A) Intelligence
B) Memory
C) Personality
D) Cognitive screening
c
Patients treated for bipolar disorder with either carbamazepine or valproate should have which laboratory test drawn q 6-12 months to monitor for toxicity.
A) CBC w/diff
B) Fasting blood glucose
C) renal functions
D) LFT’s
d
With schizophrenia hallucinations can be a presenting symptom. Of the 5 senses which are the most common hallucinations?
A) Tactile
B) olfactory
C) visual
D) auditory
d
Symptoms of schizophrenia can be divided into three groups, positive, negative, and cognitive symptoms. Which one of these is not a positive symptom?
A) anhedonia
B) delusions
C) pressured speech
D) auditory hallucinations
a
What is the gold standard treatment of antidepressants for major depressive disorder?
A) MAOI
B)Tricyclic antidepressnats
C) SNRI
D) SSRI
d
Bipolar disorder can be caused by a variety of factors including biological, genetic, and environmental. Children with one bipolar parent have what percentage of increased risk for developing the disorder compared to the general population?
A) 50%
B) 25%
C) 90%
D) 15%
d
What area of the brain is associated with executive functioning and continues to mature throughout the adolescent period?
A. Hypothalamus
B. Prefrontal Cortex
C. Medulla Oblongata
D. Corpus Callosum
b
