Pocket prep Questions Flashcards

1
Q

The shingles vaccine should not be given to these 3 groups:

A
  1. People with a weakened immune system
  2. People with HIV, AIDS, or a T-cell count below 200
  3. Patients being treated with high-dose steroids
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2
Q

oppositional defiant disorder?

A

A condition characterized by multiple examples of negativistic behavior persistent for at least six months, usually beginning when a child is three or four years old

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3
Q

Mental status exam findings of autism are as follows:

A

Little or no eye contact
Flat or blunted affect
Lack of emotional reciprocity
Stereotyped or repetitive motor mannerisms
Expressive and receptive language impairment

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4
Q

Extrapyramidal symptoms are drug-induced side effects that affect

A

motor functioning and muscle movement.

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5
Q

Typical antipsychotics like haloperidol, perphenazine, and chlorpromazine are more likely to cause

A

EPS

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6
Q

The common types of extrapyramidal symptoms are

A
Akathisia
Akinesia
dystonia
Pseudo parkinson 
tardive dyskinesia
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7
Q

Akathisia:

A
motor restlessness
inability to remain still, 
rocking, pacing, or constant motion of a unilateral limb, 
subjective sense of restlessness
often mistaken for increasing anxiety
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8
Q

Akinesia

A

absence of movement
difficulty initiating motion
subjective feeling of lack of motivation to move, often mistaken for laziness or lack of interest

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9
Q

Dystonia

A

muscle spasticity usually in the back or neck, subjectively painful, often mistaken for agitation

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10
Q

Pseudo-Parkinson’s:

A
shuffling gait
 motor slowing, 
mask-like facial expression, 
pill-rolling, 
tremors
 muscle rigidity
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11
Q

Tardive dyskinesia:

A

involuntary abnormal muscle movement of the mouth, tongue, face, and jaw that may progress to limbs;

can be irreversible

can occur as an acute process at the initiation of medications or as a chronic condition at any point during treatment

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12
Q

Nurse practitioner core competencies include the following:

A
Scientific foundations
Leadership
Quality
Practice inquiry
Technology and information literacy
Policy
Health delivery systems
Ethics
Independent practice
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13
Q

Decreased ferritin

A

levels have been known to potentiate restless leg syndrome.

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14
Q

Decreased folic acid conversion is known to be linked

A

to clients suffering from depression and anxiety disorders.

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15
Q

Albumin plays a significant role in stabilizing

A

extracellular fluid

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16
Q

Prolactin is not a blood protein but rather a

A

a hormone that directs the body to make breast milk.

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17
Q

Belladonna is a psychoactive herbal supplement that

A

produces psychological effects believed to aid in relieving psychiatric symptoms.

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18
Q

In reflective practice, the provider is

A

encouraged to tell a story about themselves and/or others in order to gain insight into practice.

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19
Q

Which part of the Medicare program covers allied health services such as physical, occupational, and speech therapy?

A

PART B

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20
Q

The Medicare program has four parts:

A

Part A, Part B, Part C, and Part D.

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21
Q

Part A:

A

Coverage for hospitalizations (up to 90 days)

skilled nursing facility (up to 100 days)

hospice (up to six months for terminally ill)

some home health care

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22
Q

Part B:

A

Coverage for ambulatory practitioner service

physical, occupational, and speech therapy

medical equipment

diagnostic tests

some preventative care

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23
Q

Part C:

A

Optional coverage for beneficiaries who can choose to receive all of their health care services through one of the provider organizations covered under the Medicare Advantage plan

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24
Q

Part D:

A

Optional coverage for outpatient pharmaceuticals

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25
Q

The Health Information Technology for Economic and Clinical Health (HITECH) Act was included under which 2009 law?

A

American Recovery and Reinvestment Act

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26
Q

American Recovery and Reinvestment Act (ARRA

A

this law aimed to save and create jobs while financing infrastructure, education, health care, and renewable resources. The ARRA includes the Health Information Technology for Economic and Clinical Health (HITECH) Act, which attempts to update the American infrastructure, including the use of electronic health records.

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27
Q

The corpus callosum is

A

a large bundle of white matter that connects the right and left hemispheres and provides an area of sensorimotor information exchange.

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28
Q

The American Nurses Association defines nursing as

A

“the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.

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29
Q

Computed tomography provides

A

a three-dimensional view of the brain structures and differentiates structures based on density. CT scans provide suggestive evidence of brain-based problems.

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30
Q

X-ray testing provides

A

minimal insight into brain-based problems and is typically used for structural diagnostics such as broken bones and the presence of fluid in organs such as the lungs.

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31
Q

EMDR (eye movement desensitization and reprocessing)

A

a form of psychotherapy used to treat patients suffering from trauma disorders.

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32
Q

Transference occurs when

A

a patient displaces feelings for significant people in their past onto the nurse practitioner

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33
Q

Counter transference

A

represents the nurse practitioner’s emotional reaction to the patient based on her past experiences. Unresolved positive and negative feelings from the nurse practitioner’s past may cause the projection of these feelings onto patients.

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34
Q

Defending the patient’s inappropriate behavior

A

reflects an underlying subjective connection with the patient, which is an example of countertransference

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35
Q

goal of family systems therapy?

A

To increase levels of self-differentiation

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36
Q

Family systems therapy was developed

A

by Murray Bowen

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37
Q

Murray bowen who developed family systems therapy believed

A

that an individual’s problematic behavior may serve a function or purpose for the family.

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38
Q

Family Systems therapy focuses on

A

the chronic anxiety within families

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39
Q

Treatment goals of family systems therapy include

A

increasing self-differentiation, which helps family members learn that their self-worth is not dependent on external relationships, circumstances, or occurrences.

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40
Q

goal of structural family therapy is

A

Changing family structure

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41
Q

A goal of experiential therapy is

A

Developing nurturing communication is

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42
Q

goal of strategic therapy is

A

Helping family members behave in ways that will not perpetuate the problem behavior

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43
Q

Evidence-based practice simply refers

A

to combining research, clinical knowledge, and patient preferences to reach a health care decision.

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44
Q

Evidenced Based practice

A

emphasizes the use of the highest-quality information and de-emphasizes the use of customs, opinions, or rituals to make a clinical judgment.

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45
Q

The goal of evidence-based practice is simple:

A

provide care that is safe, effective, and compassionate..

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46
Q

The brain itself is divided into two distinct anatomical regions:

A

the cerebrum and the brainstem.

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47
Q

The cerebrum contains the

A

cerebral cortex, limbic system, thalamus, hypothalamus, and basal ganglia.

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48
Q

The brainstem includes

A

the midbrain, pons, cerebellum, medulla, and reticular formation.

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49
Q

Patients suffering from acute delirium, acute stroke, or who have a urinary tract infection often have

A

symptoms that mimic patients with dementia. The nurse practitioner should rule out acute illnesses when performing their exam prior to diagnosing a patient with dementia.

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50
Q

Females with bipolar disorder are more likely to experience

A

rapid cycling and mixed states and are more likely to experience depressive episodes. They also have higher rates of comorbid alcohol use disorders and eating disorders.

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51
Q

The peripheral nervous system is composed

A

of the peripheral nerves that connect the central nervous system to receptors, muscles, and glands. It also includes the cranial nerves just outside the brainstem and includes both the somatic and autonomic nervous systems.

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52
Q

Mediation is a

A

voluntary and confidential process in which a third party facilitates discussion to reach an agreement.

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53
Q

Common indicators of child abuse:

A
History of unexplained multiple fractures
Burns, hand or bite marks
Injuries at various stages of healing
Evidence of neglect
Bruising on padded parts of the body
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54
Q

According to Erik Erikson, the virtue of wisdom is associated with the successful resolution of the psychosocial stage

A

Ego Integrity vs. Despair.

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55
Q

Trust vs. Mistrust:

A

Hope

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56
Q

Autonomy vs. Shame and Doubt:

A

Will

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57
Q

Initiative vs. Guilt:

A

Purpose

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58
Q

Industry vs. Inferiority:

A

Competence

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59
Q

Identity vs. Role

A

Fidelity

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60
Q

Intimacy vs. Isolation:

A

Love

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61
Q

Generativity vs. Stagnation:

A

Care

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62
Q

Ego Integrity vs. Despair:

A

Wisdom

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63
Q

The cerebral cortex is responsible for

A

receiving incoming sensory information from the thalamus.

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64
Q

The limbic system’s amygdala

A

mediates mood, fear, emotion, and aggression.

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65
Q

The limbic system’s hippocampus

A

converts short-term memory into long-term memory.

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66
Q

The basal ganglia

A

stabilizes somatic motor activity.

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67
Q

At three years of age, landmarks of normal behavioral development include the following:

A
Rides tricycle
Jumps from bottom of steps
Alternates feet going up stairs
Builds tower of 9 or 10 cubes
Imitates a three-cube bridge
Copies a circle and a cross drawing
Puts on shoes
Unbuttons buttons
Feeds self well
Understands taking turns with others
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68
Q

Level 1 evidence (strongest):

Level 2:

Level 3:

Level 4:

Level 5:

Level 6:

A

Systematic review of randomized controlled trials or systematic review of nonrandomized trials

Single randomized controlled trial or single nonrandomized trial

Systematic review of correlational or observational studies

Single correlational or observational study

Systematic review of descriptive, qualitative, or physiologic studies

Single descriptive, qualitative, or physiologic study

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69
Q

Haloperidol is an antipsychotic, and it is usually the drug of choice for managing

A

an agitated or confused patient with delirium.

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70
Q

Dosing of haldol for delirium

A

Usually, haloperidol is prescribed as 0.5 mg every 8 hours as needed for agitation or confusion. It comes in intramuscular, IV, and oral forms.

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71
Q

Diphenhydramine and benztropine possess anticholinergic properties that would

A

worsen the delirium

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72
Q

Lorazepam should be avoided in older adults because

A

it can cause a paradoxical effect, resulting in worsened agitation.

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73
Q

Medicare is funded by

A

federal tax dollars. In 2011, it provided health care for 47 million eligible people.

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74
Q

Those eligible for Medicare include the following:

A

The elderly age 65 and older having worked 40 quarters and paid Medicare taxes
Certain younger individuals with disabilities
Individuals with end-stage renal disease
Individuals in need of a kidney transplant
Individuals receiving Social Security Disability and who have amyotrophic lateral sclerosis

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75
Q

Medicaid is funded by both

A

federal and state tax dollars. In 2011, Medicaid provided health care for 60 million eligible persons, 85% of whom were children.

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76
Q

Those eligible for Medicaid include the following:

A

Low-income children
Low-income pregnant women
Elderly and disabled individuals who qualify for the Supplemental Security Income Program

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77
Q

The Centers for Medicare and Medicaid Services (CMS) administer the two major public insurance programs,

A

Medicaid and Medicare.

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78
Q

Tanner Stages define physical measurement in the

A

development of primary and secondary sex characteristics in both females and males.

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79
Q

Tanner Stages of a girl’s breast development are as follows:

A

Stage 1: Prepubertal
Stage 2: Breast bud stage with elevation of breast and papilla
Stage 3: Further enlargement of breast and areola
Stage 4: Areola and papilla form a secondary mound above the level of the breast
Stage 5: Projection of papilla related to recession of areola

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80
Q

Indications for seclusion and restraint:

A

Prevent clear, imminent harm to the patient or others
Prevent significant disruption to the treatment program or physical surroundings
Assist in treatment as part of ongoing behavior therapy
Decrease sensory overstimulation
Patient’s voluntary reasonable request

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81
Q

Contraindications for seclusion and restraint:

A

Extremely unstable medical or psychiatric condition
Delirious or demented patients unable to tolerate decreased stimulation
Overtly suicidal patients
Patients with severe drug reactions or overdoses who require close monitoring of their drug dosages
For punishment or convenience of staff

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82
Q

Testamentary capacity

A

is the level of competence required to make a legally valid will.

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83
Q

The key elements of testamentary capacity include the following:

A

Comprehension of the act of writing and signing the will
Knowledge of potential heirs
Understanding the extent of one’s assets
Lack of undue influence
The absence of delusions compromising rational thought

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84
Q

A systematic review is

A

a scientific study that gathers multiple studies and analyzes them to draw a larger conclusion. The term systematic refers to methodical order and planning. When conducting a systematic review, the researcher uses transparent and structured steps in order to avoid bias and increase confidence in the findings. There are two main types of systematic review; each differs by the type of research they analyze and how they analyze it.

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85
Q

Meta-analysis:

A

a scientific study that statistically analyzes a collection of quantitative studies. These studies use statistics to discover patterns that would be otherwise undetectable.

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86
Q

Metasynthesis:

A

a scientific study that analyzes a collection of qualitative studies. These studies discover meaning by summarizing the results in a narrative format.

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87
Q

Examples of research dissemination include the following:

A

Publishing in peer-reviewed journals
Publishing in professional newsletters or blogs
Poster presentations at local, regional, and national conferences

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88
Q

Seasonal workers are those

A

who travel from their permanent residences seasonally for agricultural employment.

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89
Q

Migrant and seasonal workers

A

have very high incidences of depression, anxiety, and substance use. Migrant and seasonal workers include men, women, and children of all cultures.

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90
Q

Psychotropic antipsychotics such as Seroquel and Risperdal can cause

A

blurry vision and cataracts. Patients are advised to have routine eye exams every six months while being treated with antipsychotics.

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91
Q

Variable expression of a gene for a disorder occurs at the

A

cellular level.

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92
Q

The four forms of health policy are

A
  1. process,
  2. policy reform
  3. policy environment
  4. policymakers.
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93
Q

Process is the

A

formulation, implementation, and evaluation of policy.

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94
Q

Policy reform is t

A

he act of changing programs and practices.

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95
Q

Policy environment refers to

A

the process taking place in the government, media, and public forums.

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96
Q

Policymakers are

A

the key players and stakeholders involved in policymaking.

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97
Q

The psychoanalytic therapy model was originated by

A

Sigmund Freud

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98
Q

Clearly defined boundaries

A

maintain a person’s separateness while emphasizing belongingness.

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99
Q

Race

A

is a concept by which human beings are grouped primarily by physiognomy.

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100
Q

Culturally competent care includes the following concepts:

A

Culture has learned beliefs and behaviors
Culture includes inherited characteristics such as racial, social, ethnic, and religious beliefs
Cultures have syndromes that are not necessarily linked to psychiatric illnesses

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101
Q

Culture can be influenced by the following:

A
Family
Ethnicity
Community
Environment, such as:
Climate
Social contacts
Housing and surroundings
Altitude
Temperature
Air pollution
Fluoride in the water
Water quality
Crime
Poverty
Transportation available
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102
Q

The PMHNP role in policy and process change is to

A

oversee and guide the psychiatric mental health nurse in designing evidence-based health information and educational programs that are geared to consumer learning needs, ability, and readiness to learn.

The PMHNP is a health care partner. It is important for the PMHNP to partner with clinicians at the bedside in order to formulate potential policy change.

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103
Q

Freud’s stages of psychosexual development:

A
Oral: birth to 12-18 months
Anal: 12-18 months to 3 years
Phallic: 3 to 5-6 years
Latency: 5-6 years to adolescence
Genital: adolescence to adulthood
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104
Q

According to Freud, successful resolution of which psychosexual stage provides the basis for the development of personal autonomy and capacity for self-confidence?

A

Latency

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105
Q

Successful resolution of the anal stage of psychosexual development .

A

provides the basis for the development of personal autonomy and capacity for self-confidence

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106
Q

Failure to resolve the anal stage results in

A

pathological traits of excessive orderliness, stubbornness, willfulness, frugality, and parsimony.

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107
Q

Anal characteristics and defenses are typically seen in

A

obsessive-compulsive disorders.

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108
Q

An intrapreneur is an employee within an established system who champions, manages, and embeds new products or services within an organization. They have characteristics similar to entrepreneurs, including commitment, motivation, and skills to take on risk and develop something new. Nurse practitioners possess a unique vantage in the health care system and are positioned to be successful intrapreneurs. is

A

an employee within an established system who champions, manages, and embeds new products or services within an organization. They have characteristics similar to entrepreneurs, including commitment, motivation, and skills to take on risk and develop something new. Nurse practitioners possess a unique vantage in the health care system and are positioned to be successful intrapreneurs.

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109
Q

Intrapreneurs characteristics include

A

They have characteristics similar to entrepreneurs, including

a) . commitment
b) . motivation
c) skills to take on risk and develop something new.

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110
Q

The claim is

A

a request to the insurance company to pay benefits for a loss.

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111
Q

Pre-approval is the requirement

A

set forth by an insurance company to approve certain care before it is provided.

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112
Q

The term appropriately describes a nurse practitioner?

A

Independently licensed practitioner

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113
Q

Symptoms of discontinuation syndrome include

A
flu-like symptoms
 fatigue and lethargy
myalgia
decreased concentration
nausea and vomiting
impaired memory,
paresthesias
irritability
anxiety
insomnia,
crying without provocation
dizziness and vertigo.
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114
Q

What mental illness affects males and females equally, worsens with each decade of life, is three times more prevalent in older adults, and is associated with indecisiveness, procrastination, avoidance, and difficulty organizing tasks?

A

Hoarding disorder–Once symptoms begin, hoarding behaviors usually become chronic.

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115
Q

About 80 to 90 percent of individuals with hoarding disorder display

A

excessive acquisition, most commonly in the form of excessive buying or excessive collection of free items. A less common type of this disorder is called animal hoarding. In animal hoarding, individuals accumulate a large number of pets and fail to provide them with minimal standards of nutrition, sanitation, or veterinary care.

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116
Q

According to Irvin Yalom, what is a responsibility of a group leader during the pre-group phase?

A

Consider the direction and framework of the group

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117
Q

Irvin Yalom was the first person to put a theoretical perspective on group work. He believed that all groups go through 6 specific phases:

A
  1. Pre-group
  2. Forming
  3. Storming
  4. Norming
  5. Performing
  6. Adjourning
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118
Q

During the pre-group phase, the group leader’s responsibilities include

A
  1. Considering the direction and framework of the group
  2. Defining the purpose and goals
  3. Determining the membership criteria and membership size
  4. Conducting a pre-group interview
  5. Obtaining informed consent
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119
Q

During the storming phase, the group leader’s responsibilities include

A
  1. Allowing expression of both positive and negative feelings
  2. Assisting the group in understanding the underlying conflict
  3. Examining unproductive behaviors
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120
Q

Factors facilitating the growth of the nurse practitioner role

A
  1. Patient demand for services
  2. Patient acceptance of and satisfaction with nurse practitioners
  3. Decreasing stigmatization of psychiatric illnesses
  4. Emphasis on the need for integrated health care services
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121
Q

Factors constraining the growth of the nurse practitioner role:

A
  1. Growing competition in the job market
  2. Reduction in salary due to nurse practitioner oversupply
  3. Reimbursement struggles with Medicare and private insurance companies
  4. Legislative battles for independent practice
  5. Mandatory physician supervision
  6. Resistance from powerful medical organizations
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122
Q

Polyuria is a sign of

A

hypokalemia,

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123
Q

Effects of hyperkalemia:

A
Muscle weakness
Paralysis
Tingling of lips and fingers
Restlessness
Intestinal cramping
Diarrhea
Electrocardiogram changes
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124
Q

Effects of hypokalemia:

A
Impaired carbohydrate metabolism
Impaired renal function
Polyuria
Polydipsia
Skeletal muscle weakness
Smooth muscle atony
Cardiac dysrhythmias
Paralysis and respiratory arrest
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125
Q

Graduates from the first nurse practitioner program were educated in what medical specialty?

A

Pediatrics

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126
Q

In 1965, Dr. Loretta Ford (a public health nurse) and Dr. Henry Silver (a pediatrician) established

A

the first nurse practitioner program at the University of Colorado. This program educated pediatric nurse practitioners with a focus on disease prevention and health promotion. Over the next decade, nurse practitioner schools proliferated across the country. Today, there are over 205,000 nurse practitioners.

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127
Q

At four weeks, landmarks of normal behavioral development include

A
Hands fisted
Head sags but can hold head erect for a few seconds
Follows moving objects to midline
Responds to speech
Smiles preferentially at mother
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128
Q

What cranial nerve assessment tests for tactile perception of the facial skin?

A

The trigeminal nerve (cranial nerve V, sensory division) assessment tests for tactile perception of the facial skin. This test is performed by touching the face and corneal reflex of the eye with a wisp of cotton and pin-pricking the skin and mucosa to test touch.

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129
Q

The facial nerve (cranial nerve VII motor division) test for

A

assessment tests for flaccid paralysis.

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130
Q

The hypoglossal nerve (cranial nerve XII) assessment checks

A

for tremors and other involuntary movements when the client protrudes their tongue.

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131
Q

The olfactory nerve (cranial nerve I) assessment tests

A

smell and ensures patency of the nasal passages

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132
Q

Cognitive therapy, originating

A

with Aaron Beck,

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133
Q

Cognitive therapy

A

purports that external events do not cause anxiety or maladaptive behaviors.

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134
Q

The goal of cognitive therapy is to

A

change the client’s faulty conceptions, irrational beliefs, and negative cognitive distortions.

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135
Q

The p-value, also known

A

as the level of significance,

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136
Q

The p-value

A

describes the probability of a particular result occurring by chance alone. For example, if p = 0.01, there is a 1% probability of obtaining the result by chance alone.

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137
Q

Children with Rett syndrome present with the following:

A
  1. Flat or blunted affect.
  2. Impairment of expressive and receptive language
  3. Stereotypic hand movements
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138
Q

Examples of nursing-sensitive adverse events(NSAEs) include:

A

Examples of NSAEs include:

Failure to rescue
Nosocomial infections
Pressure ulcers
Falls
Medication errors
Transfusion errors
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139
Q

In how many states do nurse practitioners have the legal authority to administer controlled substances?

A

39

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140
Q

Nurse practitioners do not have the legal authority to administer controlled substances in which states.

A

The 11 excluded states are Florida, Kansas, Kentucky, Louisiana, Michigan, Nebraska, New Jersey, New Mexico, North Carolina, Pennsylvania, and South Carolina.

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141
Q

The most common reasons patients seek individual psychotherapy are as follows:

A
  1. Loss
  2. Interpersonal conflict
  3. Symptomatic presentations such as panic, anxiety, phobias, and negativity
  4. Unfulfilled expectations and life transitions
  5. Characterological issues such as narcissism or aggressiveness
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142
Q

Mind-body interventions under the umbrella of complementary and alternative therapies (CATS) include the following:

A

Guided imagery
Meditation
Yoga
Biofeedback

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143
Q

Aromatherapy is

A

a biological-based therapy.

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144
Q

Acupuncture and reflexology are

A

manipulative body-based therapies.

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145
Q

A 63-year-old female with a long history of generalized anxiety disorder tells you she was out shopping two days ago when she suddenly felt dizzy, experienced heart palpitations and pressure on her chest, and felt a sense of impending doom. Shortly after, she “passed out” and woke up minutes later with a crowd of people surrounding her. She states that she then felt better and decided to keep shopping.

What is the most likely diagnosis?

A

Cardiovascular disease

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146
Q

Anxiety disorders such as panic disorder and social anxiety very .

A

rarely cause unconsciousness

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147
Q

Nonpharmacological management of ADHD includes all of the following:

A
Behavior therapy
Treatment for learning disorders
Family therapy and education
Psychoeducation
Patient and parent cognitive behavioral training
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148
Q

The Orphan Drug Act

A

incentivizes pharmaceutical companies to develop drugs to treat rare diseases. These drugs are otherwise unprofitable to develop because the demand is low.

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149
Q

New chemical entities

A

refers to any new substance submitted to the FDA for approval.

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150
Q

The Nyman model is

A

an economic theory positing that private health insurance acts as an income transfer between the sick and the healthy.

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151
Q

The Physician Payment Review Commission is

A

an independent legislative advisory committee that advises the U.S. Congress on methods used to pay physicians for services to Medicare beneficiaries.

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152
Q

Serotonin antagonist/reuptake inhibitors block

A

5HT2A receptors. This action inhibits glutamate release in the prefrontal cortex of the brain.

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153
Q

blockage of 5HT2A receptors inhibits

A

This action inhibits glutamate release in the prefrontal cortex of the brain.

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154
Q

Mean, median, mode, and range are examples

A

of descriptive statistics.

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155
Q

Systemic effects of hypernatremia include

A

restlessness, thirst, and fever.

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156
Q

Systemic effects of hyponatremia include which of

A

Confusion

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157
Q

Up to 30 percent of individuals with obsessive-compulsive disorder (OCD) disorder will

A

develop a tic disorder. This is most commonly seen in males who develop OCD as a child

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158
Q

factors that hinder and constrict growth are as follows:

A

Reimbursement struggles with Medicare and private insurance companies
Overlapping scope of practice with other NPs
Increased concerns over reimbursement fraud and abuse
Scope of practice and the need for formal supervision by or collaboration with a physician

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159
Q

Factors that foster or facilitate growth are as follows:

A

Consumer demand for services
Acceptance of the advanced practice nursing role
Emergence of the PMHNP role
Decreasing stigmatization
Emphasis on integrated health care services

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160
Q

The Office of the National Coordinator for Health Information Technology (ONC) is

A

the federal entity responsible for accomplishing the goals of the Health Information Technology for Economic and Clinical Health (HITECH) Act.

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161
Q

Health Information Technology for Economic and Clinical Health (HITECH) strategic plan includes five goals:

A
  1. Achieve adoption and information exchange through the meaningful use of health information technology (HIT)
  2. Improve care, improve population health, and reduce health care costs through the use of HIT
  3. Inspire confidence and trust in HIT
  4. Empower individuals with HIT to improve their health and the health care system
  5. Achieve rapid learning and technological advancement
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162
Q

converts the action potential in the presynaptic neuron into a chemical signal that is then transferred to the postsynaptic neuron.

A

The synapse

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163
Q

Neurotransmitters are chemicals synthesized

A

from dietary substrates that communicate information from one cell to another. They can be divided into four categories: monoamines, amino acids, cholinergics, and peptides.

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164
Q

Neurotransmitters can be divided into four categories:

A

monoamines, amino acids, cholinergics, and peptides.

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165
Q

Patients with paranoid personality disorder are

A

suspicious, have few friends, and read hidden meaning into innocent remarks.

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166
Q

Patients with narcissistic personality disorder act s

A

elf-important. They are preoccupied with envy, fantasies of success, and ruminations about the uniqueness of their own problems. They reject criticism and need constant admiration from others.

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167
Q

Patients with dependent personality disorder

A

fear abandonment, feel helpless when they are alone, and are miserable when relationships end. They desperately desire the approval of others, and they often volunteer for unpleasant tasks to gain the favor of others.

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168
Q

Patients with obsessive-compulsive personality disorder are

A

perfectionistic and rigid. They are often workaholics who are indecisive, excessively scrupulous, and preoccupied with detail.

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169
Q

In almost all cultures,———- is the most commonly used intoxicating substance. About 3.8% of all global deaths and 4.6% of global disability-adjusted life-years are due to———-. About 80% of adults in the United States consume——- at some point in their lives, and 65% of adults are current drinkers.

A

alcohol

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170
Q

About 3.6% of the world’s population

A

has an alcohol use disorder, although this varies in different parts of the globe:

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171
Q

of those in the African region have an alcohol use disorder

A

1.1%

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172
Q

alcohol use in the American region

A

5.2%

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173
Q

alcohol use in the European region

A

10.9%

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174
Q

By the age of 18, at least —% of individuals smoke tobacco regularly.

A

20 %

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175
Q

More than % of these people attempt to quit, but only 5% will be successful

A

80%; 5%

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176
Q

The female-to-male ratio of anorexia nervosa in clinical populations is

A

10:1.

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177
Q

The 12-month prevalence of anorexia nervosa among females is

A

0.4%.

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178
Q

Anorexia is most prevalent in high-income

A

countries such as the United States, Australia, New Zealand, Japan, and some European countries.

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179
Q

Risk factors for developing this AN disorder include the following:

A

Obsessional personality traits in childhood
Comorbid anxiety disorders
Living in a culture or society that highly values thinness
Having an occupation that values thinness, such as modeling or elite athletics
Having a first-degree biological relative with an eating disorder

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180
Q

put a patient at risk for possible electrocardiogram changes.

A

Tricyclic antidepressants and antipsychotics

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181
Q

systems thinking looks at

A

the whole, considering larger numbers and patterns of interaction to gain understanding. Systems thinking is fundamentally different from that of traditional analysis methods. Instead of isolating small parts of a system (providers, patients, illnesses),

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182
Q

Persistent symptoms suggestive of bipolar disorder include

A
  1. decreased need for sleep
  2. marked difference from normal baseline sleep patterns
  3. inflated self-esteem
  4. grandiosity
  5. increased goal-directed activities
  6. excessive involvement in pleasurable activities with a high potential for painful consequences
  7. unrestrained buying sprees, sexual indiscretions, unsound business ventures
  8. excessive substance use or abuse, and highly recurrent depressive episodes.
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183
Q

The systemic effects of hyperthyroidism can mimic the symptoms of bipolar I disorder. Overlapping symptoms include the following:

A
Motor restlessness
Emotional lability
Short attention span
Compulsive movement
Tremor
Insomnia
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184
Q

Thyroiditis is more likely to mimic

A

symptoms of major depressive disorder.

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185
Q

Eating disorders are characterized by

A

disordered patterns of eating accompanied by distress, disparagement, preoccupation, and a distorted perception of one’s body shape.

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186
Q

Autism spectrum disorder is described as the patient having persistent deficits in social communication and social interaction across multiple settings; it is associated with deficits in the following:

A

Social reciprocity
Nonverbal communication
Developing, maintaining, and understanding relationships
Restricted or repetitive behavior such as
Stereotyped or repetitive motor movements
Insistence on sameness
Highly restricted, fixed interests
Hyper- or hyposensitivity

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187
Q

The etiology of insomnia is found in the following:

A
  1. Dysfunction in sleep-wake circuits of the brainstem
  2. Neurochemical imbalances impinging on these circuits
  3. May be stress-related in brief episodic insomnia
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188
Q

Brief psychotic disorder is characterized by

A

at least one psychotic symptom present for less than one month.

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189
Q

Delusional disorder is a psychotic disorder characterized by the

A

presence of delusions but no other symptoms of schizophrenia

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190
Q

Schizophreniform disorder is characterized by patients experiencing symptoms of schizophrenia but who

A

have been ill for only one to six months.

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191
Q

Schizoaffective disorder is characterized by patients

A

experiencing symptoms of schizophrenia along with either depression or mania.

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192
Q

During the storming phase:

A

Members appear resistant and begin to use testing behaviors
Issues related to inclusion, control, and affection begin to surface
Leaders allow expression of both positive and negative feelings
Leaders assist the group in understanding the underlying conflict
Leaders examine unproductive behaviors

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193
Q

Hepatic cytochrome P450 enzyme interactions can

A

induce or inhibit the metabolism of certain drugs, thus changing their desired concentration levels.

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194
Q

Enzyme inducers decrease the serum level of other drugs that are substrates of that

A

, possibly resulting in subtherapeutic drug levels.

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195
Q

enzyme Inducers include

A

carbamazepine, hypericum (St. John’s wort), phenytoin, phenobarbital, and tobacco.

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196
Q

Enzyme inhibitors can

A

increase the serum level of other drugs that are substrates of that enzyme, possibly resulting in toxic levels.

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197
Q

Enzyme inhibitors include class.

A

bupropion, clomipramine, duloxetine, fluoroquinolones, nefazodone, and the SSRI

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198
Q

According to Erik Erikson, during which psychosocial stage would you expect a person to develop loving sexual relationships?

A

Intimacy vs. Isolation

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199
Q

Failure to resolve Intimacy vs. Isolation

A

is characterized by fear of relationships with others.

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200
Q

Erik Erikson’s stages of psychosocial development include the following:

A

Trust vs. Mistrust: birth to 12-18 months
Autonomy vs. Shame and Doubt: 12-18 months to 3 years
Initiative vs. Guilt: 3 to 5-6 years
Industry vs. Inferiority: 5-6 years to adolescence
Identity vs. Role Confusion: adolescence to adulthood
Intimacy vs. Isolation: adulthood
Generativity vs. Stagnation: middle adulthood
Ego integrity vs. Despair: late adulthood

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201
Q

presentations of hypernatremia:

A
Weight gain
Convulsions
Pulmonary edema
Dry mucous membranes
Tachycardia
Low jugular venous pressure
Restlessness
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202
Q

Presentations of hyponatremia:

A
Lethargy
Headache
Confusion
Apprehension
Seizures
Coma
Hypotension
Tachycardia
Decreased urine output
Weight gain
Edema
Ascites
Jugular vein distension
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203
Q

Clonazepam (Klonopin) does not carry

A

an increased risk of major fetal malformations

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204
Q

Commonly used mood-stabilizing medications for bipolar disorder carry

A

an increased risk of major fetal malformations. However, clonazepam, lorazepam, and alprazolam are effective in the management of acute manic episodes as an adjuvant to maintenance therapy in lieu of antipsychotics. As an adjuvant to lithium or lamotrigine, clonazepam may result in increased time between cycles and fewer depressive episodes.

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205
Q

During the first trimester, the use of lithium (Lithane, Lithobid)

A

increases the risk of fetal cardiac malformations to 7.7%.

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206
Q

Lithium can be used in the second and third trimesters, but it must be stopped

A

peripartum due to the rapid fluid shifts during birth.

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207
Q

Both carbamazepine (Tegretol, Carbatrol, Equetro) and divalproex sodium (Depakote)

A

increase the risk of neural tube defects.

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208
Q

SAM-e may cause the following symptoms in patient with bipolar

A

hypomania, hyperactive muscle movements, and serotonin syndrome.

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209
Q

Risk factors for suicide include being

A
  1. a male aged 45 or older or a female aged 55 or older;
  2. being divorced, single or separated
  3. being Caucasian
  4. living alone
  5. having a psychiatric disorder or a physical illness
  6. engaging in substance abuse
  7. having a previous suicide attempt
  8. having a family history of suicide
    having a recent loss.
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210
Q

A patient presenting with an alcohol use disorder

A

that is chronic will present with increased MCV and abnormal LFTs.

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211
Q

Elevated potassium and chloride levels

A

are not always indicative of an alcohol use disorder.

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212
Q

Patients with a chronic alcohol use disorder will have

A

elevated triglycerides and increased MCV.

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213
Q

Elevated potassium and chloride levels are not always i

A

indicative of an alcohol use disorder.

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214
Q

originally created interpersonal therapy.

A

Gerald Klerman and Myrna Weissman

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215
Q

Sigmund Freud created

A

psychoanalytic therapy

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216
Q

Anna Freud, along with Melanie Klein, is most well known for her

A

contributions to psychoanalytic child psychology and object relations.

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217
Q

Aaron Beck developed

A

cognitive therapy and his daughter, Judith Beck, continued his work

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218
Q

Carl Rogers originally developed

A

humanistic therapy, also known as person-centered therapy.

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219
Q

Yoga is a form of therapy and exercise that

A

originated in India. Yoga promotes a mind/body connection and uses breathing, physical movements, and meditation to aid in relaxation and healing.

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220
Q

Diagnostic criteria for panic disorder include the following:

A
Paresthesia
Chills or hot flushes
Fear of losing control or of going crazy
Fear of dying
Shortness of breath or a smothering sensation
Palpitations, pounding heart, or accelerated heart rate
Chest pain, tightness, or discomfort
Sweating, trembling, or shaking
Nausea or abdominal distress
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221
Q

There are exceptions to patient confidentiality. Exceptions include:

A
  1. If a patient reveals an intent to harm self or others
  2. For attorneys involved in litigation
  3. When records are released to insurance companies
  4. When answering court orders, subpoenas, or summons
  5. When meeting state requirements for mandatory reporting of diseases or conditions
  6. In cases of child or elder abuse
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222
Q

One of the side effects of being overmedicated with Adderall is

A

aggression.

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223
Q

stimulants are a schedule II drug,

A

and this class carries a high risk for potential abuse. Often, primary care providers treat their patients for ADHD and prescribe a stimulant. It is important to assess whether the patient is being prescribed too much medication or if he is secretly taking more than he is prescribed.

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224
Q

Cluster B disorders:

A

Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder
Narcissistic personality disorder

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225
Q

Cluster A disorders:

A

Paranoid personality disorder
Schizoid personality disorder
Schizotypal personality disorder

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226
Q

Cluster C disorders:

A

Avoidant personality disorder
Dependent personality disorder
Obsessive-compulsive personality disorder
There is no cluster D disorder category.

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227
Q

Obsessive-compulsive disorder

A

patients are bothered by senseless thoughts or behaviors that they cannot stop.

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228
Q

In body dysmorphic disorder,

A

physically normal patients believe that parts of their bodies are misshapen or ugly.

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229
Q

Trichotillomania patients

A

compulsively pull hair from various parts of their body.

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230
Q

Excoriation disorder

A

patients so persistently pick at their skin that they leave scars.

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231
Q

In 2001, the Institute of Medicine published Crossing the Quality Chasm: A New Health System for the 21st Century. This report identified six goals for quality improvement in health care:

A
  1. safe,
  2. effective,
  3. patient-centered,
  4. timely,
  5. efficient,
  6. equitable.
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232
Q

In 2001, the Institute of Medicine published Crossing the Quality Chasm: A New Health System for the 21st Century. This report identified six goals for quality improvement in health care:

A
  1. Safe: Avoiding injuries to patients from the care intended to help them
  2. Effective: Providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit
  3. Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions
  4. Timely: Reducing waits and sometimes harmful delays for both those who receive and those who provide care
  5. Efficient: Avoiding the waste of equipment, supplies, ideas, and energy
  6. Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status
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233
Q

For acute dystonia give

A

Cogentin 2 mg IM STAT is the best intervention, as Benadryl had previously been given without preventative effects.

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234
Q

In 1971, C. West Churchman, a pragmatic philosopher, laid the groundwork for

A

systems thinking.

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235
Q

C. West Churchman defined an inquiring system

A

He defined an inquiring system as a system capable of facilitating learning and organizational change. The

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236
Q

The purpose of inquiring systems is to

A

Create knowledge and thereby create the capability of choosing the right means for the desired ends.

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237
Q

Churchman’s model for the design of inquiring systems provides

A

the basis for sustaining evolving organizations.

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238
Q

A person diagnosed with schizotypal personality disorder, schizoid personality disorder, or paranoid personality disorder falls under which category of personality disorders?

A

Cluster A

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239
Q

The axon

A

transmits signals away from the neuron’s cell body to connect with other neurons and cells

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240
Q

The dendrite

A

collects incoming signals from other neurons and sends the signals toward the neuron’s cell body.

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241
Q

High-risk characteristics for committing suicide include the following:

A
Male gender
Alcohol use disorder
Previous suicide attempt
Caucasian race
History of violent behavior
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242
Q

has one of the lowest suicide rates, and females rate lower in suicide risk than males.

A

New Jersey

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243
Q

is ranked high in suicide rates among men.

A

Montana

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244
Q

In what phase of group therapy will the leader consider the direction and framework of the group?

A

Pregroup

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245
Q

In the forming phase,

A

goals and expectations are identified and boundaries established. In the storming phase, the leader is to allow expression of both positive and negative feelings and assist the group in understanding underlying conflicts and nonproductive behavior

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246
Q

In the norming phase,

A

the leader allows for open and spontaneous communication, and norms are established.

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247
Q

Patients learn to consciously control their physiological functions when

A

undergoing biofeedback,

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248
Q

Both acupuncture and acupressure are based

A

on the idea in Chinese medicine that vital energy called chi flows along specific pathways in the body. Manipulating this energy using needles or pressure can correct imbalances. Acupuncture and acupressure are thought to produce their therapeutic effects by aiding in the activity of endorphins and the immune system. It is also thought that they alter brain chemistry by changing the release of certain neurohormones and neurotransmitters.

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249
Q

Other medications approved for OCD are as follows:

A

TCAs (tricyclic antidepressants)

Second generation antipsychotics

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250
Q

FDA-approved for the treatment of OCD.

A

Prozac is an SSRI-

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251
Q

Ativan is a benzodiazepine

A

FDA-approved for generalized anxiety disorder.

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252
Q

OCD is in the family

A

of anxiety disorders

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253
Q

Risk factors of bipolar disorder include the following:

A

Genetic loading
Family history of a first-order relative having major depressive or bipolar disorder
A relative having bipolar type I disorder (24% increase in risk)

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254
Q

A common comorbidity of obsessive compulsive disorder?

A

Eating disorders. Patients suffering from obsessive compulsive disorder often experience eating disorders such as anorexia and bulimia. They also experience hypervigilance and strict associations with exercise, patterns of behavior, routines, and hobbies.

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255
Q

Agoraphobia patients fear

A

situations or places where they might have trouble obtaining help if they become scared.

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256
Q

Specific phobia patients fear

A

specific objects or situations such as animals, storms, heights, blood, airplanes, or any situation that may lead to vomiting, choking, or developing an illness.

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257
Q

Social anxiety disorder

A

patients fear embarrassment when they speak, write, or eat in public.

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258
Q

In generalized anxiety disorder (GAD), the nature of the stressor

A

shifts frequently.

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259
Q

Clients suffering from moderate/severe forms of anxiety often require adjunct therapy while being stabilized on

A

antidepressant therapy.

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260
Q

Benzodiazepines such as clonazepam and diazepam are more useful

A

for continuous, moderate-to-severe anxiety or as bridge medications while waiting for the efficacy of antidepressants.

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261
Q

Calcium values can be increased

A

during treatment with lithium, thiazide diuretics, alkaline antacids, or vitamin D.

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262
Q

In family systems therapy, what is the term for parents transmitting their own level of differentiation onto the most susceptible child?

A

Family projection process

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263
Q

The projection process follows three steps:

A

The parent focuses on a child out of fear that something is wrong with the child;
The parent interprets the child’s behavior as confirming the fear; and
The parent treats the child as if something is really wrong with them.

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264
Q

In a nuclear family emotional system, the level of differentiation of the parents is

A

usually equal to the level of differentiation for the entire family.

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265
Q

Multitransmission process refers to

A

family dysfunction that is present in several generations.

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266
Q

Triangles in family

A

are groups of three family members that form in order to decrease stress. The presence of triangles indicates a lower level of family adaptation.

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267
Q

Countertransference can present in the provider as r

A

recurrent episodes of anxiety and uneasiness when dealing with a particular client. Countertransference is the nurse’s emotional reaction to the client based on his or her own experiences.

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268
Q

Which federal plan replaced Medicare + Choice and gave enrollees the option of choosing private insurance plans?

A

Medicare Advantage

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269
Q

Research and studies show that the Recovery Model of Care is t

A

he single most important goal in the transformation of mental health care over the past two decades.

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270
Q

Which term best describes the use of aggregate variance data to change a system of health care practice?

A

Outcomes management

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271
Q

Variance is any

A

event that alters patient progress toward expected outcomes. Sources of variance include practitioner behavior (competency), the severity of illness, and practice patterns that either expedite care or inhibit delivery of care.

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272
Q

Which of the following is a common non-psychoactive supplement used to help cure symptoms of illnesses such as depression, osteoarthritis, and liver disease?

A

SAM-e

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273
Q

is a dietary supplement used to treat depression, osteoarthritis, and liver disease.

A

SAM-e

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274
Q

common non-psychoactive dietary supplements with physiological (not psychological) effects used to cure illnesses and maintain health are as follows:

A
Omega-3 fatty acids
Tryptophan
Vitamin E
Melatonin
Fish oil
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275
Q

Omega-3 fatty acids

A

are important in the treatment and prevention of heart disease.

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276
Q

Tryptophan is a

A

dietary supplement aiding in nitrogen balance in adults and growth in infants. Tryptophan also aids in the creation of niacin, which is essential in creating the neurotransmitter serotonin.

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277
Q

Tryptophan also aids in the creation

A

of niacin, which is essential in creating the neurotransmitter serotonin.

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278
Q

Fish oil is a

A

dietary supplement known to reduce inflammation in the body and improve hypertriglyceridemia.

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279
Q

In a hospital psychiatric consultation setting, what is one of the most common mental illness diagnoses?

A

Adjustment disorders are very common. They are one of the most common diagnoses given in a hospital psychiatric consultation setting, frequently reaching up to 50 percent.

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280
Q

About 5 to 20 percent of patients in an outpatient mental health clinic meet the criteria for this diagnosis as well.

A

Adjustment disorders

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281
Q

describes an individual with antisocial personality disorder?

A

They show no remorse for their behavior

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282
Q

Patients with antisocial personality disorder exhibit

A

criminal behavior beginning in childhood, such as truancy, fighting, destructiveness, and theft. They often default on debts, behave irresponsibly, and act recklessly. They show no remorse for their behavior.

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283
Q

Patients with schizoid personality disorder

A

care little for social relationships, have restricted emotional range, and appear indifferent to criticism or praise.

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284
Q

Patients with borderline personality disorder exhibit i

A

impulsivity, self-harm, inappropriate anger, and affective instability. They feel empty and bored, and they frantically try to avoid abandonment.

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285
Q

Patients with avoidant personality disorder are

A

timid and easily wounded by criticism from others. They fear embarrassment and hesitate to form interpersonal relationships.

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286
Q

schizoaffective disorder

A

A disorder characterized by patients experiencing symptoms of schizophrenia along with either depression or mania

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287
Q

Delusional disorder is a

A

psychotic disorder characterized by the presence of delusions but no other symptoms of schizophrenia

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288
Q

Brief psychotic disorder is characterized

A

by at least one psychotic symptom present for less than one month. Schizophreniform disorder is characterized by patients experiencing symptoms of schizophrenia but who have been ill for only one to six months.

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289
Q

You are a new nurse practitioner opening your own solo practice. You understand that you are expected to be competent in your role of treating and diagnosing patients. As a nurse practitioner, you are expected to be competent in all of the following core competency areas except:

A

Practice inquiry
Technology and information literacy
Policy

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290
Q

Nurse practitioner core competencies include the following:

A
Scientific foundations
Leadership
Quality
Practice inquiry
Technology and information literacy
Policy
Health delivery systems
Ethics
Independent practice
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291
Q

Barriers to the implementation of meaningful use include

A
  1. staff training,
  2. usability,
  3. workflow changes
  4. . altered patient-provider interaction,
  5. clinician resistance to change.
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292
Q

The federal government did provide incentives in the form

A

of financial rewards and potential reduction in Medicare reimbursement.

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293
Q

Some states use the umbrella term advanced practice nurse to refer to all of the following providers

A

Mid-level provider

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294
Q

Some states use the umbrella term advanced practice nurse to refer to nurse practitioners, clinical nurse specialists, nurse-midwives, and nurse anesthetists. Nurse practitioners differ from advanced practice nurses in that

A

they offer a wider range of services to a wider portion of the population.

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295
Q

Patients suffering from impaired memory or Alzheimer’s disease present with a decrease in

A

acetylcholine.

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296
Q

Patients suffering from Parkinsonian symptoms present with an increase in

A

acetylcholine.

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297
Q

Patients suffering from schizophrenia present with an increase in .

A

dopamine

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298
Q

Patients suffering from psychosis due to ischemic neurotoxicity or excessive pruning present with an increase in.

A

glutamate

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299
Q

stabilizes somatic motor activity, initiates complex motor function, and maintains muscle tone, posture, and common reflexes.

A

The basal ganglia

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300
Q

not the basal ganglia, is responsible for connecting sensory smell information with emotions.

A

limbic system’s amygdala

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301
Q

Which of the following takes place during the installation phase of eye movement desensitization and reprocessing (EMDR)?

A

The patient inserts and strengthens the positive thought that replaced the original negative thought in their mind

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302
Q

Eye movement desensitization and reprocessing (EMDR) is a form of behavioral therapy that was developed by . It is most commonly used in posttraumatic stress disorder, and its goal is adaptive resolution.

A

Francine Shapiro

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303
Q

EMDR

A

It is most commonly used in posttraumatic stress disorder, and its goal is adaptive resolution.

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304
Q

There are three phases in EMDR:

A

desensitization, installation, and body scan.

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305
Q

The patient visualizes the trauma, verbalizes negative or maladaptive beliefs, and remains attentive to physical sensations. The patient also blocks out negative thoughts, breathes deeply, and verbalizes what he or she is imagining.

A

Desensitization

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306
Q

The patient installs and strengthens the positive thought that he or she has declared as a replacement of the original negative thought.

A

installation

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307
Q

The patient visualizes the trauma along with the positive thought and then scans his or her body mentally to identify any tension within

A

Body scan

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308
Q

Who was the first person to put a theoretical perspective on group work?

A

Irvin Yalom

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309
Q

Sigmund Freud founded

A

psychoanalysis.

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310
Q

Carl Rogers originally developed

A

humanistic therapy.

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311
Q

Viktor Frankl developed

A

existential therapy.

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312
Q

Irvin Yalom was the first person to put a theoretical perspective on group work. He identified 10 curative factors that differentiate group work from individual therapy:

A
instillation of hope
Universality
Altruism
Increased development of socialization skills
Imitative behaviors
Interpersonal learning
Group cohesiveness
Catharsis
Existential factors
Corrective refocusing
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313
Q

Patients with bipolar I disorder will present with psychomotor agitation (not retardation) and insomnia (not hypersomnia).

Other criteria include the following:

A

Inflated self-esteem
Increased goal-directed activity or energy for at least one week
Flight of ideas and distractibility

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314
Q

Which medication can potentially cause all of the following symptoms: anxiety, mood changes, psychosis, and delirium?

A

Corticosteroids

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315
Q

Corticosteroids are known to cause

A

a wide range of psychiatric symptoms including anxiety, mood changes, psychosis, and delirium.

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316
Q

medications that can potentially cause all of the following symptoms: anxiety, mood changes, psychosis, and delirium

A

Other medications that can cause all these symptoms include the following:

Analgesics
Anesthetics
Anticonvulsants
Antidepressants
Antihypertensives
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317
Q

Benzodiazepines and antiulcer agents

A

can cause mood changes.

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318
Q

NSAIDs can cause

A

psychosis.

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319
Q

Biofeedback is a process providing a person with

A

visual or auditory information about the autonomic physiological functions of their body, such as blood pressure, muscle tension, and brain wave activity

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320
Q

Biofeedback is used in the following situations:

A
Stress-related symptoms such as anxiety
Pain
Insomnia
Neuromuscular problems such as migraines or muscular tension
Neurobehavioral disorders
Enhancement of healing
Athletic and work performance
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321
Q

Dissemination includes

A

publication in peer-reviewed journals and professional newsletters.

322
Q

Histrionic, antisocial, borderline, and narcissistic personality disorders all fall under

A

Cluster B.

323
Q

Patients with histrionic personality disorder

A

are most likely to act overly emotional and seductive. They often demand constant reassurance about their appearance.

324
Q

Patients with antisocial personality disorder exhibit

A

criminal behavior beginning in childhood, such as truancy, fighting, destructiveness, and theft. They often default on debts, behave irresponsibly, and act recklessly. They show no remorse for their behavior.

325
Q

Patients with borderline personality disorder exhibit

A

impulsivity, self-harm, inappropriate anger, and affective instability. They feel empty and bored, and they frantically try to avoid abandonment.

326
Q

Patients with narcissistic personality disorder act

A

self-important. They are preoccupied with envy, fantasies of success, and ruminations about the uniqueness of their own problems. They reject criticism and need constant admiration from others.

327
Q

Nurse practitioner:

A

Evaluate, diagnose, and treat a wide range of medical conditions

328
Q

Clinical nurse specialist:

A

Consult, research, educate, and coordinate care

329
Q

Nurse anesthetist:

A

Preoperative assessment, administration of anesthesia, and postanesthesia recovery

330
Q

Certified nurse-midwife:

A

Well-woman gynecological care, management of pregnancy and childbirth, antepartum and postpartum care

331
Q

OCD is the

A

presence of anxiety-provoked obsessions or compulsions that function to reduce the person’s subjective anxiety level.

332
Q

Acute panic disorder with anxious traits and generalized anxiety disorder, acute, single episode, are symptoms of

A

OCD.

333
Q

The following are specific attributes often found in those suffering from major depressive disorders:

A
Unkept appearance
Tired appearance
Wearing dark-colored clothing
Wearing loose-fitting clothing
Significant weight gain or loss
334
Q

Lorazepam is an

A

antianxiety medication in the class of benzodiazepines. This medication can help alleviate her anxiousness prior to the surger

335
Q

Lorazepam can

A

can help alleviate her anxiousness prior to the surgery

336
Q

Specifiers are

A

special descriptions added to a patient’s diagnosis to provide more information. Specifiers help characterize the condition and describe its overall course. Specifiers used to describe mood disorders include the following:

337
Q

Mood disorder with atypical features:

A

These patients eat a lot and gain weight, sleep excessively, and have a feeling of being sluggish or paralyzed. They are also sensitive to rejection.

338
Q

Mood disorder with melancholic features:

A

These patients feel worse in the morning than in the afternoon, and they experience decreased appetite, weight loss, and agitation. They also tend to feel excessively guilty and have trouble making decisions.

339
Q

Mood disorder with anxious distress:

A

These patients have high levels of tension, restlessness, worry, and fear.

340
Q

Mood disorder with catatonic features

A

These patients exhibit either motor hyperactivity or inactivity.

341
Q

Mood with mixed features:

A

These patients are experiencing a mixture of both manic and depressive symptoms.

342
Q

Mood disorder with peripartum onset:

A

These patients develop a mood episode during pregnancy or within a month of having their baby.

343
Q

Mood disorder with psychotic features:

A

These patients develop delusions or hallucinations along with their mood symptoms.

344
Q

Mood disorder with rapid cycling:

A

These patients have experienced at least four mood episodes in the past year.

345
Q

Mood disorder with seasonal pattern:

A

These patients regularly become ill at a certain time of the year.

346
Q

To establish a medical malpractice suit, the plaintiff must establish that

A

a dereliction of duty directly caused damage (also known as the four Ds of medical malpractice). The plaintiff must establish that:

347
Q

four Ds of medical malpractice

A

dereliction of duty directly caused damage

348
Q

The plaintiff must establish that:

A

The nurse practitioner owed the plaintiff a duty
The nurse practitioner’s conduct fell below the standard of care
The nurse practitioner’s conduct caused the plaintiff injury

349
Q

The burden of proof in medical malpractice suits is

A

by a preponderance of evidence (greater than 50%). Medical malpractice suits are civil cases. Proof beyond reasonable doubt applies to criminal cases.

350
Q

Medical malpractice suits are

A

civil cases

351
Q

Patients requiring inpatient hospitalization are

A

at an illness state that requires acute stabilization. The outpatient setting is an inappropriate level of care when the disease state is at this point.

352
Q

Cyclothymic disorder can be described as

A

a chronic, fluctuating mood disorder with symptoms similar to but less severe than those of bipolar disorder. Onset later in life usually suggests the patient may have a general medical condition called multiple sclerosis.

353
Q

Cyclothymic disorder is a mental disorder that

A

involves numerous periods of depressive symptoms and hypomanic symptoms. However, they are not sufficient to be diagnosed as a major depressive episode or a hypomanic episode.

354
Q

In obsessive-compulsive disorder (OCD),

A

males have an earlier age of onset. Up to 25 percent of males with OCD are diagnosed before they turn 10 years old. Onset in childhood often indicates that it will be a lifelong illness.

355
Q

For OCD, the mean age of onset

A

is 19.5 years, and onset after the age of 35 is very rare.

356
Q

Females are affected with OCD at a

A

slightly higher rate than males. The 12-month prevalence of OCD in the United States is 1.2

357
Q

Social anxiety disorder

A

patients fear embarrassment when they speak, write, or eat in public.

358
Q

Panic disorder patients experience .

A

brief episodes of intense dread accompanied by physical symptoms like chest pain, chills, shortness of breath, and an irregular heartbeat

359
Q

Generalized anxiety disorder patients feel

A

tense or anxious a majority of the time and worry about many different issues.

360
Q

Agoraphobia patients

A

fear situations or places where they might have trouble obtaining help if they become scared.

361
Q

Agranulocytosis is a potential serious risk when prescribing patients

A

mood stabilizers such as carbamazepine and antipsychotics such as clozapine.

362
Q

Health care informatics is

A

the integration of computer science, information science, and health care. Examples of tools in health care informatics include clinical guidelines, electronic health records, patient care technology devices, and databases of health care outcomes.

363
Q

Examples of tools in health care informatics include

A

clinical guidelines, electronic health records, patient care technology devices, and databases of health care outcomes.

364
Q

childhood-onset fluency disorder,

A

Stuttering occurs when the normal fluency of speech is frequently interrupted.

365
Q

Tourette’s disorder is characterized

A

by two or more motor tics and at least one vocal tic that occur frequently throughout the day.

366
Q

Attention-deficit/hyperactivity disorder is characterized by

A

hyperactivity, impulsivity, and inattentiveness.

367
Q

Oppositional defiant disorder is characterized

A

by multiple examples of negativistic behavior persisting for at least six months, usually beginning when a child is three or four years old.

368
Q

Alprazolam is a

A

benzodiazepine used to treat panic disorder.

369
Q

benzodiazepine

A

used to treat panic disorder.

370
Q

Nurse practitioner standards of practice:

A

Give authoritative statements regarding the quality and type of practice that should be provided
Offer a way to judge the nature of care provided
Reflect the expectation for the care that should be provided to patients
Reflect professional agreement focused on the minimum levels of acceptable performance
Can be used to legally describe the standard of care
May be either precise or general guidelines

371
Q

Nurse practitioner scope of practice:

A

Defines the nurse practitioner’s roles and actions
Identifies competencies assumed to be held by all nurse practitioners who function in a particular role
Has broad variations from state to state due to outdated legislation

372
Q

The S-MAST, also known

A

as the Michigan Alcoholism Screening Test for Geriatrics,

373
Q

the Michigan Alcoholism Screening Test for Geriatrics,

A

is a clinical assessment tool used to assess and screen for alcoholism in geriatric populations.

374
Q

The COWS means

A

(Clinical Opiate Withdrawal Scale)

375
Q

The COWS

A

assessment is used to assess the withdrawal severity of opiates.

376
Q

The CIWA assessment is used

A

to assess the withdrawal severity of alcohol and/or benzodiazepines.

377
Q

The AUDIT assessment

A

is an alcohol use assessment tool, less commonly used than CIWA.

378
Q

The benefits of group therapy include the following:

A

It increases insight about oneself
It increases social skills
It is cost-effective
It promotes a sense of community

379
Q

Individual counseling provides

A

a set time for patients to attend exclusively to their own needs.

380
Q

The definition of primary care is:

A

The provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community

381
Q

The following common medications can induce depression:

A
Beta blockers such as propranolol
Steroids
Interferon
Isotretinoin
Some retroviral drugs
Neoplastic drugs
Benzodiazepines
Progesterone
382
Q

The following medications can induce mania:

A

Steroids
Disulfiram
Isoniazid
Antidepressants

383
Q

According to Piaget, the cognitive-spatial concept of reversibility develops

A

during middle childhood, not adolescence.

384
Q

Piaget’s stages of cognitive development:

A
Infancy (birth to 2 years): Sensorimotor
Early Childhood (2 to 5 years): Preoperational
Middle Childhood (6 to 11 years): Concrete operational
Adolescence (11 to 19 years): Formal operational
385
Q

During the formal operational stage, adolescents develop the following cognitive-spatial concepts:

A

Hypothetical-deductive reasoning: quick to think of excuses
Imaginary audience: feel as though everyone is looking at them
Personal fable: inflated opinion of themselves
Propositional thinking: can think of many possibilities

386
Q

A body mass index higher than the ————percentile places children at an increased risk of becoming overweight.

A

85th

387
Q

Intrauterine insults may include

A
  1. prenatal exposure to toxins,
  2. including viral agents
  3. oxygen deprivation
  4. maternal malnutrition
  5. substance use
  6. other illnesses.
388
Q

Countertransference represents a nurse practitioner’s

A

emotional reaction to a patient based on his or her past experiences

389
Q

Signs that indicate the presence of countertransference include

A
  1. Intense emotional reactions during the first encounter with a patient
  2. Recurrent anxiety or uneasiness while dealing with a patient
  3. Uncharacteristic carelessness when following up with a patient
  4. Difficulty empathizing
  5. Resistance to others treating the patient
  6. Preoccupation with or dreaming about the patient
  7. Frequently running overtime or cutting time short with a patient
  8. Depression during or after an interaction with a patient
390
Q

Magnesium is responsible for neuromuscular activity and excitability. An increased level of magnesium in the body is linked to all of the following

A
Hyperthyroidism
Hypothyroidism
Renal failure
Addison's disease
Diabetic ketoacidosis
Dehydration
391
Q

Alcoholism is

A

linked to decreased levels of magnesium in the body.

392
Q

According to Piaget, children between the ages of six and eleven years develop which cognitive-spatial concept

A

Conservation

393
Q

Piaget’s stages of cognitive development:

A
Infancy (birth to 2 years): Sensorimotor
Early Childhood (2 to 5 years): Preoperational
Middle Childhood (6 to 11 years): Concrete operational
Adolescence (11 to 19 years): Formal operational
394
Q

Children between the ages of six and eleven years develop the following cognitive-spatial concepts:

A
Hierarchical classification
Reversibility
Conservation
Decentration
Spatial operations
Horizontal decalage
Transitive inference
395
Q

Egocentrism and transductive reasoning are

A

developed during early childhood (2 to 5 years),

396
Q

Imaginary audience is

A

developed during adolescence.

397
Q

Poor community integration is an example

A

of a social risk factor for developing a psychiatric condition.

398
Q

Psychiatric risk factors fall into three categories:

A

biological, psychological, and social.

399
Q

Biological risk factors:

A

History of mental illness in the family
Poor nutritional status
Poor general health

400
Q

Psychological risk factors:

A

Poor self-concept
External locus of control
Poor ego defenses

401
Q

Social risk factors:

A

Stressful occupation
Low socioeconomic status
Poor level of social integration

402
Q

Which class of psychiatric medications is most likely to cause extrapyramidal side effects?

A

Typical antipsychotics

403
Q

Extrapyramidal symptoms are drug-induced side effects that affect

A

motor functioning and muscle movement.

404
Q

The common types of extrapyramidal symptoms are

A

akathisia, akinesia, dystonia, pseudo-Parkinson’s, and tardive dyskinesia.

405
Q

Typical antipsychotics

A

(also known as first-generation antipsychotics) are more likely to cause these side effects than

406
Q

atypical antipsychotics

A

(also known as second-generation antipsychotics).

407
Q

The etiology of insomnia is found in the following:

A

Dysfunction in sleep-wake circuits of the brainstem
Neurochemical imbalances impinging on these circuits
May be stress-related in brief episodic insomnia

408
Q

n 2010, the Institute of Medicine published a groundbreaking report titled The Future of Nursing: Leading Change, Advancing Health. This report considered the obstacles that all nurses encounter as they provide quality health care in the United States. The report was actively challenged

A

by the American Medical Association. They iterated that physicians are the true leaders of health care.

409
Q

The psychoanalytic theory attends to

A

past, developmental, environmental, and psychodynamic factors that shape present behaviors.

410
Q

In systems thinking,

A

the belief is that a system is perfectly designed to produce what it produces. The belief is that whatever comes from a system is what the system was designed to produce, regardless of whether the design of the system was planned or unplanned and whether the results were intended or unintended.

411
Q

Testamentary capacity

A

is the level of competence required to make a legally valid will.

412
Q

The key elements of testamentary capacity include the following:

A
  1. Comprehension of the act of writing and signing the will
  2. Knowledge of potential heirs
  3. Understanding of the extent of one’s assets
  4. Lack of undue influence
  5. The absence of delusions compromising rational thought
413
Q

What psychiatric condition accounts for 25 percent of all completed suicides?

A

Bipolar disorder

414
Q

Bipolar disorder accounts for percent of all completed suicides.

A

25%

415
Q

The lifetime risk of suicide in those diagnosed with bipolar disorder is

A

15 times greater than that of the general population. These individuals are more likely to complete suicide if they have a history of suicide attempts and have spent the majority of the past year in a depressed episode.

416
Q

What was the original name of the Centers for Medicaid and Medicare Services (CMS)?

A

Health Care Financing Administration

417
Q

The Health Care Financing Administration (HCFA) was an agency of the United States Department of Health and Human Services that was created to

A

oversee the financing and quality-control programs for Medicare and the federal portion of Medicaid. The agency has since been renamed Centers for Medicaid and Medicare Services (CMS).

418
Q

Forensic risk assessment is intended to protect

A

the public from persons with known mental disorders having dangerous, violent, and criminal histories.

419
Q

In 2001, the Institute of Medicine published Crossing the Quality Chasm: A New Health System for the 21st Century. This report identified six goals for quality improvement in health care:

A

Safe: Avoiding injuries to patients from the care intended to help them
Effective: Providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit
Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions
Timely: Reducing waits and sometimes harmful delays for both those who receive and those who provide care
Efficient: Avoiding the waste of equipment, supplies, ideas, and energy
Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status

420
Q

Safe

A

Avoiding injuries to patients from the care intended to help them

421
Q

Effective:

A

Providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit

422
Q

Patient-centered:

A

Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions

423
Q

Timely:

A

Reducing waits and sometimes harmful delays for both those who receive and those who provide care

424
Q

Efficient:

A

Avoiding the waste of equipment, supplies, ideas, and energy

425
Q

Equitable:

A

Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status

426
Q

Which federal entity is responsible for accomplishing the goals of the Health Information Technology for Economic and Clinical Health (HITECH) Act?

A

Office of the National Coordinator for Health Information Technology (ONC)

427
Q

The Office of the National Coordinator for Health Information Technology (ONC) is

A

the federal entity responsible for accomplishing the goals of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Their strategic plan includes five goals

428
Q

Office of the National Coordinator for Health Information Technology (ONC). Their strategic plan includes five goals:

A
  1. Achieve adoption and information exchange through the meaningful use of health information technology (HIT)
  2. Improve care, improve population health, and reduce health care costs through the use of HIT
  3. Inspire confidence and trust in HIT
  4. Empower individuals with HIT to improve their health and the health care system
  5. Achieve rapid learning and technological advancement
429
Q

Disorganized thinking, loose associations, tics, and stereotypic behavior suggest that a patient is experiencing an excess of which neurotransmitter?

A

Dopamine

430
Q

A_____ ____ results in symptoms of disorganized thinking, loose associations, tics, and stereotypic behavior.

A

dopamine excess

431
Q

A _______ results in symptoms of Parkinson’s disease,endocrine alterations, poor spatiality, and lack of abstract thought.

A

dopamine deficit

432
Q

A___________ results in restlessness, agitation, myoclonus, and vital sign abnormalities.

A

serotonin excess

433
Q

A ______________ results in restlessness, agitation, myoclonus, and vital sign abnormalities.

A

serotonin excess

434
Q

An _________results in over-inhibition, anxiety, somatic complaints, self-consciousness, and drooling

A

acetylcholine excess

435
Q

A _________ results in hyperalertness, paranoia, and decreased appetite.

A

norepinephrine excess

436
Q

What method do adolescents most commonly use to successfully commit suicide?

A

Firearms

437
Q

Firearms are the most common method

A

by which adolescents commit suicide.

438
Q

Drug overdose is the most common

A

method of suicide attempts, but it accounts for far fewer completed suicides.

439
Q

Factors constraining growth of the NP:

A
  1. Growing competition in the job market in general for NPs
  2. Reimbursement struggles with Medicare and private insurance companies
  3. Overlapping scope of practice with other NPs
  4. Increased concerns over reimbursement fraud and abuse
  5. Scope of practice and need for formal supervisory or collaborative relationships with physicians
440
Q

foster and facilitate growth of NP are as follows:

A
  1. Consumer demand for services
  2. Acceptance of the advanced practice nursing role
  3. Emergence of the PMHNP role
  4. Decreasing stigmatization
  5. Emphasis on integrated health care services
441
Q

Social anxiety disorder

A

patients fear embarrassment when they speak, write, or eat in public.

442
Q

Generalized anxiety disorder patients feel

A

tense or anxious a majority of the time and worry about many different issues.

443
Q

Panic disorder patients experience

A

brief episodes of intense dread accompanied by physical symptoms like chest pain, chills, shortness of breath, and an irregular heartbeat.

444
Q

Extrapyramidal symptoms are

A

drug-induced side effects that affect motor functioning and muscle movement. Typical antipsychotics like haloperidol, perphenazine, and chlorpromazine are more likely to cause these side effects than atypical antipsychotics like olanzapine, lurasidone, and risperidone.

445
Q

Akathisia:

A

motor restlessness, inability to remain still, rocking, pacing, or constant motion of a unilateral limb, subjective sense of restlessness, often mistaken for increasing anxiety

446
Q

Akinesia:

A

absence of movement, difficulty initiating motion, subjective feeling of lack of motivation to move, often mistaken for laziness or lack of interes

447
Q

Dystonia:

A

muscle spasticity usually in the back or neck, subjectively painful, often mistaken for agitation

448
Q

Pseudo-Parkinson’s:

A

shuffling gait, motor slowing, mask-like facial expression, pill-rolling, tremors, muscle rigidity

449
Q

Tardive dyskinesia:

A

involuntary abnormal muscle movement of the mouth, tongue, face, and jaw that may progress to limbs; can be irreversible, can occur as an acute process at the initiation of medications or as a chronic condition at any point during treatment

450
Q

Medicare Part B provides coverage for ambulatory practitioner services and physical, occupational, and speech therapy. It also covers medical equipment, diagnostic tests, and some preventative care. Covered preventative services include the following:

A
Pap smears
Mammography
Screening for colorectal cancer
Screening for prostate cancer
Screening for cardiovascular disease
Screening for diabetes
Glaucoma screening
Influenza vaccinations
Pneumonia vaccinations
451
Q

Cognitive-behavioral therapy combines

A

techniques from cognitive and behavioral therapy, both of which can help alleviate symptoms of panic disorder. Cognitive techniques will help this patient identify maladaptive thought processes or cognitive distortions. Behavioral techniques might include exposing the patient to feared situations in a safe environment in order to extinguish anxiety.

452
Q

non-benzodiazepine anxiolytic used for treating anxiety in adults.

A

Tiagabine is a non-benzodiazepine anxiolytic used for treating anxiety in adults.

453
Q

Alprazolam is a

.

A

benzodiazepine.

454
Q

Levomilnacipran is

A

an antidepressant.

455
Q

Brexpiprazole is

A

an antipsychotic

456
Q

most common reasons that patients seek individual psychotherapy

A

Characterological issues such as narcissism or aggressiveness

457
Q

The most common reasons patients seek individual psychotherapy are as follows:

A
  1. Loss
  2. Interpersonal conflict
  3. Symptomatic presentations such as panic, anxiety, phobias, and negativity
  4. Unfulfilled expectations and life transitions
  5. Characterological issues such as narcissism or aggressiveness
458
Q

What type of study is considered the cornerstone of evidence-based practice?

A

Systematic reviews

459
Q

the cornerstone of evidence-based practice.

A

Systematic reviews

460
Q

Systematic reviews integrate the results from

A

multiple studies using methodical and/or statistical procedures. When possible, nurse practitioners make their clinical judgments based on the findings of systematic reviews.

461
Q

What virtue is associated with the successful resolution of the psychosocial stage Trust vs. Mistrust?

A

Hope

462
Q

What virtue is associated with the successful resolution of the psychosocial stage Autonomy vs. Shame and Doubt:

A

Will

463
Q

What virtue is associated with the successful resolution of the psychosocial Initiative vs. Guilt:

A

Purpose

464
Q

What virtue is associated with the successful resolution of the psychosocial Industry vs. Inferiority:

A

Competence

465
Q

What virtue is associated with the successful resolution of the psychosocial Identity vs. Role Confusion:

A

Fidelity

466
Q

What virtue is associated with the successful resolution of the psychosocial Intimacy vs. Isolation:

A

Love

467
Q

What virtue is associated with the successful resolution of the psychosocial Generativity vs. Stagnation:

A

Care

468
Q

What virtue is associated with the successful resolution of the psychosocial Ego Integrity vs. Despair:

A

Wisdom

469
Q

Decision #3 of the Team Leadership Model states that

A

Decision #3 states that the leader should “decide whether it is necessary to intervene internally or externally.”

470
Q

Decreased levels of calcium can cause which of the following?

A

Renal failure

471
Q

example of management of a patient’s health status.

A

Conducting a physical exam and ordering diagnostic tests is an

472
Q

Nurse practitioner core competencies:

Providing culturally sensitive care

A

Management of the patient’s health status
Maintenance of the nurse practitioner-patient relationship
Teaching and coaching
Professional role
Negotiating health care delivery systems
Monitoring quality of care

473
Q

Nurse practitioner core competencies in teaching and coaching:

A

Offering health promotion and disease prevention techniques
Using motivational interviewing to direct behavioral change
Providing psychoeducation
Risk reduction
Providing psychopharmacological education

474
Q

According to Irvin Yalom, which curative factor occurs when participants reexperience family conflicts within group therapy?

A

Corrective refocusing

475
Q

the first person to put a theoretical perspective on group work.

A

Irvin Yalom

476
Q

Irvin Yalom identified 10 curative factors that differentiate group therapy from individual therapy:

A
Instillation of hope
Universality
Altruism
Increased development of socialization skills
Imitative behaviors
Interpersonal learning
Group cohesiveness
Catharsis
Existential factors
Corrective refocusing
477
Q

Corrective refocusing occurs when

A

participants reexperience family conflicts in the group. These experiences allow them to recognize and change their problematic behaviors.

478
Q

Interpersonal learning allows participants.

A

to increase their adaptive interpersonal relationships through group therapy sessions

479
Q

Altruism results from

A

sharing oneself with another.

480
Q

Universality occurs as participants

A

discover that others have similar problems, thoughts, or feelings.

481
Q

Social anxiety (phobia) disorder is described

A

as a marked and persistent fear of social or performance situations in which embarrassment may occur.

482
Q

Patients with social anxiety (phobia) disorder lack

A

assertiveness.

483
Q

Other descriptive features include the following:

A

Sensitivity to criticism

Inferiority feelings

484
Q

Medicare Part B provides coverage for ambulatory practitioner services and physical, occupational, and speech therapy. It also covers medical equipment, diagnostic tests, and some preventative care. Covered preventative services include the following:

A
Pap smears
Mammography
Screening for colorectal cancer
Screening for prostate cancer
Screening for cardiovascular disease
Screening for diabetes
Glaucoma screening
Influenza vaccinations
Pneumonia vaccinations
485
Q

Galantamine dual actions of (s.

A

1) inhibiting acetylcholinesterase and (2) positive allosteric modulation of nicotinic cholinergic receptor

486
Q

Concrete forms of communication are

A

specific, definite, and vivid rather than vague and general.

487
Q

Proverbial forms of communication are more

A

general and commonly use adages such as “practice makes perfect.”

488
Q

prohibit nurse practitioners in a managed care setting from discussing alternative treatment options not covered by the insurance plan. They are also prohibited from providing information on the limitations of the plan or commenting negatively about the plan to patients.

A

Gag rules

489
Q

The general function of norepinephrine involves

A

alertness, orientation, fight-or-flight, learning, memory, and focus and attention.

490
Q

The general function of serotonin involves

A

regulation of sleep, pain perception, mood states, temperature, aggression, and libido.

491
Q

The general function of glutamate involves

A

memory and sustained autonomic functions.

492
Q

he general function of dopamine involves

A

normal functioning of thinking, decision-making, reward-seeking behavior, fine muscle action, and integrated cognition.