BARKLEY DRT FOR PMHNP NEWEST ACTUAL EXAM 100

BARKLEY DRT FOR PMHNP NEWEST ACTUAL EXAM 100

QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED

ANSWERS) |ALREADY GRADED A+

• During a suicide intervention with your 28yo male patient, to which agreement should you ask for his consent,

verbally or in writing?

• -“No Harm” contract- health care professionals are obligated to ask suicidal patients to agree to a no

harm contract, verbally or in writing, detailing specifically that the patient will restrain from harming themselves

• “No Suicide” contract- typical contracts used in the prevention of suicide
• “Prevention” Contract- typical contracts used in the prevention of suicide
• “Affirming Life” contract- typical contracts used in the prevention of suicide
• Courtney 35 is a rape victim. You note that she has an expressed style of coping in her acute rape trauma

syndrome. Which of the following would most lead you to this conclusion?

• Patients Masked face
• Patients Distractibiity
• Patient Smiling
• Patient having difficulty making decisions
• Which of the following patients would not require hospitalization?
• A 29yo self-admitted bulimic male with bradycardia
• A 27yo female with repeated use of laxatives and diuretics at least two times a week for 3 months
• A 20yo male suffering from persistent hypothermia
• A 18yo young woman who is 5’4” and weighs 92 pounds
• Terry, 35yo, visits your office with the assumption that he is experiencing depression. Terry explains that he has

a history of substance abuse and a family history of mood disorders. He claims that he has recently been incredibly fatigued, possessing no energy to even perform day to day activities. Even with the sudden onset of fatigue. Terry explains that he is still experiencing insomnia. He also complains about recurring confusion and loss of weight, and confesses that he has been experiencing more recurrent suicidal thoughts. Of the following which is the best medication to prescribe Terry for his situation?

• Sympathomimetics- thought to be most effective pharmacological treatment for depression, however

they have a potential for abuse

• Bupropion- better choice due to history of substance abuse
• Olanzapine- mood stabilizer more effective for bipolar
• Risperidone- for mania
• You are attending to a 30yo male after he was shot at and almost killed. By showing empathy, confrontation,

and immediacy, you are exhibiting which of the following?

• Identifying the hazard and precipitating event- involves differentiating the precipitating event from long

term psychological problems.Three of the counseling keystones relevant to assessment of a crisis are empathy, confrontation, and immediacy.

• Identifying coping mechanisms- does not involve wide-ranging keystones such as empathy, but rather

specific actions such as questioning and increasing adaptive coping by recommending the patient seek information.

• Counseling keystones relevant to assessment of a crisis-

• Situational support
• A patient with which of the following findings should be referred to primary care for cardiovascular problems?
• A patient with a blood pressure of 130/85- considered prehypertension and should be referred to

primary care.

• Systole
• Diastole
• Low density lipoprotein level (LDL) of 69 mg/dl- is the desired LDL for patients, anything over 100 mg/dl

should warrant a referral to primary care for evaluation of cholesterol.

• Patients with severe and persistent mental illness (SPMI) exhibit symptoms which interfere with occupational,

academic, and social functioning. Which of the following illnesses eventually touches 100% of patients affected with SPMI?

• Unipolar depression- affects 20-30% of SPMI patients
• Schizophrenia- affects 90% of SPMI patients
• Dementia- 100% of patients with SPMI are eventually affected by varying degrees of dementia which

interfere with occupational, academic and social functioning

• Bipolar Depression- affects 40-50% of SPMI patients
• Before patients enter a hospice they are advised of their right to refuse care, but only if they have which of the

following?

• Decisional capability
• A living will
• A healthcare directive
• Informed consent
• Which of the following statements is not a correct association with the Bronfenbrenner’s ecological system

model?

• Children are dynamic entities and develop the skills necessary to _____ that setting
• The ___ child ____ may be established as _____ by the parents relationships
• Objective reality influences behaviors and development more than ones perception of environment
• Changes in family structure such as the birth of a sibling affect a child’s development
• A 34yo man who recently had a major car accident comes to your office. He reports that his car hit the car in

front of him. The man says he has a relative with intermittent explosive disorder and worries, that he may also have it. He is worried that if he has this disorder, it could lead to further problems in the future. When asked if he hit the car on purpose, he initially denies it, but then indicates that he was particularly annoyed with the driver in front of him. Which of the following would not be a typical characteristic of this disorder?

• The degree of aggression was out of proportion to the precipitating psychological stressor
• He had been drinking alcohol extensively earlier in the night
• He felt immediately guilty after the episode
• He experienced tingling and chest tightness shortly before episode.
• Of the following antidepressant medications, which is a tetracyclic antidepressant?
• Maprotiline- a tetracyclic antidepressant, chemical compound consists of primarily 4 rings of atoms.
• Amitriptyline- tricyclic antidepressant
• Amoxapine- tricyclic antidepressant
• Phenetzine sulfate- MAOI
• The sexually transmitted disease that causes superficial, painful ulcers surrounded by an erythematous halo in

men but is usually asymptomatic in women is which of the following?

• Chancroid- although women are usually asymptomatic, men usually have superficial painful, and erosive

ulcers, which are surrounded by an erythematous halo, on the genitalia when affected by chancroid.

• Herpes Simplex virus type I- painful ulcers on face no halo
• Human Papillomavirus- single or multiple soft, fleshy, papillary, or sessile, painless keratinized growth

around anus, vulvovaginal area, penis urethra, or perineum.

• Lymphogranuloma venereum- painless and involves bubo
• The medical profession categories the various levels of prevention that caregivers practice on their patients. A

pap smear screening corresponds to which of these types of prevention?

• Primary prevention
• Secondary prevention
• Quaternary Preventioin
• Tertiary Prevention
• Schizophrenia is a complex illness with certain accepted phases; and often lifelong movement between phases,

which of the following is not a phase of schizophrenia?

• Prodromal
• Premorbid
• Relapsable
• Acute
• Eric, a 34yo male, diagnosed as schizophrenic 5yrs ago. Among his characteristics and features is an apparent

emotional detachment from his action and surroundings. During interviews with him, you note his persistently confused speech and behavior. You are also informing Eric’s family members of his diagnosis, you should tell them that Eric displays characteristics of which type of schizophrenia?

• Disorganized
• Catatonic
• Residual
• Paranoid
• In the treatment of GAD, benzos are advisable typically for short term use. Which of the following is not a risk

associated with this treatment?

• Tolerance
• Blood clots
• Dependency
• Withdrawal symptoms when discontinued
• Vitamin B12 deficiency can lead to clinical symptoms of dementia. In patients with dementia, which of the

following findings would you also expect to see as a result of this deficiency?

• Markedly increased neuritic plaques and neurofibrillary tangles- hallmark of Alzheimers as is decreased

availability of acetylcholine.

• Demyelination and axon loss in the brain and spinal cord- dementia due to B12 is caused by

demyelination and axon loss in brain and spinal cord.

• Decreased availability of acetylcholine
• Substantial reduction in neurons in the substantia nigra -aka atrophy of the substantia nigra is a clinical

feature of Parkinson’s disease and not related to B12.

• You are treating SergeI, who speaks limited English, and you do not know enough Russian to treat him.

According to the standards of Culturally and Linguistically Appropriate Services, you must provide all of the

following for Sergei, except:

a, b, and c all are part of (CLAS)- One of the standards of Culturally and Linguistically Appropriate Services (CLAS) is the requirement that health organizations must provide language assistance Services. This includes bilingual staff or interpreter services at no cost to the patient. Their right to this service must be made known to the

patient in their preferred language, both verbally and in written notices. Additionally, the patient’s family or friends may be used as translators unless specifically requested by the patient.

• Bilingual staff and interpreter services at no cost to the patient
• An English-Russian translator application on your computer- does not meet the stadards of CLAS
• Verbal and written notices in the patient’s native language
• A trusted family member or friend who can translate, if requested
• Matthias, 8yo male, is having difficulty in school. His mother is concerned about his social withdrawal and

isolation. His mother tells you that she is worried that it may be schizophrenia because her older brother has the condition. You tell her that Matthias may be in the premorbid phase of schizophrenia, which requires early intervention. The premorbid phase contains all of the following characteristics except:

• Echopraxia- the involuntary repetition of another individual’s observed actions. This is a feature of the

acute or psychotic phase of schizophrenia, not the premorbid phase.

• Enuresis- premorbid phase can also include involuntary urination or enuresis
• Irritability and or anger- major characteristics of premorbid phase
• Depression- major characteristics of premorbid phase
• A physical therapist helps Chris who was paralyzed below his waist after falling off a horse. He is now post spinal

cord surgery and he is able to feel his legs and feet again. What level of prevention is occurring here? a.Secondary Prevention

• Tertiary Prevention
• Primary Prevention
• Quaternary prevention
• The following choices represent the predisposing factors for enuresis except:
• African American
• Male
• Small bladder capacity
• Poor nutrition
• You are meeting Ginger, a 10yo, who was brought to you by a social worker. You notice that Ginger is wary of

adult contact, withdrawn and responds to your questions in monosyllabic answers. You also gather that she is frightened of her parents, yet she makes constant efforts to please them. The patient’s behavior is most indicative of which of the following?

• Neglect y caretakers
• Emotional abuse by caretakers
• Sexual abuse by caretakers
• Physical abuse by caretakers
• Despite the fact that she claims she “forgot” to pay for the items. Cynthia was recently arrested for shoplifting at

a clothing store. Looking at this 32yo, female’s history, you realize she has a history of shoplifting often by herself and with no apparent need or want for the items. Which of the following would you expect to see in Cynthia’s family history?

• Her sister was addicted to pain killers
• Her mother has OCD
• Her father was an alcoholic
• Her aunt suffered from panic attacks
• You are performing a comprehensive health history of 20yo Ricky. He has been in and out of juvenile detention

centers because of his violent history over the last 3 years. You are trying to delineate whether his propensity for violence is associated with internal or external factors. Yu should pay special attention to the following

possible issues except: