NR668 PMHNP Final Diagnostic Exam

Robby is a 51 year old male who was recently diagnosed with Parkinson’s Disease. He has delayed his appointment with a neurologist after he has convinced himself that he will die soon. He has been avoiding work despite his ability to perform his occupation as an engineer. He describes nightmares since his diagnosis 1 month ago. He has been experiencing guilt that his former boxing career must have brought on the disease. What diagnosis best describes this clinical scenario?

Generalized Anxiety disorder
Adjustment disorder ✅
Acute stress disorder
Major depressive disorder with psychotic features

A 38-year-old male presents for follow up chronic back pain and spasm. Four years earlier, he sustained a motorcycle accident. He has been taking morphine extended release 40mg PO BID and Hydrocodone 10mg IR Qd PRN. Today he complains that the medication is no longer effective. He notes diarrhea and restlessness when he skips a dose. He continues to be employed and has not missed any work days. He has been filling the prescription 1 day early each month and visited an urgent care twice this summer requesting additional pain control. There are no changes on exam today and no focal deficits. Which of the following do you recommend for this patient?

Evaluate for Opioid use disorder, recommend a slow taper off full opioid agonists and then start buprenorphine. ✅
Hospitalize for detox immediately.
Xanax 0.25mg po BID
Increase the standing Morphine and re-evaluate in 2 weeks.

Felipe is a 22 year old male who punctured his foot with a rusty nail and smothered the wound with dirt. Several days later he sought medical care. He verbalized to his PCP that he must have stepped on something while walking his dog. In the absence of secondary gain, this example best represents which diagnosis?

Factitious disorder ✅
Malingering
Conversion disorder
Borderline personality disorder

Which of the following medications may contribute to REM sleep behavior disorder?

Beta blockers
Serotonin Norepinephrine Reuptake Inhibitors
All of these contribute to REM sleep behavior disorder. ✅
Selective Serotonin Reuptake inhibitors

Which of the following is true with insomnia disorder?

All of these statements are true.
More prevalent amongst males than females
Complaint of dissatisfaction of sleep quality or quantity ✅
Begins in childhood

A 75 year old man who lives alone has a history of alcohol use disorder is admitted to the ICU with a COPD exacerbation. He develops severe agitation, visual hallucinations, and fluctuating levels of consciousness. His current treatment includes supplemental oxygen, a corticosteroid taper, and albuterol nebulizers. Which factor is most likely contributing to his delirium, and what is the best initial approach?

A. Albuterol induced delirium; reduce albuterol dosage
B. Steroid induced delirium; initiate haloperidol
C. Hypoxia related delirium; increase oxygen supplementation
D. Alcohol withdrawal delirium; initiate benzodiazepines ✓ ✅

Ron complains of a new tingling sensation in both of his hands and feels his hands are now “weak”. This occurred 5 days after his partner abruptly ended their 3 year relationship. Ron became very distressed and booked an urgent appointment with his primary care provider. Ron has no other complaints, rarely calls his primary care provider and denies any recent injury. Upon exam, Ron has no evidence of a medical condition other than his new sensory function complaint. Given the limited information in this scenario, this is likely an example of what?

Factitious disorder
Body dysmorphic disorder
Somatic Symptom Disorder
Conversion disorder ✅………………………….purchase all the 150 questions and answers at a discounted rate of $99 only.