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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Professional Role and Policy | 14% | - Ethical and Legal Standards
|
| Topic 2: Scientific Foundation | 19% | - Research and Evidence-Based Practice
|
| Topic 3: Diagnosis and Treatment | 43% | - Treatment Planning
|
| Topic 4: Advanced Practice Skills | 24% | - Psychopharmacology
|
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402. Frage
A 19-year-old male college student was attacked outside his dormitory by a group of men who "wanted to teach him a lesson." He was severely beaten but he could not identify the men who did this to him. He was admitted to the university hospital for treatment of his injuries and for crisis counseling. You are asked to address the student's mental condition and to help him with crisis interventions. You understand that the purpose of crisis counseling includes which of the following?
Antwort: B
Begründung:
The primary goal of crisis counseling is to address the immediate mental and emotional distress experienced by individuals who have undergone traumatic incidents, such as the college student who was attacked. One of the core objectives of crisis intervention is to reduce the intensity of the individual's reactions to the crisis. This includes alleviating overwhelming emotions, stabilizing mental and emotional disturbances, and mitigating extreme physical and behavioral responses that might have arisen from the trauma.
Crisis intervention is not primarily concerned with the physical healing of wounds, as that is the role of medical professionals. However, the emotional support provided during crisis counseling can indirectly aid in the overall healing process by promoting a positive mental state that can enhance physical recovery.
Another aspect that is not a direct aim of crisis counseling is helping authorities find the perpetrators. While ensuring justice and safety is crucial, the focus of crisis intervention remains on the victim's psychological well-being and immediate needs rather than on legal outcomes.
Additionally, while monitoring the progress of a hospital stay might be indirectly involved, it is not a primary focus of crisis counseling. Medical staff primarily handle the physical aspects of patient care in a hospital setting, whereas crisis counselors focus on emotional and psychological support.
In summary, the essence of crisis intervention, particularly in the context of the attacked college student, revolves around reducing the intensity of his emotional, mental, physical, and behavioral reactions to the attack. This helps the victim regain a sense of normalcy and functionality post-crisis, improves their coping mechanisms for future challenges, and supports their journey towards psychological recovery and resilience.
403. Frage
You are a nurse practitioner treating a seven-year-old male. His mother brings him in for his initial appointment, stating, "My son's teacher is concerned because he is not able to finish his in-class schoolwork. I just don't know what to do." You suspect the client may have attention deficit hyperactivity disorder (ADHD), but you need more information. Per the mother, the patient often fidgets in his seat, gets distracted easily, is extremely disorganized, and has a difficult time remembering to turn in his classwork.
Which of the following symptoms is most indicative of hyperactivity?
Antwort: A
Begründung:
Hyperactive and impulsive traits of ADHD are as follows:
* Fidgets
* Leaves seat
* Runs or climbs
* Is unable to engage in quiet activities
* Is always on the go
* Talks excessively
* Blurts out information
* Has a difficult time waiting their turn
* Interrupts others
Inattentive traits of ADHD include all of the following:
* Fails to give attention to details
* Has difficulty sustaining attention
* Does not listen when spoken to
* Does not follow through on instructions
* Is disorganized
* Avoids or dislikes tasks that require sustained mental effort
* Loses things
* Is distracted
* Is forgetful
404. Frage
You are a new nurse practitioner opening a clinic specifically to treat children and adolescents. You have an initial evaluation appointment today with the mother of a six-year-old who is concerned about her daughter's inability to keep up with schoolwork. You decide to screen for autism spectrum disorder (ASD).
Which of the following assessments is least appropriate for screening this patient for ASD?
Antwort: D
Begründung:
Although this is an evidence-based and adequate tool, it is for toddlers only; this patient is too old for this assessment tool.
Screening for developmental delays is a critical component of assessing for ASD. Checklists for this include the following:
* Modified Checklist for Autism in Toddlers (Age-Specific)
* Autism Diagnostic Observation Schedule-Generic (ADOS-G)
* Ages and Stages Questionnaires
Parents may also report the following symptoms:
* No cooing by age one year, no single words by age 16 months, no two-word phrases by age 24 months
* Loss of language skills
* No imaginary play
* Little interest in playing with other children
* Extremely short attention span
* No response when called by name
* Little or no eye contact
* Intense tantrums
* Fixations on single objects
* Unusually strong resistance to changes in routines
* Oversensitivity to certain sounds, textures, or smells
* Appetite or sleep-rest disturbance, or both
* Self-injurious behavior
405. Frage
Hyperthyroidism often mimics symptoms of bipolar affective mood disorders. A patient with hypothyroidism is most likely to present with which of the following symptoms?
Antwort: B
Begründung:
In hypothyroidism, T4 is decreased and TSH is increased, producing slowed processes and depressive-like symptomatology. Patients with hypothyroidism may present with the following symptoms:
* Confusion
* Decreased libido
* Impotence
* Decreased appetite
* Memory loss
* Lethargy
* Constipation
* Headaches
* Slow or clumsy movements
* Syncope
* Weight gain
* Fluid retention
* Muscle aching and stiffness
* Slowed reflexes
* Somatic discomfort including aching and joint stiffness
* Slowed speech and thinking
* Sensory disturbances, including hearing
* Cerebellar ataxia
* Loss of amplitude in ECG
In hyperthyroidism, T4 is increased and TSH is decreased, which produces excitatory and labile/anxious-like symptomatology.
Other presentations of hyperthyroidism include the following:
* Motor restlessness
* Emotional lability
* Tremors
* Insomnia
* Impotence
* Weight loss
* Increased appetite
* Abdominal pain
* Excessive sweating
* Flushing
* Elevated upper eyelid leading to decreased blinking, staring, and fine tremors of the eyelid
* Tachycardia
* Dysrhythmias
406. Frage
According to Irvin Yalom, what would you expect to occur during the forming phase of group therapy?
Antwort: A
Begründung:
Irvin Yalom was the first person to put a theoretical perspective on group work. He believed that all groups go through specific phases:
1. Pre-group
2. Forming
3. Storming
4. Norming
5. Performing
6. Adjourning
During the forming phase:
* Members appear concerned about self-disclosure and rejection
* Goals and expectations are identified
* Boundaries between the leader and participants are established
* Trust and rapport begin to develop
407. Frage
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