Primary Care Art and Science of Advanced Practice Nursing 4th Edition by Dunphy Test Bank

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Primary Care Art and Science of Advanced Practice Nursing 4th Edition by Dunphy Test Bank


Chapter 18. Psychosocial Problems

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?
a. Acetylcholine
b. Gamma-aminobutyric acid (GABA)
c. Dopamine
d. Serotonin

____ 2. The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:
a. 1 month
b. 3 months
c. 6 months
d. 12 months

____ 3. A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack?
a. Pheochromocytoma
b. Hyperthyroidism
c. Cardiac arrhythmias
d. All of the above

____ 4. Which of the following is considered first-line treatment for panic disorders?
a. Benzodiazepines
b. Selective serotonin reuptake inhibitors (SSRIs)
c. Tricyclic antidepressants
d. Cognitive behavioral therapy

____ 5. Which of the following symptoms is not part of the diagnostic criteria for post-traumatic stress disorder (PTSD)?
a. Hypersomnolence
b. Blunted feelings
c. Loss of interest in significant activities
d. Intrusive recurrent recollections of the event

____ 6. Which of the following neuroendocrine abnormalities is implicated in depression?
a. Decrease in adrenal size
b. Increased cortisol and corticotrophin-releasing hormone
c. An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone
d. Increased inhibitory response of glucocorticoids to dexamethasone

____ 7. The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?
a. SSRIs are more effective than TCAs.
b. SSRIs take less time to work than TCAs.
c. SSRIs have a more favorable side-effect profile than TCAs.
d. SSRIs are not lethal in overdose.

____ 8. After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor?
a. 2 weeks
b. 3 weeks
c. 4 weeks
d. 5 weeks

____ 9. It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period?
a. Before the initiation of treatment
b. 1 to 2 weeks after the initiation of treatment
c. When switching to a different medication
d. 1 to 2 weeks after tapering off medications

____ 10. A patient is experiencing extrapyramidal side effects from his antipsychotic medications. The clinician would most likely take which of the following approaches to treating these side effects?
a. Give the patient a drug holiday until the symptoms resolve and then restart the medication.
b. Switch the patient to a different antipsychotic.
c. Treat the patient with anticholinergics.
d. Treat the patient with anticonvulsants.

____ 11. According to Kbler-Ross, the stages of grief occur in which order?
a. Anger, denial, depression, bargaining, acceptance
b. Anger, denial, bargaining, acceptance, depression
c. Denial, anger, depression, bargaining, acceptance
d. Denial, anger, bargaining, depression, acceptance

____ 12. The clinician is educating a patient about the effects of marijuana. The patient stated she has been smoking for years and believes the use does not interfere with her life. What is a significant long-term sequelae of marijuana use that the clinician should educate this patient about?
a. Memory impairment
b. Sexual dysfunction
c. Dry mouth
d. There are no long-term consequences of marijuana use.

____ 13. Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?
b. Acetylcholine
c. Dopamine
d. Serotonin

____ 14. What blood alcohol level corresponds with the signs of stupor and confusion?
a. 0.05
b. 0.1
c. 0.2
d. 0.3

____ 15. Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep?
a. Every 30 minutes
b. Every 60 minutes
c. Every 90 minutes
d. Every 180 minutes

____ 16. Which of the following is a laboratory finding commonly found in patients with anorexia nervosa?
a. Hypercholesterolemia
b. Hypermagnesmia
c. Leukocytosis
d. Decreased TRH

____ 17. Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?
a. Sertraline
b. Fluoxetine
c. Citoprolam
d. Imipramine

____ 18. Which of the following would be important to monitor in a child receiving methylphenidate for treatment of attention deficit-hyperactivity disorder (ADHD)?
a. Liver function
b. Vision
c. Growth parameters
d. Renal function

____ 19. It is important for the clinician to discuss the long-term effects of sexual assault with survivors. Which of the following is the most common long-term effect of sexual assault?
a. Depression
b. Obsessive-compulsive disorder
c. Substance abuse

____ 20. Women are at the highest risk for developing postpartum depression for up to how long after childbirth?
a. 2 weeks
b. 1 month
c. 3 months
d. 6 months

____ 21. Which is the most prevalent psychiatric condition in the United States?
a. Depression
b. Anxiety
c. Substance-related addictions
d. Gambling

____ 22. What is recorded as clinical category two of the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision)?
a. Clinical disorder or focus of clinical attention
b. Personality or environmental problems
c. Environmental and psychosocial stressors
d. Global assessment of functioning

____ 23. Which of the following may be used to evaluate a persons suicide risk?

____ 24. Assessing for adherence with prescribed medications and developing a plan for what to do if they are stopped is a major treatment issue for which of the following diagnostic groups?
b. Bipolar
c. Depression
d. Anxiety

____ 25. Bipolar disorder requires differential diagnosis from all of the following except?
a. Substance abuse and medication effects
b. Medical and neurological disorders
c. Cluster B personality disorders and depression
d. Obsessive-compulsive disorder

Indicate whether the statement is true or false.

____ 1. The use of benzodiazepines in the patient with generalized anxiety disorder and comorbid depression can exacerbate depressive symptoms.

____ 2. Depressive episodes associated with bipolar disorder are treated the same as major depressive disorder.

____ 3. Women in abusive relationships have a greater chance of being killed by their batterers when they leave the relationship than women who stay.

____ 4. Adults must show childhood onset of symptoms to receive a diagnosis of ADHD.

____ 5. Parkinsons disease and dementing illnesses may commonly manifest depressive symptoms.

____ 6. The best predictor of suicide risk is a history of suicide attempts.

____ 7. A no-suicide contract can prevent a suicide attempt.

____ 8. Depression is the most chronic disabling and economically catastrophic medical disorder of the severe mental illnesses.

____ 9. Clozapine (Clozaril) requires laboratory monitoring at specified frequencies with results reported to a national registry.

____ 10. When combined with certain other medications, serotonin-specific antidepressants can have significant liver P450-interaction effects.

Chapter 18. Psychosocial Problems
Answer Section


1. ANS: B PTS: 1

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