Jen is a 31-year-old female who presents for care complaining of depressed mood. During the interview it becomes apparent that she has a long history of depressive symptoms, as well as a long history of being socially isolated and feeling generally inadequate. When considering a diagnosis of persistent depressive disorder, the PMHNP considers that the core concept of persistent depressive disorder refers to subaffective or subclinical depressive disorder with all of the following except:

A. Low-grade chronicity for at least 2 years  
B. Insidious onset, usually in childhood or adolescence
C. Strong family history of depression and bipolar disorder 
D. Long asymptomatic periods between episodes  

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YouTube: https://www.youtube.com/watch?v=z-OTtAp0kHs&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=8

Validated and reliable instruments are an important part of assessment for both clinical practice and research in mental health. Which of the following tools is currently considered the standard for assessing clinical outcomes in treatment studies of schizophrenia?

A. SCID
B. BPRS 
C. PANSS 
D. HAM-D

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YouTube: https://www.youtube.com/watch?v=KaCK-iVbQ1U&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=7

Laura is a 27-year-old female who is being seen today for psychiatric evaluation. She has no significant psychiatric or medical history and denies any history of substance abuse. She is being seen today because she is persistently having olfactory hallucinations. For the last three months she has been having a progressive sense of smelling particularly foul odors – feces, rotting food, and trash, with no obvious cause. She made the appointment because she had an uncle who had schizophrenia and he used to have hallucinations, although he was mostly hearing voices. The PMHNP knows that a priority of assessment includes a :

A.  BPRS 
B.  Toxicology screen 
C.  Head imaging 
D.  Family history 

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Youtube: https://www.youtube.com/watch?v=OM9tYH88q2Y&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=6

C.J. is a 23-year-old male being seen today by the PMHNP today for an initial evaluation. He says that he does not think anything is wrong but his family, specifically his mother, grandmother, and aunt, have all told him that he must be “mentally ill.” He cannot hold a job. He has worked as a cook at more than 5 chain restaurants in the last 6 months. He has no real friends – he says his friends only call him when they need something. He is currently staying with his grandmother but will soon be homeless “unless things change.” While he is telling his story the PMHNP appreciates that he repeatedly includes details that make it hard to understand his point. When asked why he thinks he will be homeless, he responds by talking about how many hours he has worked, and how everything was going well until his car broke down and he couldn’t afford to fix it because his tax return was held by the IRS. The PMHNP recognizes that this represents an abnormal:  

A.  Affect 
B.  Cognition
C.  Thought process  
D.  Abstract reasoning 

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Youtube :  https://www.youtube.com/watch?v=bAWGIj0gfYk&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=5

The PMHNP is asked to evaluate the parent of one of her existing patients. The patient reports that her father, a 78-year-old man who lives alone, has always been in good health. However, last Sunday during breakfast with him he was overtly confused and at first he did not even seem to recognize his daughter. This patient is concerned that her father has Alzheimer’s disease and is amazed because two days prior he was “completely fine.” The PMHNP knows that the most likely cause of this presentation is: 

A. Urinary tract infection 
B. Mild neurocognitive disorder
C. Normal pressure hydrocephalus 
D. Depression

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YouTube: https://www.youtube.com/watch?v=ztvh4Yxc3v0&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=4

The PMHNP is conducting an office visit with a 42-year-old male who is in treatment for the management of symptoms related to problems in his marriage. During the visit he begins to cry and the PMHNP responds to his tears by gently moving a box of tissues toward him. This is a facilitating intervention known as: 

A. Reinforcement 
B. Reassurance
C. Encouragement
D. Acknowledgement

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YouTube: https://www.youtube.com/watch?v=HYl_lTC5viI&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=3

In documenting a mental status exam (MSE) for Janet, a 54-year-old female, the PMHNP notes that she is bradykinesic, has poverty of speech, is depressed, and has flat affect. This includes all of the following elements of physical examination except:

A. Appearance

B. Motor Activity 

C. Mood

D. Affect

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YouTube: https://www.youtube.com/watch?v=1CU-TrnkfDY&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=2&t=1s

The psychiatric mental health nurse practitioner on call is asked to evaluate a 21-year-old male who was just arrested following an altercation at a local bar. The patient has never been incarcerated before and there is no psychiatric or medical history available. His toxicology screen was negative for alcohol or any drugs of abuse. His mother is available, and she reports that in the past he has had some episodes of agitation. But this is the first time it's been a problem. Reportedly, he and some coworkers were at the bar celebrating a birthday, and before anyone knew what happened, an argument appeared to escalate. The patient became very loud, was yelling and acting crazy, began breaking bottles and finally punched a coworker. When considering a manic or hypomanic episode, the psychiatric mental health nurse practitioner expects that his speech would most likely be characterized as:

A. Stuttered

B. Increased 

C. Childlike  

D. Confused 

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YouTube: https://youtu.be/ew33_ghv6Ik?si=dgOw0WjB9hiFOwnX