Suicide assessment should include an assessment of both risk factors and protective factors. Which of the following is a true statement with respect to suicide assessment?

A. Each protective factor mitigates a risk factor

B. Bonding with a pet is an internal protective factor

C. Strong sense of cultural identity is an external protective factor

D. There is no clear increase in suicidal rates with antidepressant use
---
YouTube: https://www.youtube.com/watch?v=1vG6aYVNno8&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=41

A 19-year-old male is in your office for evaluation of profound anxiety. He is in his first year of college and last week there was an active shooter on campus. Three people were killed. Although he didn’t know any of them, it was in the building where he has one of his classes and he is having severe anxiety and nightmares. He gets profoundly distressed when discussing this with anyone, he feels detached from his friends and even his family, is having trouble sleeping, and finds himself getting angry with everyone for no good reason. The PMHNP explores for additional symptoms to support a diagnosis of:

A. Post traumatic stress disorder

B. Acute stress response

C. Dissociative disorder

D. Panic disorder
---
YouTube: https://www.youtube.com/watch?v=gvM_PjicmQI&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=40

The PMHNP is asked to evaluate a 5-year-old child who has been having difficulty adjusting to kindergarten and has been disruptive in the classroom. The child is pleasant in the office, responds to questions, and seems to understand that she is having this appointment because she does not seem happy in kindergarten. Via role play and discussion the PMHNP learns that the child is sad and frightened because she was angry with her Daddy and wished he didn’t live there anymore. Very shortly thereafter, her parents told her that Daddy would be moving out. Daddy moving out made Mom sad, the 5-year-old thinks it’s all her fault. This is why she is so unhappy. This is characteristic of which of Piaget’s developmental stages?

A. Sensorimotor

B. Preoperational

C. Concrete operational

D. Formal operational
---
YouTube: https://www.youtube.com/watch?v=qmn1sXSUmTI&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=39

While performing a mental status exam, the PMHNP asks the patient to count backwards, beginning with 100 and subtracting 7. This is an effort to assess which element of the mental status exam?

A. Concentration

B. Orientation

C. Visuospatial function

D. Recall
---
YouTube: https://www.youtube.com/watch?v=p3x-HNGaWXY&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=38

A new patient is being evaluated at the request of her primary care provider. While conducting the interview the PMHNP has a very difficult time getting direct answers to questions. The patient will try to answer but often drifts off topic, talking about things that appear related, but she never actually answers the question. The PMHNP documents which abnormality of thought process?

A. Circumstantiality

B. Tangentiality

C. Perseveration

D. Flight of ideas
---
YouTube: https://www.youtube.com/watch?v=zjym13JPesM&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=37

When counseling the parents of a 7-year-old patient regarding pharmacotherapy for attention deficit disorder, the PMHNP identifies which clinically relevant difference between clonidine and guanfacine?

A. Guanfacine may be used as adjunct therapy to psychostimulants.

B. Clonidine is available in a long-acting formulation.

C. Clonidine is selective for alpha-2a adrenergic receptors.

D. Guanfacine is appreciably less sedating.
---
YouTube: https://www.youtube.com/watch?v=8jYx5O0eEOQ&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=36

Which of the following is not a validated tool used to evaluate attention deficit disorder?

A. The Vanderbilt Assessment Scale

B. The Connors Comprehensive Scale

C. The Early Childhood Screening Assessment

D. The Child Behavior Checklist
---
YouTube: https://www.youtube.com/watch?v=pmuMEFrjBLg&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=35

Alzheimer’s disease is the most common cause of major neurocognitive disorder and and while largely managed with non-pharmacologic interventions, there are also a variety of pharmacotherapeutics available for use when appropriate. Which of the following is considered a first-line pharmacologic intervention for symptom control in the patient with Alzheimer’s disease?

A. Lecanemab

B. Donepezil

C. Memantine

D. Namzaric®
---
YouTube: https://www.youtube.com/watch?v=-z2D99MLGuM&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=34

A new patient presents for evaluation of self-diagnosed bipolar disorder. An assessment of her history of interpersonal relationships increases your index of suspicion for borderline personality disorder as opposed to bipolar disorder. Which of the following circumstances is most characteristic of borderline personality disorder?

A. Her fluctuations in mood have caused problems with interpersonal relationships at work.

B. Both parents have expressed significant concern over the depths of her mood when she is depressed.

C. The history reveals that relationships with significant others always seem to be very tumultuous.

D. She is resistant to treatment because when her mood is good she is very productive.
---
YouTube: https://www.youtube.com/watch?v=i-FojtAgRCE&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=33

A 32-year-old female patient with diagnoses of bipolar I disorder and borderline personality disorder was recently transferred to your care. She was managed on desvenlafaxine ER 150 mg daily and olanzapine 10 mg daily but experiencing increasingly elevated mood. In an attempt to wean off desvenlafaxine you reduce her from 150 mg to 100 mg daily. She experiences profound discontinuation syndrome symptoms. What is the most appropriate approach?

A. Resume desvenlafaxine ER 150 mg daily

B. Add valproic acid 750 mg daily

C. Increase olanzapine to 15 mg daily

D. Begin fluoxetine 20 mg daily
---
YouTube: https://www.youtube.com/watch?v=6Z6t5IAVPpc&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=32