APEA Psychiatry Exam at at Northern Kentucky University

A 32-year-old single man has a childhood history of repeated instances of torturing animals, setting fires, stealing, running away from home, and skipping school. These behaviors started at age 9 years. As an adult, he has a history of lying and engaging in check forgery. He has multiple felony convictions for physical assault. He also has fathered several children with several women, none of whom he married. He has used aliases to avoid paying child support. There is no history of manic, depressive, or psychotic symptoms. What is the appropriate diagnosis?

An NP is providing patient education about the risks of abruptly stopping a medication. Which of the following medications is associated with the most significant discontinuation/withdrawal syndrome, if stopped abruptly?

A 21-year-old unmarried man has near-daily intrusive thoughts that his neighbors knock on his door at night. He tells the PMHNP he knows this knocking is just his "imagination" because the neighbors work nights and are not home. However, he feels compelled to get out of bed and open the door, no matter what time it is. He opens and closes the door repeatedly for at least an hour, sometimes longer. He says he has had this problem "in the past" and did not seek help for it. This time it has been going on at least 6 months and is becoming "problematic." It is interfering with his ability to get a good night's sleep and he is having problems at work. His roommate is also very troubled by it. The PMHNP will diagnose him with which of the following?

Two weeks ago, the PMHNP prescribed the antidepressant escitalopram (Lexapro) for a 28-year-old female client with generalized anxiety disorder. At her initial appointment, she scored 28 on the Hamilton Anxiety Rating Scale (HAM-A). At today's follow-up visit, she scored 26. She reports no side effects from the Lexapro. Which of the following is the next step for the PMHNP?

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), how long must symptoms be present to justify a diagnosis of a specific phobia?

The PMHNP is assessing an adolescent patient with adjustment disorder. Which of the following findings indicate a worse prognosis for this patient?

A 29-year-old nurse presents to the PMHNP for evaluation after a traumatic event. Two weeks ago, she was attacked by a patient on the behavioral unit where she works. She says she is having flashbacks about the event and keeps wondering "what could I have done to prevent it?" She has had several panic attacks since the incident, and she is to the point now where she is considering quitting nursing. She says, "I guess I am too weak to be a nurse if I can't handle one attack." What is her most likely diagnosis?

A 29-year-old single woman presents to the PMHNP for evaluation of a chief complaint of fatigue. She states she has been feeling "tired" and "empty" for the past 4 years. She sleeps up to 11 hours a day and is still tired. She has trouble concentrating and has difficulty making decisions. She has gained 10 pounds over the past 2 years due to overeating and little physical activity. She reports no suicidal ideation or manic symptoms, and no delusions or hallucinations. What is the most likely diagnosis?

Which of the following aspects of bipolar disorder predicts a favorable response to lithium treatment?