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College Admission American Nurses Credentialing Center: Adult Psychiatric-Mental Health Nurse Practitioner-Board Certified Sample Questions (Q1235-Q1240):

NEW QUESTION # 1235
Which of the following has been removed from the DSM-5 as a circadian rhythm sleep-wake disorder?

Answer: B

Explanation:
Circadian rhythm sleep-wake disorders are characterized by a mismatch between a person's biological clock and the environment. There are five subtypes:
* Delayed sleep phase type: falling asleep and waking later than desired
* Advanced sleep phase type: falling asleep and waking earlier than desired
* Irregular sleep-wake type: falling asleep and waking at random times
* Non-24-hour sleep-wake type: falling asleep and usually waking progressively later than desired
* Shift work type: sleepiness associated with changes in work schedule
Jet lag refers to feeling sleepy or "hungover" after crossing time zones. It is no longer considered a sleep disorder by the DSM-5.


NEW QUESTION # 1236
Attachment, in terms of infant psychosocial development, is the enduring and specific affective bond that develops over the first year of life. In an insecure-disorganized attachment the underlying process/emotion is which of the following?

Answer: B

Explanation:
In the realm of infant psychosocial development, attachment theory, as originally formulated by John Bowlby and later expanded by Mary Ainsworth, posits that infants form a close emotional bond with their caregivers, which significantly influences their emotional and social development. This bond, or attachment, varies in its nature and quality, leading to different patterns of attachment: secure, insecure-avoidant, insecure-anxious (or ambivalent), and insecure-disorganized.
The correct answer to the question regarding the underlying process or emotion in an insecure-disorganized attachment is confusion/dysfunction. To understand why, it's helpful to differentiate among the types of attachment: 1. **Secure Attachment**: Typically evident when the caregiver is responsive and consistently available to meet the needs of the child. The underlying emotion in this type of attachment is love, characterized by feelings of safety, security, and comfort when the caregiver is present. 2. **Insecure-Avoidant Attachment**: This form develops when the caregiver is emotionally distant or unresponsive. The child learns to suppress their natural desire for closeness and intimacy, leading to a predominant emotion of anger or indifference towards the caregiver. 3. **Insecure-Anxious Attachment**: Here, the caregiver's response is inconsistent-sometimes sensitive, sometimes neglectful. This inconsistency leads to feelings of anxiety and ambivalence in the child, as they are unsure of whether and when their needs will be met. 4. **Insecure-Disorganized Attachment**: This type of attachment occurs in the most extreme and dysfunctional caregiving environments. It is often seen in children who have been exposed to serious neglect or abuse. The primary emotion and process underlying this attachment style are confusion and dysfunction. The child shows a lack of clear attachment behavior because their caregivers, who are supposed to be sources of comfort and safety, are simultaneously sources of fear or disorientation. This leads to contradictory behaviors where the child may both seek and resist closeness, exhibiting disorganized or disoriented reactions to the caregiver.
In conclusion, when discussing insecure-disorganized attachment, the focus is on the significant confusion and dysfunctional interactions that characterize the relationships between the child and caregiver. These children do not exhibit a consistent strategy for getting their needs met by their caregivers, which significantly differentiates this type of attachment from the others where a more organized approach to dealing with stress and fear can be observed.


NEW QUESTION # 1237
Which of the following takes place during the installation phase of eye movement desensitization and reprocessing (EMDR)?

Answer: B

Explanation:
Eye movement desensitization and reprocessing (EMDR) is a form of behavioral therapy that was developed by Francine Shapiro. It is most commonly used in post-traumatic stress disorder, and its goal is adaptive resolution.
There are three phases in EMDR: desensitization, installation, and body scan.
1. Desensitization: The patient visualizes the trauma, verbalizes negative or maladaptive beliefs, and remains attentive to physical sensations. The patient also blocks negative thoughts, breathes deeply, and verbalizes.
2. Installation: The patient installs and strengthens the positive thought declared as a replacement for the original negative thought.
3. Body scan: The patient visualizes the trauma along with the positive thoughts and then scans their body mentally to identify any tension within.


NEW QUESTION # 1238
A PMHNP recently prescribed psychotropic medication to a patient with anxiety symptoms. During the clinic visit, the patient reports worse anxiety after two weeks of medication. They cannot stop pacing and shaking their legs. Which of the following neuropsychological tests can assess the presence of akathisia related to the new medication?

Answer: B

Explanation:
The Barnes Akathisia Rating Scale (BARS) is a clinician-administered assessment tool used to rate both subjective and objective symptoms of motor restlessness in patients receiving psychotropic medications.
The Clinical Opiate Withdrawal Scale (COWS) measures symptoms of withdrawal from opiates. The CAGE-AID is a screening tool for alcohol withdrawal symptoms. The Mini Mental State Examination (MMSE) assesses cognition.


NEW QUESTION # 1239
Which of the following amino acids is implicated in bipolar disorder, seizures, and schizophrenia?

Answer: C

Explanation:
Glutamate is also known as the universal excitatory neurotransmitter and has been connected to bipolar disorder, seizures, mood imbalance, and schizophrenia.
Aspartate is another excitatory neurotransmitter and works in conjunction with glutamate. GABA and glycine are inhibitory neurotransmitters.


NEW QUESTION # 1240
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