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
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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.
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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
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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®
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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.
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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
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YouTube: https://www.youtube.com/watch?v=6Z6t5IAVPpc&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=32

You are evaluating a 71-year-old female patient and have made a diagnosis of major depressive episode, moderate. The patient is agreeable to pharmacotherapy. When considering pharmacologic treatment options, you review her existing medication list for potential interactions and contraindications. Which of the following classes of medication might increase the patient’s risk of cognitive impairment with the addition of an SSRI?

A. A calcium channel blocker

B. An antiepileptic

C. A diuretic

D. A proton pump inhibitor
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YouTube: https://www.youtube.com/watch?v=HkgHo5uf0D8&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=31

Piaget’s sensorimotor stage of development is characterized by all of the following except:

A. Object permanence

B. Magical thinking

C. Exploring

D. Manipulating environment
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YouTube: https://www.youtube.com/watch?v=Z3amwp7QVzY&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=30