Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 26-year-old female patient reports 1 week of an elevated and expansive mood. Along with other symptoms, evidence of which of the following would suggest she is experiencing a hypomanic, not a manic, episode?
A. Decreased need for sleep
Decreased need for sleep can be present in both hypomania and mania; it does not differentiate the two.
B. Irritability
Irritability is also common in both hypomanic and manic episodes and is not specific for hypomania.
C. Psychotic symptoms
Psychotic symptoms, such as delusions or hallucinations, are indicative of mania, not hypomania.
D. Increased productivity at work
Increased productivity, heightened energy, and elevated mood without significant functional impairment or psychotic features suggest a hypomanic episode rather than full mania.
This question is an excerpt from Nurse Dive's nursing test bank - Mental Health Northern Kentucky University Proctored Exam 6. Take the full exam now
Full Explanation
Choice A reason: Decreased need for sleep can be present in both hypomania and mania; it does not differentiate the two.
Choice B reason: Irritability is also common in both hypomanic and manic episodes and is not specific for hypomania.
Choice C reason: Psychotic symptoms, such as delusions or hallucinations, are indicative of mania, not hypomania.
Choice D reason: Increased productivity, heightened energy, and elevated mood without significant functional impairment or psychotic features suggest a hypomanic episode rather than full mania.
Similar Questions
A mom brings her 13-year-old daughter to the PMHNP for an evaluation of suspected attention-deficit hyperactivity disorder (ADHD). For an adolescent who presents with distractibility, which of the following additional features would suggest an association with bipolar II disorder rather than ADHD?
A. A report of less need for sleep
Reduced need for sleep is a hallmark feature of hypomanic episodes in bipolar disorder and is not typical of ADHD.
B. Evidence that the symptoms are episodic
Symptoms that occur episodically rather than consistently over time suggest a mood disorder rather than a chronic condition like ADHD.
C. Rapid speech noted on examination
Rapid speech can occur in both ADHD and hypomanic episodes, making it less specific.
D. Complaints of racing thoughts
Racing thoughts are characteristic of hypomanic episodes in bipolar disorder, helping distinguish it from ADHD.
Full Explanation
Choice A reason: Reduced need for sleep is a hallmark feature of hypomanic episodes in bipolar disorder and is not typical of ADHD.
Choice B reason: Symptoms that occur episodically rather than consistently over time suggest a mood disorder rather than a chronic condition like ADHD.
Choice C reason: Rapid speech can occur in both ADHD and hypomanic episodes, making it less specific.
Choice D reason: Racing thoughts are characteristic of hypomanic episodes in bipolar disorder, helping distinguish it from ADHD.
A 41-year-old Malaysian man is referred to the PMHNP following an incident at work. He says a coworker insulted him, and the next thing he knows the police were called. He does not remember attacking the coworker, but he was arrested for assault. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?
A. Ataque de nervios
Ataque de nervios is common in Latin American cultures and involves intense emotional upset with crying, trembling, and verbal or physical aggression, often in response to a stressor, but usually within a family context.
B. Khayal
Khayal is a Southeast Asian cultural syndrome involving anxiety with physical symptoms like palpitations and dizziness, not violent outbursts.
C. Possession syndrome
Possession syndrome involves acting under the control of a spirit or external entity but is distinct from culturally recognized violent episodes such as amok.
D. Amok
Amok is a culture-bound syndrome observed in Malaysia and other Southeast Asian regions, characterized by sudden, dissociative episodes of violent behavior, often followed by amnesia for the event. This aligns with the patient's presentation.
Full Explanation
Choice A reason: Ataque de nervios is common in Latin American cultures and involves intense emotional upset with crying, trembling, and verbal or physical aggression, often in response to a stressor, but usually within a family context.
Choice B reason: Khayal is a Southeast Asian cultural syndrome involving anxiety with physical symptoms like palpitations and dizziness, not violent outbursts.
Choice C reason: Possession syndrome involves acting under the control of a spirit or external entity but is distinct from culturally recognized violent episodes such as amok.
Choice D reason: Amok is a culture-bound syndrome observed in Malaysia and other Southeast Asian regions, characterized by sudden, dissociative episodes of violent behavior, often followed by amnesia for the event. This aligns with the patient's presentation.
For a 39-year-old woman with a recent diagnosis of psoriatic arthritis who is treatment-naive with mild disease, which of the following would be considered an appropriate first-line therapy?
A. Intra-articular glucocorticoids
Intra-articular glucocorticoids may be used for flare management in specific joints but are not first-line systemic therapy for mild psoriatic arthritis.
B. NSAIDs
NSAIDs are first-line therapy for mild psoriatic arthritis, providing anti-inflammatory and analgesic effects without the risks associated with immunosuppressants.
C. Opioids
Opioids are not recommended for arthritis management due to risk of dependence and do not address inflammation.
D. Pregabalin (Lyrica)
Pregabalin is indicated for neuropathic pain, not inflammatory arthritis, and is not appropriate for first-line treatment of psoriatic arthritis.
Full Explanation
Choice A reason: Intra-articular glucocorticoids may be used for flare management in specific joints but are not first-line systemic therapy for mild psoriatic arthritis.
Choice B reason: NSAIDs are first-line therapy for mild psoriatic arthritis, providing anti-inflammatory and analgesic effects without the risks associated with immunosuppressants.
Choice C reason: Opioids are not recommended for arthritis management due to risk of dependence and do not address inflammation.
Choice D reason: Pregabalin is indicated for neuropathic pain, not inflammatory arthritis, and is not appropriate for first-line treatment of psoriatic arthritis.