APEA Mental Health in Primary Care 5

Question 1

An 82-year-old hospitalized with pneumonia develops acute confusion that waxes and wanes, with poor attention and disturbed sleep-wake cycle. Which diagnosis best fits?

Accepted Answer

Delirium

Answer

Acute onset, fluctuating course, and inattention distinguish delirium from dementia.

Question 2

A patient with heavy daily alcohol use stops drinking. When is the risk of alcohol withdrawal seizures greatest?

Accepted Answer

Within 6 to 48 hours after the last drink

Answer

Withdrawal seizures typically occur within 6-48 hours, whereas delirium tremens usually appears at 48-96 hours.

Question 3

When nutrition is restarted in a severely malnourished patient with anorexia nervosa, which electrolyte abnormality is the hallmark of refeeding syndrome?

Accepted Answer

Hypophosphatemia

Answer

Insulin release during refeeding moves phosphate into cells, causing dangerous hypophosphatemia.

Question 4

A 16-year-old is started on fluoxetine for major depression. What does the FDA boxed warning require of the prescriber?

Accepted Answer

Close monitoring for worsening depression and suicidal thoughts, especially early in treatment

Answer

Antidepressants have a boxed warning for increased suicidality in patients under 25, so close monitoring is required, especially after starting or changing the dose.

Question 5

Before prescribing a stimulant for ADHD, which history item matters most to screen for?

Accepted Answer

Personal or family history of structural heart disease or sudden cardiac death

Answer

Stimulants raise heart rate and blood pressure, so cardiac risk factors should be assessed before starting.

APEA - Advanced Practice Education Associates Practice Test

APEA - Advanced Practice Education Associates Practice Test

APEA Mental Health in Primary Care 5