NP Mental Health & Psychiatric NP 3

Question 1

An 80-year-old patient develops sudden-onset confusion, disorientation, and fluctuating consciousness over hours after hip surgery. This presentation is most consistent with:

Accepted Answer

Delirium

Answer

Delirium is characterized by acute onset, fluctuating course, and impaired attention, typically triggered by a medical cause such as surgery, infection, or medication.

Question 2

A patient with borderline personality disorder frequently alternates between idealizing and devaluing the NP during clinical encounters. This pattern is best described as:

Accepted Answer

Splitting

Answer

Splitting is the hallmark defense mechanism in BPD, in which individuals view people as either all good or all bad without integration of both qualities.

Question 3

A patient with alcohol use disorder desires to maintain sobriety after detoxification. Which medication works by blocking opioid receptors to reduce alcohol craving and reward?

Accepted Answer

Naltrexone (Vivitrol)

Answer

Naltrexone is an opioid antagonist that blocks the euphoric and reinforcing effects of alcohol by antagonizing mu-opioid receptors involved in dopamine reward pathways.

Question 4

A patient on clozapine develops high fever, muscle rigidity, altered consciousness, and autonomic instability. Which condition must be immediately suspected?

Accepted Answer

Neuroleptic malignant syndrome (NMS)

Answer

NMS is a rare but life-threatening reaction to antipsychotics characterized by hyperthermia, lead-pipe rigidity, autonomic instability, and altered consciousness.

Question 5

A patient taking sertraline is started on tramadol by another provider and presents with agitation, diaphoresis, tremor, clonus, and hyperthermia. What is the most likely diagnosis?

Accepted Answer

Serotonin syndrome

Answer

Serotonin syndrome results from excess serotonergic activity, classically presenting with the triad of altered mental status, autonomic dysfunction, and neuromuscular abnormalities including clonus.

NP - Nurse Practitioner Practice Test

NP - Nurse Practitioner Practice Test

NP Mental Health & Psychiatric NP 3