Psychiatric-Mental Health Nurse Practitioner Exam Special Populations in Psychiatric Care 2

Question 1

A PMHNP assessing an older adult for dementia versus depression should recognize that pseudodementia (depression presenting as cognitive decline) most commonly presents with:

Accepted Answer

Acute onset, awareness of deficits, and mood symptoms preceding cognitive changes

Answer

Insidious onset and no subjective complaints

Answer

Normal mood and sleep patterns

Answer

Confabulation as a primary feature

Question 2

When treating an autistic patient with psychiatric comorbidities, which communication strategy is most appropriate?

Accepted Answer

Use clear, literal, concrete language and provide structure

Answer

Use metaphors and abstract language for better engagement

Answer

Avoid written instructions to prevent overwhelm

Answer

Focus sessions on emotional expression only

Question 3

A PMHNP treating a transgender patient should understand that gender dysphoria refers to:

Accepted Answer

Clinically significant distress resulting from incongruence between assigned sex and gender identity

Answer

A mental illness caused by gender identity

Answer

Refusal to accept biological sex

Answer

A personality disorder variant

Question 4

Which eating disorder is characterized by recurrent binge eating without compensatory behaviors and is the most prevalent eating disorder in the US?

Accepted Answer

Binge-eating disorder (BED)

Answer

Anorexia nervosa

Answer

Bulimia nervosa

Answer

Avoidant/restrictive food intake disorder

Question 5

A PMHNP working with veterans notes that moral injury differs from PTSD in that moral injury primarily involves:

Accepted Answer

Guilt, shame, and spiritual distress from actions violating personal moral code

Answer

Intrusive flashbacks and nightmares

Answer

Hyperarousal and startle response

Answer

Avoidance of trauma reminders

Question 6

When prescribing psychotropics to elderly patients, the PMHNP should follow the Beers Criteria, which primarily warns against using:

Accepted Answer

Benzodiazepines, anticholinergics, and first-generation antipsychotics due to fall and cognitive risks

Answer

SSRIs for all elderly patients

Answer

All antipsychotics regardless of indication

Answer

Lithium in any patient over 65