NR528 Leading and Managing Evidence-based Change in Nursing

  

Week 1 Quiz Question 1American psychologist Edward L. Thorndike described: Select one:  a.Drive reduction theory  b.Behaviorism  c.Trial-and-error learning  d.Respondent behavior  e.Operant behavior Question 2Attachment theory states that: Select one: a.Infants are generally polytropic in their attachments  b.Attachment disorders may lead to failure to thrive  c.Attachment occurs instantaneously between the mother and the child  d.Attachment is synonymous with bonding  e.Separation anxiety is most common when an infant is 5 months old Question 3Erikson differs from Freud by his placing greater emphasis on: Select one:  a.Interpersonal relationships  b.Cultural factors in development  c.Instinctual drives  d.Psychosexual development  e.Object relations Question 4In which of the following age groups is the stage of preoperational thought present? Select one:  a.Birth to 2 years  b.Ages 2 to 7 years  c. Ages 7 to 11 years  d.Age 11 through the end of adolescence  e.None of the above Question 5The PMHNP is discussing medication management with a 16 y/o adolescent. It is important to remember that adolescents are often resistant to complying with medications for which of the following reasons? Select one:  a.The success of anti-drug education  b.Side effects  c.Resistance to the perceived control by authority figures d.A resurgence of interest in natural medicines     Week 2 Quiz Question 1According to Prochaska and DiClemente Change Theory, at what stage of change would ambivalence be evident? Select one:  a.Contemplation  b.Action  c.Denial d.Precontemplation Question 2As a practicing PMHNP, you diagnose a patient with polysubstance dependence and decide to proceed with motivational interviewing (MI). MI incorporates all of the following principles EXCEPT ________. Select one:  a.expressing empathy  b.giving advice c.developing discrepancy  d.rolling with resistance  e.supporting self-efficacy Question 3Match the following statement with the appropriate leadership skill term: To let clients know they are heard and understood beyond the level of words requires Select one:  a.Active listening  b.Restating  c.Clarifying  d.Empathizing e.Reflecting feelings Question 4Several communication styles are key to the spirit of MI. Select the one that is the most likely to contribute to resistance. Select one:  a.Guiding  b.Focusing  c.Following  d.Directing Question 5The PMHNP knows that an essential component embedded in the role and scope of practice is critical thinking. Critical thinking ________. (Choose all that apply.) Select one or more:  a.is defined as rehabilitative services  b.entails making clinical decisions based on evidence-based practice  c.develops self-awareness by a metacognitive mechanism to gather additional insights about one’s self  d.None of the answers is .   Week 3 Quiz Question 1All of the following regarding Postpartum Depression are true except: Select one:  a.May last months to years if untreated  b.Occurs within 3-6 months post deliver  c.Is associated with a history of a mood disorder d.Is rarely associated with feelings of guilt or inadequacy Question 2All of the following regarding the “Baby Blues” are true except: Select one:  a.Occur in up to 50% of women who give birth  b.Occurs 3-5 days post delivery  c.Are associated with a history of a mood disorder  d.Can cause sleep disturbance Question 3Research has shown that children of mothers with Borderline Personality are more likely to exhibit all of the following except: Select one:  a.Higher rates of emotional and behavioral problems  b.Higher rates of psychiatric disorders  c.Disorganized attachment to the mother at one year of age  d.Successful interpersonal functioning Question 4Spouse abuse is: Select one:  a.Carried out by spouses who tend to be independent and assertive  b.A recent phenomenon  c.Least likely to occur if a woman is pregnant  d.Directed at specific actions of the spouse Question 5The following screening tool is routinely used to screen for depression in the perinatal setting. Select one:  a.Mood Disorder Questionnaire (MDQ)  b.Edinburgh Postnatal Depression Scale (EPDS)  c.Connors’ Rating Scales  d.Ham-A Rating Scale   Week 4 Quiz Question 1A 14-year-old boy is brought to the ED by the police after the boy assaulted a passerby. The patient is slurring his speech and appears unsteady. On physical exam, he is found to have nystagmus, generalized muscle weakness, and depressed reflexes. He is sluggish and complains that he is seeing double. Which substance is most likely causing his intoxication syndrome? Select one:  a.Inhalants  b.Stimulants  c.Alcohol d.Amphetamines  e.Hallucinogens Question 2A key indicator of addiction that can be applied when assessing a client for substance use is ________. Select one:  a.calling in sick every Monday morning  b.loss of control over frequency or amount of use c.bragging about the amount of alcohol consumed  d.having withdrawal symptoms when use is stopped  e.None of the answers is . Question 3A PMHNP notices that few substance abuse treatment programs apply evidence-based practice. The PMHNP wants to initiate such a treatment program to ________. Select one:  a.implement the use of valid instruments  b.improve outcomes through analysis and synthesis of evidence c.maximize interventions and increase skill utilization  d.optimize revenue-generating potential Question 4A screening tool developed specifically to screen adolescents for high risk alcohol and other drug use is ________. Select one:  a.PACES  b.HEEADSSS  c.CRAFFT d.M-CHAT  e.None of the answers is . Question 5Although your client denies any significant drug use, he comes to his appointment today with symptoms of nausea, muscle cramping, agitation, and anxiety. Your first thought, given his history of substance abuse, is ________. Select one:  a.opiate addiction b.marijuana intoxication  c.alcohol intoxication  d.opiate withdrawal     Week 5 Quiz Question 1A 13-year-old girl’s family brings her to treatment against her wishes. The family reports that she is very short tempered, always arguing at home and with teachers, and blames them (teachers and parents) for the behaviors she’s exhibiting. She denies being depressed or anxious. No psychotic symptoms are reported. Based on the information you have, what might be the best diagnosis at this time? Select one:  a.Antisocial personality disorder  b.Conduct disorder  c.Oppositional Defiant Disorder d.Borderline Personality Disorder Question 2According to Erikson, what is the maladaptive function of adolescence? Select one:  a.Despair  b.Inferiority  c.Stagnation  d.Role confusion e.Isolation Question 3When reviewing the history of a child with ADHD the PMHNP will find that in order to meet DSM-5 criteria, the hyperactive-impulsive or inattention symptoms causing impairment must occur before which age? Select one:  a.Four  b.Seven  c.Nine  d.Twelve Question 4When talking to parents who have brought their child in to see you for what they believe might be ADHD, you inform them that ________. Select one:  a.the incidence of ADHD is estimated to be 25-35% of U.S. school age children  b.this disorder will definitely lead to difficulties with academics and substance abuse and probably employment issues  c.it is equally common in boys and girls  d.the pathology of the disease is not clear Question 5When the PMHNP talked with the parents of her 7-year-old client about ADHD, she shared that the incidence of occurrence in males ________. Select one:  a.is equal to that of females  b.falls below that of females  c.is double that of females d.exceeds that of females by a 4-to-1 ratio   Week 6 Quiz Question 1A tell-tale sign that indicates trauma or psychopathology has taken place is ________. Select one:  a.a change in school performance  b.a change in behavior at home  c.a change in usual behavior  d.a change from usual behavior  e.All of the answers are . Question 2Evidence-based literature supports which of the following therapeutic approaches for PTSD? Select one:  a.Reminiscence therapy  b.Schema therapy  c.Music therapy  d.Cognitive behavior therapy e.None of the answers is Question 3Posing questions in a direct way can help to normalize a traumatic event. This can lead to ________. Select one:  a.nondisclosure of maltreatment  b.disclosure of maltreatment  c.developing mental illness  d.avoiding answers that describe specific details   e.All of the answers are . Question 4Risk factors associated with intimate partner violence includes all the following EXCEPT ________. Select one: a.younger age  b.being a victim of physical or psychological abuse  c.history of experiencing physical discipline as a child d.childhood abuse or witness to partner abuse  e.All of the answers are . Question 5The brain structure associated with memory is the ________. Select one:  a.frontal cortex  b.amygdala  c.hippocampus d.hypothalamus   Week 7 Quiz Question 1According to the DSM-5, PTSD diagnosis must have all of the following characteristics EXCEPT ________. Select one:  a.one or more reexperiencing symptoms  b.one or more avoidance symptoms  c.two or more hyperarousal symptoms  d.two or more negative cognition symptoms  e.symptom must be present for less than 1 month and cause extreme stress Question 2Following are some of the main findings from the epidemiological research on PTSD. All are true EXCEPT ________. Select one:  a.the majority of people will experience at least one traumatic event in their lifetime  b.intentional acts of interpersonal violence, in particular sexual assault, and combat are more likely to lead to PTSD than accidents or disasters  c.men tend to experience more traumatic events than women, but women experience higher impact events (that is, events that are more likely to lead to PTSD)  d.children are not at risk to experience PTSD Question 3People at risk of PTSD include all of the following EXCEPT ________. Select one:  a.victims of violent crime (such as physical and sexual assaults, sexual abuse, bombings, and riots)  b.members of the armed forces, police, and prison service; journalists; fire service members; ambulance and emergency personnel, including those no longer in service  c.victims of war, torture, state-sanctioned violence or terrorism, and survivors of accidents or disasters  d.women following traumatic childbirth and individuals diagnosed with a life-threatening illness  e.All of the answers are . Question 4Research informs us that many children in classrooms across America have experienced at least one traumatic event. The term trauma is used to describe an event, series of events, or set of circumstances that is experienced as physically or emotionally harmful or life threatening and that has lasting adverse effects on daily functioning and mental, physical, social, emotional, or spiritual well-being (SAMHSA, 2014). Which of the following statements is FALSE about children and trauma events? Select one:  a.In the United States, more than two-thirds of children report the experience of a traumatic event by age 16.  b.In school settings, one out of four children has been exposed to a traumatic event. Approximately two out of three children has been exposed to violence.  c.Half of children who were victimized reported more than one type of victimization.  d.1 in 6 children report 6 or more exposures to violence.  e.All of these answers are True. Question 5Select which of the following statements is TRUE in regards to a child’s reaction to disasters. Select one:  a.PTSD symptoms typically arise within 6 months of the disaster.  b.PTSD symptoms usually increase over time.  c.Major depression occurs more often than PTSD.  d.Behavior problems can improve subsequent a disaster.  e.All of the answers are .           Week 8 Quiz Question 1Which of the following is a tool for collecting and organizing key relationships in a three-generational extended family? Select one:  a.Lifestyle assessment  b.Family sketch  c. Question 2Which of the following is not a basic characteristic of behavior therapy? Select one:  a.Treatment goals are specific and concrete.  b.It is grounded in learning theory.  c.Many specific techniques are supported by research.  d.The therapist is manipulative and controlling. Feedback Your answer is in. The  answer is: The therapist is manipulative and controlling. Question 3Which of the following is true regarding major depressive disorder in school-aged children? Select one:  a.May present as irritable mood rather than depressed mood  b.Usually includes pervasive anhedonia  c.Includes mood-congruent auditory hallucinations less commonly than in adults with the same disorder  d.Symptoms mirror those in adults Question 4What is the most frequent presenting complaint of parents about their child when suspecting a diagnosis of autism? Select one:  a.Their lack of usual play skills  b.Delays in acquisition of language  c.Stereotyped movements  d.Their lack of interest in social interaction Question 5Which of the following characteristics does not necessarily present in fetal alcohol syndrome? Select one:  a.Heart defects  b.Facial dysmorphology  c.Growth retardation  d.Central nervous system dysfunction   Week 9 Quiz Question 1According to the DSM-5, the criteria for insomnia disorder include “notable dissatisfaction with sleep quality or quantity” associated with which of the following? Select one:  a.Difficulty initiating sleep  b.Difficulty maintaining sleep  c.Early morning awakening  d.Minimum of 3 times per week for 3 months  e.All of these answers are . Question 2All of the following psychiatric disorders can induce insomnia EXCEPT ________. Select one:  a.mania  b.schizophrenia  c.depression  d.anxiety disrders  e.All of the answers are . Question 3Brief behavioral therapy for insomnia includes which of the following? Select one:  a.Limit time in bed to estimated sleep time plus 30 minutes  b.Keep the same rise time every day, regardless of sleep duration  c.Only go to bed when sleepy  d.Avoid naps e.All of these answers are . Question 4Components of sleep hygiene for insomnia includes all of the following EXCEPT _____? Select one:  a.Reduce time in bed  b.Use the bed only for sleep or sexual activity (nothing else)  c.Practice meditation  d.Limit caffeine and alcohol  e.Increase exercise right before bedtime Question 5Deanna is a patient who is having trouble sleeping, but she declines to use “Western medicine” drugs. Select the following dietary supplement/herbs that may be helpful to improve her sleep health. Select one:  a.Lemon balm  b.Chamomile  c.Melatonin  d.Valerian Root  e.All these supplements may improve sleep health.   Week 10 Quiz Question 1A 73-year-old man presents with his wife for evaluation of cognitive function. Although he is pleasant and cooperative, his wife is concerned because she can’t “trust him” anymore. She describes an incident where she left him sitting alone in the shopping mall while she returned an item to the store. When she came back he was at a table of young women discussing plans to go out with them. She also describes being embarrassed because he will often pat the backside of strange women. One condition that is at the top of your differential list is ________. Select one: a.cluster B personality disorder  b.frontal lobe dysfunction c.Alzheimer’s dementia  d.temporal lobe epilepsy  e.None of these answers is . Question 2As a PMHNP, you know that normal aging is associated with memory performance and cognitive speed changes. Which of the following best describes this process? Select one: a.Crystallized intelligence is the short-term portion of one’s memory and remains stable as we age.  b.Fluid intelligence and problem-solving abilities often improve with age.  c.Crystallized intelligence is one’s lifetime of intellectual achievement and general fund of knowledge. This remains stable as we age. d.The capacity to recognize words and name items begins to fail during the fourth decade. Question 3In mild cognitive impairment (MCI), there is likely to be ________. Select one:  a.serious social and vocational disability  b.pronounced impairment of instrumental activities of daily living (IADLs)  c.deficits in memory d.wandering and disorientation Question 4Mild cognitive impairment (MCI) is now thought to occur at least a decade before the actual presentation of symptoms. Which of the following best describes this phenomenon? Select one:  a.The cognitive decline is greater than expected for the patient’s age and educational level. b.MCI is not implicated in the transition to a more serious form of dementia.  c.MCI consists only of objective data.  d.Activities of daily living (ADLs) are always affected. Question 5The goal of treatment for major and mild neurocognitive disorders includes which of the following? Select one:  a.Stabilize symptoms  b.Enhance quality of life  c.Support the caregivers  d.Enhance independence  e.All of these answers are .   Week 11 Quiz Question 1A client tells you the following: “I started my new job and right away, my boss starts giving me a hard time. I bet he is an unhappy and angry person. You know, when he hired me I had a sense he was unhappy. He told me that he was going on a business trip and that I would be unsupervised for the next two weeks.” You notice that almost none of this communication has to do with the client. A useful way to think about this communication is ____. Select one:  a.to conclude that the client is actually the one who is unhappy and angry  b.to wonder about what the client is leaving out c.to conclude that the client has a hard time fitting into new situations  d.to consider the symbolic meaning of “boss” Question 2A PMHNP therapist has the sense that the client is not making wise decisions about her current romantic relationship, and tends to believe that the client will never be able to appreciate the thoughts and feelings of her partner. The client would like to stay with her current partner and says they are generally doing well, but that they are having communication problems about household chores. What is the best approach for the helper to take? Select one:  a.Attend to the client’s strengths and misused opportunities. b.Transfer the client.  c.Evaluate the client for personality disorders.  d.Ask the client to leave her partner.  e.None of these answers is . Question 3According to Carl Rogers, empathic listening means ____. Select one:  a.entering the private perceptual world of the client and becoming thoroughly at home in it b.being in control of the client at all times  c.reading the client’s unconscious messages through their facial expressions  d.being genuine in your response to what you hear the client saying  e.all of these answers are Question 4From the perspective of positive psychology, a PMHNP therapist should always listen to the client for ____. Select one:  a.comments that are optimistic  b.client strengths, opportunities, and resources c.information that will lead to positive growth  d.comments that interrupt the flow of discussion Question 5How can helpers best avoid information overload? Select one:  a.By identifying key messages and feelings b.By taking notes  c.By asking the client to focus only on what is most important  d.By gently and respectfully asking the client to refrain from speaking too much   e.All of these answers are   Week 12 Quiz Question 1Distress experienced by some individuals whose gender identity does not correspond with their assigned sex at birth. Select one:  a.Gender dysphoria b.Gender binary  c.Heteronormativity  d.Homophobia Question 2Intersex refers to: Select one:  a.A rare condition where the sex organs do not develop as expected  b.Hermaphrodites  c.The LGBTQ+ community  d.Involuntary or unwanted disclosure about sexuality Question 3Organizational strategies to overcome barriers to healthcare in LGBTQ+ identifying youth are: Select one:  a.Develop office policy in compliance with local laws regarding confidentiality for unemancipated minors  b.Train all staff on LGBT health and competencies  c.Display posters or flyers that include LGBTQ youth, samesex couples, and symbols  d.All of the above Question 4Sexual orientation is: Select one:  a.How a person characterizes their emotional and sexual attraction to others b.The way a person looks  c.When a person transitions to the opposite gender  d.How a heterosexual identifying person relates to the opposite sex Feedback Your answer is . The  answer is: How a person characterizes their emotional and sexual attraction to others Question 5STI screening and HIV testing should be performed every 3-6 months for those who: Select one:  a.Have multiple or anonymous sexual partners.  b.Use illicit drugs (especially methamphetamine) in conjunction with sex.  c.Have sex partners who engage in any of the above.  d.All of the above   Week 13 Quiz Question 1Which of the following statements is not true about guidelines for ethical practice in counseling and psychotherapy? Select one:  a.Most professional organizations provide broad guidelines.  b.Therapists ultimately have to discover their own guidelines for reasonable practice.  c.Practitioners are free to formulate any ethics they choose. d.Ethical issues should be periodically reexamined throughout your professional life. Question 2Human change is complex and difficult to measure beyond such a simplistic level that the change may be meaningless. Select one:  True  False Question 3Behavior therapy has been criticized for a variety of reasons. Which of the following is one listed in the book? Select one: a.Behavior therapy has an overemphasis on feeling and the neglect of cognition.  b.Behavior therapy has an overemphasis upon insight.  c.Behavior therapy may change behaviors, but it does not change feelings. d. Behavior therapy has a need for long-term treatment to effect change. Question 4Multimodal therapy is a therapeutic approach that is grounded on: Select one:  a.cognitive behavior therapy.  b.social cognitive learning theory. c.applied behavior analysis.  d.operant conditioning. Question 5The cognitive distortion that consists of forming conclusions based on an isolated detail of an event is: Select one:  a.labeling and mislabeling.  b.overgeneralization.  c.arbitrary inferences.  d.selective abstraction.   Week 14 Quiz Question 1During her sessions, Justine questions whether she is trying to meet her clients’ needs or her own needs. Justine is: Select one:  a.being overly analytical.  b.actively working toward expanding her self-awareness and learning to recognize her areas of prejudice and vulnerability. c.self-absorbed and insecure.  d.behaving unethically since she is preoccupied during her clients’ sessions. Question 2The ethics codes mandate avoidance of all dual or multiple relationships. Select one:  True  False Question 3Behavior therapists look to the current environmental events that maintain problem behaviors and help clients produce behavior change by changing environmental events, through a process called: Select one:  a.functional assessment. b.motivational interviewing.  c.mindfulness-based stress reduction.  d.reorientation. Question 4In terms of ethical accountability, behavior therapy: Select one:  a.does not address this issue.  b.is ethically neutral in that it does not dictate whose behavior or what behavior should be changed. c.offers a greater chance of abusing interventions than do other approaches.  d.makes use of techniques that have questionable validity. Question 5The four steps of the strengths-based CBT application of the NEW paradigm for chronic issues and personality disorders include all of the following, except: Select one:  a.conceptualize the OLD system of operating and help clients understand they do things “for good reasons.”  b.construct NEW systems of how clients would like to be.  c.strengthen the NEW using behavioral experiments to try on NEW ways of being and edit them as needed.  d.strength training.

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