Question 1          

A PMHNP is treating a 45-year-old female patient who is upset that her brother has not been calling since his divorce. When asked to describe her brother and what prompts him not to call as frequently, she says, “Everything is about him, not me. I think he’s jealous that I have a good marriage and he wants me to be unhappy, too. So he doesn’t call to upset me and ruin my relationships.” Based on this information, the PMHNP can conclude that the patient _________.                                         

A. may lack ability to see independent motivations

B. has an insistent emphasis on the feelings of others

C. has an intrusive interpersonal relationship

D. all of the above      

Question 2

When a PMHNP is seeing a patient for the first time, what is an important step to assure that the patient and provider understand the limits of their discussion?

A. Assure the patient that she is safe to discuss her secrets

B. Talk about the importance of being truthful andopen

C. Have a discussion about the confidentiality andits limits

D. Mention the possible need for selective self-disclosure

Question 3          

You are seeing a 29-year-old widow whose husband recently died overseas while serving his country in the military. She has been mourning the loss of her husband for several months, and continues to grieve. She refuses to go to group grieving sessions, but reports that she is still able to go to work and her fitness classes sometimes, and even makes attempts to stay social. She says, “Sometimes it’s like he’s not even gone. Other times it feels like it’s been an eternity since I’ve seen him. It’s hard to talk about this type of stuff with my girlfriends, especially since all of their husbands are still alive.” The PMHNP understands that it is appropriate to employ which therapeutic principle?

A. Encouraging catharsis

B. Encouraging abreaction to repressed feelings

C. Identifying conflict-resolution techniques

D. All of the above

Question 4          

The PMHNP is treating a 35-year-old male officer in the military. He discloses that both of his parents are deceased and that he loved them. However, he says that he had feelings of inadequacy because his parents held him to a standard that he could never achieve. He went on to say that nothing he did ever felt good enough. The PMHNP assesses that this patient has perfect creases in his uniform with no strings or tags out of place; she also notices that he has perfect posture and questions him about ritualistic behaviors. She suspects that this patient has maladaptive responses to the expectations placed on him as a teenager and young adult. Which statements made by the patient would verify the PMHNP’s suspicion?

A.”I typically don’t listen to anyone. I take care of my own wants and needs so I feel like no one can judge me or criticize me, period.”

B.”I don’t mean to hurt other people’s feelings. When people cry or say that I have made them upset in some way, that’s not my fault; some people are just sensitive.”

C.”I like to listen to the beat of my own drum; I don’t mind spending most of my days alone. I don’t need recognition or praise; I would just like to be left alone.”

D.”I believe in systems; I have to have order and rules in my everyday life. If a task must be completed, I will often complete it myself versus depending on someone else.”

Question 5          

The PMHNP is working with a patient who experiences anxiety around her parents that later leads to poor impulse control. What will the PMHNP do to employ psychodynamic psychotherapy properly for this patient?              

A. Emphasize the past

B. Focus on expressions of emotion

C. Identify patterns in relationships

D. All of the above

Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system.

 For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the “Advocacy Through Legislation” template to complete this assignment. You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.  

Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system.

 For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the “Advocacy Through Legislation” template to complete this assignment. You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.  

The Assignment: 5 pages

Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

• Briefly explain and summarize the      case for this Assignment. Be sure to include the specific patient factors      that may impact your decision-making when prescribing medication for this      patient.

Decision #1 (1 page)

• Which decision did you select?
• Why did you select this decision? Be      specific and support your response with clinically relevant and      patient-specific resources, including the primary literature.
• Why did you not select the other two      options provided in the exercise? Be specific and support your response      with clinically relevant and patient-specific resources, including the      primary literature.
• What were you hoping to achieve by      making this decision? Support your response with evidence and references      to the Learning Resources (including the primary literature).
• Explain how ethical considerations      may impact your treatment plan and communication with patients. Be      specific and provide examples.

Decision #2 (1 page)

• Why did you select this decision? Be      specific and support your response with clinically relevant and      patient-specific resources, including the primary literature.
• Why did you not select the other two      options provided in the exercise? Be specific and support your response      with clinically relevant and patient-specific resources, including the      primary literature.
• What were you hoping to achieve by      making this decision? Support your response with evidence and references      to the Learning Resources (including the primary literature).
• Explain how ethical considerations      may impact your treatment plan and communication with patients. Be      specific and provide examples.

Decision #3 (1 page)

• Why did you select this decision? Be      specific and support your response with clinically relevant and      patient-specific resources, including the primary literature.
• Why did you not select the other two      options provided in the exercise? Be specific and support your response      with clinically relevant and patient-specific resources, including the      primary literature.
• What were you hoping to achieve by      making this decision? Support your response with evidence and references      to the Learning Resources (including the primary literature).
• Explain how ethical considerations      may impact your treatment plan and communication with patients. Be      specific and provide examples.

Conclusion (1 page)

• Summarize your recommendations on the      treatment options you selected for this patient. Be sure to justify your      recommendations and support your response with clinically relevant and      patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources.  

 In 2004, the Healthy People Curriculum Task Force emphasized that ” an essential element of any effort to change a health care system must be the education of future clinicians who will practice new approaches in new contexts”. Based on this statement, is there a need for healthcare professional education reform? To what end?