A 19-year-old male is in your office for evaluation of profound anxiety. He is in his first year of college and last week there was an active shooter on campus. Three people were killed. Although he didn’t know any of them, it was in the building where he has one of his classes and he is having severe anxiety and nightmares. He gets profoundly distressed when discussing this with anyone, he feels detached from his friends and even his family, is having trouble sleeping, and finds himself getting angry with everyone for no good reason. The PMHNP explores for additional symptoms to support a diagnosis of:

A. Post traumatic stress disorder

B. Acute stress response

C. Dissociative disorder

D. Panic disorder

The PMHNP is asked to evaluate a 5-year-old child who has been having difficulty adjusting to kindergarten and has been disruptive in the classroom. The child is pleasant in the office, responds to questions, and seems to understand that she is having this appointment because she does not seem happy in kindergarten. Via role play and discussion the PMHNP learns that the child is sad and frightened because she was angry with her Daddy and wished he didn’t live there anymore. Very shortly thereafter, her parents told her that Daddy would be moving out. Daddy moving out made Mom sad, the 5-year-old thinks it’s all her fault. This is why she is so unhappy. This is characteristic of which of Piaget’s developmental stages?

A. Sensorimotor

B. Preoperational

C. Concrete operational

D. Formal operational
---
YouTube: https://www.youtube.com/watch?v=qmn1sXSUmTI&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=39

While performing a mental status exam, the PMHNP asks the patient to count backwards, beginning with 100 and subtracting 7. This is an effort to assess which element of the mental status exam?

A. Concentration

B. Orientation

C. Visuospatial function

D. Recall
---
YouTube: https://www.youtube.com/watch?v=p3x-HNGaWXY&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=38