A 54-year-old Latino man receives a phone call that his mother has had a stroke and is in ICU at his local hospital. Soon after, he begins trembling, then shouting and screaming. The impression is that he is completely out of control. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?

Khayal

Ataque de nervios

Amok

Dhat

Answer and Explanation

The Correct Answer is B

Choice A reason: Khayal is a South Asian culture-bound syndrome associated with anxiety and somatic complaints, not acute episodes of shouting and aggression.

Choice B reason: Ataque de nervios is a Latino culture-bound syndrome triggered by acute stress or trauma, characterized by shouting, trembling, and emotional outbursts, matching this patient’s presentation.

Choice C reason: Amok is a Southeast Asian syndrome involving sudden aggressive outbursts, but it is culturally specific to Malaysia and the Philippines.

Choice D reason: Dhat is a South Asian culture-bound syndrome involving anxiety about semen loss, not acute aggressive episodes.

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Correct Answer is B

Explanation

Choice A reason: The triglyceride triad refers to elevated triglycerides, small dense LDL, and low HDL, which is part of metabolic syndrome but not the overall term.

Choice B reason: Metabolic syndrome is the correct term encompassing obesity, insulin resistance, dyslipidemia, and hypertension, which collectively increase the risk of cardiovascular disease, diabetes, and stroke.

Choice C reason: Cardiovascular cluster is not a standardized medical term.

Choice D reason: Endocrine failure refers to organ-specific hormonal insufficiency and is unrelated to metabolic syndrome.

A. Dexamethasone suppression test B. Liver function test C. CSF 5-HIAA level D. Thyroid function tests

Correct Answer is D

Explanation

Choice A reason: The dexamethasone suppression test is used primarily to assess for hypercortisolism or Cushing's syndrome, which is less commonly linked to mood cycling.

Choice B reason: Liver function tests are important for monitoring medication metabolism but are not typically used to identify the etiology of rapid cycling bipolar disorder.

Choice C reason: CSF 5-HIAA levels can reflect serotonin metabolism but are not standard for evaluating rapid cycling bipolar disorder and are rarely used in clinical practice.

Choice D reason: Thyroid dysfunction, including hyperthyroidism or hypothyroidism, can present with mood disturbances and contribute to rapid cycling in bipolar disorder; therefore, thyroid function tests are critical to rule out an underlying medical cause.

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Naxlex Comprehensive Predictor Exams

The factors that raise the risk for heart disease, diabetes, and stroke are collectively known as:

Correct Answer is B

Explanation

A 37-year-old man presents to the PMHNP based on a referral from his primary care physician, who suspects rapid cycling bipolar I disorder. Which of the following should be ordered to rule out an underlying medical etiology?

Correct Answer is D

Explanation

The PMHNP is working on an inpatient geropsychiatric unit. He is conducting the Montreal Cognitive Assessment (MoCA) on an 89-year-old woman with suspected dementia. He asks her to draw a clock to test her praxis abilities. Which area of the brain is responsible for this function?

The NP is providing teaching to a 53-year-old woman who was recently diagnosed with osteoporosis. Which statement by the woman would indicate a need for further teaching?

The PMHNP works on an inpatient geriatric psychiatric unit. She knows that which of the following features is commonly present in Lewy body dementia?

A 31-year-old woman with a history of intellectual disability and congenital heart defects presents to the nurse practitioner with new onset neurologic deficits. Magnetic resonance imaging is contraindicated in patients with a history of which of the following?

A 51-year-old woman is diagnosed with primary osteoarthritis (OA) of the knee. The NP will educate the woman that which of the following could have contributed to or might worsen her OA?

A 30-year-old woman who has tried for a year to become pregnant presents to the nurse practitioner, who diagnoses cervical stenosis as the probable cause of her infertility. Which is the most appropriate treatment?