The PMHNP is evaluating a 47-year-old man admitted to the substance abuse facility where she is rounding. His pulse is 105 and he is sweating. He has bilateral hand tremors and is nauseated, restless, and agitated. He says he has not slept in 24 hours. What is his most likely diagnosis?

Opioid withdrawal

Alcohol withdrawal

Sedative, hypnotic, or anxiolytic withdrawal

Stimulant withdrawal

Answer and Explanation

The Correct Answer is B

Choice A reason: Opioid withdrawal typically presents with symptoms such as muscle aches, diarrhea, rhinorrhea, and yawning. While restlessness and insomnia may occur, tremors and autonomic instability (e.g., elevated pulse and sweating) are more characteristic of alcohol withdrawal.

Choice B reason: Alcohol withdrawal is marked by autonomic hyperactivity (elevated pulse, sweating), tremors, nausea, agitation, and insomnia. These symptoms match the clinical presentation described. If untreated, it can progress to delirium tremens, which includes hallucinations and seizures.

Choice C reason: Sedative, hypnotic, or anxiolytic withdrawal (e.g., benzodiazepines) can resemble alcohol withdrawal but typically includes more pronounced anxiety, irritability, and risk of seizures. However, the classic signs of autonomic hyperactivity and tremors are more strongly associated with alcohol withdrawal.

Choice D reason: Stimulant withdrawal often includes fatigue, depression, increased appetite, and sleep disturbances. It does not typically present with tremors, autonomic instability, or nausea, making it less likely in this case.

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Correct Answer is A

Explanation

Choice A reason: The CRAFFT screening tool is specifically designed for adolescents and young adults to assess substance use and related risks. Asking question 1 — “Have you ever ridden in a Car driven by someone (including yourself) who was ‘high’ or had been using alcohol or drugs?” — is a developmentally appropriate and validated approach for this age group.

Choice B reason: The CAGE questionnaire is intended for adults and is less effective in identifying substance use issues in adolescents. It lacks the contextual sensitivity needed for youth screening.

Choice C reason: While offering advice may be helpful later, the priority is to assess the client’s own risk and exposure. Prematurely giving advice without screening may overlook important information.

Choice D reason: Moving on without screening would be inappropriate. Even if the client denies use, her concern about peers warrants further exploration using a validated tool like CRAFFT.

A. The independent variable (the treatment) caused a change in the dependent variable (the outcome). B. The sample is representative of the population and the results can be generalized. C. The P value is 0.1. D. The research has been accepted by a peer-reviewed journal.

Correct Answer is B

Explanation

Choice A reason: This describes internal validity, which assesses whether the observed effect is due to the intervention and not confounding variables. It does not address generalizability.

Choice B reason: External validity refers to the extent to which study findings can be generalized beyond the specific sample used. If the sample accurately reflects the broader population, the results are more likely to apply in real-world settings, enhancing external validity.

Choice C reason: A p-value of 0.1 suggests that the results are not statistically significant at the conventional threshold of 0.05. It does not relate to external validity, which is about generalizability, not statistical significance.

Choice D reason: Peer-reviewed publication indicates that the research has undergone expert scrutiny, but it does not guarantee external validity. Generalizability depends on study design and sample characteristics, not publication status.

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The PMHNP is evaluating a 47-year-old man admitted to the substance abuse facility where she is rounding. His pulse is 105 and he is sweating. He has bilateral hand tremors and is nauseated, restless, and agitated. He says he has not slept in 24 hours. What is his most likely diagnosis?

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

When interpreting research findings, which of the following most closely describes the concept of external validity?

Correct Answer is B

Explanation

Which act provides financial incentives for pharmaceutical companies to develop medications that treat rare diseases?

A 29-year-old pregnant woman is referred to the psychiatric-mental health nurse practitioner for medication-assisted treatment (MAT) for opioid use disorder (OUD). Which of the following will the PMHNP prescribe?

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A 21-year-old male college student scored 2 on the CAGE screening tool. What does this score indicate?

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Which of the following most accurately defines deontological theory in ethics?

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