mental health exam 4-IV

Which statement best affirms an individual's strengths consistent with MI? a. "The work that you are doing to cope with stress and quit smoking is difficult." b. "Tell me why you have not used your strengths to reach your goals since we last met." c. "As you talk about smoking, I hear your reasons to continue and to quit." d. "Let me stop and summarize what I hear you say and we have talked about."

*a. "The work that you are doing to cope with stress and quit smoking is difficult." Giving the patients affirmation for their strengths and solution-finding will help build trust and confidence in the clinician.

Which clinician action(s) would be most effective when the screening of an individual indicates that more discussion is needed about his or her substance use, including opportunities for treatment? a. Acknowledging that the individual has the choice to change and advising him or her that he or she can b. Completing a random drug screen to prove that the individual needs intervention c. Organizing a formal intervention to confront the individual's denial d. Referring the individual to the best option for treatment as determined by the clinician

*a. Acknowledging that the individual has the choice to change and advising him or her that he or she can Inherent in an effective approach is the recognition that an individual can make the choice to change, that the primary care provider can be a partner in the process, and that individuals have options, no matter what treatment level is needed. Authentic feedback offered with respect and empathy by the clinician supports and encourages self-determination and motivation to change.

A patient experienced a physical assault 2 weeks ago and has symptoms such as nightmares, irritability, sleep disturbance, and intrusive thoughts of being harmed. What is the most likely current diagnosis? a. Acute stress disorder b. PTSD c. Adjustment disorder with disturbance of conduct d. Anxiety disorder

*a. Acute stress disorder Acute stress disorder—symptoms begin at time of event and past 3 days to 1 month; PTSD— symptoms or disturbance occur after 1 month.

What three regions of the brain are involved in the neuroadaptations underlying the development and persistence of substance use disorders? Choose three. a. Basal ganglia b. Cerebellum c. Extended amygdala d. Hypothalamus e. Prefrontal cortex

*a. Basal ganglia *c. Extended amygdala *e. Prefrontal cortex

Which of the following injuries should prompt the clinician to be concerned about physical abuse? Select all that apply. a. Ear bruising in a 4-year-old b. Abrasion to the elbow in a 6-year-old c. Bilateral shin bruising in a 2-year-old d. Subconjunctival hemorrhage in a 3-month-old e. Abdominal bruising in a 22-month-old

*a. Ear bruising in a 4-year-old *d. Subconjunctival hemorrhage in a 3-month-old *e. Abdominal bruising in a 22-month-old Answers a, d, and e are all concerning injuries in these aged patients and should prompt further workup to look for occult injuries. TEN-4, the clinical decision rule by Pierce et al., described the characteristics predictive of abuse as bruising to the torso, ears, or neck for any child less than or equal to 4 years old and bruising in any location on an infant less than 4 months old. When these injuries are found, it should prompt the clinician to initiate a workup for physical abuse, investigating for other occult injuries. Although bruises to the face, back, abdomen, arms, buttocks, ears, and hands are suggestive of physical abuse, any injury can be inflicted and no injury should be interpreted in isolation.

The MI core skill continuing the paragraph means to do what? a. Listen and reflect on what may be next (as yet unspoken) by the patient. b. Speculate about what a patient or client is feeling. c. Reflect on both sides of the patient or client's ambivalence. d. Paint a picture that can clarify the individual's position.

*a. Listen and reflect on what may be next (as yet unspoken) by the patient. Continuing the paragraph is a method of reflective listening in which the interviewer offers what could potentially be next (as left unsaid) by the client.

Which term best describes interventions used to improve an individual's health by continuously monitoring his or her status or strategies intended to deliver interventions to users in their own environment? a. Mobile health or mHealth b. Telehealth c. Telemedicine d. Transdisciplinary health

*a. Mobile health or mHealth

Which of the following is true in regard to the Children's Online Privacy Protection Act (COPPA)? a. Parental consent must be obtained. b. A privacy policy is optional. c. Parents do not have the right to review information collected on their children. d. COPPA applies to children aged 18 years and younger.

*a. Parental consent must be obtained. The rule states that consent must be obtained, must display a privacy policy that complies with the COPPA, and must give parents the right to review information collected on their children.

An athlete comes in for a preparticipation physical examination to a convenience care clinic. He has a blood pressure of 134/74. He denies any cardiac symptoms including headache, chest pain, or shortness of breath. What should the clinician do? a. Provide clearance for the athlete and tell him to follow-up with his primary care clinician for a blood pressure recheck in 2 to 3 weeks. b. Deny clearance for the athlete and ask him to return to his primary care clinician for a blood pressure recheck in 2 to 3 weeks. c. Deny clearance for the athlete and refer him to a pediatric cardiologist. d. Provide clearance for the athlete without any further stipulations.

*a. Provide clearance for the athlete and tell him to follow-up with his primary care clinician for a blood pressure recheck in 2 to 3 weeks.

When a concussion is reported in an athlete, the clinician should do the following: a. Temporarily restrict play b. Allow the athlete to keep playing with mandated episodes of rest c. Order a CT scan to ensure there is no major head injury d. Allow the coach and parents to determine whether the athlete is in suitable condition to play

*a. Temporarily restrict play Concussion is a contraindication for sports participation.

Which of the following statements are TRUE regarding child sexual abuse (select all that apply)? a. The majority of child sexual abuse victims will have a normal/nonspecific anogenital examination. b. Most children disclose their victimization soon after experiencing sexual abuse. c. Healthcare clinicians must be knowledgeable regarding state laws/protocols defining acute versus nonacute child sexual abuse. d. The ultimate goal of the anogenital examination for child sexual abuse is to provide reassurance to patients and families that their bodies are normal and/or will heal despite their experience of sexual abuse.

*a. The majority of child sexual abuse victims will have a normal/nonspecific anogenital examination. *c. Healthcare clinicians must be knowledgeable regarding state laws/protocols defining acute versus nonacute child sexual abuse. *d. The ultimate goal of the anogenital examination for child sexual abuse is to provide reassurance to patients and families that their bodies are normal and/or will heal despite their experience of sexual abuse.

Which are TRUE about traumatic experience? Select all that apply. a. Traumatic experience overwhelms a person's capacity to cope. b. One-time incidents are generally not considered to be traumatic. c. No two individuals will experience trauma in the same way. d. There are consistent patterns of responses commonly seen in survivors of trauma.

*a. Traumatic experience overwhelms a person's capacity to cope. *c. No two individuals will experience trauma in the same way. *d. There are consistent patterns of responses commonly seen in survivors of trauma.

The preparticipation physical has not been shown to be effective at decreasing rates of sudden cardiac death during sports in young athletes. a. True b. False

*a. True The preparticipation examination has not been shown to be effective at decreasing rates of sudden cardiac death during sports in young athletes but it is mandatory in most states for sport participation.

Which is true about therapeutic communication? a. Using effective communication is standard of practice in completing patient assessment. b. Trauma-informed care is outside the scope of practice for most clinicians. c. Clinicians do not have time to integrate motivational interviewing in health assessment. d. Using communication strategies is important, but not likely to impact patient outcomes.

*a. Using effective communication is standard of practice in completing patient assessment. Use of therapeutic communication is an expected, evidence-based standard of care in clinician- patient encounters, including advanced assessment, with consideration of patient age, developmental level, health literacy level, cultural perspectives, and unique dimensions of health and well-being.

Healthcare assessment findings that are highly suggestive of sexual abuse include a. a spontaneous disclosure of sexual abuse made by the child b. genital warts noted on examination of an 18-month-old female delivered vaginally to a mother known to have genital warts c. urine NAAT positive for chlamydia in a 6-year-old female d. absence of hymenal tissue at 6 o'clock when examined in both supine and knee-chest position

*a. a spontaneous disclosure of sexual abuse made by the child *c. urine NAAT positive for chlamydia in a 6-year-old female *d. absence of hymenal tissue at 6 o'clock when examined in both supine and knee-chest position Attention should be focused on the posterior rim between 3 and 9 o'clock, as this is where abnormalities from sexual abuse generally occur (Adams et al., 2018). Nonacute/residual/healed findings are more difficult to detect, but may include healed hymenal transections in the posterior rim extending to the base of the hymen or to the vaginal wall, missing hymenal tissue in the posterior rim, scarring of the posterior fourchette, or perianal scarring (Adams et al., 2018). Always confirm nonacute anogenital findings in supine and knee-chest position wherever possible (see pages 44-46 and Box 24.8).

Some of the physical characteristics of Marfan syndrome include a. myopia, mitral valve prolapse, and increased limb length b. joint hyperflexibility, hypertension, and shortness of breath c. pectus carinatum, hindfoot deformity, and asthma d. scoliosis, tinea corporis, and webbed fingers

*a. myopia, mitral valve prolapse, and increased limb length

Which is the most useful, empathetic, and patient-centered response by the clinician after assessing that an individual is misusing opioids? a. "You need to stop before your overdose." b. "Tell me more about what leads you to use opioids." c. "Let us discuss options to decrease the risk of overdose." d. "Here is more information about overdose."

*b. "Tell me more about what leads you to use opioids." Motivational support should be engaging, empathetic, and patient centered.

What are the steps of assessment and intervention when an individual has tobacco use disorder? a. Admit, Assess, Analyze, Admonish, Admire b. Ask, Advise, Assess, Assist, Arrange c. Seek, Stop, Solve, Support, Succeed d. Start, Stop, Strengthen, Support, Succeed

*b. Ask, Advise, Assess, Assist, Arrange 5 A's from Box 23.3.

Which of the following is not part of the Security Rule when being compliant with the Health Insurance Portability and Accountability Act (HIPAA)? a. Data must be encrypted. b. Data cannot be sent via SMS or Skype. c. Data must be accessed with a unique identifier. d. Technology must have an automatic log off.

*b. Data cannot be sent via SMS or Skype. To be compliant with the HIPAA, one must follow the Security Rule, which states that all protected health information must be encrypted, must be accessed with a unique identifier, and the technology must have an automatic log off (HIPPA Journal Team, 2019).

Which is true about digital health interventions? a. Any digital health intervention that is intended to change behavior is unethical. b. Digital health interventions can foster and support behavior change. c. Persuasive technologies are coercive and not likely to support behavior change. d. Using technology to monitor behaviors is not likely to improve anyone's health.

*b. Digital health interventions can foster and support behavior change.

Which one of these is one of the four processes of MI that are relevant to health assessments? a. Distraction b. Evoking c. Imagination d. Deter

*b. Evoking There are four processes of MI that are relevant to health assessments: Engaging, Focusing, Evoking, and Planning. Evocation includes the MI spirit and a process of evoking change talk from clients.

It is not ever necessary to search for gray literature when locating health technology evidence. a. True b. False

*b. False As health technology continues to evolve, inclusion of gray literature (but not standalone) is essential to understand emerging approaches in health and can serve as powerful additions to traditional search methods (Cooper, 2009; Haddaway, Collins, Coughlin, & Kirk, 2015; Higgins & Green, 2011).

If you ask a person whether he or she is thinking about killing himself or herself, it will give him or her the idea and increase the risk he or she will now attempt suicide? a. True b. False

*b. False False. Asking about suicide will not put that idea in a patient's mind. In fact, being asked is often a relief to patients who need to talk about their thoughts and fears.

During the preparticipation physical, an athlete reports that she recently had an episode of syncope during exercise and you note a mid-systolic murmur at the left lower sternal border that increased with intensity when you had her do the Valsalva maneuver. What would be your concern? a. Female athlete triad b. Hypertrophic cardiomyopathy c. Marfan syndrome d. Hypertension

*b. Hypertrophic cardiomyopathy Mid-systolic murmur at the apex radiating to the axilla or a mid-systolic, crescendo-decrescendo murmur, often heard loudest at the left lower sternal border, and that increases intensity with the Valsalva maneuver or a squat to stand would be a red flag for hypertrophic cardiomyopathy. For other symptoms and physical examination findings in hypertrophic cardiomyopathy.

In the study by Pakpour regarding childhood obesity and MI, which strategies showed the most effective results? a. MI solely b. MI plus parental engagement c. Not using MI d. Partially using MI and a dietary plan suggested by a physician

*b. MI plus parental engagement MI in additional to parental involvement is an effective strategy in changing obesity-related outcomes and has additional effects-surpassing benefits of MI with adolescents solely.

Which action is most consistent with the principles of motivational interviewing (MI)? a. Recognizing that every individual needs to be educated about health b. Reviewing an individual's thoughts and beliefs about health and wellness c. Showing the client problems that resulted from his or her poor health choices d. Teaching every individual the correct way to care for his or her own health

*b. Reviewing an individual's thoughts and beliefs about health and wellness

Which of the following is not a factor for real-world data (RWD) to be suitable for the Food and Drug Administration (FDA) to use for regulatory decisions? a. The data collected from the device contains enough detail to answers questions about a specific population. b. The data collected from the device are focused on populations aged 18 years and older. c. When appropriate analytical methods are used, the data collected from the device are capable of addressing the specified question. d. The data and evidence provided from the device can inform clinical and scientific judgment.

*b. The data collected from the device are focused on populations aged 18 years and older. In order for RWD to be suitable for the FDA to use for regulatory decisions, several criteria must be met, including: • The data collected from the device contain enough detail to answers questions about a specific population. • When appropriate analytical methods are used, the data collected from the device are capable of addressing the specified question. • The data and evidence provided from the device can inform clinical and scientific judgment.

An order for what lab test would be indicated for a person experiencing fatigue, low mood, and sleep problems? a. C-reactive protein b. Thyroid studies, including TSH c. Serotonin level d. Low-density lipoprotein and high-density lipoprotein

*b. Thyroid studies, including TSH Order thyroid studies with the rationale that hypothyroidism presents like depression, and hyperthyroidism presents like an anxiety disorder.

Which level of alcohol consumption would be defined as moderate drinking? a. Any level of consumption, as long as it is not daily *b. Up to one 6-ounce glass of wine per day for women c. Up to three 12-ounce cans of beer per day for men d. Any level of consumption, as long as it is only beer or wine

*b. Up to one 6-ounce glass of wine per day for women Based on the 2015 to 2020 Dietary Guidelines for Americans, a standard drink contains 14 g (0.6 ounce) of pure alcohol, which equates to one 12-ounce can of beer, one 5-ounce glass of wine, or one shot of 1.5 ounces of a distilled beverage. Moderate drinking is up to 1 standard drink per day for women and 2 per day for men.

Who does the USPSTF recommends routine screening for IPV at all preventive health encounters at regular intervals? a. Children aged 0 to 18 b. Women of childbearing age c. People of low socioeconomic status d. Heterosexual couples

*b. Women of childbearing age Children should be routinely evaluated for signs and symptoms of abuse, but caregivers may be screened for occurrence of IPV within the family. IPV can occur among all people without regard to socioeconomic status or sexual orientation. The USPSTF recommends routine IPV screening for all women of childbearing age.

Having an empathetic approach to discussing substance misuse with patients implies that the clinician a. feels sorry for these individuals because they lack will power b. has the ability to share emotions and consider patients' perceptions c. is justifiably angry at their choices but is able to treat them with sympathy d. can treat individuals with tolerance despite their low motivation to change

*b. has the ability to share emotions and consider patients' perceptions Clinician empathy is the ability to recognize and share the emotions and perceptions of the patient.

Serious mental disorders (bipolar disorder, thought disorders, and severe persistent mental health disorders) generally are first diagnosed a. in childhood b. in late adolescence c. in middle age d. in preschool years

*b. in late adolescence The usual age of onset of serious mental disorders (bipolar disorder, thought disorders, and severe persistent mental health disorders) is generally in late adolescence and young adulthood, but can occur earlier or later.

Which was the fifth A added to the "4 A's" by The Canadian Task Force? a. Advise b. Arrange c. Agree d. Assess

*c. Agree A fifth A "agree" was added by the Canadian Task Force, and the model was recommended as a general approach for behavioral counseling.

Which area of the brain is responsible for normal regulation of emotions, such as fear, anger, anxiety, and panic? a. Thalamus b. Hippocampus c. Amygdala d. Frontal lobe

*c. Amygdala The study of the structure and function of the nervous system, or neuroanatomy, identifies the amygdala within the temporal lobe as the component of the brain and limbic system most associated with strong emotions, anxiety, and panic. The amygdala of the brain evolved to detect danger and mediate the fear response.

A 2-month-old presents to clinic for routine well-child check. Upon physical examination, a bruise is found on the chest. What do you do next? a. Call in a report to Children Services because of the concern for physical abuse. b. Obtain a head CT and skeletal survey. c. Ask the caregiver about the injury. d. Obtain hematology laboratory studies.

*c. Ask the caregiver about the injury. Answer c should be the first step when an injury is found. However, owing to patient's age, all of the other steps should be performed as well. Bruising, although a common accidental injury in a mobile child, is a critical injury in a young infant.

Which is most accurate about components of the SBIRT clinical model? a. Screening is a discussion between the patient and clinician using the clinician's experience of working with patients with addiction. b. SBIRT is focused on diagnosing substance use disorder. c. Brief intervention is meaningful conversation about a patient's opioid use. d. After a brief intervention, the clinician is able to decide whether the patient should complete a standardized screening tool. e. At a follow-up appointment, the clinician should reassess if a referral to treatment is necessary.

*c. Brief intervention is meaningful conversation about a patient's opioid use. SBIRT is a model emphasizing the use of a standardized screening tool to guide the brief intervention, which is a meaningful conversation regarding the patient's opioid use. Referral to treatment is immediately offered.

Which athlete needs a referral to a cardiologist? a. Fifteen-year-old male with a history of asthma and bilateral wheezes are noted during his examination on forced expiration b. Seventeen-year-old female with a history of bulimia who is currently not menstruating c. Eighteen-year-old male who reports chest pain on exertion and a heart murmur d. Eighteen-year-old female with anemia and shortness of breath during moderate activity

*c. Eighteen-year-old male who reports chest pain on exertion and a heart murmur

Which statement is TRUE regarding the relationship between IPV and child abuse? a. There is no correlation between IPV and child abuse. b. When IPV occurs in a home, children are not affected unless they become involved in the violent episode between caregivers. c. In a family in which IPV is occurring, it is more likely that child abuse is also occurring. d. Pregnancy decreases a woman's risk of experiencing IPV.

*c. In a family in which IPV is occurring, it is more likely that child abuse is also occurring. Pregnancy increases a woman's risk of experiencing IPV and subsequent poor effects on the infant such as low birth weight or premature birth. Children who witness IPV are also at risk for significant psychosocial trauma from experiencing traumatic events. In up to 60% of families in which IPV or child abuse is occurring, the other form of abuse is also occurring.

According to the ACE study, childhood adversity and household dysfunction impact all but which of the following later in life? a. Healthcare utilization b. Disease incidence and risk factors c. Incidence of criminal behavior in adulthood d. Quality of life

*c. Incidence of criminal behavior in adulthood The aims of the study were to determine retrospectively and prospectively the impact that childhood adversity and household dysfunction have on the following outcomes later in life: disease incidence and risk factors, healthcare utilization, quality of life, and mortality. Researchers first described the prevalence and interrelation among exposures to child abuse and household dysfunctions. Researchers then studied how the number of exposures to childhood adversity may later be related to the incidence of chronic diseases that are the underlying causes of death in adults.

Which term best describes work that is characterized by being interactive and that analyzes, synthesizes, and harmonizes links among disciplines into coordinated whole? a. Multidisciplinary b. Transdisciplinary c. Interdisciplinary

*c. Interdisciplinary

Which would be a cause to restrict sports participation? a. Pectus excavatum b. Sinus arrhythmia c. Mononucleosis d. Myopia

*c. Mononucleosis Mononucleosis can cause splenomegaly and this is a reason to restrict participation because of splenic rupture.

Which of these is the correct order of the "stages of change"? a. Precontemplation, Maintenance, Contemplation, Determination, Action, Recurrence b. Precontemplation, Contemplation, Determination, Maintenance, Recurrence, Action c. Precontemplation, Contemplation, Determination, Action, Maintenance, Recurrence d. Precontemplation, Contemplation, Recurrence, Action, Maintenance, Determination

*c. Precontemplation, Contemplation, Determination, Action, Maintenance, Recurrence The correct order of the stages of change is as follows: Precontemplation, Contemplation, Determination, Action, Maintenance, Recurrence.

Which statement is not true about depression in adolescents? a. CBT is the first-line intervention for mild-to-moderate depression. b. Irritability and anger are symptoms of depression in adolescents. c. Racing thoughts, rapid speech, and staying up all night are common depression symptoms. d. Hopelessness and acquiring a gun indicate high risk for suicide.

*c. Racing thoughts, rapid speech, and staying up all night are common depression symptoms. Screening for mania is key to identifying assessments that may indicate bipolar disorder; these include not needing sleep for days, excessive enthusiasm, and periods of great excitement and obsession. Key questions are as follows: (a) Do you have racing thoughts? (b) Has your speech been so fast that it is hard to follow? Pressurized speech and flight of ideas are correlated with mania.

Which clinician is most likely to be effective in intervening with individuals experiencing opioid use disorder? The clinician who a. is able to strongly confront the patient about his or her destructive behavior b. does not allow the patient's past to be an excuse for the patient's current unethical behavior c. recognizes that stress can add to the patient's vulnerability for opioid use disorder d. successfully holds addicts accountable for their shameful behavior e. uses the patient's fears and guilt to point out to him or her the need to change

*c. recognizes that stress can add to the patient's vulnerability for opioid use disorder Clinicians who are able to recognize that patient stress, adverse childhood events, lack of social support, and other factors contribute to patient vulnerability for opioid use disorder are better able to assist a patient.

What are some ways to help prevent or reduce exposure to emotional maltreatment? a. The Nurse-Family partnership program b. In-home vising program for first-time mothers c. Anticipatory guidance on developmental expectations d. All of these are ways to prevent and reduce exposure to maltreatment.

*d. All of these are ways to prevent and reduce exposure to maltreatment.

Which is not a mental health screening instrument for children or teens that would identify depression, anxiety, or a mood disorder? a. SCARED b. PSC c. PHQ-9 A d. Audit-C

*d. Audit-C AUDIT-C is for adult substance use screening).

3. Which is true about the delivery of care by telehealth? a. Clinicians are legally permitted to deliver care by telehealth to anyone in any state. b. Clinicians can legally provide care by telehealth no matter where the clinician is located. c. Clinicians cannot provide care by telehealth to anyone who they have not met in person in the office. d. Clinicians must follow state practice laws regarding telehealth; regulations vary widely.

*d. Clinicians must follow state practice laws regarding telehealth; regulations vary widely. A clinician's ability to assess and/or manage patient care may be limited by where he or she is physically located and/or where the individual is located during a telehealth visit; licensing and regulations vary from state to state, especially regarding the provision of care across state lines.

Which of the following statements is true about an individual with a substance disorder being "in recovery"? a. Individuals in recovery rarely stay sober. b. Individuals in recovery often feel more isolated. c. Clinicians should avoid asking an individual in recovery about substance use. d. Clinicians should ask an individual in recovery about his or her substance use.

*d. Clinicians should ask an individual in recovery about his or her substance use Ask about sponsorship and sobriety. Positive clinician feedback can be a significant part of breaking the cycle of shame, guilt, stigma, and secrecy.

The female athlete triad is characterized by what three abnormalities? a. Menstrual, thyroid, and bulimia b. Bone density, hypertension, and fatigue c. Bone density, menstrual, and stress fracture d. Menstrual, energy, and bone density

*d. Menstrual, energy, and bone density The female athlete triad is characterized by menstrual, energy, and bone densities abnormalities

Which of the following statements is true about adolescent substance use? a. Rarely, an adolescent would develop substance use disorder or addiction. b. Rarely, an adolescent would have changes in brain function from substance use. c. Neuroplasticity protects the adolescent brain from the effects of substance use. d. Neuroadaptations from substance use can be dramatic during adolescence.

*d. Neuroadaptations from substance use can be dramatic during adolescence. The American Academy of Pediatrics defines addiction as a developmental disorder and recommends screening for substance use disorder as a routine part of adolescent care (American Academy of Pediatrics, 2015). The rationale for this position is based on the understanding of neurobiology and the neuroadaptations that result from substance use, which can be more dramatic and happen more quickly during adolescence.

Which of the following is not a component of the mental status examination related to appearance? a. Affect b. Posture c. Hygiene d. Reflexes

*d. Reflexes Appearance—(a) Affect: appropriate for the situation? Labile? Pleasant? Flat? Nontoxic? (b) Posture: lying, sitting, or standing? Comfortable? Obvious limitations or defects? (c) Hygiene and grooming: appropriately dressed.... Disheveled? Neatly groomed? (d) Body habitus: height, weight, waist circumference, and BMI?

Which one of these is not a general concept of therapeutic communication? a. Receiver b. Message c. Sender d. Voicing doubt

*d. Voicing doubt

In a preparticipation physical, the history should include all EXCEPT a. a family history of sudden cardiac death in a relative under the age of 50 b. a previous head injury c. supplement use d. depression screen

*d. depression screen Depression screening is not indicated for a preparticipation physical examination.

The neurotransmitter primarily associated with initiative, focus, and energy is a. serotonin b. γ-aminobutyric acid (GABA) c. dopamine d. norepinephrine

*d. norepinephrine Norepinephrine (NE) is associated with an individual's energy, focus, initiative, and active adrenaline response (fight, flight, or freeze).

The examination for a preparticipation physical examination includes all of the following EXCEPT a. heart auscultation b. height and weight c. Snellen chart d. urine test

*d. urine test Urine tests were frequently screened for glucose and protein; however, recently, those screenings have fallen out of favor because of inadequate evidence to support their inclusion.

In a hospital-based study, a single 3-hour motivational interviewing (MI) training session completed by nurses on an oncology unit resulted in which findings? a. No changes in the nurse participants' MI skills b. Reductions in fall rates during the study intervention c. Reductions in fall rates that lasted for 2 years after the intervention d. Improved nurse participant MI skills e. b, c, and d f. b and d

*f. b and d Fall rates decreased during and for a short time after the study to 0. Fifty-seven percent of the nurses showed improvement in their knowledge scores with the posttest. Their skills in reflective listening and eliciting change talk improved significantly. This was very consistent with expectations for newly trained MI clinicians and reflects that the nurse participants were developing awareness and achieving the spirit of MI.

What parental risk factors may carry an association with emotional maltreatment? Select all that apply. a. Poor parenting skills b. Substance use c. Depression d. Suicidal ideation and/or suicide attempt e. Low self-esteem f. Inadequate social support g. All of the above

*g. All of the above

A key indicator that the patients meet criteria for a mental disorder is a. their symptoms are interfering with functioning at work and home b. they have had the symptoms for more than a month c. they see a psychotherapist d. they have a family history of schizophrenia

a. their symptoms are interfering with functioning at work and home Note if the symptoms currently interfering with functioning at work (school) and home? This is a key question as interference with functioning is often one important indicator of a mental health diagnosis.