5. An adult psychiatric and mental health nurse practitioner uses the interpersonal therapy model with a patient to establish a therapeutic alliance based upon empathy and trust. The nurse practitioner recognizes the patient's readiness to terminate therapy when the patient demonstrates: A. an understanding that leaving a significant other may be painful, but also presents an opportunity for growth. B. breathing and muscle relaxation exercises that decrease muscle tension and anxiety. C. free association, and considers the nurse practitioner's interpretation of the patient's dreams. D. new adaptive skills and responses after completing "homework assignments." {Ans: A. an understanding that leaving a significant other may be painful, but also presents an opportunity for growth.}13. A male patient informs an adult psychiatric and mental health nurse practitioner that he has not slept in three days, has poor concentration, and denies fatigue. The patient's diagnosis is: A. attention-deficit hyperactivity disorder. B. bipolar disorder. C. panic disorder. D. primary insomnia. {Ans: B. bipolar disorder.}15. The neurochemical pathophysiology of Tourette disorder involves: A. decreased levels of gamma-aminobutyric acid and increased levels of glutamate in the brain. B. deficits in the prefrontal cortex-mediated executive functions of the brain. C. imbalances in dopaminergic, serotonergic, and