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2023-2024 ANCC PMHNP PSYCH-MENTAL HEALTH
NP EXAM LATEST (TEST 1 ,2,& 3 ) QS & ANS
GRADED A
TEST 1
Your patient, whose wife died a few months ago, appears to be very unkempt and apathetic. Although several months have passed since his wife's death he has not progressed at all through his grieving. You assess this condition as which of the following? disenfranchised grief panic disorder complicated grief physiologic grief - -Correct Answer: complicated grief RATIONALE: A person has uncomplicated grief when he or she has normal physical, psychological, cognitive and spiritual responses to the death of a significant other. But when the person shows persistent maladaptive behaviors such as not taking care of personal hygiene and/or appearance and does not progress through the mourning process, this is complicated grief. If a patient has had a myocardial infarction, which of the following atypical antidepressants should not be prescribed within the recovery phase? Trazodone Duloxetine Bupropion Desvenlafaxine - -Correct Answer: Trazodone
RATIONALE: If a patient has had a myocardial infarction, during the recovery phase, the patient should not be prescribed this medication. Trazodone (Desyrel) can cause the patient to develop orthostatic hypotension and priapism. To get your teaching ideas and concepts across to a poor reader which of the following would be most appropriate? Use longer sentences. Use abstract concepts. Discourage questioning. Use examples and review. - -Correct Answer: Use examples and review. RATIONALE: To get the idea across to a poor reader use examples and review. The other choices are not helpful. You should use short sentences and easy to read layouts; be concrete rather than abstract; and teach them how to ask questions about their health. Also, tell context first and use visual, use common words and examples, and explain meaning. A 21-year old woman presents with complaints of milky discharge from her breasts. She doesn't have any other symptoms and is not pregnant, nor has been before. She tells the nurse about each medication that she takes. Which of these drugs may be implicated as the cause of the symptom? aspirin Lamotrigine Risperidone sertraline - -Correct Answer: Risperidone RATIONALE: Risperidone can cause the greatest prolactin elevation among atypical psychotics. A milky white discharge known as galactorrhea could be a sign of an underlying condition. The fact that the woman takes Risperidone, an atypical antipsychotic, would likely point to the cause and should be switched with one less likely to have that same side effect. Which of the following would be considered one of the main things that is responsible for about 2/3 of psychiatric hospital readmissions? Not sufficient care. Medication noncompliance Biophysical assessments None of the above - -Correct Answer: Medication noncompliance RATIONALE: Medication noncompliance is a major problem with the psychiatric mental health patients. The home health nurses assists by
Which of the following would be considered an important form of communication that can help to promote consistency in the care of the patient at the same time that it justifies their stay in the hospital? Review of care. Documentation Verbal reporting None of the above - -Correct Answer: Documentation RATIONALE: The other 3 options above are incorrect. One of the most important aspects of nursing is documentation. Documentation can promote consistency in the care of the patient and is also used to help justify the patient remaining in the hospital. Effects of an overdose of LSD (Lysergic acid diethylamide) can include all of the following except? Vomiting Respiratory failure Hypertensive crisis Seizures - -Correct Answer: Hypertensive crisis RATIONALE: Hypertensive crisis would be considered a symptom of PCP overdose. Vomiting, respiratory failure and seizures would be considered an effect of LSD overdose. Symptoms of serotonin syndrome include all of the following EXCEPT: insomnia nausea loss of coordination sweating or shivering with goose bumps - - Correct Answer: nausea Symptoms of serotonin syndrome can present in patients that have drug combinations that are contraindicated. They can vary from restlessness and agitation to tremors, chills, headaches, and insomnia as well as loss of coordination. Nausea has not been implicated in serotonin syndrome. What is the rate of suicide attempts for patients having dissociative identity disorder? 30% 45% 70% 60% - -Correct Answer: 70%
RATIONALE: People with dissociative identity disorder have one of the highest risks for suicide. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM- 5),more than 70% of outpatients with DID have attempted suicide, and multiple suicide attempts are common. Of the following, which would not be considered a phase of schizophrenia treatment? Maintenance Acute Cognitive Stabilization - -Correct Answer: Cognitive RATIONALE: Cognitive is not one of the three phases of schizophrenia treatment. The three phases are: Phase 1: acute Phase 2: stabilization Phase 3: maintenance The patient should be monitored for effects of psychotropic medications which can impact cardiac rhythms. Which of the following could be a potential cardiac side effect? A prolonged QT interval Narrowing of the QRS Both A and B None of the above - -Correct Answer: A prolonged QT interval RATIONALE: With antipsychotic drugs, the triclyclic action can cause problems. These medications can cause a widening of the QRS or a prolonged QT interval. This is a measure of the ventricular repolarization. Sullivan described three developmental cognitive modes of experience and believed that mental disorders are related to the persistence of one of the early modes. The mode that begins in early childhood as the child begins to connect experiences in sequence is which of the following? prototaxic mode parataxic mode syntaxic mode composite mode - -Correct Answer: parataxic mode RATIONALE: The parataxic mode begins in early childhood. The child
Which of the following acts have provided the greatest protection for the individual not to lose or be denied health insurance coverage? Patient Protection and Affordable Care Act OSHA ISPN None of the above - -Correct Answer: Patient Protection and Affordable Care Act RATIONALE: The other 3 options above are incorrect. For several decades now, the ANA (American Nurses Association) has been working and advocating for reforms that will help to guarantee the access of high-quality health care. This act has helped millions of people, but ANA recognizes the fact that this debate is far from being over. The ANA is dedicated to educating the nursing public about the changing systems and their impacts on people's lives and the nursing profession. Which of the following is an example of Western alternative medical systems? TCM (traditional Chinese medicine) naturopathy ayurveda acupuncture - -Correct answer: naturopathy Naturopathy and homeopathy are examples of Western alternative medical systems. Naturopathy emphasizes health restoration rather than disease treatment and combines nutrition, homeopathy, therapeutic counseling and other therapies. The underlying belief is that the individual assumes responsibility for his or her recovery. What is NOT a sign of alcohol intoxication? Nystagmus Mood lability The face has pale skin. Aggressive impulses - - Correct Answer: The face has pale skin. RATIONALE: A flushed face is a sign of alcohol intoxication. Other signs include disinhibition of sexual impulses, impaired judgment, and impaired occupational functioning. In terms of styles of leadership in therapeutic groups, which type of leader encourages individual creativity and group cohesiveness? autocratic democratic
laissez-faire psychotherapeutic - -Correct
RATIONALE: There are three main styles of group leadership: autocratic, democratic, and laissez-faire. A democratic leadership style focuses on the members of the group. Members are encouraged to participate fully in problem-solving of issues that relate to the group. This type of leader encourages individual creativity and group cohesiveness. All of the following are considered to be types of family structures except? Nuclear family Behavioral family Blended family Extended family - -Correct Answer: Behavioral family RATIONALE: The major types of family structures are: Nuclear family Blended family Extended family Single- parent family Other familial systems What would NOT be an appropriate way to deal with a patient in the psychiatric unit who is prone to protracted angry outbursts? Using reassuring touch Determining the source of the patient's anger Remaining calm Setting verbal limits on behavior - -Correct answer: Using reassuring touch RATIONALE: This would not be appropriate for interacting with an angry patient. When coping with an angry patient, don't shout or argue with the client and avoid touching the client or invading the client's space. This can escalate the anger. Touching the client can be threatening and make them feel cornered. This may result in retaliation. N-STAT is an ANA program that does which of the following? unifies nurses' political voices recommends nursing health policies assures a safe workplace for nurses evaluates Medicare and Medicaid reforms - - Correct Answer: unifies nurses' political voices RATIONALE: Nurses are the largest group among the health care disciplines The Nurses Strategic Action Team (N-STAT) is an ANA
program that unifies nurses' political voices across the country to enact measures to benefit health care for everyone. Examples of DSM-V diagnostic criteria for schizophrenia include all of the following EXCEPT: hallucinations
Which of the following would more than likely be included in treatment of the patient with depression? Cognitive therapy Psychopharmacology Individual therapy All of the above - -Correct Answer: All of the above RATIONALE: Treatment of depression can include: Cognitive therapy Psychopharmacology Individual therapy Group/family therapy Electroconvulsive therapy Light therapy Transcranial magnetic stimulation Which of the following individuals would be the most likely to be homeless? 16 year old white male. 67 year old Hispanic female 49 year old female Native American 19 year old Asian male - -Correct Answer: 16 year old white male. RATIONALE: Studies have shown that approximately 39 percent of the homeless are under the age of 18. Studies have shown that more males are homeless then females. Studies have shown that 39 percent of the homeless are white. What test should be administered for a patient who is taking lithium, and it is suspected has arrhythmia? ACH EKG ABG EEG - -Correct answer: EKG RATIONALE: Arrhythmia is a side effect of lithium. The patient needs to be monitored for risky side effects. An EKG or electrocardiogram would be used. Akathisia, akinesia, dystonia, and tardive dyskinesia are all side effects considered to affect which system: lymphatic skeletal endocrine muscular - -Correct Answer:
muscular
Shelters Patient homes Work sites Mental health clinics Senior centers Schools/colleges Clinics for the homeless What action would be appropriate for documenting a patient's care? Charting opinions Charting in ink Charting events before they happen Charting generalizations - -Correct Answer: Charting in ink RATIONALE: This is the only appropriate charting action. You would not chart the following: opinions that are not supported by facts or defame patients, chart events before they happen, chart generalizations, suppositions or pat phrases, obliterate, erase, alter or destroy a record, or leave blank spaces. If an incident report is filed, do not note it in the chart. Relationships between people are each unique. However, all relationships can be categorized into three major types. They are: social, intimate, and therapeutic social, intimate, and empathetic social, warm, and empathetic public, private, and therapeutic - - Correct Answer: social, intimate, and therapeutic RATIONALE: The three categories of relationship types are: social, intimate, and therapeutic. Social relationships are primarily for friendship. Intimate relationships involve two people who are emotionally committed to each other. The therapeutic relationship focuses on the needs, experiences, feelings, and ideas of the client only. If the client cannot organize his or her thoughts, or has difficulty answering open-ended questions, the nurse should do which of the following? continue to ask the open-ended questions until the client can answer stop questioning the client altogether ask more direct questions focused on one specific behavior or symptom ask general multiple choice questions - -Correct Answer: ask more direct questions focused on one specific behavior or
symptom RATIONALE: If the client cannot organize his or her thoughts, or has difficulty answering open-ended questions, the nurse should use more direct questions to obtain information. Questions need to be clear simple, and focused on one specific behavior or symptom; they should not cause the client to remember several things at once.
determine the potential outcomes and goals for the patient? Family Housekeeping
Members of the interdisciplinary team Both A and C - -Correct Answer: Both A and C RATIONALE: Housekeeping is not typically included. The nurse typically communicates with the: Family significant others Members of the interdisciplinary team Patient What is the best course of action to be taken for a patient who insists on taking Gingko Biloba for anxiety? Explain that it is dangerous Respect preference Refuse to give consent Try to dissuade the patient - -Correct answer: Respect preference RATIONALE: Gingko Biloba is shown to have some effect in treating anxiety. The patient preference needs to be respected in care. Herbal remedies need to be considered when prescribing other medications. Neurobiological defects found in schizophrenia are suspected to have abnormalities in chemical neuronal signal transmission. Which of the following is not a neuronal signal transmission found in people with schizophrenia? excess dopamine in mesolimbic pathway decreased norepinephrine decreased GABA decreased dopamine in the mesocortical pathway - - Correct Answer: decreased norepinephrine RATIONALE: Impaired neuronal communication is suspected to lead to the abnormalities in the brain. Excess glutamate and dopamine in the mesolimbic pathway; decreased dopamine in the mesocortical pathway, and in GABA and serotonin are implicated in people affected by schizophrenia. Decreased norepinephrine is implicated in depression. What is the risk for a 50 year old patient taking NSAIDs while taking SSRIs? Seizures Arrhythmia Serotonin syndrome Gastrointestinal bleeding - -Correct Answer: Gastrointestinal bleeding
