Download 2024-2025 ANCC PMHNP Psych-Mental Health NP Exam Latest Questions and Answers and more Exams Psychology in PDF only on Docsity!
2024 - 2025 ANCC PMHNP
PSYCH-MENTAL HEALTH NP
EXAM LATEST (TEST 1 ,2,&
3 ) QS & ANS GRADED A+
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: 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 may not
make logical sense of the experiences and may see them as coincidence or
chance events. The child seeks to relieve anxiety by repeating familiar
experiences, although he or she may not understand what he or she is doing.
Answer: democratic
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: 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 helping the patients
to see the relationship between their compliance with their medication regimen and
control of their symptoms.
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
RATIONALE: The muscular system is responsible for extrapyramidal side
effects. The best way to prevent involuntary muscular movements that
could be irreversible is to monitor carefully. If symptoms are present, it can
be treated by reducing the current dose, or changing the patient to an
atypical agent.
The gathering and interpretation of data based on valid observed and
patient-reported information, in addition to research-derived evidence, is
known as which of the following?
Interventions
Managed care
Evidence-based
Crisis intervention - - Correct
Answer: Evidence-based
RATIONALE: Evidence-based practice is typically used in the nursing
process. The best available evidence is applied in order to improve
the quality of clinical judgments.
Preventative factors are those that protect the individual from a disorder.
Which of the following would be considered a social preventative factor?
healthy nutritional status
good self-esteem
healthy ego defenses
higher level of education - - Correct
answer: higher level of education
RATIONALE: Preventative factors are those that protect the individual from
a disorder. They are coping mechanisms or resources that facilitate a
healthy response to stress. Social preventative factors include: low-stress
occupations; higher socioeconomic status; and a higher level of education.
Which of the following would probably not be considered as having a
partnership with community-based mental health care?
Crisis centers
Insurance companies
Group homes
Shelters - - Correct Answer:
Insurance companies
RATIONALE: Insurance companies would not be the typical partner with
mental health care.
Such places could include:
Crisis centers
Group homes
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.
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
RATIONALE: Patient medications need to be monitored for possible
interactions. There are different risks with different medications.
Gastrointestinal bleeding is a risk that will increase if a patient takes both
SSRIs and NSAIDs.
When the registered nurse is making the decision about delegating any care
to an unlicensed person, which of the following statements would not be
correct?
If the task is to be performed under the nurses scope of practice,
then do not delegate it.
If the outcome is not one that is reasonably predictable, then do not delegate
it.
If the task cannot be safely performed according to clear
directions, then it is all right to delegate it.
If there are any specific laws against delegation of the task, do not
delegate it. - - The other 3 options above would be correct examples of when
not to delegate a task to an unlicensed person. If the task cannot be safely
performed according to clear directions, then it would not be all right to
delegate it.
Attention deficit hyperactivity disorder (ADHD) is divided into three subtypes
that specify the dominant associated behaviors. They include all but which of
the following?
hyperactive-impulsive type
manic type
inattentive type
combined type - - Correct
Answer: manic type
RATIONALE: There is no manic type of ADHD. ADHD is among the most
common of childhood psychiatric conditions. It is characterized by symptoms
of inattention, impulsivity, and overactivity that occur in at least two different
settings, with significant impairment in functioning.
Typically, which type of mental health care involves a minimum of about 3
months and is reserved for patients that have been transferred from acute
care setting
that are at a chronic risk for harming themselves or others because of mental
illness?
Community-based care
Primary care
Long-term care
Residential services - - Correct
Answer: Long-term care
RATIONALE: This type care can be referred to as intermediate or long-term
care. They can
admit a patient directly, but typically the patients are transferred
there from an acute care setting.
day treatment programs
social skills training
case management for vocational needs - - Correct
answer: disaster response
RATIONALE: Disaster response would be a secondary prevention measure
that is aimed at decreasing the prevalence of mental disorders. The other
three choices are tertiary prevention measures that are aimed at
decreasing the disability and severity of a mental disorder.
What is used to delineate the responsibilities and authority at all levels for the
various activities in the organization?
Mission statement
Policy
Philosophy statement
Procedures - - Correct answer: Policy
RATIONALE: The governing body of an organization establishes broad
policies for regulating the relations, operations, and outcomes in a health
care enterprise. Policies are needed to guide actions in given sets of
circumstances. They serve to delineate responsibilities and authority at all
levels and for various activities in the organization.
What activity is least likely to reduce role conflict and ambiguity of role?
Discouraging freedom in the role
Use of the chain of command
Personal development
Adaptation to change - - Correct answer:
Discouraging freedom in the role
RATIONALE: This is least likely to reduce role conflict and ambiguity of role.
Toleration of freedom is more likely to reduce role conflict and ambiguity.
Other activities to reduce role conflict and ambiguity include increased need
fulfillment, structure and standards, and facilitation of teamwork.
Of the following statements about involuntary admission to a psychiatric
facility, which is the least accurate?
Involuntary admission requires that the patient retain freedom from
unreasonable bodily restraints.
Those patients who have been involuntarily admitted no longer have the
right to refuse medications.
Patients have the right to legal counsel and to take their cases before a judge
who may order release.
Forced treatment raises ethical dilemmas regarding autonomy versus
paternalism. - - Correct answer:
Those patients who have been involuntarily admitted no longer have the
right to refuse medications.
M RA an T a I g O e N d A ca L r E e is used or employed by purchasers of health services.
T
hese people will make decisions about different services so that quality and costs can be
monitored. In this type of program, people will get health care based on their needs.
This statement is least accurate. Involuntary admission requires that the
patient retain the right to refuse medications. This refusal can include
psychotropic or antipsychotic medications.
Managed care is used by whom?
Stake holders.
High Management.
Purchasers of health services.
Insurance companies. - - Correct Answer:
Purchasers of health services.
75 year old male is suffering from an altered mental status. What is
happening to him?
The memory is overloaded.
There are changes to the brain's normal functions.
The patient is dying.
There is no change to the patient's brain activity. - - Correct Answer: There
are changes to the brain's normal functions
RATIONALE: Patients suffering from an altered mental status suffer general
changes to the brain's normal functions. Symptoms that are associated with
this state are confusion, loss of orientation, amnesia, and poor regulation of
emotions.
In order to provide health care, a health care professional must be assertive.
This would include all of the following attributes EXCEPT:
confidence in the necessary competencies and skills
direct and effective communication
acting as an advocate and consultant to the client
pressuring a client to accept treatment - - Correct
Answer: pressuring a client to accept treatment
RATIONALE: A client has the right to accept or refuse treatment. Being
assertive does not mean that the nurse can impose his or her opinions on the
client.
What term best describes a nurse's ability to best determine the end result?
Expected outcome.
Evaluation.
Competency.
Autonomy. - - Correct Answer:
Expected outcome.
intergroup
intragroup - - Correct Answer:
intragroup
Conflict among members of a particular group is intragroup conflict. Conflict
among members of two or more groups is known as intergroup conflict.
Human development is what?
The ability of disease to live inside of the body.
The process of dying.
The process of growing to maturity.
The growth rate of humans. - - Correct
Answer: The process of growing to
maturity
The process of growing to maturity is referred to as human development. It
is based upon the theory that humans are born, grow, age, and then die.
The NP sees a 12-year-old male who was referred to her because of
disruptive behavior and physical aggression against his peers. He is
generally hostile in temperament and easily irritated. The child is also failing
academically. This child most likely suffers from which of the following
disorders?
attention deficit hyperactivity disorder
oppositional defiant disorder
posttraumatic stress disorder
autistic disorder - - Correct
answer: oppositional defiant
disorder
This child would most likely be diagnosed with oppositional defiant disorder
(ODD). Children with ODD are disruptive, argumentative, hostile and irritable.
They have social problems with peers and adults and impaired academic
functioning.
Under what category would employee vacation pay, sick leave, and education
be listed?
Non productive time
Productive cost
Long term plan
Productive time - - Correct
answer: Non productive time
Non productive time must be considered. This includes benefits and pay that
employees receive that are not provided for work that has been
accomplished. Vacation and sick time are included in the Non productive
budget.
The neuroendocrine system contains all of the following EXCEPT:
hippocampus
hypothalamus
