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2024 ANCC PMHNP PSYCH-MENTAL HEALTH
NP EXAM LATEST 2024-2025 (TEST 1 ,2,& 3 )
QUESTIONS & CORRECT VERIFIED ANSWERS
WITH RATIONALE (TEST 1-3 LATEST UPDATED
VERSIONS) | ALREADY GRADED A+ NEW!!
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 - ANSWER>>Correct ANSWER: complicated grief
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 - ANSWER>>Correct ANSWER: Trazodone
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. - ANSWER>>Correct ANSWER: Use examples and review.
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 - ANSWER>>Correct ANSWER: Risperidone
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 - ANSWER>>Correct ANSWER: Medication noncompliance
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.
What is the rate of suicide attempts for patients having dissociative identity disorder? 30% 45% 70% 60% - ANSWER>>Correct ANSWER: 70%
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 - ANSWER>>Correct ANSWER: Cognitive
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 - ANSWER>>Correct ANSWER: A prolonged QT interval
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 - ANSWER>>Correct ANSWER: parataxic mode
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.
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 - ANSWER>>Correct ANSWER: Patient Protection and Affordable Care Act
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 - ANSWER>>Correct ANSWER: naturopathy
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 - ANSWER>>Correct ANSWER: Using reassuring touch
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 - ANSWER>>Correct ANSWER: unifies nurses' political voices
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 thought insertion disorganized speech delusions - ANSWER>>Correct ANSWER: thought insertion
DSM-V diagnostic criteria for schizophrenia include delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms.
Abraham Maslow established that human needs are hierarchical, with lower level (most basic) needs being critical to survival. Which of the following is the highest level of needs in Maslow's hierarchy? esteem and recognition self-actualization love and belonging safety - ANSWER>>Correct ANSWER: self-actualization
Abraham Maslow's hierarchy of needs from lowest to highest are: physiologic, safety, love and belonging, esteem and recognition, and self-actualization. Self-actualization is the fulfillment of a person's unique potential.
How well a drug passes through natural body barriers such as the skin or stomach is known as the drug's: diffusion metabolism bioavailability absorption - ANSWER>>Correct ANSWER: absorption
A drug's absorption is how well it passes through natural body barriers such as the skin, stomach, intestines, blood-brain barrier and other membranous tissues. Some considerations include whether the barrier is a lipid base or not.
Antidepressant medications are known to work by increasing the concentration of which of the following in the body? Serotonin Dopamine Norephinephrine All of the above - ANSWER>>Correct ANSWER: All of the above
These actions occur because the brain blocks the reuptake of these neurotransmitters by the neurons. In addition, the enzyme monoamine oxidase can inactive these at various sites in the nervous system.
Akathisia, akinesia, dystonia, and tardive dyskinesia are all side effects considered to affect which system: lymphatic skeletal endocrine muscular - ANSWER>>Correct ANSWER: muscular
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 - ANSWER>>Correct ANSWER: Evidence-based
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 - ANSWER>>Correct ANSWER: higher level of education
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 - ANSWER>>Correct ANSWER: Insurance companies
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 - ANSWER>>Correct ANSWER: Charting in ink
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
Hypokalemia - ANSWER>>Correct ANSWER: Hypokalemia
Some of the more common side effects of paroxetine would be considered: Somnolence GI upset Headache Dizziness Insomnia
Which of the following physical conditions could potentially cause a patient to exhibit potential psychiatric symptoms such as confusion? Urinary tract infections Chest pain Thyroid disorders Both A and C - ANSWER>>Correct ANSWER: Both A and C
When a patient is having an admission assessment, there should be a physical examination performed prior to the psychiatric assessment. Such problems as urinary tract infections, especially with the older adults can cause the patient to exhibit symptoms of confusion, among other things.
Which of the following does the nurse typically work with to help determine the potential outcomes and goals for the patient? Family Housekeeping Members of the interdisciplinary team Both A and C - ANSWER>>Correct ANSWER: Both A and C
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 - ANSWER>>Correct ANSWER: Respect preference
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 - ANSWER>>Correct ANSWER: decreased norepinephrine
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 - ANSWER>>Correct ANSWER: Gastrointestinal bleeding
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?
day treatment programs social skills training case management for vocational needs - ANSWER>>Correct ANSWER: disaster response
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 - ANSWER>>Correct ANSWER: Policy
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 - ANSWER>>Correct ANSWER: Discouraging freedom in the role
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. - ANSWER>>Correct ANSWER: Those patients who have been involuntarily admitted no longer have the right to refuse medications.
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. - ANSWER>>Correct ANSWER: Purchasers of health services.
Managed care is used or employed by purchasers of health services. These 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.
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. - ANSWER>>Correct ANSWER: There are changes to the brain's normal functions
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
The phases of a nurse-client relationship are (in sequence): orientation, identification, exploitation, and resolution. In the identification phase the nurse structures the relationship to focus on the client and facilitates the expression of problems and feelings. The nurse avoids fostering unnecessary dependency and encourages self-care.
Most malpractice suits are filed under which of the following areas of law? tort law criminal law administrative law contract law - ANSWER>>Correct ANSWER: tort law
Most malpractice suits are filed under tort law. Torts are private civil wrongs committed by one individual against another for which money damages are collected by the injured party from the wrongdoer.
Conflict among members of a particular group is classified as which of the following? intrapersonal interpersonal intergroup intragroup - ANSWER>>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. - ANSWER>>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 - ANSWER>>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 - ANSWER>>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 gonads pancreas - ANSWER>>Correct ANSWER: hippocampus
The hippocampus is not a part of the neuroendocrine system. It is a part of the brain located in the medial temporal lobe. It is an important site for the formation and storage of immediate and recent memories. The neuroendocrine system contains the hypothalamus, pituitary gland, thyroid gland, adrenal glands, gonads, and pancreas.
