ANCC-PMHNP Board Certification Complete Test Guide 2024, Exams of Nursing

Download ANCC-PMHNP Board Certification Complete Test Guide 2024 and more Exams Nursing in PDF only on Docsity! PMHNP Board Certification COMPLETE TEST GUIDE 2024 1. Which neurotransmitter imbalance is primarily associated with Major Depressive Disorder (MDD)? - A. Dopamine - B. Serotonin - C. Glutamate - D. Acetylcholine Answer: B. Serotonin. Rationale: Serotonin is widely recognized for its role in mood regulation, and its imbalance is commonly associated with MDD. 2. What is the primary action of selective serotonin reuptake inhibitors (SSRIs) in the CNS? - A. Inhibit the degradation of serotonin - B. Block the reuptake of serotonin - C. Stimulate serotonin release - D. Block serotonin receptors Answer: B. Block the reuptake of serotonin. - D. Young Mania Rating Scale (YMRS) Answer: B. Hamilton Anxiety Rating Scale (HAM-A). Rationale: The HAM-A is specifically designed to quantitatively measure the severity of anxiety symptoms. Diagnosis and Treatment 7. Which antipsychotic medication requires regular monitoring of white blood cell count due to the risk of agranulocytosis? - A. Risperidone - B. Olanzapine - C. Clozapine - D. Quetiapine Answer: Clozapine. Rationale: Clozapine has a significant risk of causing agranulocytosis, necessitating regular WBC monitoring. 8. When diagnosing ADHD in adults, which symptom is less likely to be prominent compared to children? - A. Inattention - B. Hyperactivity - C. Impulsivity - D. Academic underachievement Answer: B. Hyperactivity. Rationale: Hyperactivity often decreases with age, whereas inattention and impulsivity tend to persist in adults with ADHD. 9. Which statement about the use of benzodiazepines in anxiety disorders is correct? - A. They are recommended for long-term management of anxiety. - B. They carry a risk of dependence and tolerance. - C. They are first-line treatments for generalized anxiety disorder. - D. They should be used with caution in individuals without a history of substance abuse. Answer: B. They carry a risk of dependence and tolerance. Rationale: Benzodiazepines are known for their potential for dependence and tolerance, limiting their use for long-term management. Psychotherapy and Related Theories 10. Which of the following is a principle technique used in Cognitive Behavioral Therapy (CBT)? - A. Dream analysis - B. Free association - C. Cognitive restructuring - D. Hypnosis Answer: C. Cognitive restructuring. Rationale: Cognitive restructuring is a key technique in CBT aimed at changing maladaptive thought patterns. 11. In Dialectical Behavior Therapy (DBT), what is the primary function of the skill “distress tolerance”? - A. To challenge cognitive distortions - B. To create a hierarchy of problematic behaviors - C. To accept and tolerate distressing situations - D. To identify and modify thought patterns Answer: C. To accept and tolerate distressing situations. - D. Honoring the patient’s choices. Answer: B. Avoiding harm to the patient. Rationale: Nonmaleficence entails an obligation to not inflict harm intentionally on the patient. Cultural Care 16. When providing culturally competent care, a PMHNP should: - A. Apply the same approach to all clients, regardless of cultural background. - B. Avoid discussing cultural differences to prevent discomfort. - C. Understand and respect each patient’s cultural background and beliefs. - D. Focus primarily on the biological aspects of care. Answer: C. Understand and respect each patient’s cultural background and beliefs. Rationale: Culturally competent care requires understanding and respecting each patient’s unique cultural background and beliefs. 17. Which of the following is an example of cultural humility in psychiatric practice? - A. Assuming the cultural norms of the patient’s population are uniform. - B. Reflecting on one’s biases and actively engaging in self-critique. - C. Dictating treatment plans without patient collaborative input. - D. Prioritizing clinical guidelines over cultural practices. Answer: B. Reflecting on one’s biases and actively engaging in self- critique. Rationale: Cultural humility involves self-reflection and recognition of one's biases, promoting open-minded engagement with diverse populations. 18. In treating a refugee patient with PTSD, the PMHNP should prioritize: - A. Medication management. - B. Isolating the patient to avoid triggers. - C. Trauma-informed care and understanding cultural context. - D. Immediate exposure therapy. Answer: C. Trauma-informed care and understanding cultural context. Rationale: For refugee patients with PTSD, trauma-informed care that considers cultural context is essential for effective treatment. More Diagnosis and Treatment 19. Which medication class is typically first-line treatment for Obsessive- Compulsive Disorder (OCD)? - A. Benzodiazepines - B. Atypical antipsychotics - C. SSRIs - D. Mood stabilizers Answer: C. SSRIs. Rationale: SSRIs are effective and typically first-line treatments for OCD. 20. Which of the following is an accurate description of the mechanism of action of lithium in bipolar disorder? - A. Inhibition of dopamine reuptake - B. Modulation of glutamate activity - C. Enhancement of GABAergic transmission - D. Decreasing postsynaptic serotonin signaling Answer: B. Modulation of glutamate activity. - B. Sharing de-identified patient data for research. - C. Discussing patient details in a public setting. - D. Accessing patient records for professional reasons. Answer: C. Discussing patient details in a public setting. Rationale: Discussing patient information in public violates HIPAA's privacy rules. More Cultural Care 25. How should a PMHNP handle a situation where a patient’s cultural beliefs conflict with medical advice? - A. Adhere strictly to medical protocol. - B. Disregard the patient’s beliefs. - C. Engage in a respectful discussion to find a mutually acceptable solution. - D. Refer the patient to another provider. Answer: C. Engage in a respectful discussion to find a mutually acceptable solution. Rationale: Incorporating cultural beliefs into treatment planning fosters patient compliance and respect. 26. In a multicultural team meeting, the PMHNP should aim to: - A. Minimize cultural discussions to focus on clinical aspects. - B. Encourage open dialogue about cultural impacts on care. - C. Enforce a uniform approach to patient care. - D. Delegate cultural considerations to a specific team member. Answer: B. Encourage open dialogue about cultural impacts on care. Rationale: Open dialogue about cultural considerations promotes a more comprehensive and respectful approach to patient care. More Diagnosis and Treatment 27. Which psychotherapy is considered highly effective for Borderline Personality Disorder (BPD)? - A. Cognitive Behavioral Therapy (CBT) - B. Dialectical Behavior Therapy (DBT) - C. Interpersonal Therapy (IPT) - D. Psychodynamic Therapy Answer: B. Dialectical Behavior Therapy (DBT). Rationale: DBT was specifically developed for BPD and has strong evidence supporting its effectiveness. 28. Which of the following best describes a contraindication for using bupropion in treating depression? - A. Anxiety disorder - B. History of seizures - C. Hypothyroidism - D. Diabetes mellitus Answer: B. History of seizures. Rationale: Bupropion lowers the seizure threshold and is contraindicated for patients with a history of seizures. More Psychiatry and Related Theories 29. In Family Systems Theory, the concept of triangulation refers to: - A. Redirection of emotions onto a third party. - B. Establishment of strong family boundaries. - C. Direct communication within the family. - D. Encouraging independent problem-solving. - Rationale: Reflective listening is a core technique in motivational interviewing, helping patients to explore their feelings and motivations. Diagnosis and Treatment 5. Which diagnostic tool is most commonly used to assess the severity of depression in clinical practice? - A) Beck Depression Inventory (BDI) - B) Hamilton Anxiety Rating Scale (HAM-A) - C) Mini-Mental State Examination (MMSE) - D) Positive and Negative Syndrome Scale (PANSS) - Correct Answer: A) Beck Depression Inventory (BDI) - Rationale: The BDI is widely used to assess the severity of depression and monitor treatment progress. 6. What is the first-line treatment for generalized anxiety disorder (GAD)? - A) Benzodiazepines - B) Selective serotonin reuptake inhibitors (SSRIs) - C) Tricyclic antidepressants (TCAs) - D) Monoamine oxidase inhibitors (MAOIs) - Correct Answer: B) Selective serotonin reuptake inhibitors (SSRIs) - Rationale: SSRIs are considered the first-line treatment for GAD due to their efficacy and safety profile. Psychotherapy and Related Theories 7. Which psychotherapy approach focuses on changing maladaptive thought patterns to improve emotional regulation and develop personal coping strategies? - A) Psychoanalysis - B) Cognitive-behavioral therapy (CBT) - C) Humanistic therapy - D) Gestalt therapy - Correct Answer: B) Cognitive-behavioral therapy (CBT) - Rationale: CBT aims to change maladaptive thought patterns and behaviors, making it effective for a variety of mental health conditions. 8. In psychodynamic therapy, what is the term for the unconscious redirection of feelings from one person to another? - A) Transference - B) Countertransference - C) Projection - D) Displacement - Correct Answer: A) Transference - Rationale: Transference involves the redirection of feelings and desires, often unconsciously, from one person to another, typically from a patient to a therapist. Ethics, Legal Principles, and Cultural Care 9. Which ethical principle is primarily concerned with doing good and acting in the best interest of the patient? - A) Autonomy - B) Beneficence - C) Nonmaleficence - D) Justice - Correct Answer: B) Beneficence - Rationale: Beneficence involves actions that promote the well-being of patients and is a fundamental principle in healthcare ethics. 10. What is the primary legal concern when a mental health professional breaches patient confidentiality? - A) Informed consent - B) Malpractice - C) Duty to warn - D) Breach of privacy - Correct Answer: D) Breach of privacy - Rationale: Breaching patient confidentiality can lead to legal issues related to privacy violations and can undermine trust in the therapeutic relationship. - B) Anhedonia - C) Hallucinations - D) Social withdrawal - Correct Answer: C) Hallucinations - Rationale: Positive symptoms in schizophrenia include hallucinations and delusions, which are additions to normal behavior. 16. Which medication is considered a first-line treatment for bipolar disorder? - A) Lithium - B) Fluoxetine - C) Clozapine - D) Diazepam - Correct Answer: A) Lithium - Rationale: Lithium is a mood stabilizer commonly used as a first-line treatment for bipolar disorder due to its efficacy in managing both manic and depressive episodes. 17. What is the primary focus of the biopsychosocial model in mental health care? - A) Biological factors only - B) Psychological factors only - C) Social factors only - D) Integration of biological, psychological, and social factors - Correct Answer: D) Integration of biological, psychological, and social factors - Rationale: The biopsychosocial model emphasizes the importance of considering biological, psychological, and social factors in understanding and treating mental health conditions. 18. Which of the following is a key component of trauma-informed care? - A) Ignoring past trauma - B) Focusing solely on symptoms - C) Recognizing the impact of trauma on behavior - D) Using a one-size-fits-all approach - Correct Answer: C) Recognizing the impact of trauma on behavior - Rationale: Trauma-informed care involves understanding and recognizing the impact of trauma on an individual's behavior and providing care that is sensitive to this history. 19. Which legal principle requires mental health professionals to report suspected child abuse? - A) Confidentiality - B) Duty to warn - C) Mandatory reporting - D) Informed consent - Correct Answer: C) Mandatory reporting - Rationale: Mandatory reporting laws require mental health professionals to report any suspected cases of child abuse to the appropriate authorities. Advanced Concepts in Scientific Foundation: Case Study: A patient with a history of schizophrenia presents with new- onset visual hallucinations. Which neurotransmitter is most likely implicated in this presentation? A) Serotonin B) Dopamine C) Acetylcholine D) GABA Correct Answer: B) Dopamine Rationale: Dopamine dysregulation is commonly associated with psychotic symptoms like hallucinations in schizophrenia. Advanced Practice Skills: Case Study: A PMHNP is assessing a patient for suicidal ideation. What is the priority action during this assessment? A) Assess the patient's past medical history B) Establish rapport and trust with the patient C) Inquire about the patient's social support system D) Ask about the patient's specific suicide plan D) GABA Correct Answer: C) Dopamine Rationale: Dopamine plays a key role in the brain's reward system and is associated with motivation, reinforcement, and pleasure. Question: When conducting a mental status examination, which component assesses a patient's ability to recall past events and information? A) Attention B) Memory C) Insight D) Judgment Correct Answer: B) Memory Rationale: Memory assessment is a crucial part of the mental status examination as it provides insight into a patient's cognitive functioning and ability to recall information. Diagnosis and Treatment: Question: Which of the following is a common side effect associated with the use of selective serotonin reuptake inhibitors (SSRIs)? A) Weight gain B) Hypertension C) Sexual dysfunction D) Insomnia Correct Answer: C) Sexual dysfunction Rationale: Sexual dysfunction, such as decreased libido and difficulty achieving orgasm, is a commonly reported side effect of SSRIs. Psychotherapy and Related Theories: Question: Cognitive-behavioral therapy (CBT) focuses on identifying and challenging: A) Unconscious conflicts B) Early childhood experiences C) Maladaptive thoughts and behaviors D) Attachment patterns Correct Answer: C) Maladaptive thoughts and behaviors Rationale: CBT aims to help individuals identify and challenge negative thought patterns and behaviors that contribute to their psychological distress. Ethics, Legal Principles, and Cultural Care: Question: Informed consent in psychiatric practice involves: A) Mandating treatment against the patient's will B) Ensuring the patient understands the risks and benefits of treatment C) Withholding information from the patient to avoid distress D) Delegating consent to a family member Correct Answer: B) Ensuring the patient understands the risks and benefits of treatment Rationale: Informed consent requires that patients are provided with relevant information about their treatment options so they can make autonomous decisions.