Download ANCC PMHNP Psych-Mental Health NP Exam Questions and Answers and more Exams Nursing in PDF only on Docsity!
ANCC PMHNP PSYCH-MENTAL HEALTH
NP_EXAM QUESTIONS AND DETAILED
ANSWERS | 100% VERIFIED
Akathisia, akinesia, dystonia, and tardive dyskinesia are all side effects considered to affect which system: lymphatic skeletal endocrine muscular - ✔✔✔ Correct 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 - ✔✔✔ Correct 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 - ✔✔✔ Correct 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 - ✔✔✔ Correct 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 - ✔✔✔ Correct 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.
Epidemiology is the study of the distribution, incidence, prevalence, and duration of a disease. Etiology refers to cause or origination of a disease. Pathogenesis is the manner of development of the disease. Pharmacokinetics refers to the movement of the drug into, through and out of the body. Which of the following would not be considered a common side effect of paroxetine? Somnolence GI upset Headache Hypokalemia - ✔✔✔ Correct 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 - ✔✔✔ Correct 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 - ✔✔✔ Correct 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 - ✔✔✔ Correct 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 - ✔✔✔ Correct 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?
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 > Correct Answer: Long-term care 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. Which of the following would be an example of a secondary prevention measure for psychiatric practice? disaster response day treatment programs social skills training case management for vocational needs - ✔✔✔ Correct 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 - ✔✔✔ Correct 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 - ✔✔✔ Correct 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. - ✔✔✔ Correct 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. - ✔✔✔ Correct Answer > Correct Answer: Purchasers of health services.
health will be based on patient cooperation, assessments, tests, observations, and the diagnosis. All details related to the patient's health are considered, and used to determine the expect outcome. What might be a cause for a member of the collaborative team to receive complaints concerning his communication skills? Poor eye contact Sitting too close Professional dress Gestures that accompany words - ✔✔✔ Correct Answer > Correct Answer: Sitting too close Body language is an important communicator. Sitting too close to people invades their personal space. This results in negative communication. When a nurse structures the relationship with a client to focus on the client and facilitates expression of problems and feelings, this is part of which phase of the nurse-client relationship? identification orientation exploitation resolution - ✔✔✔ Correct Answer > Correct Answer: identification 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 - ✔✔✔ Correct 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 - ✔✔✔ Correct 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. - ✔✔✔ Correct 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 - ✔✔✔ Correct 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.
The type of hospital admission to a psychiatric inpatient setting that does not require a written application is which of the following? voluntary admission involuntary admission temporary admission informal admission - ✔✔✔ Correct Answer > Correct Answer: informal admission Informal admission is one type of voluntary admission that is similar to any general hospital admission in which there is no formal or written application. An informal admission is sought by the patient. The normal doctor-patient relationship exists, and the patient is free to stay or leave, even against medical advice. Which of the following is NOT a drug associated with date rape? Risperidone GHB Rohypnol Ketamine - ✔✔✔ Correct Answer > Correct answer: Risperidone Risperidone is not a drug associated with date rape. It is an antipsychotic. Date rape drugs may render a woman incapable of resisting a rape and are purported to facilitate acquaintance rape. Once the drugs are ingested, victims lose their ability to ward off attackers, develop amnesia and become unreliable witnesses. What is the term used for the study of ethical problems resulting from scientific advances? Medical ethics Ethical acculturation Bioethics Deontology - ✔✔✔ Correct Answer > Correct Answer: Bioethics Nursing ethics is part of a broader system known as bioethics. New questions surface as science and technology produce new ways of knowing. Bioethics is the term used for the study of ethical problems resulting from scientific advances.
The responsibilities of the nurse leader in using change management include all but which of the following? using change theory serving as a change agent supporting staff during times of difficult transitions having a rigid leadership style - ✔✔✔ Correct Answer > Correct Answer: having a rigid leadership style Having a rigid leadership style is not part of good change management. Adapting leadership style to situational needs is more effective. The responsibilities of the nurse leader in using change management include all of the first three choices. They also include: recognizing one's own reaction to change and striving to remain open to new ideas and approaches. The NP asks a patient with schizophrenia what the saying, "people in glass houses shouldn't throw stones" means to him. The patient replies that "the glass might break." This is an example of the patients inability to process which of the following? concrete thinking abstract thinking delusion echolalia - ✔✔✔ Correct Answer > Correct Answer: abstract thinking This patient is not able to process abstraction. Concreteness is often assessed through the patient's interpretation of proverbs. Concreteness reduces one's ability to understand and address abstract concepts such as love or the passage of time. If you teach a client how to navigate through the complexities of the health care delivery system to receive prompt treatment this is a form of: primary prevention secondary prevention tertiary prevention enabling - ✔✔✔ Correct Answer > Correct Answer: secondary prevention You should develop teaching programs that coincide with the level of prevention needed by the client. Because primary prevention is not possible in all cases, a significant share of your time is spent teaching at the secondary or tertiary level.
A 58 year old woman is dealing with symptoms of vasomotor instability, sleep disturbances, hot flashes, urinary frequency, and dyspareunia. What is the likely cause of her symptoms? High cholesterol. Estrogen deficiency. Estrogen surplus. Testosterone surplus. - ✔✔✔ Correct Answer > Correct Answer: Estrogen deficiency Menopause upsets the balance of estrogen in the body. There are many symptoms associated with menopause, and they are all commonly because of an estrogen deficiency. Defamation of a person in written form is which of the following? breach of contract slander fraud libel - ✔✔✔ Correct Answer > Correct Answer: libel Defamation is defined as an oral or written communication to a third party about another party that is false and that tends to injure the other party's reputation. Libel is defamation in written form; slander is oral defamation. What leaders do or how they conduct themselves is the basis of what theory of leadership? trait theory contingency theory behavioral theory contemporary theory - ✔✔✔ Correct Answer > Correct Answer: behavioral theory What leaders do, or how the behave, is the focus of behavioral theorists. For example, impoverished leaders have a low concern for both people and production, while the team leaders show high concern in both of these dimensions. A psychiatric mental health nurse will work how? In a restricted environment. Alone and as a team player.
Alone only. As a team only. - ✔✔✔ Correct Answer > Correct Answer: Alone and as a team player. Registered nurses need to know how to work by themselves or as team players. Working as a team is an integral part of the nursing process. If nurses can collaborate, they can provide better care to patients. What would be the first action to be taken if a patient who has been diagnosed with PTSD because she was a witness to her brother being killed and is now staying in a psychiatric unit is having trouble sleeping, thinks she hears people trying to get into her room, and at times having nightmares? Listen to the patient's story of what has been happening to her. Assess the risk of suicide. Have the patient talk about the traumatic event. Encourage her to talk to others who have had similar experiences. - ✔✔✔ Correct Answer > Correct answer: Assess the risk of suicide. A patient with post traumatic stress syndrome (PTSD) has experienced a traumatic event that has affected their life severely. The patient will be experiencing a high level of anxiety and as a result, the possibility of self-destructive behavior is present. This should be the first concern to be addressed. What statement concerning conduct disorder in children is accurate? Conduct disorder is more common in children of parents with antisocial personality disorder than in the general population. Conduct disorder affects more girls than boys. Onset is earlier for girls than boys. The child must have one or more symptoms of the disorder in the past year to be diagnosed with conduct disorder. - ✔✔✔ Correct Answer > Correct answer: Conduct disorder is more common in children of parents with antisocial personality disorder than in the general population. This is the accurate statement. It is also more common in children of parents with alcohol dependence, mood disorders, or schizophrenia rather than in the general population. Conduct disorder affects more boys than girls. Its onset is earlier for boys than girls. The child must have three or more symptoms of
Duration of hours to days Gradual change in mental status Change in psychomotor activity, either hyperactive or hypoactive Perceptual disturbances - ✔✔✔ Correct Answer > Correct answer: Gradual change in mental status This is a characteristic of dementia. The other choices are all characteristic of delirium. Dementia has a gradual and insidious onset. Delirium does not have an insidious onset; its onset is abrupt. It can usually be noted at a precise date as a rapidly progressive change in mental status. There are how many conditions that allow NPs to challenge a patient's refusal of treatment after informed consent?
- ✔✔✔ Correct Answer > Correct Answer:
There are five conditions that allow NPs to challenge a patient's refusal to treatment. They include: when a patient is mentally incompetent, when refusing treatment causes danger to the life/health of another, in an emergency situation, when the patient is a child, and in the case of therapeutic privilege. When would a patient's informed consent not be necessary? The patient has dementia. The patient has delusional thoughts. The patient is exhibiting violent ideation. The patient has bipolar disorder. - ✔✔✔ Correct Answer > Correct answer: The patient is exhibiting violent ideation. Informed consent is not always necessary. Exceptions are made in an effort to preserve life. A patient who is experiencing violent ideation and is a threat to others may be treated without informed consent. According to studies, which group of people with bipolar I is more likely to experience rapid cycling? Older people Men
Young people Women - ✔✔✔ Correct Answer > Correct answer: Women According to evidence, female patients are more likely to experience rapid cycling. Male patients have a higher risk of manic episodes. Long-term involuntary admission to a psychiatric inpatient setting is for extended care and treatment of the mentally ill. The patient can be admitted for this type of admission through which of the following means? medical certification judicial review administrative action all of the above - ✔✔✔ Correct Answer > Correct answer: all of the above Long-term involuntary admission has as its primary purpose extended care and treatment of the mentally ill. Those who undergo extended involuntary hospitalization are admitted through medical certification, judicial review, or administrative actions. This type of involuntary hospitalization generally lasts 60 to 180 days, but may also be for an indeterminate period. If there is an absence of state statutes, what is used as the basis of liability for injuries related to negligence? Federal law. Common law. Administrative law. Criminal law. - ✔✔✔ Correct Answer > Correct Answer: Common law If there is an absence of state statutes, common law is used as the basis of liability for injuries related to negligence. Common law is also used for malpractice as well, if there is an absence of state statutes. What key principle of ethical decision making is defined as the right of self-determination, independence, and freedom? Autonomy Justice Fidelity Beneficence - ✔✔✔ Correct Answer > Correct answer: Autonomy
