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ANCC PMHNP PSYCH-MENTAL HEALTH NP LATEST
TEST 1 ,2,& 3 EXAM 100 QUESTIONS AND ANSWERS
EACH WITH RATIONALE LATEST 2024 /2025 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 helping the patients to see the relationship between their compliance with their medication regimen and control of their symptoms.
(DSM5),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. 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 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.
thought insertion disorganized speech delusions - - Correct Answer: thought insertion RATIONALE: 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 - - Correct Answer: self- actualization RATIONALE: 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 - - Correct Answer: absorption RATIONALE: 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 - - Correct Answer: All of the above
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. RATIONALE: 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.
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. The study of the distribution, incidence, prevalence, and duration of a disease is known by which of the following terms? pharmacokinetics etiology epidemiology pathogenesis - - Correct Answer: epidemiology RATIONALE: 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: Hypokalemia RATIONALE: 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
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. 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: 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
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. RATIONALE: An expected outcome occurs when you can determine the end results of a patient's care. Mental health nurses can make an educated assumption on what the outcome of their patient's 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: Sitting too close RATIONALE: 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 nurseclient relationship? identification orientation exploitation resolution - - Correct Answer: identification
RATIONALE: 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: tort law RATIONALE: 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: 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
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: 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: 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: 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: 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: 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: 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. What is the best course of action to be taken if a peer arrives at work hung over, therefore it is necessary to act quickly to prevent patient injury? Respect their privacy. Report the individual. Ignore the incident. Discuss the incident with coworkers. - - Correct answer: Report the individual Employees and peers have the right to expect personal privacy. This right however, does not protect unethical conduct. The individual placed others in danger and should be reported. What step of the nursing process, is the diagnoses, outcome and care revised if needed? Evaluation. Diagnosis. Planning. Implementation. - - Correct Answer: Evaluation The nursing process is a problem solving approach. There are 6 steps in the nursing process. They include: diagnosis, outcome identification, planning, implementation,
