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ANCC PMHNP Psych-Mental Health NP_Test 1 Questions and Answers Rated A+, Exams of Nursing

A series of questions and answers related to mental health nursing. It covers topics such as grief, antidepressants, teaching strategies, prolactin elevation, cognitive modes, health insurance, alternative medical systems, alcohol intoxication, leadership styles, family structures, drug absorption, neurotransmitters, depression treatment, homelessness, arrhythmia, extrapyramidal side effects, and evidence-based practice. The questions are multiple-choice and provide explanations for the correct answers.

Typology: Exams

2022/2023

Available from 03/16/2023

ClemBSC
ClemBSC 🇺🇸

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Download ANCC PMHNP Psych-Mental Health NP_Test 1 Questions and Answers Rated A+ and more Exams Nursing in PDF only on Docsity!

ANCC PMHNP Psych-Mental Health

NP_Test 1 Questions and Answers Rated

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

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

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.

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

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

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

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

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 implicated in serotonin syndrome.

What is the rate of suicide attempts for patients having dissociative identity disorder? 30% 45% 70% 60% ✔✔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 ✔✔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 ✔✔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 ✔✔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 ✔✔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 ✔✔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.

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

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

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

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

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 ✔✔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 ✔✔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 ✔✔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 ✔✔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.

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

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.

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

Arrhythmia is a side effect of lithium. The patient needs to be monitored for risky side effects. An EKG or electrocardiogram would be used.

Akathisia, akinesia, dystonia, and tardive dyskinesia are all side effects considered to affect which system: lymphatic skeletal endocrine muscular ✔✔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:

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: 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: 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: 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 public, private, and therapeutic ✔✔Correct Answer: social, intimate, and therapeutic

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

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

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

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: 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: 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: 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: 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 ✔✔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? 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

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

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

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

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

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.

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.

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. ✔✔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 acting as an advocate and consultant to the client pressuring a client to accept treatment ✔✔Correct Answer:

pressuring a client to accept treatment

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.

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

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: 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: 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: 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 gonads pancreas ✔✔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.

In which stage of the standards of practice for psychiatric nursing would the nurse document measurable goals? assessment implementation planning outcomes identification ✔✔Correct Answer: outcomes identification

Outcomes identification includes documenting expected outcomes as measurable goals. It also includes identifying attainable and culturally expected outcomes and including time estimate for expected outcomes.

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?