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ANCC® PMHNP Psych-Mental Health
NP EXAM 1 NEWEST 2024 ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS)
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 - ANSWERS,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 - ANSWERS,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. - ANSWERS,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 - ANSWERS,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/ of psychiatric hospital readmissions? Not sufficient care. Medication noncompliance
of LSD overdose. Symptoms of serotonin syndrome include all of the following EXCEPT: insomnia nausea loss of coordination sweating or shivering with goose bumps - ANSWERS,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% - ANSWERS,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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,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?
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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,Correct Answer: thought insertion DSM-V diagnostic criteria for schizophrenia include delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms.
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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,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
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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,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 - ANSWERS,Correct Answer: Hypokalemia Some of the more common side effects of paroxetine would be considered: Somnolence GI upset Headache Dizziness Insomnia
Refuse to give consent Try to dissuade the patient - ANSWERS,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 - ANSWERS,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 - ANSWERS,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. - ANSWERS,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 - ANSWERS,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 - ANSWERS,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.
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. - ANSWERS,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. - ANSWERS,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. - ANSWERS,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 - ANSWERS,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. - ANSWERS,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
