Download Test Bank for PMHNP Boards Exam Questions and Correct Answers (Verified) and more Exams Nursing in PDF only on Docsity!
2025 Test Bank for PMHNP Boards Exam Questions and
Correct Answers (Verified)
What is true of interprofessionality? ✔✔ All health professionals have individual professional competencies What is the significance of an experimental p-value of 0.05 ✔✔ There is a 5% chance of a similar result occurring by chance alone What percentage of children with oppositional defiance disorder will develop conduct disorder? ✔✔ 30% In the DSM-5, selective mutism is now considered what type of disorder? ✔✔ anxiety disorder Symptoms of selective mutism must persist for at least ✔✔ 1 month Common competencies ✔✔ overlap more than one health care professional, although not necessarily all health care professionals, and are competencies expected of all health care professionals Complementary competencies ✔✔ enhance the qualities of other professions in provision of care Collaborative competencies ✔✔ those that each individual profession must possess to work with others, including those who practice within different specialties within a profession. Interpersonal collaboration is centered ✔✔ patient Cognitive therapy is recommended for patients that have ✔✔ negative cognitive distortions irrational beliefs faulty conceptions Humanistic Therapy focuses on assisting patients with ✔✔ self-actualization and self- directed growth Behavioral Therapy focuses on ✔✔ changing maladaptive behaviors through the use of behavioral modification techniques Existential therapy is for ✔✔ reflection on life confronting self
120 who got diarrhea ate lettuce. 80 with diarrhea did not eat lettuce. 40 without diarrhea ate lettuce. 160 without diarrhea ate lettuce. What is the odds ratio of eating lettuce and developing diarrhea? ✔✔ 6 ((120X160)/(80x40)) The New Freedom Commission on Mental Health (NFCMH) released a report that suggested ✔✔ implementation a national campaign to reduce the stigma of seeking care Focusing on promoting recovery and building resilience The efficacy of mental health treatments was found to be well documented in ✔✔ influential report issued by US Surgeon General in 1999 State of high negative emotion and pessimism ✔✔ neuroticism Commonly known as an optimistic outlook on life They are are outgoing, like social interaction, respond to external rewards, have more active dopamine networks, and are responsive to positive reinforcement. ✔✔ Extraversion (high levels protect from psychiatric illness) Introverts are more likely to be motivated and more likely to respond to reinforcement ✔✔ internally negative (more likely to interact with internal motivation/self-image) Interpersonal trait of cooperation, easy going nature. Tend to have smooth relationships often at the expense of self-assertion ✔✔ Agreeableness Associated with self-control and a focused, organized approach to life. Are achievement-oriented goal setters who can delay immediate gratification to obtain their long term desired outcome. They are considered responsible, reliable, and dependable. ✔✔ conscientiousness In behavioral couples therapy, the initial sessions are spent doing a functional analysis of behavior (FAB). What is true about FAB? ✔✔ FAB is concerned only with observable stimuli connected to operant behavior FAB is based on operant conditioning (identifying antecedent stimuli, operant behaviors, and consequent stimuli) The goal of FAB is modifying willful operant behavior Gestalt theory deals with , not ✔✔ perceptual psychology behavior Medication that can delay ejaculation in patients with premature ejaculation ✔✔ Paroxetine (and other SSRIs) (others include:
Citalopram Escitalopram Venlafaxine Duloxetine Buspar A surrogate has the right to terminate pregnancy if ✔✔ the pregnancy threatens her health or life or she is a genetic parent If the surrogate receives both ovum and sperm from couple, she loses the right to ✔✔ determine whether or not child will be aborted (this is up to the couple) Which medication is most effective for treating social phobia/social anxiety disorder, especially when refractory? ✔✔ Phenelzine A 55-year-old female patient has Stg II HTN. On exam, she has trace pedal edema bilaterally, but her lungs are clear. Her ECG reveals 2nd degree heart block. Which of the following BP medications should be avoided? ✔✔ Calcium Channel Blockers 3 Contraindications to use a calcium channel blocker ✔✔ 1st or second degree heart block Bradycardia CHF 4 Side effects of calcium channel blockers ✔✔ Headache Lower extremity edema Bradycardia Heart Block An NP is evaluating a 78 year old female with depression. She suspects the patient may have Parkinson's disease. Which of the following is consistent with that diagnosis? ✔✔ Postural instability Pill-rolling tremor Shuffling Gait Difficulty initiating movement Mask-like facies (difficulty initiating movement) Writhing movements occur with ✔✔ Huntington's chorea 10 Non-motor manifestations of Parkinsons ✔✔ Autonomic dysfunction Gastrointestical dysfunction
Rhinorrhea Sleep disturbance Fatigue Mood disorder Cognitive dysfunction Dementia Psychosis Hallucinations What type of therapy is most useful in depressed HIV positive outpatients? ✔✔ Interpersonal psychotherapy What type of therapy is most useful in patients with borderline personality disorder? ✔✔ Dialectical behavioral therapy The NP is caring for a patient dying of lymphoma. The pt's wife states that the pt has been mismanaged and that another practitioner must be assigned to the patient for him to improve. This NP suspects that this individual is in which stage of grief according to Elizabeth Kugler-Ross? ✔✔ Bargaining Involves resisting or refusing to remember information that has been supplied ✔✔ Denial Pica and spoon shaped nails are associated with ✔✔ Iron-deficiency anemia (microcytic) 2 common causes of microcytic anemia ✔✔ iron deficiency anemia of inflammation/chronic disease (TB, HIV, endocarditis, RA, Chrohn's DM, kidney disease, CA) (Other causes: lead toxicity, alcohol/drug use, zinc excess (copper deficiency)) Initial symptoms of B12 deficiency ✔✔ Generalized weakness Paresthesias Possible ataxia Late symptoms of B12 deficiency ✔✔ Memory impairment Depressed mood 5 P's of Vitamin B12 deficiency ✔✔ Pancytopenia (Peripheral and Posterior spinal cord) neuropathy Pyramidal tract signs
Pt wanting something immediate and non-addictive for breakthrough anxiety ✔✔ Hydroxyzine How long do GAD symptoms need to occur to make the diagnosis? ✔✔ 6 months First lab test to check for Sjogren's ✔✔ Anti-nuclear antibody tests To diagnose Cyclothymic disorder, it must be present for in adults ✔✔ 2 years To diagnose Cyclothymic disorder, it must be present for in pediatrics ✔✔ 1 year 4 physiological disturbances that may explain some of the symptoms of panic ✔✔ impaired lactate metabolism abnormality of locus coeruleus (Ser, NE, GABA, Dop, cholecystokinin) carbon dioxide hypersensitivity (hyperventilation) A 45-year-old man presents to the ER for "panic attack". He appears agitated, confused, and dizzy. He became more agitated and combative with staff upon further questioning. He states he was prescribed Xanax 0.5mg 3x daily by outpatient psychiatrist. His vitals are WNL. What is most likely his dx ✔✔ Benzodiazepine intoxication Anxiety, tremors, nightmares, insomnia, anorexia, nausea, vomiting, hypotension, Benzodiazepine withdrawal (serious medical complications including death) Confusion, AH, VH following a period of insomnia can be a sx of ✔✔ withdrawal delirium Female patients with PTSD commonly have this comorbid diagnoses ✔✔ Major depressive disorder (50%) Percentage of people with PTSD who have alcohol use disorder ✔✔ male 50% female 27% Percentage of people with PTSD who have simple or social phobias ✔✔ 30% both male and female Percentage of people with PTSD who have persistent depressive disorder ( previously dysthymia) ✔✔ 20% for both male and female seizures, delirium and hyperprexia are sx of. which can result in ✔✔
Treatment plan for OCD ✔✔ SSRI or Clomipramine Psychotherapy Normal Rinne test is for this nerve ✔✔ CN VIII What ethnic groups are at higher risk for social phobia ✔✔ Native American What ethnic groups are at lower risk for social phobia ✔✔ Asian Black Latino Onset of social phobia is ✔✔ Usually begins in late adolescence or early adulthood (13- 20 years) 3 CBT techniques for social phobias ✔✔ exposure cognitive restructuring social skills training Medication used to help with social phobia for public speaking ✔✔ propranolol FDA approved SSRI for social phobia ✔✔ paroxetine What type of fracture is a red flag for child abuse? ✔✔ Spiral of long bone (caused by twisting of extremity) Bruises on the torso in different stages of healing often indicate ✔✔ abuse Tanner Stage: Breast buds undeveloped with papilla elevation only. Villus hair only ✔✔ I Tanner Stage: Breast buds palpable, straight pubic hair mostly on labia ✔✔ II Tanner Stage: Areola begins to enlarge and pubic hair becomes darker, coarser, and curly ✔✔ III Tanner Stage: Areola forms a secondary mound on the breast and hair is of adult quality ✔✔ IV Tenderness at McBurney's point is suggestive of ✔✔ appendicitis About 30% of patients with this disorder have OCD thoughts ✔✔ Tourette's disorder Rx that can cause anxiety ✔✔ Steroids (prednisone) Albuterol
Acute stress disorder is diagnosed if the characteristic symptoms present within what period of time after experiencing the traumatic event? ✔✔ 1 month In what Tanner's stage will a male's penis grow more in length than width ✔✔ III In what Tanner's stage will a male's scrotum begins to grow and redden. Where pubic hair will be straight, fine and sparse ✔✔ II In what Tanner's stage will a male's pubic hair look more like an adult, but will not cover as much area. Where penis will thicken, testes and scrotum continue to grow. ✔✔ IV Brain structure R/T development of GAD ✔✔ Amygdala What circumstance(s) are often correlated to the onset of panic disorder ✔✔ separation from family serious illness of friend/family accident major relationship loss/change abusing substances postpartum Lifetime prevalence of anxiety disorders in the US ✔✔ 25 - 35% (18% prevalence) Buspar needs to have similar efficacy to benzodiazepines ✔✔ 4 weeks How many panic symptoms must be present for diagnoses. ✔✔ 4 Part of Brain responsible for smell ✔✔ Limbic Part of brain (lobe) responsible for visual functions ✔✔ Occipital Part of brain (lobe) responsible for sensory integration and somatosensory function ✔✔ Parietal Part of brain (lobe) responsible for executive function, social conduct, judgement, and some motor function ✔✔ Frontal Occasional crossing of eyes is not normal after the infant is older than ✔✔ 2 months If strabismus is left untreated, what may result? ✔✔ ambylopia (affected eye decrease in vision) What would be the normal testosterone level of a Tanner V male ✔✔ 265 - 800 ng/dl
Bactrim is contraindicated in ✔✔ Glucose- 6 - phosphatase deficiency Folate deficiency anemia patients with significant hepatic impairment pregnant patiens Pt has severe headache behind right eye with eye pain and tearing, sees halos around light fixtures. C/o N/V. R pupil fixed more oval than round, mid-dilated and cloudy. What might be happening ✔✔ Acute angle closure glaucoma (Emergency) What STD is not reportable in all 50 states ✔✔ HPV Romberg test is a test of ✔✔ balance A child will recognize faces and smile appropriately at familiar faces by age ✔✔ 3 A typical can count up to 20 with minimal assistance of an older child or parent ✔✔ 4 year old A typical can run/walk up and down the stairs ✔✔ 21 month old A typical is beginning to acquire language skills ✔✔ 14 month old What herbal supplement is effective for a pt with an adjustment disorder with anxiety according to RCT ✔✔ Kava Kava What herbal supplement is effective for somatoform disorders according to RCT ✔✔ St. John's Wort Recurrent spontaneous episodic vertigo, hearing loss. Must have aural fullness or tinnitis on one size to make dx. ✔✔ Meniere's Disease ADPIE stands for ✔✔ Assessment Diagnosis Planning Implementation Evaluation If diagnosed with an adjustment disorder, which dx is most guarded: that of an adult or that of an adolescent? ✔✔ adolescent (more likely to develop major psychiatric illness) Gastrointestinal lithium toxicity symptoms can overlap with ✔✔ normal side effects (N/V) What is FDA approved for suicidality in schizophrenia ✔✔ Clozapine
The MOST important component when developing evidence based guidelines ✔✔ An evidence review How does botox improve depression? ✔✔ Reducing frown lines when injected into glabellar region According to a study in the 1990s mothers of anorexic pts have an increased prevalence of this disorder ✔✔ Obsessive-compulsive disorder The AST:ALT ratio in patients with Alcoholic liver disease ✔✔ <0.
Liver biopsy reveals fibrosis, necrosis of liver cells, and nodule formation ✔✔ Liver cirrhosis Acute condition with nystagmus, ataxia, confusion, and opthalmoplegia ✔✔ Wernicke- Korsacoff syndrome Elevated bilirubin level is often found in ✔✔ Alcoholic hepatitis Which drug's mechanism of action includes blockage of the voltage dependent sodium channel blockers, augmentation of gamma amino butyrate activity of GABA-A receptors, antagonism of AMPA/kainate subtype of glutamate receptor, and inhibition of carbonic anydrase enzyme? ✔✔ Topiramate Ex of drugs that are partial agonists at postsynaptic serotonin receptors ✔✔ Hallucinogens like LSD and MDMA Drug associated with inhibition of catecholamine reuptake in neurons and blockage of NMDA glutamate receptors ✔✔ PCP Individuals with panic disorder are most commonly affected by which other psychiatric disorder ✔✔ Agoraphobia When is the use of transdermal selegiline not beneficial? ✔✔ For patients with pheochromocytoma (excess NE can cause HTN crisis) and with planned surgery (need to dc patch for 10 days prior to elective surgery) Responsible for the catabolism of serotonin, norepinephrine and dopamine ✔✔ Monoamine oxidase (MAO) Medication that is an irreversible MAO inhibitor that works by selectively inhibiting both MAO-A and MAO-B in the CNS with preservation of MAO-A in the gut. Unless high dosed, little need to follow tyramine restricted diet. ✔✔ Selegiline
Adverse effect of carbamazepine that can be an emergency ✔✔ hyponatremia toxic epidermal necrolysis Erythema multiform Steven's Johnson Thrombocytopenia Aplastic Anemia Agranulocytosis SLE arrhythmias Hepatitis An NP advises a patient with a significant family hx of breast cancer to perform monthly self-examinations. What term helps to identify this measure? ✔✔ Secondary Prevention Prevention type designed for early detection of a disease so that morbidity and mortality may be reduced ✔✔ Secondary Prevention Preventing the disease or condition from occurring ✔✔ Primary Prevention WIC and promotion of workplace safety laws designated by OSHA are this type of prevention ✔✔ Primary Prevention Rehabilitation and prevention of complications of disease ✔✔ Tertiary prevention A support group for a disease or condition is this type of prevention ✔✔ Tertiary Prevention Exercise for an obese patient is this type of prevention ✔✔ Tertiary Antisocial personality disorder criteria must show a pattern of disregard of others since age ✔✔ 15 How many criteria does a pt who meets criteria for an Antisocial personality disorder have to have ✔✔ 3 of 7 Name the 7 criteria that pts with Antisocial personality disorder have (must meet 3 of them) ✔✔ Breaking the law Deceitfulness for personal profit or pleasure Impulsivity/failure to plan ahead Aggressiveness/Irritability (physical fights/assaults) Reckless disregard for safety of self or others Consistent irresponsibility Lack of remorse
Symptoms can be associated with another medical condition ✔✔ Somatic symptom disorder Somatic symptom disorder symptoms persist for ✔✔ >6 months Despite frequent doctors visits and tests, this pt is rarely reassured and can feel that his/her medical care is insufficient ✔✔ Somatic symptom disorder In order to meet DSM V criteria for somatic symptom disorder, in addition to somatic symptoms, pts must have ✔✔ maladaptive thoughts, feelings, and behaviors that define the disorder, in addition to their somatic symptoms. The Mental Health Party Act (1996) provides ✔✔ equal lifetime and annual limits for mental health care as compared to physical health care. The zoster vaccination is recommended for ✔✔ adults over the age of 60 The pneumococcal vaccination is recommended for ✔✔ adults over the age of 65 The Tdap vaccination is recommended ✔✔ every 10 years Understanding the objective reality of a situation coupled with the motivation and emotional impetus to master the situation or change behavior is: ✔✔ true insight Form of thinking that is logical, organized, reality oriented, and influenced by the demands of the environment ✔✔ second process thinking What percentage of the population meets the criteria for 1 or more personality disorders? ✔✔ 15% Study on daily exercise improving sleep quality in seniors. What is the dependent variable ✔✔ Sleep quality The federal law that allows parents to provide insurance coverage for their children up to age 26 is ✔✔ Affordable Care Act (ACA) Pedophiles attracted to female victims usually prefer females of what age? ✔✔ 8 - 10 years old What is true of appropriation bills? ✔✔ They provide for spending authority for a single fiscal year
What bills establish laws or programs and although they recommend dollar amounts in some cases, do not allocate the funds or guarantee funds for the program ✔✔ Authorization bills What bills usually originate in the House of Representatives and provide spending authority for a single fiscal year ✔✔ Appropriation Bills Provide additional funding for projects as needed thought the current fiscal years ✔✔ Supplemental appropriations Authorization bills are funded by ✔✔ Appropriation Bills What is required for entry to practice as a Nurse Practitioner ✔✔ Competency in nine content domains The NP is caring for a 16 year old who is depressed with suicidal ideation. The pt asked the nurse NOT to tell her parents. The most appropriate intervention for the nurse to do is: ✔✔ Talk to parents and pt together to help the family discuss the pt's depression According to Mahler, which of the following stages of infant development is disrupted in children who develop borderline personality disorder ✔✔ Rapproachment According to Mahler, which of the following stages of development was disrupted int children who developed narcissistic personality disorder ✔✔ Symbiotic phase Phase during first weeks of life, characterized by total detachment and self-absorption, infant spends most of his or her time sleeping ✔✔ Autistic stage When does the symbiotic phase occur ✔✔ about 5 months of age According to Mahler, separation-individuation has 3 stages ✔✔ Hatching (5-9 months) Practicing (9- 16 months) Rapproachment (15- 24 months) Phase where infant explores the outside world but requires that the mother is present and able to support the child appropriately and emotionally in completing the task? ✔✔ Rapprochment (15- 24 months) Phase in which infant develops the physical ability to separate from mother ✔✔ Practicing (9- 16 months) Disturbance of the rapprochement subphrase is associated with ✔✔ persistent longing for and dread of fusion with object that is thought to be secondary to aggression or
Identification of research evidence to support a change in clinical practice ✔✔ 3rd stage of Iowa Model Implementation of change ✔✔ 4th step of Iowa Model Monitoring of Outcomes ✔✔ 5th and final step of Iowa Model Knowledge-focused triggers include ✔✔ new research practice guidelines Problem-Focused Triggers include ✔✔ Clinical problems Issues in risk management The first step in getting a bill to the floor is? ✔✔ Drafting a bill Probability results of study are due to chance ✔✔ P value Medicare part A coverage includes ✔✔ 1. hospital care and medicines received in hospital
- SNF
- nursing home care
- hospice
- home health services Sampling used when the proportion of the study population belonging to each group of interest in known, to obtain an adequate study sample from a small group in the study population. ✔✔ Stratified sampling Selection of groups under study is random ✔✔ Cluster sampling Choosing individuals at regular intervals from a sampling frame by selecting a number to determine where to begin selecting individual subjects from a list. ✔✔ Systematic sampling Making a numbered list of all units in a population from which you want to draw a sample, deciding on the sample size, and selecting the required number of sampling used using a table of random numbers or a lottery method ✔✔ Simple random sampling What is the prevalence of borderline personality disorder in psychiatry outpatients? ✔✔ 10% What is the prevalence of borderline personality disorder in psychiatric inpatients ✔✔ 20%
Diagnosis of borderline personality disorder includes 5 or more of the following criteria ✔✔ frantic avoidance of abandonment unstable relationships disturbance of identity recurrent suicidality unstable mood/affect chronic feelings of emptiness intense bouts of difficult-to-control anger transient paranoia or dissociation Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation ✔✔ Avoidant Pervasive pattern of detachment from social relationships and a restricted range of expression ✔✔ Schizoid Pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent ✔✔ Paranoid Pervasive pattern of social and interpersonal discomfort with, and reduced capacity for, close relationships as well as cognitive or perceptual distortions and eccentricities ✔✔ Schizotypical Pervasive pattern of grandiosity, need for admiration, and lack of empathy ✔✔ Narcissistic Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation ✔✔ Dependent The prevalence of borderline personality disorder in primary care ✔✔ 6% The prevalence of borderline personality disorder in the general population ✔✔ 1.5- 5.9% What best determines the effectiveness of an educational intervention? ✔✔ Pt's behavior modification and compliance rates After suffering the loss of a child, more than 50% of parent couples go through the following ✔✔ Divorce Rubbing against non-consenting people ✔✔ frotteurism Fantasies about watching unsuspecting individuals undressed or in sexual activity ✔✔ voyeurism
