Nursing homework help

To Prepare

• Reflect on your practice exam question results from Week 2. Identify content-area strengths and opportunities for improvement.
• Also reflect on your overall test taking. Was the length of time allotted comfortable, or did you run out of time? Did a particular question format prove difficult?

The Assignment

• Based on your practice test question results, and considering the national certification exam, summarize your strengths and opportunities for improvement. Note: Your grade for this Assignment will not be derived from your test results but from your self-reflection and study plan.
• Create a study plan for this quarter to prepare for the certification exam, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress. Nursing homework help
• Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.

 

Based on your practice test question results and considering the national certification exam, summarize your strengths and opportunities for improvement.	23 (23%) – 25 (25%) The response provides an accurate, clear, and complete summary of both the strengths and opportunities for improvement.	20 (20%) – 22 (22%) The response provides an accurate summary of both the strengths and opportunities for improvement.	18 (18%) – 19 (19%) The response provides a somewhat vague and/or inaccurate summary of both the strengths and opportunities for improvement.	0 (0%) – 17 (17%) A summary of both the strengths and opportunities for improvement are incomplete or missing.
Create a study plan, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.	27 (27%) – 30 (30%) The response provides three or four clear and appropriate SMART goals for the study plan, including tasks to complete to accomplish each goal. A clear timeline is provided for the study plan as well as a description of how progress toward goal completion will be measured.	24 (24%) – 26 (26%) The response provides three or four appropriate SMART goals and objectives for the practicum experience. Appropriate tasks, timeline, and description of how progress will be measured are provided.	21 (21%) – 23 (23%) The response provides three or four somewhat vague or general goals for the study plan. Tasks, timeline, and description of how progress toward goals will be measured are vague or somewhat inappropriate.	0 (0%) – 20 (20%) The response provides three or four unclear or inappropriate goals for the study plan, or goals are missing. Tasks, timeline, and a description for how progress will be measured are incomplete or missing.
Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.	27 (27%) – 30 (30%) The response provides a clear description of appropriate resources to support the study plan that are tailored to individual need.	24 (24%) – 26 (26%) The response provides a description of appropriate resources to support the study plan that are somewhat tailored to individual need.	21 (21%) – 23 (23%) The response provides a description of general resources that are not tailored to individual need.	0 (0%) – 20 (20%) The response provides a description of inappropriate resources to support the study plan, or the description of resources is vague or missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.	5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.	4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.	3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.	0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time. Purpose statement, introduction, and conclusion were not provided.
Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation	5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors	4 (4%) – 4 (4%) Contains one or two grammar, spelling, and punctuation errors	3.5 (3.5%) – 3.5 (3.5%) Contains several (three or four) grammar, spelling, and punctuation errors	0 (0%) – 3 (3%) Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference list.	5 (5%) – 5 (5%) Uses correct APA format with no errors	4 (4%) – 4 (4%) Contains one or two APA format errors	3.5 (3.5%) – 3.5 (3.5%) Contains several (three or four) APA format errors	0 (0%) – 3 (3%) Contains many (five or more) APA format errors
Total Points: 100

 

 

To Prepare

Reflect on your practice exam question results from Week 2. Identify content-area strengths and opportunities for improvement.

Also reflect on your overall test taking. Was the length of time allotted comfortable, or did you run out of time? Did a particular question format prove difficult?

The Assignment

Based on your practice test question results, and considering the national certification exam, summarize your strengths and opportunities for improvement. Note: Your grade for this Assignment will not be derived from your test results but from your self-reflection and study plan.

Create a study plan for this quarter to prepare for the certification exam, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress. Nursing homework help

Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.

PRACTICE TEST

QUESTIONS

1. A 42-year-old male with alcohol use disorder for 5 years is referred to

the PMHNP from his primary care provider for addiction treatment.

Which of the following laboratory findings would be consistent with

his diagnosis?

1. Increased urine and serum creatinine levels
2. Increased mean corpuscular volume and triglycerides
3. Increased potassium and chloride levels
4. Decreased mean corpuscular volume and normal triglyceride level
5. A 9-year-old girl with a history of generalized anxiety disorder has been

stable on fluoxetine 10 mg for 6 months and presents for follow-up

complaining of bilateral leg pain. The physical exam, complete blood

count, and metabolic profile are normal except for an elevated alkaline

phosphatase. The PMHNP understands that this finding is:

1. Consistent with liver disease
2. Abnormal and should be repeated immediately
3. Abnormal and requires further evaluation of autoimmune hepatitis
4. A commonly occurring pre-puberty finding known as growing

pains

3. A 50-year-old physician presents with complaints of fatigue, headache,

abdominal distress, and weight loss. His husband reports increasing

irritability, inattentiveness, and low libido over the last month. He was

seen by his primary care provider, who just notified him he had pre-

diabetes, hypercholesterolemia, and hypertension despite weight loss.

These findings are most consistent with

1. Dysthymia
2. Major depression
3. Generalized anxiety disorder
4. Seasonal affective disorder
5. The purpose of a professional organization’s scope and standards of

practice is to:

1. Define the roles and actions for that particular profession
2. Define the differences between professions
3. Establish the legal authority to practice for a profession
4. Define the legal statutes that are governing a profession
5. An APRN recognizes the essential nature of primary prevention

strategies for a community. Which of the following is an example of a

primary prevention strategy?

1. A skills class for at risk adolescents
2. A suicide hotline
3. Mandated treatment
4. A psychosocial clubhouse for the mentally ill
5. Which of the following is representative of legal ruling trends over the

past 30 years?

1. Juries have been encouraged to find defendants not guilty because

of insanity

1. People with mental illness retain their inalienable rights even when

committed to a mental hospital

1. Courts place increased trust in the professional judgment of mental

healthcare providers to make ethical decisions

1. The time in bringing cases before a magistrate for commitment

hearings has been reduced

7. A patient who has been voluntarily committed is experienc2i3n6g

symptoms of psychosis; he declares he has the right to refuse his

medications despite the court order because God told him he would be

healed by his faith alone. Based on your knowledge of court-ordered

treatment, which of the following statements is true? Nursing homework help

1. Psychiatric clients cannot refuse treatment
2. Psychiatric clients can refuse treatment unless it is court ordered
3. Psychiatric clients cannot act in their own best judgment
4. The professional judgment of the PMHNP supersedes the client’s

right to refuse medication

8. Which of the following elements is reflective of a professional

relationship rather than a social relationship?

1. In a professional relationship, there is no place for social

interactions

1. In a professional relationship, the PMHNP is solely responsible for

making the relationship work

1. In a professional relationship, the primary focus is on the client

and their needs

1. In a professional relationship, goals are left vague so that the client

feels any issue can be discussed

9. In light of the recent school shootings, the local high schools have

noticed an unusually high incidence of depressive symptoms and illicit

drug use among their students. The PMHNP formulates a plan to

address the problem. The goal of the program is to enhance the

capabilities of families and teachers to identify antecedents of

depression and drug use and to prevent new cases from developing.

What level of prevention is this strategy?

1. Tertiary prevention
2. Secondary prevention
3. Solution-focused prevention
4. Primary prevention

237

10. A 45-year-old White female agreed to hospitalization after presenting to

the emergency department with passive suicidal ideations. After 24

hours she states that she wishes to leave because “this place cannot

help me.” Which of the following actions reflects the legal right of the

client?

1. The patient should be discharged immediately
2. The patient is discharged after she signs forms indicating her

actions and acknowledging her actions are against medical advice

1. Contact a collaborating physician to convert the patient to an

involuntary status

1. Explain that the patient cannot leave until further assessments are

completed and collateral information is obtained

11. The PMHNP is aware that the essentials of the therapeutic alliance

include all of the following except:

1. Formulating a differential diagnosis
2. Genuineness
3. Acceptance
4. Authenticity
5. A 39-year-old woman has been in therapy for the last 3 months. She has

shown much improvement in her functioning and has developed much

insight into her illness. This week during her session you discuss

service determination, and she suddenly begins to demonstrate the first

symptoms that brought her into therapy initially. She is now hesitant

for discharge and wants to continue services as she is displaying

regressed behavior. What is the best explanation for her symptom

return?

1. Acute stress reaction
2. Reaction formation
3. A normal resistance seen in the termination time of therapy
4. A sign of undiagnosed pathological attachment
5. A 30-year-old man reports low self-esteem, demonstrates poor selfcontrol, exhibits much self-doubt, and requires a high degree of

reassurance. What developmental task has he failed to master?

1. Trust versus mistrust
2. Industry versus inferiority
3. Generativity versus stagnation
4. Integrity versus despair
5. A 25-year-old male has been seeing his psychoanalyst four times a week

for the last year and is bothered by recent episodes of forgetfulness

including misplacing everyday items and missing appointments. Nursing homework help

Which Freudian psychodynamic principle assumes all behavior

conveys purpose?

1. The Ego development principle
2. Psychic determinism principle
3. The Id principle
4. The Superego mediation principle
5. Which of the following is an example of a mature defense mechanism?
6. Projection
7. Repression
8. Altruism
9. Regression
10. A Black man in the fifth decade of life has been seen for several weeks

of psychotherapy to discuss his current stressors. He proceeds to curl

up in the fetal position and lie on the floor. Which defense mechanism

is he manifesting?

1. Repression
2. Projection
3. Denial
4. Regression
5. An ambulance brings a 26-year-old female to the emergency department

after a suicide attempt by self-mutilation. Which of the following is the

most critical factor to consider when conducting your assessment?

238

1. Past medical and psychiatric history
2. Hemodynamic stability
3. The current level of suicidality
4. Effective coping mechanisms
5. For which of the following reasons are selective serotonin reuptake

inhibitors (SSRIs) considered the first-line drug of choice for

depression without psychotic features?

1. Ease of dosing for step-wise titration
2. Promote sleep
3. Difficulty in overdosing for suicidal patients
4. Drug level monitoring capabilities
5. A man diagnosed with major depressive disorder is started on a selective

serotonin reuptake inhibitor (SSRI). Which of the following ways is

most effective for the PMHNP to monitor the client’s response to

medication?

1. An EKG for QTc prolongation
2. Basic metabolic profile
3. Urine toxicology screen
4. A standardized rating scale for depression
5. The following statement is reflective of which type of therapy: “If a

miracle were to happen and all of your symptoms that brought you into

therapy no longer existed, what would be different?”

1. Cognitive behavioral therapy
2. Dialectical behavioral therapy
3. Solution-focused therapy
4. Psychoanalysis
5. According to family systems theory, which of the following is

reflective of homeostasis?

1. Family members placate each other to keep the peace
2. Family members behave erratically to reduce predictability
3. Stability in the interpersonal relationships despite dysfunctions
4. A crisis restores peace
5. A married couple of 7 years presents for therapy because the wife

perceives her husband to be a constant nag. He believes that he is

correct and only trying to help. You assign him a paradoxical directive

to schedule 1 hour per day in which he nags her, and once that hour is

over to keep a list and save it until the next day. The PMHNP

recognizes this type of therapy as:

1. Experiential therapy
2. Strategic therapy
3. Structural therapy
4. Solution-focused therapy
5. Which of the following is an essential principle of cognitive behavioral

therapy?

1. Recognizing and accepting automatic thoughts
2. Recognizing and changing automatic thoughts
3. Seeing reality as the private provider sees it
4. Changing reality through environmental restructuring
5. Which of the following principles of group dynamics enhances

therapeutic efficacy?

1. Cost efficiency
2. Acquiring curative factors
3. Enhancing social skills
4. All of the above
5. The patient is referred by his primary care physician for the treatment of

panic disorder with agoraphobia. He had been titrated on paroxetine

CR 37.5 mg daily and clonazepam 0.5 mg daily as needed. He has

been on this regimen for the last year, but he admits that he sometimes

requires as many as five clonazepam tablets to get the same effect.

Which pharmacokinetic property is influencing this phenomenon?

1. Potency

239

1. Tolerance
2. Kindling
3. Addiction
4. The process by which the body affects the drug is known as:
5. Metabolism
6. Distribution
7. Pharmacokinetics
8. Pharmacodynamics
9. Which of the following neuroleptic mood stabilizing medications

commonly used to treat bipolar disorder is associated with which

teratogenic effects?

1. Divalproex (shortened limbs); lithium (seizure disorder)
2. Lithium (Ebstein’s anomaly); divalproex (neural tube defects)
3. Divalproex (Ebstein’s anomaly); lithium (cleft lip and palate)
4. Lithium (spina bifida); divalproex (neural tube defects
5. Which of the following conditions that occur with the aging process

affects drug metabolism?

1. Increased muscle mass
2. Reduced protein binding
3. Increased liver metabolization pathways leading to toxicity
4. Decreased body fat
5. Which of the following classes of medications is thought to exacerbate

or cause depression?

1. Proton pump inhibitors
2. Beta blockers
3. Antihistamines
4. PD 5 inhibitors
5. A patient with chronic renal failure and type 2 diabetes is sent to the

PMHNP with symptoms of depression marked by increasing fatigue,

confusion, irritability, anhedonia, and apathy. Which of the following

is the best action to take at this time?

1. Increase his antidepressant medication
2. Augment his selective serotonin reuptake inhibitor (SSRI) with a

partial agonist antipsychotic

1. Order blood work to evaluate his renal function and electrolytes
2. Order a 12-lead EKG
3. A 36-year-old pharmacist has a history of depression and suicide attempt

1 month ago by hanging. She had been started on a tricyclic

antidepressant but abruptly stopped taking the medication a week after

she started saying it was “ineffective.” The PMHNP meets with this

patient to plan care. Which of the following is the most appropriate

initial action?

1. Ask the patient how to help her
2. Provide teaching about the long timeframe it takes for tricyclic

antidepressants (TCAs) to work

1. Contract with the patient for six sessions of therapy
2. Tell the patient how suicide might affect her family
3. A 90-year-old Black woman tells the PMHNP “some days life is just not

worth living. I would be less of a burden if I were not here anymore.”

The most therapeutic response for the PMHNP to make is

1. “Everybody loves you and likes being around you”
2. “Tell me what you mean when you say ‘life is not worth living’”
3. Therapeutic use of silence
4. “Are you thinking suicide might be an option for you?”
5. During the first session of therapy, the patient makes the following

statement: “All my other kids got through their drug use phase and

were able to get on with their lives. I have grounded him, taken away

his privileges, and I even tried to cut out his allowance, but I’m just not

sure what I should do now?” What is the most therapeutic response for

the PMHNP to make?

240

1. Therapeutic use of silence
2. “I wonder if locking him in his room was abusive.”
3. “Maybe that depends on what you’re trying to accomplish.”
4. “Perhaps talking to his friends, coaches, and teachers would be

helpful.”

34. While performing a mental status exam on a patient, you ask them to

interpret this proverb: “A stitch in time saves nine.” The patient replies

“The garment would be more likely to rip.” How would you interpret

these findings?

1. The patient is psychotic
2. The patient is anxious
3. The patient is intellectually disabled
4. There is not enough information to interpret the statement without

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knowing the client’s age

35. A client states that he “did not realize the time” and apologized for

running late. The PMHNP replies “This is the fourth time in a row

that you’ve been late to our sessions; I’m just wondering how

committed you are to this therapy.” What communication technique

was used by the PMHNP?Nursing homework help

1. Reflecting
2. Restating
3. Presenting reality
4. Validating
5. The PMHNP will evaluate a recently admitted 22-year-old male and

formulate the initial treatment plan. The patient asks to go to his room

because “people make me nervous.” The PMHNP’s action should be

based on the awareness that the best location to do an initial evaluation

is:

1. In the patient’s room because it’s the least noisy and most

comfortable for him

1. In a public area to observe his interactions with others
2. In a treatment room with the door closed in a neutral location
3. In a quiet but public place to get assistance should it be required

during the evaluation

37. What is the primary goal of a comprehensive psychiatric evaluation?
38. To complete the necessary forms for a maximum reimbursement
39. To develop a correct diagnosis
40. To communicate with others about the patient’s healthcare needs
41. To identify the mental health needs of the patient
42. Psychotropic medications are used to treat
43. Psychiatric disorders
44. Psychiatric symptoms
45. Neurological conditions
46. Endocrine disorders
47. A patient is experiencing memory deficits, difficulty in prioritizing and

planning, no insight into problems, and poor impulse control. Which

lobe of the brain is responsible for the symptoms?

1. Parietal lobe
2. Frontal lobe
3. Temporal lobe
4. Occipital lobe
5. Which of the following neurotransmitters is excitatory?
6. Gamma-aminobenzoic acid (GABA)
7. Dopamine
8. Norepinephrine
9. Glutamate
10. Which of the following is a contraindication for brain MRI?
11. Automated internal cardiac defibrillator (AICD)/pacemaker
12. History of traumatic brain injury

241

1. Hip replacement
2. Pregnancy
3. Which area of the brain regulates appetite, the sleep-wake cycle, and

libido?

1. Hippocampus
2. Amygdala
3. Hypothalamus
4. Limbic system
5. Which of the following areas of the brain produces dopamine?
6. Substantia nigra
7. Raphe nuclei
8. Locus ceruleus
9. Basal nucleus
10. What purpose does a neurotransmitter serve in the nervous system?
11. Enzyme breakdown
12. Amino acid scaffolding
13. Communication medium
14. Enzyme production
15. A patient who was able to escape the World Trade Center during 9/11 is

dysphoric several months after the event and tells the PMHNP that she

does not want to talk about her coworkers who were lost because it

hurts so much. Which defense mechanism is being utilized?

1. Denial
2. Suppression
3. Undoing
4. Projection
5. A patient who is unable to recall his involvement in a psychological

trauma is using which of the following defense mechanisms?

1. Denial
2. Suppression
3. Deep depression
4. Undoing
5. A sole survivor from a house fire tells the PMHNP that she does not

remember anything about how she got out. Which defense mechanism

is being used?

1. Suppression
2. Denial
3. Repression
4. Sublimation
5. A man finds his coworkers exceptionally difficult to work with, and he

finds them generally incompetent. He does not share his thoughts with

his coworkers or his boss out of fear of hurting their feelings. He

suddenly has the urge to bring baked goods several times a week.

Which defense mechanism is the best explanation for this behavior?

1. Denial
2. Suppression
3. Repression
4. Undoing
5. Which of the following is a defense mechanism purpose?
6. Alert to danger
7. Protect the Id
8. Resolve conflicts
9. Suppress intuition
10. Which of the following is the best intervention for a client experiencing

ataque de nervios?

1. Benzodiazepines
2. Using a family member to interpret
3. Involuntary admission

242

1. Referral to supportive psychotherapy by a therapist who speaks the

language

51. Which of the following ADHD symptoms overlap with PTSD in

children and adolescents?

1. Talkativeness, hyperactivity, distractibility
2. Avoidance behaviors, mood lability, irritability
3. Recklessness, hypervigilance, aggressiveness
4. Disorganization, interrupting, carelessness
5. A 17-year-old male, high school senior who is on the wrestling team, is

being treated for an eating disorder. He is of average weight, socially

engaged, and attention seeking at times among his peers. Which of the

following eating disorders is most consistent with these symptoms?

1. Anxiety-induced eating disorder
2. Binge eating disorder
3. Bulimia nervosa
4. Anorexia nervosa
5. His two fathers bring a hyperactive 7-year-old boy for follow-up

treatment of attention deficit hyperactivity disorder. Also on this visit

is the newest addition to the family, an 8-month-old baby boy. The

PMHNP notices that this child has a small head along with stereotypic

motions of the hands, slapping and licking behaviors, and is seemingly

regressed. Language skills are also more primitive than expected.

What medical condition does the PMHNP suspect the 8-month-old

baby boy has developed?

1. Autism spectrum disorder
2. Rett syndrome
3. Selective mutism
4. Progeria
5. A PMHNP is about to start an 8-year-old girl on a stimulant for attention

deficit hyperactivity disorder (ADHD). Your clinical observations and

rating scales corroborate the diagnosis. What assessments need to be

completed before starting stimulant medication?

243

1. The ADHD rating scale completed by the grandparents
2. Rule out a family history of bipolar disorder
3. Check blood pressure and pulse
4. Blood pressure, pulse, height, weight, and 12-lead EKG
5. Many psychotropic medications come with a black box warning,

particularly for use in children and young adults. What specific

education must you provide to a 22-year-old male as the PMHNP to

the patient?

1. Risk of increased impulsive behavior
2. Risk of increased suicidal thoughts
3. Risk of sexual side effects
4. Risk of teratogenic sperm production
5. According to the DSM-5, personality disorders are categorized according

to which of the following?

1. Axis II
2. Axis III
3. Axis IV
4. The primary psychiatric disorder
5. Which of the following is NOT an example of the defense mechanism of

isolation, as may be exhibited by someone with a Cluster C personality

disorder?

1. Not leaving the house for many days
2. Declining invitations for social events
3. Remaining private and introverted in the workplace to avoid

coworkers

1. Expressing detailed information without flat affect
2. Which of the following is considered a genetic and social risk factor

for a person to develop antisocial personality disorder?

1. Psychotic disorders
2. Oppositional defiant disorder
3. Generalized anxiety disorders
4. Affective disorders
5. A 35-year-old female with a Cluster A personality disorder states that “I

hear people outside the office door during our sessions. Are they

listening in on us?” What would be your best response?

1. Validate her, and ask her to tell of a time in her life when she had a

similar experience

1. Using humor, ask a rhetorical question to stimulate reflection and

then reassure her that she is that special

1. Distract her from the topic and insist that there is no way for

someone outside to hear your session

1. Validate her, and inform her that the white noise sound machine

muffles the sounds of the session and it would be hard to hear the

conversation outside the office

60. In speaking with a 50-year-old man with a Cluster A personality

disorder, which would be the best strategy?

1. Do not challenge his negative views or recollections of past events
2. Confront misinterpreted thoughts and feelings, especially those

that are negative

1. Make time for a detailed and emotionally engaging dialogue
2. Deflate any grandiose thoughts he may have
3. Which of the following personality disorders are classified as Cluster A?
4. Paranoid personality disorder, schizoid personality disorder,

schizotypal personality disorder

1. Antisocial personality disorder, borderline personality disorder,

histrionic personality disorder, narcissistic personality disorder

1. Avoidant personality disorder, dependent personality disorder,

obsessive compulsive personality disorder

1. Paranoid personality disorder, antisocial personality disorder,

obsessive compulsive personality disorder, histrionic personality

disorder

244

62. Which of the following personality disorders are classified as Cluster B?
63. Paranoid personality disorder, schizoid personality disorder,

schizotypal personality disorder

1. Antisocial personality disorder, borderline personality disorder,

histrionic personality disorder, narcissistic personality disorder

1. Avoidant personality disorder, dependent personality disorder,

obsessive compulsive personality disorder

1. Paranoid personality disorder, antisocial personality disorder,

obsessive compulsive personality disorder, histrionic personality

disorder

63. Which of the following personality disorders are classified as Cluster C?
64. Paranoid personality disorder, schizoid personality disorder,

schizotypal personality disorder

1. Antisocial personality disorder, borderline personality disorder,

histrionic personality disorder, narcissistic personality disorder

1. Avoidant personality disorder, dependent personality disorder,

obsessive compulsive personality disorder

1. Paranoid personality disorder, antisocial personality disorder,

obsessive compulsive personality disorder, histrionic personality

disorder

64. What is the primary goal of psychotherapy and treating someone with a

personality disorder?

1. Enhance the client’s ego strength and encourage the use of mature

defense mechanisms

1. Review the antecedents to this pathological personality

development, paying particular attention to trauma

1. Help parents and the client to form secure attachments
2. Make the client change their personality so that they’re more

adaptable in everyday life

65. In working with a 34-year-old man initially seen for substance use

disorder who continues in therapy to develop effective coping

through the use of mature defense mechanisms, the patient states “I

noticed your Rolex watch, is that new? You have exquisite taste.”

What is the best response from the psychiatric mental health nurse

practitioner?

1. “You’re right, I do.”
2. “I didn’t realize you paid such close attention to what I wear.”
3. “I noticed you had a Rolex watch as well. How do you like it?”
4. “It sounds like you value luxury items. Tell me more about that.”
5. Which of the following defense mechanisms are most commonly used in

patients with Cluster C personality disorders?

1. Displacement and reaction formation
2. Motivation and disassociation
3. Projection and distortion
4. Isolation and intellectualization
5. When asking an adolescent male about his cannabis use disorder, which

of the following signs or symptoms would you expect him to report?

1. Enhanced motor skills
2. Accelerated time passage
3. Heightened sensitivity to external stimuli
4. Lower heart rate
5. The PMHNP sees a 34-year-old male 2 weeks after an opioid detox. The

patient states “I feel like I’m going to die if I don’t get something to

relieve my symptoms.” What would be the best response? Nursing homework help

1. “This feeling will pass, you just have to tolerate the discomfort for

the short term.”

1. “Let me check your vital signs to see if you would be able to

tolerate a clonidine patch.”

1. “You have been using OxyContin for a long time, and it will take

several months for the withdrawal to end. In the meantime I should see

you twice a week.”

245

1. “You are no longer in withdrawal as it has been 14 days since your

last use and your urine tox screen is clean.”

69. An RN from the detox unit reports to you that a 54-year-old man who

was admitted 3 days ago for alcohol use disorder has a Clinical

Institute Withdrawal Assessment (CIWA)-Alcohol score of 20. How

severe are his symptoms?

1. Severe withdrawal
2. Moderate withdrawal
3. Mild withdrawal
4. Delirium tremens

For Questions 70 and 71, use the following scenario:

70. During your session with a 17-year-old male with cannabis use disorder,

who engages in petty theft, and has refused school since 7th grade, the

patient makes the following statement: “I don’t know why I continue

to see you, you just charge my parents so much money, and all I want

to do is feel good.” The PMHNP replies, “You feel confused about the

process.” To which the boy replies, “I never thought I’d have a shrink

come to my house.” You then reply, “Thank you for allowing me into

your home, and I recognize the courage it must have taken to allow

this to happen.” A typical counseling technique used by PMHNPs is

motivational interviewing. What are techniques from motivational

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interviewing in this dialogue?

1. Affirming and reflecting
2. Interrupting and reassuring
3. Open-ended questions and summarizing
4. Clarification and data collection
5. According to Prochaska’s transtheoretical model, which stage of

change is the patient in Question 70 in?

1. Precontemplation
2. Contemplation
3. Preparing to take action
4. Taking action
5. One of the most common problems encountered by a PMHNP on the

consultation liaison (CL) service is delirium. Why must the CL

maintain a high index of suspicion for this condition?

1. High risk of a 1-year mortality rate
2. High risk for depression
3. High risk for self-harm and harm to others
4. High risk for persistent psychosis
5. Which of the following is the best treatment for AIDS-related complex

dementia?

1. Anti-Parkinson agents
2. Nonpharmacological supportive care
3. Antiretroviral therapy
4. Acetylcholinesterase inhibitors
5. A PMHNP is contracted to a student health clinic to work with incoming

freshman and transfer students for several weeks. The PMHNP

encounters a student who describes himself as shy and uncomfortable

in social situations. He reports having few friends in high school and

has realized that he needs a few drinks to loosen up before going out to

party. Upon further questioning, it is revealed he consistently drinks

two to three beers on the weekend to enhance his socialization.

According to the DSM-5, does this student have a mental illness?

1. Yes, mild alcohol use disorder
2. No, the student does not meet the criteria for mental illness
3. Yes, adjustment disorder with mixed features
4. Yes, social anxiety disorder
5. A PMHNP in private practice is experiencing feelings of resentment

toward a patient who missed his last two appointments at the last

minute because he forgot. Which of the following is an example of a

therapeutic response?

1. “You seem ambivalent about seeking treatment.”
2. “It’s obvious you don’t want to come for treatment.”

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1. “You knew you would have to be charged for missed

appointments.”

1. “Help me understand what’s going on so we can figure out how to

proceed.”

76. A 42-year-old White female presents with concerns about her memory.

She states that her grandmother experienced Alzheimer’s dementia and

that her 63-year-old mother with obesity, hypertension, and depression

is also increasingly forgetful. The patient wants to do everything

possible to prevent or significantly postpone the onset of dementia.

She currently works full time, is the mother of two children, is

president of the PTA, attends church regularly, exercises three to four

times a week, volunteers for various organizations, and is sexually

active with her husband of 10 years. She occasionally forgets dates and

misplaces things. What is the best response to this patient?

1. “Continue your regular activities but be careful of the exercise,

less because of injury to self but because a prolonged hospitalization

and loss of independence would increase your risk for dementia.”

1. “We can start you on some fish oils, vitamin E supplements, and

medication to enhance your memory.”

1. “While most brain development occurs early in life, we still form

new brain cells in various areas of the brain throughout our lives.

Continue with your activities because they offer the best protection of

cognitive function.”

1. “Researchers know that we do continue to form new brain cells

throughout the entire brain during adulthood. Keep up with your

activities because you are producing new brain cells in the frontal lobe

and this will decrease your risk of dementia.”

77. David is a 43-year-old veteran of Operation Iraqi Freedom. A PMHNP

is currently treating him for generalized anxiety disorder and major

depressive disorder. During their last visit the PMHNP learned that

David had a blast injury and sustained head trauma during his tour in

Iraq. At the time he was diagnosed with a traumatic brain injury. His

current regimen includes fluoxetine 40 mg daily and clonazepam 1 mg

twice daily. In light of this new information what are some potential

adverse effects?

1. Benzodiazepines cause memory problems and confusion in clients

with a history of traumatic brain injury

1. Benzodiazepines increase the risk of a subsequent traumatic brain

injury

1. Benzodiazepines are addictive, and therefore banned from the VA

formulary

1. Benzodiazepines lower the seizure threshold particularly in clients

with traumatic brain injury

78. A 23-year-old male with schizoaffective disorder and a history of four

past hospitalizations for manic episodes has been started on clozapine.

During the weekly complete blood count with differential, which of the

following results would necessitate discontinuing treatment?

1. Absolute neutrophil count (ANC) less than 2,000
2. Leukocytes less than 5,000
3. ANC less than 1,000
4. Leukocytes less than 2,000 and ANC less than 1,200
5. A new psychotropic drug is on the market with an indication for

schizophrenia and bipolar disorder. The mechanism of action involves

D2 receptor blockade and 5 HT2a antagonism. What type of

established drug is this most similar to?

1. Risperidone
2. Haloperidol
3. Chlorpromazine
4. Thiothixene
5. Which of the following hallucinations is more common in patients with

an organic etiology such as substance-induced altered mental status or

delirium rather than in patients with psychosis such as schizophrenia,

schizophreniform disorder, and brief psychotic episode?

1. Tactile hallucinations
2. Auditory hallucinations
3. Visual hallucinations

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1. Combined hallucinations
2. Which of the following best summarizes the evidence-based practice

guidelines regarding the initiation of antipsychotic medication?

1. Physical exam to include blood glucose, lipid profile, height and

weight, blood pressure, waist circumference, and a review of

cardiovascular risk factors and the family history

1. Physical exam to include a comprehensive metabolic panel, body

mass index, complete blood count, and thyroid function

1. Serum glucose or hemoglobin A1C, lipid profile, weight, body

mass index, blood pressure, waist circumference, and review of family

cardiovascular disease

1. Serum glucose, complete blood count, assessment of family

history regarding cardiovascular disease, and cancer

82. A 59-year-old man has been seeing the PMHNP for schizophrenia. He

was first diagnosed when he was 21 years old. He remains medication

compliant. In getting to know the patient, it is revealed that he has very

few social interactions, prefers to be alone, and has never had a

romantic interest or desire to pursue one. Which type of symptoms is

pervasive in this clinical presentation?

1. Affective disorder
2. Positive symptoms
3. Negative symptoms
4. Self-care deficit
5. A 33-year-old married gay man employed as a corporate attorney

wonders aloud to the PMHNP: “Things are going well in our

relationship, our 8-year-old boy is about to enter third grade, our 6-

year-old girl is entering 1

first grade; my husband is a successful

published author, but for some reason I don’t feel happy. I think I have

been depressed for much of my life.” From a transactional analytic

(TA) perspective, the PMHNP understands that many factors affect

personality. Which of the following demonstrates a core concept in

TA?

1. “Do you recall long periods of separation from your mother or

father as a child which may be affecting your ability to accept love and

experience happiness?”

1. “During your adolescence have you experienced any events that

forced you into a parentified role?”

1. The patient has a distorted thought pattern affecting interpersonal

relationships.

1. The patient likely had a traumatic event in his childhood in which

thoughts and feelings have become locked together and are

inaccessible to the conscious mind.

84. Dialectical behavioral therapy (DBT) therapy involves reconciling the

tension to find the truth between:

1. Experience and avoidance
2. Radical acceptance and change
3. Crisis survival and radical acceptance
4. Confrontation and avoidance
5. In conducting a risk-benefit analysis regarding healthcare resource

utilization in the planning of a psychosocial clubhouse for an at-risk

population, what are two economic concepts that must be considered

in allocating public funds to demonstrate a return on investment and

access to care with the greatest number of people?

1. Affordability and quality
2. Equity and efficiency
3. Cost and benefits
4. Opportunities and risks
5. The PMHNP is asked to review a medical malpractice case for merit.

Which elements must be present to substantiate a claim of negligence?

1. Deceit, breach of standards of care, and intent to harm
2. Breach of care, violation of ethics, patient abandonment
3. Beneficence, nonmaleficence, veracity, breach of standards

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1. Duty to care, breach of a standard of care, injury related to the

breach of the standard of care

87. According to the American Nurses Association position statement, which

of the following is aimed at reducing human error and creating an open

and fair environment for interprofessional equality and collaboration to

promote patient safety?

1. Just culture
2. Personnel policies and HIV in the workplace
3. Standardization of health information technology
4. Civil disobedience
5. An 88-year-old female is prescribed fluvoxamine for generalized anxiety

disorder. Which of the following must the PMHNP consider?

1. Drugs are metabolized more slowly through the liver
2. Treatment is shorter in duration
3. The therapeutic dose is higher than for children
4. Titration should be faster to delay first pass effects
5. A 36-year-old female reports increasing fatigue, decreased energy,

difficulty concentrating, sleepiness through the day, and anhedonia.

The most bothersome symptom was the impaired concentration. She

was started on venlafaxine 37.5 mg once daily 1 week ago by her

primary care provider until she was able to see the PMHNP. During

your evaluation, you note pressured speech to the point where she is

uninterruptible at times, her affect is expansive, she continues to report

difficulty sleeping but states her energy is terrific, and she can “get so

much done.” Which of the following is a plausible explanation for this

clinical presentation?

1. She is psychotic
2. She has become euthymic
3. She is hypomanic
4. These are adverse effects of venlafaxine
5. A middle-aged married man was referred to you for management of his

depression. His symptoms include fatigue throughout the day, leading

him to drink five to six cups of coffee daily to stay awake; this leads to

him feeling too wired to sleep at night. He drinks one to two drinks

every night. He has no trouble falling asleep. However, his wife kicks

him due to his snoring and describes him as a restless sleeper, and he

also sweats profusely every night. Which of the following is the most

likely cause of his middle insomnia?

1. Attention deficit disorder which he is medicating with caffeine
2. Alcohol withdrawal syndrome
3. Caffeine use disorder
4. Obstructive sleep apnea
5. According to the License, Accreditation, Certification, and Education

(LACE) Consensus Model for Advanced Practice Registered Nurse

Regulation, which of the following statements is true?

1. A licensed board certified PMHNP would be grandfathered into

practice and would not need to obtain a doctorate of nursing practice

(DNP) degree

1. The PMHNP will not be able to continue practicing after 2025
2. The PMHNP will have to take a doctoral level board exam to be

able to keep practicing after 2025

1. The PMHNP without a DNP will be required to have a

collaborating physician after 2025, even if they are in a full practice

authority state

92. You are a board certified PMHNP working in a rural critical access

hospital-based clinic, and you are doing medication management for a

patient with bipolar 2 disorder, who has comorbid hypertension. When

checking his blood pressure, you note that the client is hypertensive,

and upon further questioning, the client states he has not seen his

primary care provider for 9 months because he finds the cost of the

visit and the medication prohibitive. The patient would like you to

refill his antihypertensive medication. What is the most appropriate

action?

1. Call the pharmacy to confirm the medication and dosage and order

a refill for 1 month until the patient can see his primary care provider

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1. Advise the patient to go to the emergency department if any signs

and symptoms develop

1. Send the patient to urgent care for evaluation and refill of the

antihypertensive medication

1. Call the patient’s primary care provider to explain the situation,

and coordinate an appointment and plan for medication refills

93. A PMHNP is attending a post-master’s doctorate of nursing practice

(DNP) program, and for his capstone project, he would like to see how

many patients discharged from inpatient psychiatry are seen for follow

up within 7 days and devise a system to ensure this standard is

consistently met. What type of evidence-based project is this?

1. Quality improvement
2. Research proposal
3. Needs assessment survey
4. Dissertation
5. A physician is admitted to the hospital and requires an appendectomy.

He is medically stable and would like to try conservative

management with IV antibiotics. The surgeon consults psychiatry to

see if the patient is competent to refuse care. Which of the following is

the best response given the scope of practice of the PMHNP?

1. Refer the case to a psychiatrist because this is outside the scope of

practice for PMHNPs

1. Complete the assessment and write an attestation to the patient’s

competence

1. Call the consulting physician and explain that competence is a

legal designation, and assess the patient for the capacity to refuse care

1. Refer the case to the hospital general counsel so that the patient

can have a competency designation

95. A nonprofit organization would like to develop a vaccination program,

but the grant that will provide the funding requires the project leader to

have a doctoral degree, and they have selected a PMHNP on the

faculty at a local university to lead this project. Which prevention

category are vaccination programs?

1. Preventive care
2. Primary prevention
3. Secondary prevention
4. Tertiary prevention
5. A PMHNP is opening a private practice and decided to offer free

screening for depression in her local church during their annual health

fair. Which prevention category is testing for disease?

1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
4. Preventive care
5. A PMHNP would like to expand her revenue streams for her private

practice. She decides to start a concierge model specifically targeting

those who are recently discharged from the hospital after their first

manic episode or with a diagnosis of bipolar disorder with the goal of

reducing recidivism through medication compliance and administering

long-acting injectable medications. This service is an example of

which kind of prevention strategy?

1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
4. Acute treatment
5. Which ethical principle supports an individual’s right to choose to accept

or refuse care despite medical advice?

1. Beneficence
2. Justice
3. Nonmaleficence
4. Autonomy
5. Which cranial nerve is the PMHNP examining when the patient is asked

to stick out their tongue?

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1. II-optic nerve
2. III-oculomotor nerve
3. X-vagus nerve
4. XII-hypoglossal nerve
5. The PMHNP is working in a movement disorders clinic due to the

incidence of depression and dementia associated with Parkinson’s

disease. The patient is unable to shrug his shoulders. Which cranial

nerve might be affected?

1. XII
2. XI
3. IX
4. V

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