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ANCC PMHNP Exam Prep Questions
And Answers A+ Verified
1. Conrad, a 26-year-old male, is being treated for cuts after being arrested for
breaking the windows in the home of his girlfriend, who has just told him that they are through. He has a history of having been physically abused by his father, setting fires as a child, treatment for substance abuse, and arrest for stealing a car. Which of the following person- ality disorders might the clinician consider? Question 1 options:a) Narcissistic b) Paranoid c) Antisocial d) Histrionic: Antisocial
2. In a biopsychosocial case formulation, social contributions would be con-
sidered to be: a) Genetic influences and adverse circumstances of birth b) Substance use and medical disorders c) Cognitive deficits and dysregulation of emotions d)
2 / Religious/cultural factors and living situations: Religious/cultural factors and living situations
3. Which of the following criteria would preclude the use of brief dynamic
therapy? a) Adequate ego strengths b) Psychological problems in multiple domains c) Use of mature defense mechanisms d) Adequate ability to process information: Use of mature defense mechanisms
4. In treatment of the acute phase of mania, the focus is on:a)
Protecting the patient's biopsychosocial safety b) Educating the patient about social rhythms theory c) Interventions that address impairment of vocational functioning d) Interventions for self-management of finance: Protecting the patient's biopsy- chosocial safety
5. During an initial assessment, the relevant features of communication are its
ability to: a)
4 / c) Tricyclic antidepressants (TCAs) d) Serotonin norepinephrine reuptake inhibitors (SNRIs): Tricyclic antidepressants (TCAs)
8. A 16-year-old male patient is hospitalized for depression after attempting
suicide by overdose. Several days later, the patient reports feeling less de- pressed and having fewer suicidal thoughts, but begins to threaten suicide "if things do not work out." Nursing staff members report feeling resentful and manipulated, but fear for the patient's safety. The adult psychiatric and mental health nurse practitioner's intervention is to a) :assist the staff in developing a treatment plan that limits contact with the patient to one person per shift. b) develop a "no suicide" pact with the patient to decrease his helplessness and increase his feelings of control. c) encourage the patient to express his fears of improving and being abandoned or of leaving the safe environment. d) increase supervision and restrict milieu participation to decrease the sec- ondary gain from manipulation.: encourage the patient to express his fears of improving and being abandoned or of leaving the safe environment.
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9. A female client complains of an intense, overwhelming fear of driving a car.
The fear has disrupted all elements of her life. She does not go to the grocery store unless someone transports her, has relinquished her job, and has few social contacts. Her treatment plan includes: assertiveness training. b) biofeedback. c) stress management assistance. d) systematic desensitization.:
10. A patient with borderline personality disorder experiences intense anxiety
when an adult psychiatric and mental health nurse practitioner goes on va- cation. The best explanation for this reaction is that the patient:: has failed to develop clear ego boundaries. b) has failed to master object constancy. c) is employing primitive idealization. d) is employing projective identification.
11. An outpatient mental health clinic-based adult psychiatric and mental
health nurse practitioner treats a 32-year-old patient who has diabetes and a
7 / Basal ganglia c) Corpus callosum d) Hypothalamus
14. On evaluation, the patient appears to be having difficulty with working
memory, planning, and insight into his problems. The psychiatric advanced practice nurse recognizes that these symptoms are associated with problems with the:) Frontal lobe b) Temporal lobe c) Parietal lobe d) Occipital lobe: Frontal lobe
15. n cognitive therapy, therapists focuses on patients':a)
Use of immature defense mechanisms b) Learned behavior of helplessness c) Automatic negative thoughts
8 / d) Attachment patterns: Automatic negative thoughts
16. With regard to the biological markers for schizotypal personality disorder,
all of the following have been reported except: a) Increased ventricles b) Increased cerebrospinal fluid c) Impaired smooth pursuit eye movements d) Impaired of executive functioning: Impaired of executive functioning
17. Serving as a member on a crisis team, an adult psychiatric and mental
health nurse practitioner provides crisis intervention to the survivors of a plane crash. Forty-eight hours after the accident, the survivors describe vivid flashbacks, startle reactions, and disrupted sleep patterns. The nurse practi- tioner responds by: a) advising the survivors to consider using a hypnotic medication for a brief period. b) educating the survivors about prodromal symptoms of posttraumatic stress disorder. c)
10 / 93 Determine patient's level of social support: Generate an understanding of the person as a whole
20. Which behavior reflects existentially oriented therapy?
a) Attempting to understand a patient's subjective world b) Challenging a patient's irrational beliefs c) Developing specific plans for change d) Establishing general group goals: Attempting to understand a patient's subjective world
21. When a research study is based on a small sample size, the findings may::
be statistically significant, but will be less generalizable than if the sample size had been larger. b) be statistically significant, but will not be clinically significant. c) not be statistically significant, because the research design was quasi-experimental instead of experimental. d) not be statistically significant, because the research was poorly conducted.
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22. Brain plasticity, which refers to the brain's capacity to change in response
to an event,:: ) Is the same for all individuals b) Involves physical changes of the brain c) Is absent in older adults d) Is independent of genetic influence
23. A 23-year-old female patient with borderline personality disorder reports a
frequent desire to cut herself and insists that only a specific psychiatric and mental health nurse can help her. The nursing care plan for the patient includes:: a) allowing her to choose the nurse assigned to her. b) decreasing stimuli. c) holding frequent interdisciplinary staff meetings to provide consistent care. d) providing one-to-one suicide precautions.
24. The older typical antipsychotic medications would be expected to be most
effective for which of the following target symptoms?: Social isolation b)
13 / c) Glutamate d) Acetylcholine
27. The neurotransmitters most widely accepted to be dysregulated in deliri-
um are:: a) Norepinephrine and acetylcholine b) Norepinephrine and serotonin c) Serotonin and acetylcholine d) Dopamine and acetylcholine
28. The process of allostasis includes:: Mobilization of energy, activation of cog-
nition, and behavioral changes b) Reduction of production of cortisol c) Decreased levels of norepinephrine d) Development of a state of exhaustion
29. Patients' perceptual difficulties may have an adverse effect on the thera-
peutic alliance.
14 / Which of the following is likely to have the greatest negative effect?: The patient perceives the office seating arrangement as belittling. b) The patient perceives the clinician as being part of her delusional system. c) The patient perceives the sound in the hall as messages for the patient. d) The patient perceives the clinician's glancing at his watch as nonvalidating.
30. A short-term goal for a patient with Alzheimer disease is:: )
improved problem-solving in activities of daily living. b) increased self-esteem and improved self-concept. c) optimum functioning in the least restrictive environment. d) regained sensory perception and cognitive function.
31. Narcissistic personality disorder is more likely to occur in families that:: -
Teach children to put family and community ahead of personal desires. b) Encourage children to develop problem-solving skills. c) Teach children that they are special and entitled to the best in life.
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34. An adult psychiatric and mental health nurse practitioner uses a cogni-
tive-behavioral approach to help an adolescent patient change self-defeating behaviors. After identifying the initial stressor that is causing the inappropri- ate behavior, the therapeutic intervention is to identify: Question 34 options: a) alternative positive responses to the stressor. b) negative consequences of the behavioral response to the stressor. c) possible outcomes of alternative responses. d) rational and irrational beliefs about the stressor.:
35. In GAD, which of the following is true?
Question 35 options: a) GAD is rare in older adults. b) Worrying may be associated with the belief that it keeps the family safe. c) Worrying is usually limited to one type of worry, such as locking doors. d) Worrying is usually accompanied by ritualistic behaviors.:
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36. Which of these brain structures puts emotional meaning on a stimulus,
forms emotional memories, and is involved with rage and fear? Question 36 options: a) Hippocampus b) Temporal lobe c) Amygdala d) Midbrain:
37. A psychiatric and mental health nurse verbally reviews medication in-
formation with an adolescent male patient and provides him with several handouts. The patient listens intently, nods, ignores the handouts, and states that he fully understands the information. The nurse further assesses for: Question 37 options: a) attentional deficits. b) level of intelligence. c) literacy. d)
19 / Borderline:
40. The neurochemical pathophysiology of Tourette disorder involves:
Question 40 options: a) decreased levels of gamma-aminobutyric acid and increased levels of gluta- mate in the brain. b) deficits in the prefrontal cortex-mediated executive functions of the brain. c) imbalances in dopaminergic, serotonergic, and noradrenergic systems in multiple regions of the brain. d) overstimulation of noradrenergic activity located in the locus coeruleus of the brain.:
41. Before implementing evidence-based practice changes, an adult psychi-
atric and mental health nurse practitioner's initial action is to: Question 41 options: a) brainstorm with stakeholders and draft a detailed problem list. b) compare data with internal and external benchmarks, and coordinate ongoing education. c)
20 / 93 facilitate a collaborative multidisciplinary group to synthesize evidence and compare key themes. d) identify potential barriers and facilitators that reflect patients' values and expectations.:
42. Which area of the brain is a very primitive in terms of evolution and is
involved in swallowing, arousal, and breathing? Question 42 options: a) Parietal lobe b) Insula c) Cerebellum d) Brainstem:
43. For a patient who is overinclusive or rambling, the clinician:
Question 43 options: a) Asks the patient to tell his story b) Uses direction and redirection
