ANCC PMHNP Chapters 2-4 Sample Test Questions
with Complete Solutions| Verified Answers
introduction phase - ✔✔also known as orientation phase of therapeutic nurse-client
relationship; nurse creates trusting environment, establishes professional boundaries,
establishes length of interaction, provides diagnostic evaluation, sets mutually agreed upon tx
objectives. Client has initial hesitancy (approach avoidance)
working phase - ✔✔also known as the Identification and Exploitation phase of therapeutic
nurse-client relationship; nurse clarifies client expectations/goals, implements tx plan, monitors
health, undertakes preventative health, measures/evaluates outcomes of care, reprioritizes
plans/objectives as needed. Transference/countertransference may occur. Client may have
resistance to care practices/change
termination phase - ✔✔also known as the resolution phase of therapeutic nurse-client
relationship; nurse reviews client's progress toward objectives, establishes plan for long term
care, focuses on self-management strategies, disengages from relationship, refers to other
services. Client may resist termination, regress, and have reemergence of symptoms/problems
trust vs mistrust - ✔✔birth-1 year; mastery includes ability to form meaningful relationships,
hope about the future, trust in others. Indications of failure include poor relationships, lack of
future hope, suspiciousness of others
autonomy vs shame and doubt - ✔✔1-3 years; mastery indications include self-control, self-
esteem, willpower. Indications of failure include poor self-control, low self esteem, self doubt,
lack of independence
initiative vs guilt - ✔✔3-6 years; mastery indications include self-directed behavior, goal
formation, sense of purpose. Failure indications include lack of self-initiated behavior, lack of
goal orientation
,industry vs inferiority - ✔✔6-12 years; mastery indications include ability to work, sense of
competency and achievement. Failure includes sense of inferiority, difficulty learning, working
identity vs role confusion - ✔✔12-20 years; mastery includes personal sense of identity;
failure includes identity confusion, poor self-identification in group settings
intimacy vs isolation - ✔✔20-35 years; mastery includes committed relationships, capacity to
love; failure includes emotional isolation and egocentrism
generativity vs stagnation - ✔✔35-65 years; mastery includes ability to give time and talents
to others, ability to care for others. Failure includes self-absorption, inability to grow and
change as a person, inability to care for others
integrity vs despair - ✔✔65+; mastery includes fulfillment and comfort with life, willingness
to face death, insight and balanced perspective on life's events; failure includes bitterness,
sense of dissatisfaction with life, despair over impending death
psychodynamic theory - ✔✔developed by Freud, focus is on concepts of intrapsychic conflict
among the structures of the mind; assumes behavior is purposeful and meaningful
principle of psychic determinism - ✔✔tenet of psychodynamic theory that states that even
apparently meaningless, random, or accidental behavior is actually motivated by underlying
unconscious mental content
age of onset for intellectual disability - ✔✔infancy- usually evident at birth
age of onset for ADHD - ✔✔early childhood; per DSM-5 by age 12
age of onset for schizophrenia - ✔✔18-25 for men; 25-35 for women
, age of onset for major depression - ✔✔onset is late adolescence to young adulthood
age of onset for dementia - ✔✔most common after age 85
id - ✔✔contains primary drives or instincts, urges (hunger, sex, aggression) or fantasies;
drives are largely unconscious, sexual, or aggressive in content, and infantile in nature; operates
on the pleasure principle; seeks immediate satisfaction; present at birth and motivates early
infantile actions; "I want"
ego - ✔✔contains the concept of external reality; rational mind, responsible for logical and
abstract thinking, mediates demands of drives and environmental realities; operates on reality
principle; begins to develop at birth as infant struggles to deal with environment; responsible
for use of defense mechanisms; "I think, I evaluate"
superego - ✔✔is the ego-ideal; contains sense of conscience or right vs wrong; contains
aspirations, ideals, morals; regulated by guilt and shame; begins to fully develop around age 6
as child comes into contact with external authority figures; "I should or ought"
oral stage - ✔✔0-18 months; primary means of discharging drives and achieving gratification
are sucking, chewing, feeding, and crying; failure linked to schizophrenia, substance abuse,
paranoia
anal stage - ✔✔18 months-3 years; primary means of discharging drives and achieving
gratification are sphincter control, activities of expulsion and retention; failure linked to
depressive disorders
phallic stage - ✔✔3-6 years; primary means of discharging drives and achieving gratification
are exhibitionism, masturbation with focus on Oedipal conflict, castration anxiety, and female
fear of lost maternal love; failure linked to sexual identity disorders