PMHNP Boards Exam Questions And Answers

A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical examination is unremarkable. Laboratory results are within normal limits except for a markedly elevated alkaline phosphatase level. The psychiatric-mental health nurse practitioner - ANS interprets the findings as normally occurring during a rapid adolescent growth spurt Laboratory findings for a patient with an alcohol use disorder indicate increased liver function values and: - ANS increased MCV and elevated triglyceride levels. A new patient arrives at the office for treatment for depression. The patient reports taking simvastatin (Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatric-mental health nurse practitioner eliminates fluoxetine (Prozac), based on the knowledge that the combination can lead to increased plasma levels of the statin, resulting in an increased risk of muscle damage and rhabdomyolysis. The nurse practitioner's reason is that: - ANS one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor. A 28-year-old patient who is psychotic arrives at the clinic with family members but refuses to meet if the family members are present. The psychiatric-mental health nurse practitioner - ANS asks the family members to leave for the appointment. The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement at a community mental health clinic. The effective strategy for evaluating the clinic's services is to: - ANS use a survey to elicit patient satisfaction responses. The psychiatric-mental health nurse practitioner evaluates a new adult patient via telemedicine. The patient has questions about a new medication that he or she recently started. The nurse practitioner decides to provide psychoeducation and to: - ANS e-mail drug information and resources Any court of law that evaluates the standards of care provided by a psychiatric-mental health nurse practitioner - ANS considers what a reasonably prudent health care provider would do. The psychiatric-mental health nurse practitioner and a team of local mental health professionals are asked to provide crisis counseling service, after a gunman recently took a class hostage at a local elementary school, wounded several students, and then shot himself. In preparing for this assignment, the nurse practitioner recognizes that: - ANS a child's developmental stage will influence his or her response to catastrophic stress Which community-based program is a tertiary level intervention? - ANS Partial hospitalization program that provides intensive group therapy for rehabilitation. A 32-year-old female patient informs the psychiatric-mental health nurse practitioner that she is three months pregnant. She has been stable on fluoxetine (Prozac) for the last two years. The patient asks whether she may safely continue this medication during her pregnancy. The nurse practitioner responds: - ANS "Let's review the risks and benefits of continuing or discontinuing Prozac for you and your baby." Established clinical guidelines suggest that suicidality is decreased by treating patients who have borderline personality disorder with: - ANS dialectical behavioral therapy. A six-year-old patient with autistic spectrum disorder has not responded to six months of psychosocial interventions and continues to demonstrate aggressive tendencies toward a younger sibling. The psychiatric-mental health nurse practitioner prescribes: - ANS risperidone (Risperdal) 0.25 mg once a day. The psychiatric-mental health nurse practitioner working in a crisis stabilization unit evaluates a patient verbalizing suicidal thoughts after being sexually assaulted. Before processing through the traumatic event, the nurse practitioner first attempts to - ANS provide an environment of safety. The psychiatric-mental health nurse practitioner uses a cognitive-behavioral approach to help a patient address self-defeating behaviors. After identifying the stressor that causes the inappropriate behavior, the initial strategy is to explore: - ANS rational and irrational beliefs about the stressor. A patient who has borderline personality disorder experiences intense anxiety when the psychiatric-mental health nurse practitioner goes on vacation. The most appropriate explanation for this reaction is that the patient: - ANS has not developed object constancy. An initial psychiatric evaluation of a patient reveals a normal mental status and appropriate behavior, despite a parent's reports of "disobedience, poor grades, and laziness." To further assess the patient's functioning, the psychiatric-mental health nurse practitioner: - ANS meets with the parent and patient together to explore the discrepant report. The psychiatric-mental health nurse practitioner is employed in a newly created attending role on a psychiatric inpatient unit. To promote an interprofessional environment, the nurse practitioner: - ANS assigns a role for all staff members in improving patient outcomes. The psychiatric-mental health nurse practitioner sees a 12-year-old patient who takes lisdexamfetamine (Vyvanse) 50 mg daily for attention-deficit hyperactivity disorder. The nurse practitioner observes a tic, which the parents report began after the patient began taking the psychostimulant, and it has been increasing in severity. Both the parents and the school report that the medication is helpful. The nurse practitioner: - ANS discontinues the psychostimulant, prescribes guanfacine extended release (Intuniv), and monitors the patient. A patient from India emphasizes a strong feeling that he or she is one with Brahma and connected to life through this being. While developing a treatment plan, the psychiatric-mental health nurse practitioner realizes that this patient's spirituality also guides his or her: - ANS interpretation of life events. The psychiatric-mental health nurse practitioner is tasked with continually improving the quality of care on an inpatient unit. The nurse practitioner implements: - ANS a plan-do-study-act process To improve treatment and patient outcomes, the psychiatric-mental health nurse practitioner utilizes evidence-based practices. An acceptable resource for evidence-based meta analysis is the: - ANS Cochrane database. The psychiatric-mental health nurse practitioner is concerned about access-to-care issues in the local community and wants to help develop health care policy to help patients access care more effectively. The nurse practitioner knows one of the most effective avenues for developing and advocating for policy is: - ANS working with the local chapter of the nurse's professional association. A patient is referred to an outpatient psychiatric clinic for evaluation of depressive episodes after bouts of overeating. Assessment reveals a five-year history of episodes of uncontrollable overeating precipitated by feelings of tension. This occurs about two to three times per week and for the past year has been associated with laxative use, self-induced vomiting, and periods of fasting to maintain body weight. The patient reports becoming increasingly depressed and has considered suicide in the past. The treatment plan includes medical evaluation with electrolyte studies and: - ANS referral for cognitive behavioral therapy. The psychiatric-mental health nurse practitioner evaluates a female patient referred with a three-month history of moderate to severe postpartum depression. The patient has been in therapy for three weeks and has not been prescribed medication, despite several interactions with her obstetrician and primary care provider. After researching the health care system's organizational factors that contributed to this fragmented care, the nurse practitioner - ANS files a complaint with the appropriate regulatory boards regarding the patient's prior care. The neuroprotective treatment of choice for bipolar disorder is: - ANS lithium (Eskalith). Which of the following would not be included in a progress note - ANS incident report on medication error (are included in organizational reporting but not in a patient's record) Which is not insured by the University Bill of Rights for Mental Health patients? - ANS The right to refuse a particular mode of treatment is insured unless danger to self or others. NP contacts 8 patients to ask them to phone their state senator who heads HHS to approve bill for housing the mentally ill. The nurse practitioner is acting as a... - ANS Advocate (not necessarily a policymaker) Greatest risk factors for major depressive disorder? - ANS Women have 2 x greater risk than men, mean age is 40 with range between (20-50) without close relationships (divorced)