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2.
10. When lobbying a local congressional representative to include nurse practitioners in
reimbursement for services in all areas of the country, an adult psychiatric and mental health
nurse practitioner emphasizes the:
A. ability of nurse practitioners to provide health care that patients need.
B. fact that nurse practitioners are caring in their patient care delivery.
C. importance of broadening the scope of nursing practice.
D. necessity of offering equivalent services both to urban and rural patients. - ansA. ability of
nurse practitioners to provide health care that patients need.
11. For 12 years, a 65-year-old patient with bipolar affective disorder has been treated with
lithium (Eskalith) 900 mg daily. When oral hydrochlorothiazide (HCTZ) 12.5 mg daily is added
for hypertension, the patient develops nausea, vomiting, ataxia, and muscle weakness and the
patient's serum lithium level is 2.0 mEq/L. The interaction of the lithium and the thiazide
diuretic has induced:
A. hypokalemia.
B. hyponatremia.
C. increased renal clearance of lithium.
D. reduced renal clearance of lithium. - ansD. reduced renal clearance of lithium.
12. Which statement by a male patient who has posttraumatic stress disorder (PTSD) and
chronic persistent suicidal ideation indicates a need for hospital assessment?
A. "I feel so bad all the time. I wish I were dead."
B. "My wife is so scared that she has taken all my guns out of the house."
C. "My wife just left with the children. I have no one left and no future."
D. "Those medications you gave me make me feel worse. I stopped taking them." - ansC. "My
wife just left with the children. I have no one left and no future."
13. A male patient informs an adult psychiatric and mental health nurse practitioner that he
has not slept in three days, has poor concentration, and denies fatigue. The patient's
diagnosis is:
A. attention-deficit hyperactivity disorder.
B. bipolar disorder.
C. panic disorder.
D. primary insomnia. - ansB. bipolar disorder.
14. During patient education about sertraline (Zoloft), an adult psychiatric and mental health
nurse practitioner focuses upon the potential side effect of:
A. agranulocytosis.
B. hypernatremia.
C. sexual dysfunction.
D. weight loss. - ansC. sexual dysfunction
15. The neurochemical pathophysiology of Tourette disorder involves:
A. decreased levels of gamma-aminobutyric acid and increased levels of glutamate 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.
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D. overstimulation of noradrenergic activity located in the locus coeruleus of the brain. - ansC.
imbalances in dopaminergic, serotonergic, and noradrenergic systems in multiple regions of
the brain.
16. Before implementing evidence-based practice changes, an adult psychiatric and mental
health nurse practitioner's initial action is to:
A. brainstorm with stakeholders and draft a detailed problem list.
B. compare data with internal and external benchmarks, and coordinate ongoing education.
C. facilitate a collaborative multidisciplinary group to synthesize evidence and compare key
themes.
D. identify potential barriers and facilitators that reflect patients' values and expectations. -
ansD. identify potential barriers and facilitators that reflect patients' values and expectations.
17. Symptoms of anxiety and panic are associated with a low level of which neurotransmitter?
A. Cortisol
B. Dopamine
C. Gamma-aminobutyric acid
D. Glutamate - ansC. Gamma-aminobutyric acid
18. An outpatient mental health clinic-based adult psychiatric and mental health nurse
practitioner treats a 32-year-old patient who has diabetes and a major depressive disorder.
The patient reports an improved and stable mood on a trial of duloxetine (Cymbalta), but
experiences continued neuropathic pain. The nurse practitioner's initial intervention is to:
A. add gabapentin (Neurontin) to the treatment regimen.
B. conduct additional diagnostic tests.
C. contact the patient's endocrinologist.
D. increase the dosage of duloxetine (Cymbalta). - ansD. increase the dosage of duloxetine
(Cymbalta).
19. According to current clinical guidelines for treating a patient with bipolar I disorder mania
with psychotic features, an adult psychiatric and mental health nurse practitioner prescribes:
A. alprazolam (Xanax).
B. citalopram (Celexa).
C. lamotrigine (Lamictal).
D. quetiapine (Seroquel). - ansD. quetiapine (Seroquel).
20. A hospital-based adult psychiatric and mental health nurse practitioner collaborates with a
multidisciplinary team that is charged with establishing a psychiatric outpatient clinic.
Advocating for the role of advanced practice nurses, the nurse practitioner initially educates
the team that advanced practice nurses:
A. are readily available to meet patient needs.
B. can autonomously provide a full range of comprehensive services.
C. can perform case management functions.
D. provide cost-effective care delivery. - ansB. can autonomously provide a full range of
comprehensive services.
21. Which nonpharmacologic treatment modality is recommended for depression?
A. Biofeedback
B. Dialectical behavioral therapy
C. Eye movement desensitization and reprocessing therapy