A 42-year-old male with alcohol use disorder for 5 years is referred to the PMHNP from his
primary care provider for addic on treatment. Which of the following laboratory findings would
be consistent with his diagnosis?
A.)Increased urine and serum crea nine levels
B.) Increased mean corpuscular volume and triglycerides
C.) Increased potassium and chloride levels
D.) Decreased mean corpuscular volume and normal triglyceride level -correct answers Answer
B.
Elevated mean corpuscular volume (MCV) and triglycerides are conven onal biomarkers of
heavy drinking. Elevated urine and serum crea nine levels are an incongruent finding and
sugges ve of renal disease. Elevated potassium and chloride are not consistent with impaired
renal func on. Decreased MCV and normal triglycerides are nonspecific findings consistent with
microcy c anemia.
A 9-year-old girl with a history of generalized anxiety disorder has been stable on fluoxe ne 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:
A.)Consistent with liver disease
B.)Abnormal and should be repeated immediately
C.)Abnormal and requires further evalua on of autoimmune hepa s
D.)A commonly occurring pre-puberty findings known as growing pains -correct answers Answer
D.
,Growing pains is a diagnosis of exclusion occurring in pre- and early puberty, specifically
associated with osteoclas c and osteoblas c ac vity. Liver disease that causes leg pain is a very
late sign and will have associated systemic signs and symptoms. Alkaline phosphatase is a
nonspecific indicator of hepa c disease and does not rise in isola on. Elevated alkaline
phosphatase is an abnormal but nonspecific indicator of liver and bone health requiring clinical
correla on. Alkaline phosphatase in the se ng of autoimmune hepa s should present with
associated signs and symptoms and elevated liver enzymes (aspartate transaminase
[AST]/alanine aminotransferase [ALT]).
A 50-year-old physician presents with complaints of fa gue, headache, abdominal distress, and
weight loss. His husband reports increasing irritability, ina en veness, and low libido over the
last month. He was seen by his primary care provider, who just no fied him he had pre-
diabetes, hypercholesterolemia, and hypertension despite weight loss. These findings are most
consistent with
A.) Dysthymia
B.) Major depression
C.) Generalized anxiety disorder
D.) Seasonal affec ve disorder -correct answers Answer B.
Major depressive symptoms include sleep changes, interest loss, guilt, energy deficit, cogni ve
impairment, appe te change, psychomotor agita on/retarda on, and soma c complaints o en
comorbid with type 2 diabetes. Dysthymia is associated with anhedonia, hopelessness, lack of
produc vity, and low self-esteem with feelings of inadequacy las ng for at least 2 years.
Generalized anxiety disorder symptoms include persistent worrying, catastrophic thinking,
persistent ambivalence, restlessness, persistent fa gue, and muscle tension. Seasonal affec ve
disorder symptoms include a change in sleep, loss of interest, anhedonia, and cogni ve
impairment occurring in the fall or winter and remi ng in the spring and summer.
The purpose of a professional organiza on's scope and standards of prac ce is to:
A.) Define the roles and ac ons for that par cular profession
B.) Define the differences between professions
,C.) Establish the legal authority to prac ce for a profession
D.) Define the legal statutes that are governing a profession -correct answers Answer A.
The scope and standards dictated by professional organiza ons define the role and ac ons of a
par cular profession. The government appoints professional boards to define the differences
between professions, establish criteria for licensure, and define the legal statutes that govern a
profession.
An APRN recognizes the essen al nature of primary preven on strategies for a community.
Which of the following is an example of a primary preven on strategy?
A.) A skills class for at risk adolescents
B.) A suicide hotline
C.) Mandated treatment
D.) A psychosocial clubhouse for the mentally ill -correct answers Answer A.
A skills class for at-risk individuals is an example of primary preven on. The suicide hotline is an
example of secondary preven on because a specific condi on with specific interven ons is
aimed at reducing a specific risk outcome. Mandated treatment and a psychosocial clubhouse
are ter ary preven on strategies because they are aimed at improving outcomes and reducing
symptoms of a condi on that has already occurred.
Which of the following is representa ve of legal ruling trends over the past 30 years?
A.) Juries have been encouraged to find defendants not guilty because of insanity
B.) People with mental illness retain their inalienable rights even when commi ed to a mental
hospital
C.) Courts place increased trust in the professional judgment of mental healthcare providers to
make ethical decisions
, D.) The me in bringing cases before a magistrate for commitment hearings has been reduced -
correct answers Answer A.
The person has a diagnosed mental disorder and poses harm to self or others as a result of the
disorder, and treatment is likely to improve func oning. It is not sufficient for the pa ent to be
unwilling or unable to accept the nature and severity of a mental disorder without having been
diagnosed, the harm stems from the diagnosed condi on, and treatment is likely to improve the
condi on. The pa ent's threat and risk level must be as a result of a diagnosed mental disorder.
A history of serious mental illness that is currently untreated is insufficient for involuntary
admission if they are not a threat as a result of the disorder at the present me.
A pa ent who has been voluntarily commi ed is experiencing symptoms of psychosis; he
declares he has the right to refuse his medica ons 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?
A.) Psychiatric clients cannot refuse treatment
B.) Psychiatric clients can refuse treatment unless it is court ordered
C.) Psychiatric clients cannot act in their own best judgment
D.) The professional judgment of the PMHNP supersedes the client's right to refuse medica on -
correct answers Answer B.
The court order trumps the pa ent's right to exercise self-determina on and the pa ent cannot
refuse treatment. Un l the court orders treatment over objec on, the psychiatric client may
refuse treatment unless the condi on imminently threatens life or limb. The professional
judgment of two physicians does not allow for treatment unless there is an imminent threat, in
which case one opinion is sufficient.
primary care provider for addic on treatment. Which of the following laboratory findings would
be consistent with his diagnosis?
A.)Increased urine and serum crea nine levels
B.) Increased mean corpuscular volume and triglycerides
C.) Increased potassium and chloride levels
D.) Decreased mean corpuscular volume and normal triglyceride level -correct answers Answer
B.
Elevated mean corpuscular volume (MCV) and triglycerides are conven onal biomarkers of
heavy drinking. Elevated urine and serum crea nine levels are an incongruent finding and
sugges ve of renal disease. Elevated potassium and chloride are not consistent with impaired
renal func on. Decreased MCV and normal triglycerides are nonspecific findings consistent with
microcy c anemia.
A 9-year-old girl with a history of generalized anxiety disorder has been stable on fluoxe ne 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:
A.)Consistent with liver disease
B.)Abnormal and should be repeated immediately
C.)Abnormal and requires further evalua on of autoimmune hepa s
D.)A commonly occurring pre-puberty findings known as growing pains -correct answers Answer
D.
,Growing pains is a diagnosis of exclusion occurring in pre- and early puberty, specifically
associated with osteoclas c and osteoblas c ac vity. Liver disease that causes leg pain is a very
late sign and will have associated systemic signs and symptoms. Alkaline phosphatase is a
nonspecific indicator of hepa c disease and does not rise in isola on. Elevated alkaline
phosphatase is an abnormal but nonspecific indicator of liver and bone health requiring clinical
correla on. Alkaline phosphatase in the se ng of autoimmune hepa s should present with
associated signs and symptoms and elevated liver enzymes (aspartate transaminase
[AST]/alanine aminotransferase [ALT]).
A 50-year-old physician presents with complaints of fa gue, headache, abdominal distress, and
weight loss. His husband reports increasing irritability, ina en veness, and low libido over the
last month. He was seen by his primary care provider, who just no fied him he had pre-
diabetes, hypercholesterolemia, and hypertension despite weight loss. These findings are most
consistent with
A.) Dysthymia
B.) Major depression
C.) Generalized anxiety disorder
D.) Seasonal affec ve disorder -correct answers Answer B.
Major depressive symptoms include sleep changes, interest loss, guilt, energy deficit, cogni ve
impairment, appe te change, psychomotor agita on/retarda on, and soma c complaints o en
comorbid with type 2 diabetes. Dysthymia is associated with anhedonia, hopelessness, lack of
produc vity, and low self-esteem with feelings of inadequacy las ng for at least 2 years.
Generalized anxiety disorder symptoms include persistent worrying, catastrophic thinking,
persistent ambivalence, restlessness, persistent fa gue, and muscle tension. Seasonal affec ve
disorder symptoms include a change in sleep, loss of interest, anhedonia, and cogni ve
impairment occurring in the fall or winter and remi ng in the spring and summer.
The purpose of a professional organiza on's scope and standards of prac ce is to:
A.) Define the roles and ac ons for that par cular profession
B.) Define the differences between professions
,C.) Establish the legal authority to prac ce for a profession
D.) Define the legal statutes that are governing a profession -correct answers Answer A.
The scope and standards dictated by professional organiza ons define the role and ac ons of a
par cular profession. The government appoints professional boards to define the differences
between professions, establish criteria for licensure, and define the legal statutes that govern a
profession.
An APRN recognizes the essen al nature of primary preven on strategies for a community.
Which of the following is an example of a primary preven on strategy?
A.) A skills class for at risk adolescents
B.) A suicide hotline
C.) Mandated treatment
D.) A psychosocial clubhouse for the mentally ill -correct answers Answer A.
A skills class for at-risk individuals is an example of primary preven on. The suicide hotline is an
example of secondary preven on because a specific condi on with specific interven ons is
aimed at reducing a specific risk outcome. Mandated treatment and a psychosocial clubhouse
are ter ary preven on strategies because they are aimed at improving outcomes and reducing
symptoms of a condi on that has already occurred.
Which of the following is representa ve of legal ruling trends over the past 30 years?
A.) Juries have been encouraged to find defendants not guilty because of insanity
B.) People with mental illness retain their inalienable rights even when commi ed to a mental
hospital
C.) Courts place increased trust in the professional judgment of mental healthcare providers to
make ethical decisions
, D.) The me in bringing cases before a magistrate for commitment hearings has been reduced -
correct answers Answer A.
The person has a diagnosed mental disorder and poses harm to self or others as a result of the
disorder, and treatment is likely to improve func oning. It is not sufficient for the pa ent to be
unwilling or unable to accept the nature and severity of a mental disorder without having been
diagnosed, the harm stems from the diagnosed condi on, and treatment is likely to improve the
condi on. The pa ent's threat and risk level must be as a result of a diagnosed mental disorder.
A history of serious mental illness that is currently untreated is insufficient for involuntary
admission if they are not a threat as a result of the disorder at the present me.
A pa ent who has been voluntarily commi ed is experiencing symptoms of psychosis; he
declares he has the right to refuse his medica ons 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?
A.) Psychiatric clients cannot refuse treatment
B.) Psychiatric clients can refuse treatment unless it is court ordered
C.) Psychiatric clients cannot act in their own best judgment
D.) The professional judgment of the PMHNP supersedes the client's right to refuse medica on -
correct answers Answer B.
The court order trumps the pa ent's right to exercise self-determina on and the pa ent cannot
refuse treatment. Un l the court orders treatment over objec on, the psychiatric client may
refuse treatment unless the condi on imminently threatens life or limb. The professional
judgment of two physicians does not allow for treatment unless there is an imminent threat, in
which case one opinion is sufficient.
