Verified Questions & Answers | Graded A+
1. During a mental status examination, an 18-year-old patient reports feeling
bugs crawling under their skin. The PMHNP documents this as:
A) A developmental disorder
B) A hypnagogic hallucination
C) A perceptual disturbance, and suspects substance use
D) A somatic delusion
Answer C: A perceptual disturbance, and suspects substance use
Rationale: Tactile hallucinations (formication) are often associated with substance
use (e.g., cocaine, methamphetamine) or withdrawal .
2. The PMHNP is responsible for initiating quality improvement at a
community mental health clinic. The most effective strategy for evaluating
clinic services is to:
A) Analyze epidemiological data
B) Conduct a root cause analysis
C) Interview patient families
D) Use a survey to elicit patient satisfaction responses
Answer D: Use a survey to elicit patient satisfaction responses
Rationale: Patient satisfaction surveys directly measure perceived quality of
services and identify areas for improvement .
,3. A new patient reports taking simvastatin (Zocor) and lisinopril (Zestril).
When selecting an antidepressant, the PMHNP eliminates fluoxetine based
on the knowledge that:
A) Both medications are CYP450 3A4 inhibitors
B) Both medications are CYP450 3A4 substrates
C) One is a 3A4 substrate and one is a 3A4 inducer
D) One is a 3A4 substrate and one is a 3A4 inhibitor
Answer D: One is a 3A4 substrate and one is a 3A4 inhibitor
Rationale: Fluoxetine inhibits CYP450 3A4, which can increase plasma levels of
simvastatin (a 3A4 substrate), raising risk of rhabdomyolysis .
4. Laboratory findings for a patient with alcohol use disorder indicate
increased liver function values and:
A) Decreased MCV and normal triglyceride levels
B) Elevated potassium and chloride levels
C) Increased MCV and elevated triglyceride levels
D) Increased urine and serum creatinine levels
Answer C: Increased MCV and elevated triglyceride levels
Rationale: Chronic alcohol use causes macrocytosis (elevated MCV) and
hypertriglyceridemia due to hepatic effects .
,5. A 14-year-old patient has nonspecific leg pain with an unremarkable
physical exam and markedly elevated alkaline phosphatase. The PMHNP:
A) Interprets this as normally occurring during a rapid adolescent growth spurt
B) Obtains a rheumatoid profile
C) Orders a repeat blood test
D) Suspects acute pancreatitis
Answer A: Interprets this as normally occurring during a rapid adolescent
growth spurt
Rationale: Elevated alkaline phosphatase is common during adolescent growth
spurts due to bone turnover .
6. An 18-year-old with bipolar disorder wants to enter a research study
testing an experimental drug. The PMHNP's initial response is:
A) "All drug treatments are too risky for you."
B) "Let's discuss the risks of potentially changing your medications."
C) "We will have to see if you meet the inclusion criteria."
D) "You will have only a small chance of receiving the drug."
Answer B: "Let's discuss the risks of potentially changing your medications."
Rationale: Informed consent requires discussing risks and benefits; the PMHNP
should explore the patient's understanding and concerns .
7. What does the AIMS assessment tool evaluate?
A) Depression severity
, B) Presence and severity of abnormal extremity, facial, and body movements
C) Violence risk
D) Cognitive impairment
Answer B: Presence and severity of abnormal extremity, facial, and body
movements
Rationale: The Abnormal Involuntary Movement Scale (AIMS) assesses tardive
dyskinesia and other movement disorders, with higher scores indicating worse
impairment .
8. Which practitioners are qualified to make a psychiatric diagnosis?
A) RN only
B) RN and LPN
C) MD, DO, NP, and PA
D) Any licensed nurse
Answer C: MD, DO, NP, and PA
Rationale: Psychiatric diagnosis requires advanced practice providers or
physicians with appropriate training and scope of practice .
9. Which score on the Beck Depression Inventory (BDI) is associated with
moderate depression?
A) 0-13
B) 14-18
C) 19-29