300 QUESTIONS WITH ANSWERS AND RATIONALES 2026
,SECTION 1: ETHICAL, LEGAL, AND SCOPE OF PRACTICE FOUNDATIONS (Ques ons 1-80)
Ques on 1
A PMHNP is evalua ng a 14-year-old adolescent who discloses engaging in self-injurious
behavior (cu ng) without suicidal intent. The minor requests that the PMHNP not tell their
parents. Which ethical and legal principle primarily guides the PMHNP's duty regarding
confiden ality and disclosure?
A) Absolute confiden ality must be maintained because the minor did not express ac ve
suicidal idea on
B) Confiden ality is limited; safety concerns and minor consent laws dictate that
parent/guardian involvement must be navigated based on state law and risk assessment
C) The PMHNP must immediately terminate care if the pa ent refuses to allow parental
no fica on
D) The Tarasoff doctrine mandates immediate involuntary commitment of the adolescent
Correct Answer: B
Ra onale: Confiden ality with minor pa ents involves balancing minor autonomy/assent with
parental legal rights and safety concerns. Non-suicidal self-injury (NSSI) requires a thorough risk
evalua on; state laws govern minor rights to confiden al mental health treatment, but safety
risks may necessitate engaging guardians while a emp ng to preserve therapeu c rapport .
Ques on 2
Under the Tarasoff v. Regents of the University of California decision, what is the primary legal
obliga on of a PMHNP when a pa ent expresses an explicit, credible threat to harm a specific
individual?
A) Duty to protect/warn the iden fied vic m and no fy law enforcement
B) Duty to strictly preserve HIPAA confiden ality regardless of the threat
C) Obliga on only to inform the facility's legal counsel
D) Requirement to immediately order physical restraints
Correct Answer: A
,Ra onale: The Tarasoff ruling established that when a mental health professional determines
that a pa ent presents a serious threat of violence to a foreseeable vic m, the provider has a
legal "duty to protect/warn" the poten al vic m and no fy law enforcement agency personnel .
Ques on 3
A PMHNP is obtaining consent for psychotropic medica on ini a on in an 8-year-old child with
severe ADHD. Which statement accurately describes the consent process?
A) The 8-year-old child must sign a legally binding informed consent form
B) The parent/legal guardian provides legal informed consent, while the child provides informed
assent appropriate to developmental level
C) Minors are never included in discussions regarding medica on treatment
D) Assent replaces the need for parental consent in pediatric psychiatry
Correct Answer: B
Ra onale: Minors under the age of legal adulthood generally lack the legal capacity to give
formal informed consent. Therefore, the parent or court-appointed legal guardian provides
formal informed consent, while the minor child provides informed assent (agreement) adapted
to their cogni ve capacity .
Ques on 4
A PMHNP is asked by a pa ent's employer to disclose details of the pa ent's diagnosis. The NP
should:
A) Provide the informa on because the employer pays for insurance
B) Refuse to disclose without a signed release from the pa ent
C) Discuss only the treatment plan, not the diagnosis
D) Ask the employer to contact the pa ent directly
Correct Answer: B
Ra onale: HIPAA and ethical guidelines require pa ent authoriza on for release of protected
health informa on, including diagnosis .
Ques on 5
, Which of the following elements must a plain ff establish to prove medical malprac ce against
an advanced prac ce registered nurse?
A) Duty of care, breach of duty, proximate causa on, and actual damages/injury
B) Criminal intent, breach of contract, and lack of consent
C) Inten onal inflic on of emo onal distress, duty, and ba ery
D) Absence of clinical outcome improvement alone
Correct Answer: A
Ra onale: The four required legal elements of medical malprac ce are: (1) Duty of care owed to
the pa ent, (2) Breach of duty (failure to meet standard of care), (3) Causa on (breach directly
caused injury), and (4) Damages (actual harm/injury incurred) .
Ques on 6
A PMHNP working in an inpa ent psychiatric unit considers placing an agitated, non-violent
pa ent in physical restraints to manage unit staffing shortages. Which ethical principle and
standard of care is directly violated?
A) Non-maleficence and improper restraint usage (restraints are restricted to imminent safety
threats, never staff convenience or punishment)
B) Paternalis c beneficence
C) Jus ce and fair distribu on of resources
D) Fidelity to ins tu onal policies
Correct Answer: A
Ra onale: Restraints and seclusion are strictly safety interven ons of last resort when there is
imminent danger of harm to self or others. U lizing restraints for convenience or coercion
violates non-maleficence, pa ent rights, and federal emergency regula ons .
Ques on 7
A 45-year-old pa ent with schizophrenia has been stabilized on clozapine for 6 months. The
PMHNP must monitor which laboratory values at the frequency required by the REMS program?
A) CBC with differen al weekly for first 6 months
B) LFTs monthly
C) Serum crea nine quarterly
D) TSH annually
,SECTION 1: ETHICAL, LEGAL, AND SCOPE OF PRACTICE FOUNDATIONS (Ques ons 1-80)
Ques on 1
A PMHNP is evalua ng a 14-year-old adolescent who discloses engaging in self-injurious
behavior (cu ng) without suicidal intent. The minor requests that the PMHNP not tell their
parents. Which ethical and legal principle primarily guides the PMHNP's duty regarding
confiden ality and disclosure?
A) Absolute confiden ality must be maintained because the minor did not express ac ve
suicidal idea on
B) Confiden ality is limited; safety concerns and minor consent laws dictate that
parent/guardian involvement must be navigated based on state law and risk assessment
C) The PMHNP must immediately terminate care if the pa ent refuses to allow parental
no fica on
D) The Tarasoff doctrine mandates immediate involuntary commitment of the adolescent
Correct Answer: B
Ra onale: Confiden ality with minor pa ents involves balancing minor autonomy/assent with
parental legal rights and safety concerns. Non-suicidal self-injury (NSSI) requires a thorough risk
evalua on; state laws govern minor rights to confiden al mental health treatment, but safety
risks may necessitate engaging guardians while a emp ng to preserve therapeu c rapport .
Ques on 2
Under the Tarasoff v. Regents of the University of California decision, what is the primary legal
obliga on of a PMHNP when a pa ent expresses an explicit, credible threat to harm a specific
individual?
A) Duty to protect/warn the iden fied vic m and no fy law enforcement
B) Duty to strictly preserve HIPAA confiden ality regardless of the threat
C) Obliga on only to inform the facility's legal counsel
D) Requirement to immediately order physical restraints
Correct Answer: A
,Ra onale: The Tarasoff ruling established that when a mental health professional determines
that a pa ent presents a serious threat of violence to a foreseeable vic m, the provider has a
legal "duty to protect/warn" the poten al vic m and no fy law enforcement agency personnel .
Ques on 3
A PMHNP is obtaining consent for psychotropic medica on ini a on in an 8-year-old child with
severe ADHD. Which statement accurately describes the consent process?
A) The 8-year-old child must sign a legally binding informed consent form
B) The parent/legal guardian provides legal informed consent, while the child provides informed
assent appropriate to developmental level
C) Minors are never included in discussions regarding medica on treatment
D) Assent replaces the need for parental consent in pediatric psychiatry
Correct Answer: B
Ra onale: Minors under the age of legal adulthood generally lack the legal capacity to give
formal informed consent. Therefore, the parent or court-appointed legal guardian provides
formal informed consent, while the minor child provides informed assent (agreement) adapted
to their cogni ve capacity .
Ques on 4
A PMHNP is asked by a pa ent's employer to disclose details of the pa ent's diagnosis. The NP
should:
A) Provide the informa on because the employer pays for insurance
B) Refuse to disclose without a signed release from the pa ent
C) Discuss only the treatment plan, not the diagnosis
D) Ask the employer to contact the pa ent directly
Correct Answer: B
Ra onale: HIPAA and ethical guidelines require pa ent authoriza on for release of protected
health informa on, including diagnosis .
Ques on 5
, Which of the following elements must a plain ff establish to prove medical malprac ce against
an advanced prac ce registered nurse?
A) Duty of care, breach of duty, proximate causa on, and actual damages/injury
B) Criminal intent, breach of contract, and lack of consent
C) Inten onal inflic on of emo onal distress, duty, and ba ery
D) Absence of clinical outcome improvement alone
Correct Answer: A
Ra onale: The four required legal elements of medical malprac ce are: (1) Duty of care owed to
the pa ent, (2) Breach of duty (failure to meet standard of care), (3) Causa on (breach directly
caused injury), and (4) Damages (actual harm/injury incurred) .
Ques on 6
A PMHNP working in an inpa ent psychiatric unit considers placing an agitated, non-violent
pa ent in physical restraints to manage unit staffing shortages. Which ethical principle and
standard of care is directly violated?
A) Non-maleficence and improper restraint usage (restraints are restricted to imminent safety
threats, never staff convenience or punishment)
B) Paternalis c beneficence
C) Jus ce and fair distribu on of resources
D) Fidelity to ins tu onal policies
Correct Answer: A
Ra onale: Restraints and seclusion are strictly safety interven ons of last resort when there is
imminent danger of harm to self or others. U lizing restraints for convenience or coercion
violates non-maleficence, pa ent rights, and federal emergency regula ons .
Ques on 7
A 45-year-old pa ent with schizophrenia has been stabilized on clozapine for 6 months. The
PMHNP must monitor which laboratory values at the frequency required by the REMS program?
A) CBC with differen al weekly for first 6 months
B) LFTs monthly
C) Serum crea nine quarterly
D) TSH annually
