ANCC IQ DOMAINS 1-5 |ACTUAL QUESTIONS AND
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
1. You see a patient for a routine medication visit. At the end of the session, the patient
asks questions and the session ends up 50 minutes in length. You normally charge for the
30-minute appointment, but instead you charge for the 1-hour appointment. The 1-hour
appointment includes a full body assessment that you did not perform. This violation is
known as:
- Over-coding
- Super-coding
- Down-coding
- Up-coding
CORRECT ANSWER
- Up-coding
Rationale: Up-coding is a fraudulent practice in which the provider services are billed at
higher procedure codes than were actually performed, resulting in a higher payment by
Medicare or other third-party payers.
Question 2
1. During a session, your patient asks to be able to contact you via your Facebook page on
the internet. You reply:
- I cannot do that because I have a concealed Facebook identity; and I cannot reveal that to
my patients
- I would be happy to communicate with you. It makes it easier for me to reach you this way.
- I would be happy to use Facebook but you will have to use a private message so that you
can be anonymous
- I cannot do that because Facebook does not protect your Private Health Information
1
@THE STUDY VAULT
,CORRECT ANSWER
- I cannot do that because Facebook does not protect your Private Health Information
Rationale: Using Facebook breaks patient-provider confidentiality, in addition to blurring
ethical boundaries of the therapeutic relationship. Facebook does not protect private
health information. Information on the site is available for anyone to see or hack into
even if private messaged.
Question 3
1. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) insures which of
the following?
- Small employers who insure 50 or fewer covered lives are exempt from the provisions of
this MHPAEA law.
- Annual or lifetime dollar limits on mental health and substance use disorder benefits are no
lower than any such dollar limits for medical and surgical benefits offered by a group health
plan.
- Mental health and substance use disorder benefits must be available through both in-
network providers and out-of-network providers by a group health plan.
- Group health plans may obtain an exemption if they can demonstrate expected cost
increase resulting from implementation of the parity provisions greater than a 5% increase
in the cost under existing plan.
CORRECT ANSWER
- Annual or lifetime dollar limits on mental health and substance use disorder benefits
are no lower than any such dollar limits for medical and surgical benefits offered by a
group health plan.
Rationale: The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) provides
federal legislation that requires any annual or lifetime limits on medical and surgical
benefits be the same for mental health and substance use disorder benefits. Small
employers who insure 2 to 50 employees can apply for an "opt-out" waiver, but they are
not automatically exempt from the MHPAEA requirements. The group health plan will be
required to provide in-network and out-of-network mental health and substance use
disorder benefits only if it provides both in-network and out-of-network medical and
surgical benefits. The group health plan my obtain an exemption or waiver if the first
year of implementation results in 2% increase in group health plan costs over prior year
2
@THE STUDY VAULT
, that covers the following year, and if implementation results in 1% increase in group
health plan costs in subsequent years. A section on actuarial determination of these
increased costs is included in the law.
Question 4
1. A 68-year-old, retired African-American widower who served for 30 years as an Army
officer was recently diagnosed with terminal lung cancer. He made plans to die at home
with hospice care. He was hospitalized for a broken hip and succumbed to complications in
the hospital. Despite his request to be addressed as "Mr. Baxter" the hospital staff
persisted in calling him by his first name, "John." Which principle of culturally competent
care does this violate?
- Autonomy
- Advocacy
- Collaboration
- Respect
CORRECT ANSWER
- Respect
Rationale: Respect of cultural values and beliefs is violated in this scenario.
Question 5
1. PMHNPs seeking admitting privileges at a community hospital with inpatient psychiatric
services need to influence policymakers at which of the following levels?
- State board of nursing
- State legislature
- County board of health
- Local hospital
CORRECT ANSWER
- Local hospital
3
@THE STUDY VAULT
, Rationale: Local PMHNPs who want admitting privileges will want to persuade the
appropriate hospital decision maker, through facts, figures, and a presentation of
projected benefits to the hospital, of the need to change policy and allow PMHNPs to
admit patients.
Question 6
1. To demonstrate her support for social justice, within her role as a PMHNP caring for the
person who is homeless with mental illness, the PMHNP:
- Volunteers to serve food at the local Home for Girls.
- Teaches Sunday School.
- Volunteers to walk at the March of Dimes walk each year.
- Volunteers her clinical services at the psychiatric clinic, run by a local mission project.
CORRECT ANSWER
- Volunteers her clinical services at the psychiatric clinic, run by a local mission project.
Rationale: Social justice is bringing things to those who have the least means of getting
them but need them the most. In this case, the homeless mentally ill need the PMHNP's
skills more.
Question 7
1. You have students from local psychiatric nurse practitioner programs follow you in your
clinical practice to show them what you do as a PMHNP. This is called being a:
- Preceptor
- Mentor
- Teacher
- Professor
CORRECT ANSWER
- Preceptor
4
@THE STUDY VAULT
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
1. You see a patient for a routine medication visit. At the end of the session, the patient
asks questions and the session ends up 50 minutes in length. You normally charge for the
30-minute appointment, but instead you charge for the 1-hour appointment. The 1-hour
appointment includes a full body assessment that you did not perform. This violation is
known as:
- Over-coding
- Super-coding
- Down-coding
- Up-coding
CORRECT ANSWER
- Up-coding
Rationale: Up-coding is a fraudulent practice in which the provider services are billed at
higher procedure codes than were actually performed, resulting in a higher payment by
Medicare or other third-party payers.
Question 2
1. During a session, your patient asks to be able to contact you via your Facebook page on
the internet. You reply:
- I cannot do that because I have a concealed Facebook identity; and I cannot reveal that to
my patients
- I would be happy to communicate with you. It makes it easier for me to reach you this way.
- I would be happy to use Facebook but you will have to use a private message so that you
can be anonymous
- I cannot do that because Facebook does not protect your Private Health Information
1
@THE STUDY VAULT
,CORRECT ANSWER
- I cannot do that because Facebook does not protect your Private Health Information
Rationale: Using Facebook breaks patient-provider confidentiality, in addition to blurring
ethical boundaries of the therapeutic relationship. Facebook does not protect private
health information. Information on the site is available for anyone to see or hack into
even if private messaged.
Question 3
1. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) insures which of
the following?
- Small employers who insure 50 or fewer covered lives are exempt from the provisions of
this MHPAEA law.
- Annual or lifetime dollar limits on mental health and substance use disorder benefits are no
lower than any such dollar limits for medical and surgical benefits offered by a group health
plan.
- Mental health and substance use disorder benefits must be available through both in-
network providers and out-of-network providers by a group health plan.
- Group health plans may obtain an exemption if they can demonstrate expected cost
increase resulting from implementation of the parity provisions greater than a 5% increase
in the cost under existing plan.
CORRECT ANSWER
- Annual or lifetime dollar limits on mental health and substance use disorder benefits
are no lower than any such dollar limits for medical and surgical benefits offered by a
group health plan.
Rationale: The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) provides
federal legislation that requires any annual or lifetime limits on medical and surgical
benefits be the same for mental health and substance use disorder benefits. Small
employers who insure 2 to 50 employees can apply for an "opt-out" waiver, but they are
not automatically exempt from the MHPAEA requirements. The group health plan will be
required to provide in-network and out-of-network mental health and substance use
disorder benefits only if it provides both in-network and out-of-network medical and
surgical benefits. The group health plan my obtain an exemption or waiver if the first
year of implementation results in 2% increase in group health plan costs over prior year
2
@THE STUDY VAULT
, that covers the following year, and if implementation results in 1% increase in group
health plan costs in subsequent years. A section on actuarial determination of these
increased costs is included in the law.
Question 4
1. A 68-year-old, retired African-American widower who served for 30 years as an Army
officer was recently diagnosed with terminal lung cancer. He made plans to die at home
with hospice care. He was hospitalized for a broken hip and succumbed to complications in
the hospital. Despite his request to be addressed as "Mr. Baxter" the hospital staff
persisted in calling him by his first name, "John." Which principle of culturally competent
care does this violate?
- Autonomy
- Advocacy
- Collaboration
- Respect
CORRECT ANSWER
- Respect
Rationale: Respect of cultural values and beliefs is violated in this scenario.
Question 5
1. PMHNPs seeking admitting privileges at a community hospital with inpatient psychiatric
services need to influence policymakers at which of the following levels?
- State board of nursing
- State legislature
- County board of health
- Local hospital
CORRECT ANSWER
- Local hospital
3
@THE STUDY VAULT
, Rationale: Local PMHNPs who want admitting privileges will want to persuade the
appropriate hospital decision maker, through facts, figures, and a presentation of
projected benefits to the hospital, of the need to change policy and allow PMHNPs to
admit patients.
Question 6
1. To demonstrate her support for social justice, within her role as a PMHNP caring for the
person who is homeless with mental illness, the PMHNP:
- Volunteers to serve food at the local Home for Girls.
- Teaches Sunday School.
- Volunteers to walk at the March of Dimes walk each year.
- Volunteers her clinical services at the psychiatric clinic, run by a local mission project.
CORRECT ANSWER
- Volunteers her clinical services at the psychiatric clinic, run by a local mission project.
Rationale: Social justice is bringing things to those who have the least means of getting
them but need them the most. In this case, the homeless mentally ill need the PMHNP's
skills more.
Question 7
1. You have students from local psychiatric nurse practitioner programs follow you in your
clinical practice to show them what you do as a PMHNP. This is called being a:
- Preceptor
- Mentor
- Teacher
- Professor
CORRECT ANSWER
- Preceptor
4
@THE STUDY VAULT
