A 14-year-old patient has nonspecific complaints about pain in his or her legs. The
physical examination is unremarkable. Laboratory results are within normal limits except
for a markedly elevated alkaline phosphatase level. The psychiatric-mental health nurse
practitioner - ANSWER-interprets the findings as normally occurring during a rapid
adolescent growth spurt
Laboratory findings for a patient with an alcohol use disorder indicate increased liver
function values and: - ANSWER-increased MCV and elevated triglyceride levels.
A new patient arrives at the office for treatment for depression. The patient reports
taking simvastatin (Zocor) and lisinopril (Zestril). When selecting an antidepressant, the
psychiatric-mental health nurse practitioner eliminates fluoxetine (Prozac), based on the
knowledge that the combination can lead to increased plasma levels of the statin,
resulting in an increased risk of muscle damage and rhabdomyolysis. The nurse
practitioner's reason is that: - ANSWER-one medication is a CYP450 3A4 substrate and
one is a CYP450 3A4 inhibitor.
A 28-year-old patient who is psychotic arrives at the clinic with family members but
refuses to meet if the family members are present. The psychiatric-mental health nurse
practitioner - ANSWER-asks the family members to leave for the appointment.
The psychiatric-mental health nurse practitioner is responsible for initiating quality
improvement at a community mental health clinic. The effective strategy for evaluating
the clinic's services is to: - ANSWER-use a survey to elicit patient satisfaction
responses.
The psychiatric-mental health nurse practitioner evaluates a new adult patient via
telemedicine. The patient has questions about a new medication that he or she recently
started. The nurse practitioner decides to provide psychoeducation and to: - ANSWER-
e-mail drug information and resources
Any court of law that evaluates the standards of care provided by a psychiatric-mental
health nurse practitioner - ANSWER-considers what a reasonably prudent health care
provider would do.
The psychiatric-mental health nurse practitioner and a team of local mental health
professionals are asked to provide crisis counseling service, after a gunman recently
took a class hostage at a local elementary school, wounded several students, and then
shot himself. In preparing for this assignment, the nurse practitioner recognizes that: -
, ANSWER-a child's developmental stage will influence his or her response to
catastrophic stress
Which community-based program is a tertiary level intervention? - ANSWER-Partial
hospitalization program that provides intensive group therapy for rehabilitation.
A 32-year-old female patient informs the psychiatric-mental health nurse practitioner
that she is three months pregnant. She has been stable on fluoxetine (Prozac) for the
last two years. The patient asks whether she may safely continue this medication during
her pregnancy. The nurse practitioner responds: - ANSWER-"Let's review the risks and
benefits of continuing or discontinuing Prozac for you and your baby."
Established clinical guidelines suggest that suicidality is decreased by treating patients
who have borderline personality disorder with: - ANSWER-dialectical behavioral
therapy.
A six-year-old patient with autistic spectrum disorder has not responded to six months of
psychosocial interventions and continues to demonstrate aggressive tendencies toward
a younger sibling. The psychiatric-mental health nurse practitioner prescribes: -
ANSWER-risperidone (Risperdal) 0.25 mg once a day.
The psychiatric-mental health nurse practitioner working in a crisis stabilization unit
evaluates a patient verbalizing suicidal thoughts after being sexually assaulted. Before
processing through the traumatic event, the nurse practitioner first attempts to -
ANSWER-provide an environment of safety.
The psychiatric-mental health nurse practitioner uses a cognitive-behavioral approach
to help a patient address self-defeating behaviors. After identifying the stressor that
causes the inappropriate behavior, the initial strategy is to explore: - ANSWER-rational
and irrational beliefs about the stressor.
A patient who has borderline personality disorder experiences intense anxiety when the
psychiatric-mental health nurse practitioner goes on vacation. The most appropriate
explanation for this reaction is that the patient: - ANSWER-has not developed object
constancy.
An initial psychiatric evaluation of a patient reveals a normal mental status and
appropriate behavior, despite a parent's reports of "disobedience, poor grades, and
laziness." To further assess the patient's functioning, the psychiatric-mental health
nurse practitioner: - ANSWER-meets with the parent and patient together to explore the
discrepant report.
The psychiatric-mental health nurse practitioner is employed in a newly created
attending role on a psychiatric inpatient unit. To promote an interprofessional
environment, the nurse practitioner: - ANSWER-assigns a role for all staff members in
improving patient outcomes.