passed
A 78 y/o cattleman referred for treatment of refractory depression by his primary care
provider reports continued thoughts of failure, lack of purpose in life, lack of interest in
ranching, fishing, hunting, or family since losing his driver's license due to DUI six
months ago. Which of the following areas is an assessment priority?
A. Prior and current medications, dose, clinical response, side effects
B. Extent of alcohol use and motivation to reduce to safe levels
C. Thoughts of self-harm, plan, intent, access
D. Sleep patterns (early-middle-late awakening), sleep hygiene - correct answer C.
Thoughts of self-harm, plan, intent, access
A 32 y/o Caucasian Catholic female patient presents for her therapy session. She is
upset because she and her husband have been in an argument over finances. She
does not work and stays at home to take care of the children. She reports feeling sad
and has had thoughts of hurting herself. She has a past history of overdosing with
Tylenol several years ago. Which of the following places her at high-risk for suicide?
A. age
B. gender
C. previous suicide attempt
D. marital status - correct answer C. previous suicide attempt
During a follow-up medication visit with a 13 y/o male, his mother stayed longer to ask
the psychiatric mental health nurse practitioner (PMHNP) a question. Specifically, his
mother states, "the school sent home information about the human papillomavirus and
suggested my son see his primary care provider to get an immunization. Why did I get
this information for my son? Furthermore, he is not sexually active." Which of the
following would be the PMHNP's best response?
A. As your son's PMHNP, I cannot provide you with information about immunizations
B. I understand your concern with talking to your son about becoming sexually active.
Let's address how to start the conversation.
C. Decisions about immunizations can be difficult. The Centers for Disease Control and
Prevention recommend that all males between the ages of 11-12, or as early as 9 years
of age, receive this vaccination. What concerns do you have?
D. You are correct, only females need to receive the human papillomavirus vaccination.
The letter must have been sent to you by mistake. - correct answer C. Decisions about
immunizations can be difficult. The Centers for Disease Control and Prevention
recommend that all males between the ages of 11-12, or as early as 9 years of age,
receive this vaccination. What concerns do you have?
What opening question or statement by a Psychiatric-Mental Health Nurse Practitioner
facilitates communication at an initial visit?
, A. Tell me your concerns and how I may be of help.
B. Tell me what you think the problem is.
C. What seems to be the problem today?
D. What problem does your primary care physician want us to evaluate? - correct
answer A. Tell me your concerns and how I may be of help.
In evaluating the functional status of a 68 y/o woman who has depression, the
Instrumental Activities of Daily Living Scale includes which of the following activities?
A. Using telephone
B. Filing taxes
C. Bathing
D. Toileting - correct answer A. Using telephone
An adult female patient has been prescribed an SSRI for an initial episode of major
depression. She is fearful of side effects and of becoming suicidal. Which of the
following initial responses is most appropriate?
A. SSRI's are the safest antidepressant medications and rarely cause suicidal thoughts.
Try the medication and we can watch closely for any side effects.
B. SSRI's are generally quite safe and rarely cause suicidal thoughts. I could call you
every few days to see if you are having any of these thoughts.
C. Have you ever had feelings of hurting yourself? If you took the medication and had
thoughts like that, what would you do?
D. Have you ever had feelings of hurting yourself? If you took the medication and had
thoughts like that, would you be willing to call the crisis hotline? - correct answer C.
Have you ever had feelings of hurting yourself? If you took the medication and had
thoughts like that, what would you do?
A psychiatric mental health nurse practitioner (PMHNP) is working in an integrated care
clinic and his family nurse practitioner colleague asks for a consult. The family nurse
practitioner asks the PMHNP what antidepressant to start for a patient who has a score
of 15 on the patient health questionnaire 9 (PHQ9). What is the appropriate response?
A. A score of 15 on the patient health questionnaire indicates moderate depression, so
the patient should be started on a selective serotonin norepinephrine reuptake inhibitor.
B. A score of 15 on the patient health questionnaire 9 indicates possible moderate
depression, but a follow-up interview is required to assess for depression. I can see this
patient today and further assess for depression and the appropriate treatment
C. A score of 15 on the patient health questionnaire 9 indicates severe depression, so
you should start a selective serotonin reuptake inhibitor and an atypical antipsychotic.
D. A score of 15 on the patient health questionnaire 9 indicates moderate depression,
so you can refer the patient to therapy and start an antidepressant - correct answer B. A
score of 15 on the patient health questionnaire 9 indicates possible moderate
depression, but a follow-up interview is required to assess for depression. I can see this
patient today and further assess for depression and the appropriate treatment
An example of a screening tool that measures severity and tracks change in specific
symptoms is