PMHNP Questions and Answers correct

PMHNP Questions and Answers correct Defense mechanisms are best viewed as a function of the ego a. To alert us to harm and danger b. To alert us to problems c. Used to resolve a conflict d. Used to protect the id C What four elements need to be present for a malpractice lawsuit to be filed? a. Beneficence, Non-Maleficence, Truthfulness, and Justice b. Duty of care, Breach of standard of care, Injury, and Injury must be related to breach of the standard of care c. Abandonment, Breach of care, Violation of ethics, and Reimbursement for poor care d. Breach of standard of care, Injury, Deceit, and Malpractice B A client who is experiencing difficulties with working memory, planning and prioritizing, insight into his problems, and impulse control presents for assessment. In planning his care, the PMHNP should apply his or her knowledge that these symptoms represent problems with the a. Frontal lobe b. Temporal lobe c. Parietal lobe d. Occipital lobe Frontal Lobe The goal of the psychiatric assessment process performed by the PMHNP is to a. Gain an understanding of the life experiences of the client b. Correctly diagnose the client c. Identify the mental health needs of the client d. Be able to communicate with other staff about the client's health needs C When treating older adults, you should keep in mind that they are more sensitive to issues of drug toxicity because of which of the following reasons? a. Decreased body fat b. Increased liver capacity c. Decreased protein binding d. Increased muscle concentration c. decreased protein binding Which known teratogenic effects can be caused by the common psychotropic medications divalproex and lithium? a. Divalproex—Epstein anomaly; lithium—cleft palate b. Divalproex—spina bifida; lithium—Epstein anomaly c. Divalproex—limb malformations; lithium—seizure disorder d. Divalproex—mental retardation; lithium—spina bifida b When working with a dysfunctional family, you find that the father, Jim, worries excessively and is resistant to change. You give Jim a paradoxical directive to worry extremely well for 1 hour per day, knowing that he will likely be noncompliant, and thus change will occur. With this technique, you are using which type of therapy? a. Experiential therapy b. Structural therapy c. Strategic therapy d. Solution-focused therapy C In an attempt to bring the client toward the goal he or she is working on, you ask the client, "If a miracle were to happen tonight while you slept, and you awoke in the morning and the problem no longer existed, how would you know, and what would be different?" This technique is used in which type of therapy? a. Behavioral therapy b. Solution-focused therapy c. Adlerian therapy d. Existential therapy b Which of the following is the best reason for considering the SSRI among the first-line drug choices for treating major depression? a. Need to stair-step initial dosages b. Sedating and calming effect of the medication c. Safe use in suicidal overdose clients d. Ability to obtain therapeutic serum drug levels c Which of the following interventions by the PMHNP for a person experiencing ataque de nervios demonstrates culturally informed care? a. Offering brief supportive psychotherapy b. Offering a brief hospitalization c. Requesting a family member act as an interpreter d. Offering low-dose, short-term anxiolytic medication a The chief nursing officer of a large behavioral health system approached the PMHNP to discuss the new Healthcare Effectiveness Data and Information Set (HEDIS) behavioral health measures and specifications. The PMHNP is asked to do a retrospective chart review of all hospital discharge clients who received a follow-up visit within 7 days of discharge and within 30 days of discharge. The PMHNP has been asked to engage in which of the following? a. Needs assessment project b. Plan, do, study, act project c. A task that is outside of the PMHNP's scope of practice d. Quality improvement initiative D A PMHNP who is working on the consult liaison service is referred to a patient in the medical intensive care unit by the attending hospitalist. The consult note read "Evaluate the patient for competency to make independent medical decisions and consent for a surgical procedure." Based on the scope of practice of a PMHNP, which response would be most appropriate? a. Complete the patient assessment and write up the findings in the patient's medical record. b. Complete a patient assessment, including the mini mental status examination and family collateral data to determine competency. c. Call the hospitalist and provide education that competency is a legal concept and explain that you can assess the patient for the capacity to make medical decisions. d. Refuse the consult and inform the hospitalist that this is outside your scope of practice. C A 74-year-old married white woman was referred to you by her primary care provider for a psychiatric evaluation. She had a normal medical and neurological examination in the last 2 months. The client presents with her husband of 45 years who states, "My wife is just not the same anymore, she is irritable and asks the same question several times, even though I've answered it many times." The client responds, "Oh, Henry, you do the same thing, it's just a normal part of getting older, and the kids think everything is fine." During the assessment you compete the mini mental status examination (MMSE) and the client scores 18. As the PMHNP treating the client, you know the results of her MMSE indicate which level of cognitive impairment? a. No cognitive impairment b. Mild cognitive impairment c. Moderate cognitive impairment d. Severe cognitive impairment C You are working with a family: mother, father, and two biological children. Sam, the father, is very rigid and controlling, which seems to be out of fear that something might happen to his family. He worries daily and it affects his family relationships. You give Sam a paradoxical directive and instruct him to intensely worry about everything he can think of for 1 hour a day. Using a paradoxical directive is part of which therapy? a. Experimental b. Structural c. Strategic d. Cognitive C As a PMHNP working in an outpatient addiction clinic, you often refer your clients to community AA and NA meetings. Using Yalom's therapeutic factors, you are aware that peer led groups can inspire and encourage other group participants. Which therapeutic factor is instilled in AA and NA group members? a. Hope b. Altruism c. Catharsis d. Existential factors A Dialectical behavioral therapy (DBT) draws on cognitive theory and behavioral theory, along with other theories. Elements of behavioral theory in DBT include which of the following? a. Skills training and exposure b. Examination of feelings and relating feelings to visceral sensations c. Working through the transference with the therapist d. Cognitive interpretation of past traumatic experiences A Dialectical behavioral therapy (DBT) affirms dialectical thinking, which involves examining and discussing opposing ideas to find the truth. This philosophy is a supportive principle of DBT training. The central dialectical pattern emphasized in DBT involves the tension between: a. Radical acceptance and change b. Cue exposure and block avoidance c. Problem avoidance and problem-solving d. Crisis survival and acceptance A You are a PMHNP working in a hospitalist role on an acute inpatient psychiatric unit at a local hospital. As you make rounds, the registered nurse informs you that a 32-year-old client who was admitted for alcohol detox has a score of 17 on the Clinical Institute Withdrawal Assessment for Alcohol. What phase of withdrawal is this client in? a. Mild withdrawal b. Moderate withdrawal c. Severe withdrawal d. Delirium tremens B; 0-9 absent or minimal withdrawal 10-15 mild withdrawal 16-20 moderate withdrawal 21-67 severe withdrawal Signs and symptoms of cannabis intoxication include: a. Increase sensitivity to external stimuli b. Enhanced motor skills c. Fast passage of time d. Lower heart rate A; distorted perceptions, increase relaxation and sensitivity, loss of coordination Which defense mechanisms are commonly used by persons with obsessive-compulsive personality disorder? a. Rationalization, isolation, and intellectualization b. Projection, distortion, and hypochondriasis c. Regression, somatization, and dissociation d. Sexualization, displacement, and reaction formation A; OCD isolation of affect and intellectualization to make sense of their behavior The TCA class of medications can be characterized by all of the following properties except: a. Safety in overdose b. Inexpensive cost of medications c. Significant side-effect concerns d. Long half-life A; - TCAs are generally unsafe in overdose The psychodynamic theory of anxiety states that the etiology of anxiety is a. Conflict between the id and the superego b. Conflict between the ego and the id c. Interpersonal conflict between significant others d. Perceived disapproval from significant others A; - according to Freud, anxiety resulted from psychic conflict between the unconscious sexual or aggressive wishes and the corresponding threats from the superego As part of treatment planning, the PMHNP places a note on Mrs. Jay's chart about seizure precautions. The client notices the note and states she doesn't understand and that she has no history of seizures. The PMHNP explains that a. It is a clerical error, and she will correct it b. Seizures are common in mental illness, and the note is just a precaution c. Reactions to psychotropic medications are unpredictable d. Typical antipsychotic medications can lower seizure threshold D - all antipsychotics lower the seizure threshold, therefore precautions should be taken After a few weeks, you see Mrs. Anders again. She is refusing to take Haldol because of continued problems with stiff muscles and blurred vision. She tells you that she has not taken her medication for 1 week, and the stiffness and blurred vision are better but still a problem. Mrs. Anders says, "Something else must be seriously wrong with me, I stopped the Haldol, and I'm still not okay." Your best explanation is that Mrs. Anders is a. Fixated on her medications b. Experiencing an unusual reaction to Haldol c. Experiencing a lipophilic reaction to Haldol d. Experiencing some problem other than a side effect of Haldol C - - after the depot injection, the active ingredient is slowly absorbed in the bloodstream, and effects will last for 3-4weeks following the injection