PMHNP Boards (Latest ) Complete
Exam Questions and 100% Correct Answers
(Verified Pass)
• Medicare Part A Coverage -✓✓Hospital insurance that covers inpatient and most
skilled care. Mandatory copays for hospital days 21-150, getting higher with each period
of time.
• Medicare Part A Eligibility -✓✓>65 in social security automatic enrollment
• Medicare Part A Cost -✓✓No cost if automatically qualified. 30-39 work quarters:
~$250/mo <30 work quarters: ~$450/mo
• Medicare Part B Coverage -✓✓Supplemental medical insurance. Outpatient services,
care, physical/speech therapy, some home health care, medical equipment
• Medicare Part B Eligibility -✓✓Voluntary if >65
• Medicare Part B Cost -✓✓Deducted from monthly social security check. *Enroll 3
months before 65th birthday or 4 months after, otherwise increased costs to enroll*
• Medicare Part C -✓✓Medicare Advantage. Get all their medical services through that
plan.
• Medicare Part D coverage -✓✓Prescription drug coverage
• Medicare Part D Cost -✓✓Varies depending on how extensive drug benefit is. Different
plans have different benefits.
• Medigap Plans -✓✓Fill gaps in coverage that occur with Medicare
• Medicare Advantage Plan -✓✓Will likely eliminate need for medigap insurance?
• Medicaid Eligibility -✓✓Automatic coverage not guaranteed except for poor pregnant
women and children. States can refuse to cover adults/head of households who lose
Temporary Assistance to Needy Families d/t refusal to work. Generally covers poor
people.
• Medicaid funding -✓✓Federal + state. States determine how much they want to pay in,
different states have different qualities of Medicaid
,• HMO -✓✓Four components: Enrolled population, prepayment of premiums, coverage
of comprehensive medical svcs, centralization of medical and hospital svcs
• Closed-panel HMO -✓✓Specific providers identified by plan to provide the medical
services to members. Staff can be salaried by HMO or an agency/group contracted by
the HMO.
• Open-panel HMO -✓✓Network HMO, Individual Practice Association, Point of Service
Plans
• Network HMO -✓✓HMO contracts with more than one group of practices
• Individual Practice Association -✓✓Insurance coverage. Contract with an association
of physicians to provide services to members
• Point of Service (POS) and Preferred Provider Organizations (PPOs) -✓✓Insurance
coverage. Patients allowed to self-refer to specialist but pay higher premium to do so.
POS requires PCP is gatekeeper but pt can see a provider outside of HMO for more $$.
PPOs contract to a selected group of participating providers and give discount for using
a selected group of providers. Financial risk held by insurer in PPO, held by providers in
POS
• Managed indemnity -✓✓Traditional model insurance coverage.. Pre-certification,
catastrophic case management, minimal contract arrangement with providers. Provider
groups and health plans can use quality control, utilization review, bundling of services,
incentives for health behaviors. MUST seek National Committee on Quality Assurance
(NCQA) accreditation
• Licensure -✓✓Member of profession is granted ability to practice
• Accreditation -✓✓Formal review and approval by a recognized agency of
educational degree or certification programs in nursing or nursing-related programs.
• Certification -✓✓Tests knowledge, skills, abilities for entry into practice. Formal
recognition of the knowledge, skills, and experience
demonstrated by the achievement of standards identified by the profession
• Education -✓✓Formal preparation of APRNs in graduate degree-granting or
postgraduate
certificate programs
• Factors facilitating NP growth -✓✓Demand for svcs, acceptance of role, emphasis on
integrated healthcare svcs, emergence of PMHNP and decreasing stigmatization
, • Factors constraining NP growth -✓✓Growth competition, reimbursement struggles,
overlapping scopes with other NPs, concerns about reimbursement fraud/abuse, scope
of practice requiring physician supervision/collab
• Exceptions to confidentiality -✓✓Information given to attorneys involved in litigation,
records to insurance companies, answering court orders, mandatory state reporting,
harm to self or others or child/elder abuse, determined need for info outweighs principle
of confidentiality
• Deontological Theory -✓✓Action is judged as good or bad based on the act itself
regardless of the consequences
• Teleological Theory -✓✓An action is judged as good or bad based on the
consequence or outcome
• Virtue Ethics -✓✓Actions are chosen based on moral virtues (honesty, courage,
compassion, etc) or the character of the person making the decision
• Elements of negligence that must be established to prove malpractice -✓✓Duty,
breach of duty, proximate cause, damages
• Duty (negligence) -✓✓NP had a duty to exercise reasonable care when undertaking
and providing treatment to the client
• Breach of duty (negligence) -✓✓The NP violated the applicable standard of care in
treating the client's condition
• Proximate cause (negligence) -✓✓There is a causal relationship between the breach
in the standard of care and the client's injuries
• Damages (negligence) -✓✓Client experiences permanent and substantial damages as
a result of the breach in the standard of care
• Competency: Legal or medical? -✓✓Legal (NOT medical)
• Competency -✓✓Determination that a client can make reasonable judgments and
decisions regarding treatment and other health concerns
• Durable power of attorney -✓✓Designates an agent to act on behalf of person should
he/she become unable to make healthcare decisions. Consider psychiatric DPOA for
chronically ill folks! LEGALLY BINDING ALL STATES
Exam Questions and 100% Correct Answers
(Verified Pass)
• Medicare Part A Coverage -✓✓Hospital insurance that covers inpatient and most
skilled care. Mandatory copays for hospital days 21-150, getting higher with each period
of time.
• Medicare Part A Eligibility -✓✓>65 in social security automatic enrollment
• Medicare Part A Cost -✓✓No cost if automatically qualified. 30-39 work quarters:
~$250/mo <30 work quarters: ~$450/mo
• Medicare Part B Coverage -✓✓Supplemental medical insurance. Outpatient services,
care, physical/speech therapy, some home health care, medical equipment
• Medicare Part B Eligibility -✓✓Voluntary if >65
• Medicare Part B Cost -✓✓Deducted from monthly social security check. *Enroll 3
months before 65th birthday or 4 months after, otherwise increased costs to enroll*
• Medicare Part C -✓✓Medicare Advantage. Get all their medical services through that
plan.
• Medicare Part D coverage -✓✓Prescription drug coverage
• Medicare Part D Cost -✓✓Varies depending on how extensive drug benefit is. Different
plans have different benefits.
• Medigap Plans -✓✓Fill gaps in coverage that occur with Medicare
• Medicare Advantage Plan -✓✓Will likely eliminate need for medigap insurance?
• Medicaid Eligibility -✓✓Automatic coverage not guaranteed except for poor pregnant
women and children. States can refuse to cover adults/head of households who lose
Temporary Assistance to Needy Families d/t refusal to work. Generally covers poor
people.
• Medicaid funding -✓✓Federal + state. States determine how much they want to pay in,
different states have different qualities of Medicaid
,• HMO -✓✓Four components: Enrolled population, prepayment of premiums, coverage
of comprehensive medical svcs, centralization of medical and hospital svcs
• Closed-panel HMO -✓✓Specific providers identified by plan to provide the medical
services to members. Staff can be salaried by HMO or an agency/group contracted by
the HMO.
• Open-panel HMO -✓✓Network HMO, Individual Practice Association, Point of Service
Plans
• Network HMO -✓✓HMO contracts with more than one group of practices
• Individual Practice Association -✓✓Insurance coverage. Contract with an association
of physicians to provide services to members
• Point of Service (POS) and Preferred Provider Organizations (PPOs) -✓✓Insurance
coverage. Patients allowed to self-refer to specialist but pay higher premium to do so.
POS requires PCP is gatekeeper but pt can see a provider outside of HMO for more $$.
PPOs contract to a selected group of participating providers and give discount for using
a selected group of providers. Financial risk held by insurer in PPO, held by providers in
POS
• Managed indemnity -✓✓Traditional model insurance coverage.. Pre-certification,
catastrophic case management, minimal contract arrangement with providers. Provider
groups and health plans can use quality control, utilization review, bundling of services,
incentives for health behaviors. MUST seek National Committee on Quality Assurance
(NCQA) accreditation
• Licensure -✓✓Member of profession is granted ability to practice
• Accreditation -✓✓Formal review and approval by a recognized agency of
educational degree or certification programs in nursing or nursing-related programs.
• Certification -✓✓Tests knowledge, skills, abilities for entry into practice. Formal
recognition of the knowledge, skills, and experience
demonstrated by the achievement of standards identified by the profession
• Education -✓✓Formal preparation of APRNs in graduate degree-granting or
postgraduate
certificate programs
• Factors facilitating NP growth -✓✓Demand for svcs, acceptance of role, emphasis on
integrated healthcare svcs, emergence of PMHNP and decreasing stigmatization
, • Factors constraining NP growth -✓✓Growth competition, reimbursement struggles,
overlapping scopes with other NPs, concerns about reimbursement fraud/abuse, scope
of practice requiring physician supervision/collab
• Exceptions to confidentiality -✓✓Information given to attorneys involved in litigation,
records to insurance companies, answering court orders, mandatory state reporting,
harm to self or others or child/elder abuse, determined need for info outweighs principle
of confidentiality
• Deontological Theory -✓✓Action is judged as good or bad based on the act itself
regardless of the consequences
• Teleological Theory -✓✓An action is judged as good or bad based on the
consequence or outcome
• Virtue Ethics -✓✓Actions are chosen based on moral virtues (honesty, courage,
compassion, etc) or the character of the person making the decision
• Elements of negligence that must be established to prove malpractice -✓✓Duty,
breach of duty, proximate cause, damages
• Duty (negligence) -✓✓NP had a duty to exercise reasonable care when undertaking
and providing treatment to the client
• Breach of duty (negligence) -✓✓The NP violated the applicable standard of care in
treating the client's condition
• Proximate cause (negligence) -✓✓There is a causal relationship between the breach
in the standard of care and the client's injuries
• Damages (negligence) -✓✓Client experiences permanent and substantial damages as
a result of the breach in the standard of care
• Competency: Legal or medical? -✓✓Legal (NOT medical)
• Competency -✓✓Determination that a client can make reasonable judgments and
decisions regarding treatment and other health concerns
• Durable power of attorney -✓✓Designates an agent to act on behalf of person should
he/she become unable to make healthcare decisions. Consider psychiatric DPOA for
chronically ill folks! LEGALLY BINDING ALL STATES
