PMHNP ANCC Review Exam
Questions and Answers
Question>> 1
Mr. Thompson has been forgetful lately, for example,
forgetting where he has placed his keys or what time
appointments are scheduled, and he has stated that he
thinks these are just random behaviors that have no
particular meaning. Which Freudian-based psychodynamic
principle assumes that all behavior and actions are
purposeful?
a. Pleasure principle
b. Psychic determinism principle
c. Reality principle
d. Unconsciousness principle
Answer>>
B. The psychic determinism principle states that all
behavior has purpose and meaning, often unconscious in
nature, and that no behaviors occur randomly or by
coincidence.
Question>> 2
Sarah presents for her initial intake appointment with
complaints of depression. She is being treated for
hypertension and asthma by her primary care provider.
Page 1 of 82
,Knowing that certain medications can cause or exacerbate
depression, you obtain a complete medication history. Which
of the following medications is known to exacerbate or cause
depression?
a. Omeprazole
b. Propranolol
c. Levothyroxine
d. Clarithromycin
Answer>>
B. Beta blockers can cause or exacerbate depression.
Question>> 3
Which of the following best describes homeostasis in a
family system?
a. Choices a family makes to keep the peace
b. Balance or stability that the family returns to despite its
dysfunction
c. Need for change and balance in a family
d. Calm in a family that returns after a crisis
Answer>>
B. Homeostasis is balance or stability that the family returns
to despite its dysfunction.
Question>> 4
You are treating a client with schizophrenia who takes
clozapine. What laboratory values will indicate the client
needs to discontinue treatment?
a. White blood cell count of less than 1,800/mm3 and
absolute neutrophil count of less than 1,200/mm3
b. Absolute neutrophil count of less than 1,000/uL
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,c. White blood cell count of less than 1,200/mm3
d. Absolute neutrophil count of less than 2,000/uL
Answer>>
B. The recent change in monitoring clozapine clients using
the risk evaluation and mitigation strategy (REMS) indicates
persons treated on clozapine need to have absolute
neutrophil count monitored and, if it drops below 1,000/uL,
treatment must be interrupted and can be resumed once the
absolute neutrophil count normalizes above 1,000/uL.
Question>> 5
The trend in legal rulings on cases involving mental illness
over the past 25 years has been to
a. Encourage juries to find defendants not guilty by reason
of insanity
b. Protect the person's freedoms or rights when he or she
is committed to a mental hospital
c. Place increasing trust in mental health professionals to
make good and ethical decisions
d. Decrease the "red tape" associated with commitments
so that commitments are faster and easier
Answer>>
B. Identifies the trend of ensuring the protection of individual
civil liberties for psychiatric clients.
Question>> 6
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
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, 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.
Answer>>
C. The legal system makes determination whether a person is
competent; practitioners can assess and make a
determination about a person's capacity to make medical
decisions.
Question>> 7
What differentiates atypical antipsychotic medications from
first-generation or typical antipsychotic medications?
a. 5HT2a receptor antagonist properties
b. 5HT2a receptor agonist properties
c. Specific dopamine receptor 3 and 5HT2a blockade
d. Dopamine receptor 2 antagonist properties
Answer>>
A. Typical antipsychotic medications block D2 receptors;
atypical antipsychotic medications block D2 receptors and
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Questions and Answers
Question>> 1
Mr. Thompson has been forgetful lately, for example,
forgetting where he has placed his keys or what time
appointments are scheduled, and he has stated that he
thinks these are just random behaviors that have no
particular meaning. Which Freudian-based psychodynamic
principle assumes that all behavior and actions are
purposeful?
a. Pleasure principle
b. Psychic determinism principle
c. Reality principle
d. Unconsciousness principle
Answer>>
B. The psychic determinism principle states that all
behavior has purpose and meaning, often unconscious in
nature, and that no behaviors occur randomly or by
coincidence.
Question>> 2
Sarah presents for her initial intake appointment with
complaints of depression. She is being treated for
hypertension and asthma by her primary care provider.
Page 1 of 82
,Knowing that certain medications can cause or exacerbate
depression, you obtain a complete medication history. Which
of the following medications is known to exacerbate or cause
depression?
a. Omeprazole
b. Propranolol
c. Levothyroxine
d. Clarithromycin
Answer>>
B. Beta blockers can cause or exacerbate depression.
Question>> 3
Which of the following best describes homeostasis in a
family system?
a. Choices a family makes to keep the peace
b. Balance or stability that the family returns to despite its
dysfunction
c. Need for change and balance in a family
d. Calm in a family that returns after a crisis
Answer>>
B. Homeostasis is balance or stability that the family returns
to despite its dysfunction.
Question>> 4
You are treating a client with schizophrenia who takes
clozapine. What laboratory values will indicate the client
needs to discontinue treatment?
a. White blood cell count of less than 1,800/mm3 and
absolute neutrophil count of less than 1,200/mm3
b. Absolute neutrophil count of less than 1,000/uL
Page 2 of 82
,c. White blood cell count of less than 1,200/mm3
d. Absolute neutrophil count of less than 2,000/uL
Answer>>
B. The recent change in monitoring clozapine clients using
the risk evaluation and mitigation strategy (REMS) indicates
persons treated on clozapine need to have absolute
neutrophil count monitored and, if it drops below 1,000/uL,
treatment must be interrupted and can be resumed once the
absolute neutrophil count normalizes above 1,000/uL.
Question>> 5
The trend in legal rulings on cases involving mental illness
over the past 25 years has been to
a. Encourage juries to find defendants not guilty by reason
of insanity
b. Protect the person's freedoms or rights when he or she
is committed to a mental hospital
c. Place increasing trust in mental health professionals to
make good and ethical decisions
d. Decrease the "red tape" associated with commitments
so that commitments are faster and easier
Answer>>
B. Identifies the trend of ensuring the protection of individual
civil liberties for psychiatric clients.
Question>> 6
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
Page 3 of 82
, 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.
Answer>>
C. The legal system makes determination whether a person is
competent; practitioners can assess and make a
determination about a person's capacity to make medical
decisions.
Question>> 7
What differentiates atypical antipsychotic medications from
first-generation or typical antipsychotic medications?
a. 5HT2a receptor antagonist properties
b. 5HT2a receptor agonist properties
c. Specific dopamine receptor 3 and 5HT2a blockade
d. Dopamine receptor 2 antagonist properties
Answer>>
A. Typical antipsychotic medications block D2 receptors;
atypical antipsychotic medications block D2 receptors and
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