PMHNP ANCC REVIEW QUESTIONS
EXAM (2026/2027) QUESTIONS AND
ANSWERS
The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing:
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Scope and Standards of Practice is to
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a. Define the role and actions for the NP
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b. Establish the legal authority for the prescription of psychotropic medications
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c. Define the legal statutes of the role of the PMHNP
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d. Define the differences between the physician role and the NP role - ANSWERS-
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A. The ANAs Psych-
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Mental Health Nursing Scope and Standards of Practice defines the role and actions of
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the nurse practitioner.
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D. Information reduces incidence of disease. - ANSWERS-
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Primary prevention care practices are an essential aspect of the PMHNP role. Which of
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the following is the best example of a primary prevention care strategy for community b
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ehavioral health? tf
a. Aftercare program for chronically mentally ill clients recently discharged from the hos
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pital
b. Court-ordered counseling for abusive parents
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c. 24-hour crisis hotlines
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d. Parenting skills classes for pregnant adolescents
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The trend in legal rulings on cases involving mental illness over the past 25 years has b
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een to tf
a. Encourage juries to find defendants not guilty by reason of insanity
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b. Protect the person's freedoms or rights when he or she is committed to a mental hosp
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ital
c. Place increasing trust in mental health professionals to make good and ethical decisi
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ons
d. Decrease the "red tape" associated with commitments so that commitments are fast
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er and easier - ANSWERS-
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B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric
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clients.
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Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, re
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fuses to take any of his ordered medication because he believes "Jesus Christ told me I
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am the prophet and must fast for a year." Your actions should be based on your knowle
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dge of which of the following?
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a. Psychiatric clients cannot refuse treatment
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b. Psychiatric clients do not always know what is good for them
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c. Psychiatric clients can refuse treatment
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d. Psychiatric clients cannot be trusted to make good healthcare decisions and, therefo
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re, the nurse's best clinical judgment should guide actions - ANSWERS-
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C. As with any client, psychiatric clients can refuse treatment unless a legal process res
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,ulting in involuntary commitment or mandatory court order for treatment has been obtai
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ned.
Which of the following statements best reflects the difference between the nurse-
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client (N-C) relationship and a social relationship?
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a. In the N-C relationship, the primary focus is on the client and the client's needs.
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b. Goals in the N-
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C relationship are deliberately left vague and unspoken so that the client can work on a
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ny issue. tf
c. In the N- tf tf tf
C relationship, the nurse is solely responsible for making the relationship work.
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d. In the N-C relationship, there is no place for social interaction. - ANSWERS-
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A. Social relationships are mutual interpersonal relationships in which the needs of both
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parties are addressed. The N-
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C relationship is most concerned with meeting the needs of the client.
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A community has an unusually high incidence of depression and drug use among the te
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enage population. The public health nurses decide to address this problem, in part, by
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modifying the environment and strengthening the capacities of families to prevent the d
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evelopment of new cases of depression and drug use. What is this is an example of? tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
a. Primary prevention
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b. Secondary prevention
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c. Tertiary prevention
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d. Protective factorial prevention - ANSWERS-
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A. This action focuses on interventions designed to reduce the incidence of new cases
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of disease. tf
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes t
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o leave because "this place can't help me." The best nursing action that reflects the lega
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l right of this client is
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a. Discharge the client
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b. Explain that the client cannot leave until you can complete further assessment
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c. Allow the client to leave but have her sign forms stating she is leaving against medical
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advice
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d. Immediately start the paperwork to commit the client and to allow you to treat her agai
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nst her wishes - ANSWERS-tf tf tf tf
B. Almost every state allows for a brief for a period detainment to assess a client for dan
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gerousness to self or others before allowing the client to leave a hospital setting, even if tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
the admission was voluntary.
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In forming a therapeutic relationship with clients, the PMHNP must consider developing
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many characteristics that are known to be helpful in relationship-
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building. Which of the following is an essential part of building a therapeutic relationship
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?
a. Collecting a family history
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b. Like-mindedness
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c. Authenticitytf
d. Accuracy in assessment - ANSWERS-
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C. Authenticity. Being genuine, honest, and respectful are essential elements in establi
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shing a working relationship with any client. Like-
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, mindedness is not a part of the therapeutic relationship. Although an important aspect o tf tf tf tf tf tf tf tf tf tf tf tf tf
f the PMHNP role, collecting a family history and accuracy in assessment does not in an
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d of itself facilitate relationship building.
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According to the DSM-5, which of the following is true? (Ch. 3) tf tf tf tf tf tf tf tf tf tf tf
a. A mental disorder is equivalent to the need for treatment.
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b. Diagnostic criteria are used to inform clinical judgment.
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c. Socially deviant behavior is considered a mental disorder.
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d. A culturally expected response to a stressor is not a mental disorder. - ANSWERS-
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D. All DSM- tf tf
5 disorders need to be made taking a person's culture into account. A cultural expressio
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n of a response to grief, loss, or stress is not considered a DSM-5 diagnosis.
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Mrs. French has been in individual therapy for 3 months. She has shown much growth a
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nd improvement in her functioning and insight and is to discontinue services within the n
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ext few weeks. In the next session, after you discuss service termination, she suddenly
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begins to demonstrate the original symptoms that had brought her to treatment initially.
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She is now hesitant to discharge, wants to continue services, and is displaying an incre
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ase in regressive defense mechanisms. What is the best explanation for Ms. French's b
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ehavior?
a. An exacerbation of her symptoms related to stress
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b. The normal cyclic nature of chronic mental health symptoms
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c. A sign of normal resistance to termination seen in the termination phase of therapy
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d. A sign of pathological attachment to the therapist that must be addressed -
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ANSWERS-
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C. Clients frequently display resistance and regression at the termination of a meaningf
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ul therapeutic process. The PMHNP is responsible for planning an effective termination
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and monitoring clients during the termination period.
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A client is displaying low self-esteem, poor self-control, self-
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doubt, and a high level of dependency. These behaviors indicate developmental failure
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of which of the following stages of development:
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a. Infancy tf
b. Early childhood
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c. Late childhood
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d. School age - ANSWERS-
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B. These signs indicate developmental failure of early childhood.
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Mr. Thompson has been forgetful lately, for example, forgetting where he has placed hi
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s keys or what time appointments are scheduled, and he has stated that he thinks these
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are just random behaviors that have no particular meaning. Which Freudian-
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based psychodynamic principle assumes that all behavior and actions are purposeful?
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a. Pleasure principle
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b. Psychic determinism principle
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c. Reality principle
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d. Unconsciousness principle - ANSWERS-
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B. The psychic determinism principle states that all behavior has purpose and meaning,
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often unconscious in nature, and that no behaviors occur randomly or by coincidence.
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An example of a mature, healthy defense mechanism is
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EXAM (2026/2027) QUESTIONS AND
ANSWERS
The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing:
tf tf tf tf tf tf tf tf tf
Scope and Standards of Practice is to
tf tf tf tf tf tf
a. Define the role and actions for the NP
tf tf tf tf tf tf tf tf
b. Establish the legal authority for the prescription of psychotropic medications
tf tf tf tf tf tf tf tf tf tf
c. Define the legal statutes of the role of the PMHNP
tf tf tf tf tf tf tf tf tf tf
d. Define the differences between the physician role and the NP role - ANSWERS-
tf tf tf tf tf tf tf tf tf tf tf tf tf
A. The ANAs Psych-
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Mental Health Nursing Scope and Standards of Practice defines the role and actions of
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
the nurse practitioner.
tf tf
D. Information reduces incidence of disease. - ANSWERS-
tf tf tf tf tf tf tf
Primary prevention care practices are an essential aspect of the PMHNP role. Which of
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
the following is the best example of a primary prevention care strategy for community b
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
ehavioral health? tf
a. Aftercare program for chronically mentally ill clients recently discharged from the hos
tf tf tf tf tf tf tf tf tf tf tf tf
pital
b. Court-ordered counseling for abusive parents
tf tf tf tf tf
c. 24-hour crisis hotlines
tf tf tf
d. Parenting skills classes for pregnant adolescents
tf tf tf tf tf tf
The trend in legal rulings on cases involving mental illness over the past 25 years has b
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
een to tf
a. Encourage juries to find defendants not guilty by reason of insanity
tf tf tf tf tf tf tf tf tf tf tf
b. Protect the person's freedoms or rights when he or she is committed to a mental hosp
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
ital
c. Place increasing trust in mental health professionals to make good and ethical decisi
tf tf tf tf tf tf tf tf tf tf tf tf tf
ons
d. Decrease the "red tape" associated with commitments so that commitments are fast
tf tf tf tf tf tf tf tf tf tf tf tf
er and easier - ANSWERS-
tf tf tf tf
B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric
tf tf tf tf tf tf tf tf tf tf tf tf tf t
clients.
f
Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, re
tf tf tf tf tf tf tf tf tf
fuses to take any of his ordered medication because he believes "Jesus Christ told me I
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
am the prophet and must fast for a year." Your actions should be based on your knowle
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
dge of which of the following?
tf tf tf tf tf
a. Psychiatric clients cannot refuse treatment
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b. Psychiatric clients do not always know what is good for them
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c. Psychiatric clients can refuse treatment
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d. Psychiatric clients cannot be trusted to make good healthcare decisions and, therefo
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re, the nurse's best clinical judgment should guide actions - ANSWERS-
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C. As with any client, psychiatric clients can refuse treatment unless a legal process res
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
,ulting in involuntary commitment or mandatory court order for treatment has been obtai
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ned.
Which of the following statements best reflects the difference between the nurse-
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client (N-C) relationship and a social relationship?
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a. In the N-C relationship, the primary focus is on the client and the client's needs.
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
b. Goals in the N-
tf tf tf tf
C relationship are deliberately left vague and unspoken so that the client can work on a
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
ny issue. tf
c. In the N- tf tf tf
C relationship, the nurse is solely responsible for making the relationship work.
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d. In the N-C relationship, there is no place for social interaction. - ANSWERS-
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A. Social relationships are mutual interpersonal relationships in which the needs of both
tf tf tf tf tf tf tf tf tf tf tf tf
parties are addressed. The N-
tf tf tf tf tf
C relationship is most concerned with meeting the needs of the client.
tf tf tf tf tf tf tf tf tf tf tf
A community has an unusually high incidence of depression and drug use among the te
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
enage population. The public health nurses decide to address this problem, in part, by
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
modifying the environment and strengthening the capacities of families to prevent the d
tf tf tf tf tf tf tf tf tf tf tf tf
evelopment of new cases of depression and drug use. What is this is an example of? tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
a. Primary prevention
tf tf
b. Secondary prevention
tf tf
c. Tertiary prevention
tf tf
d. Protective factorial prevention - ANSWERS-
tf tf tf tf tf
A. This action focuses on interventions designed to reduce the incidence of new cases
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
of disease. tf
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes t
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
o leave because "this place can't help me." The best nursing action that reflects the lega
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
l right of this client is
tf tf tf tf tf
a. Discharge the client
tf tf tf
b. Explain that the client cannot leave until you can complete further assessment
tf tf tf tf tf tf tf tf tf tf tf tf
c. Allow the client to leave but have her sign forms stating she is leaving against medical
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
advice
tf
d. Immediately start the paperwork to commit the client and to allow you to treat her agai
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
nst her wishes - ANSWERS-tf tf tf tf
B. Almost every state allows for a brief for a period detainment to assess a client for dan
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
gerousness to self or others before allowing the client to leave a hospital setting, even if tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
the admission was voluntary.
tf tf tf
In forming a therapeutic relationship with clients, the PMHNP must consider developing
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many characteristics that are known to be helpful in relationship-
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building. Which of the following is an essential part of building a therapeutic relationship
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?
a. Collecting a family history
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b. Like-mindedness
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c. Authenticitytf
d. Accuracy in assessment - ANSWERS-
tf tf tf tf tf
C. Authenticity. Being genuine, honest, and respectful are essential elements in establi
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shing a working relationship with any client. Like-
tf tf tf tf tf tf tf
, mindedness is not a part of the therapeutic relationship. Although an important aspect o tf tf tf tf tf tf tf tf tf tf tf tf tf
f the PMHNP role, collecting a family history and accuracy in assessment does not in an
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
d of itself facilitate relationship building.
tf tf tf tf tf
According to the DSM-5, which of the following is true? (Ch. 3) tf tf tf tf tf tf tf tf tf tf tf
a. A mental disorder is equivalent to the need for treatment.
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b. Diagnostic criteria are used to inform clinical judgment.
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c. Socially deviant behavior is considered a mental disorder.
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d. A culturally expected response to a stressor is not a mental disorder. - ANSWERS-
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D. All DSM- tf tf
5 disorders need to be made taking a person's culture into account. A cultural expressio
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
n of a response to grief, loss, or stress is not considered a DSM-5 diagnosis.
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
Mrs. French has been in individual therapy for 3 months. She has shown much growth a
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf
nd improvement in her functioning and insight and is to discontinue services within the n
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
ext few weeks. In the next session, after you discuss service termination, she suddenly
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
begins to demonstrate the original symptoms that had brought her to treatment initially.
tf tf tf tf tf tf tf tf tf tf tf tf tf
She is now hesitant to discharge, wants to continue services, and is displaying an incre
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
ase in regressive defense mechanisms. What is the best explanation for Ms. French's b
tf tf tf tf tf tf tf tf tf tf tf tf tf
ehavior?
a. An exacerbation of her symptoms related to stress
tf tf tf tf tf tf tf tf
b. The normal cyclic nature of chronic mental health symptoms
tf tf tf tf tf tf tf tf tf
c. A sign of normal resistance to termination seen in the termination phase of therapy
tf tf tf tf tf tf tf tf tf tf tf tf tf tf
d. A sign of pathological attachment to the therapist that must be addressed -
tf tf tf tf tf tf tf tf tf tf tf tf tf
ANSWERS-
tf
C. Clients frequently display resistance and regression at the termination of a meaningf
tf tf tf tf tf tf tf tf tf tf tf tf
ul therapeutic process. The PMHNP is responsible for planning an effective termination
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and monitoring clients during the termination period.
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A client is displaying low self-esteem, poor self-control, self-
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doubt, and a high level of dependency. These behaviors indicate developmental failure
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of which of the following stages of development:
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a. Infancy tf
b. Early childhood
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c. Late childhood
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d. School age - ANSWERS-
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B. These signs indicate developmental failure of early childhood.
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Mr. Thompson has been forgetful lately, for example, forgetting where he has placed hi
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s keys or what time appointments are scheduled, and he has stated that he thinks these
tf tf tf tf tf tf tf tf tf tf tf tf tf tf tf t
are just random behaviors that have no particular meaning. Which Freudian-
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based psychodynamic principle assumes that all behavior and actions are purposeful?
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a. Pleasure principle
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b. Psychic determinism principle
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c. Reality principle
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d. Unconsciousness principle - ANSWERS-
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B. The psychic determinism principle states that all behavior has purpose and meaning,
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often unconscious in nature, and that no behaviors occur randomly or by coincidence.
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An example of a mature, healthy defense mechanism is
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