ANCC Review Manual PMHNP 2023 update with verified correct answers

Core Competencies Management of Health Status Maintenance of Nurse-Patient Relationship Teaching/Coaching Professional Role Managing and Negotiating Healthcare Delivery Systems Monitoring Quality of Care Providing Culturally Sensitive Care When was NP role introduced and by whom 1965 Loretta Ford University of Colorado State Legislative Statutes Grant legal authority for NP practice Are the Nurse Practice Act of every state Provide title protection Define advanced practice Are prevailing state laws that define scope of practice Place restrictions on practice Sets NP credentialing requirements State grounds for disciplinary actions May decide about collaborative agreements Collaborative agreement Protocol that describes what types of drugs might be prescribed and defines some form of oversight board for NP practice Statutory Law Rules and regulations differ for each state May further define scope of practice and practice requirements May provide restrictions in practice unique to specific state Licensure A process by which an agency of state government grants permission to individuals accountable for the practice of a profession to engage in the practice of that profession Credentialing Process used to protect the public by ensuring a minimum level of professional competence Certification Credential that provides title protection Determines scope of practice Is the process by which a professional organization/association certifies that an individual licensed to practice as a professional has met certain predetermined standards Assures the public that an individual has mastery of a body of knowledge Assures that the individual has acquired the skills necessary to function in a particular specialty ANCC only one for psych Scope of practice Defines NP roles and actions Identifies competencies assumed to be held by all NPs who function in a particular role Has broad variations from state to state Standards of Practice Gives authoritative statements regarding the quality and type of practice that should be provided Provides a way to judge the nature of care provided Reflects the expectation for the care that should be provided to patients with various illnesses Reflects professional agreement focused on the minimum levels of acceptable performance Can be used to legally describe the standard of care that must be met by a provider May be precise protocols that must be followed or more general guidelines that recommend actions Four Rights of HIPAA 1. To be educated about HIPAA privacy protection 2. To have access to their own medical records 3. To request amendment of their health information to which they object 4. To require their permission for disclosure of their personal information HITECH Incentive payments for sharing specific EHR data Meaningful use incentives Improves outcomes Exceptions to confidentiality Intent to harm self or others Attorneys involved in litigation When records are released to insurance companies Answering court orders, subpoenas, summons Mandatory reporting of disease and conditions Tarasoff principle: Duty to warn potential victims of imminent danger of homicidal patients Child/elder abuse Justice Doing what is fair, fairness in all aspects of care Beneficience Promoting well being and doing good Nonmalfeasance Doing no harm Fidelity Being true and loyal Autonomy Doing for self Veracity Telling the truth Respect Treating everyone with equal respect Deontological Theory An 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 the moral virtues (honesty, courage, compassion, wisdom, gratitude, self respect) or the character of the person making the decision Four elements of negligence to prove malpractice Duty: NP had a duty to exercise reasonable care when undertaking and providing treatment to the patient Breach of duty: NP violated the applicable standard of care in treating the patient's condition Proximate cause: causal relationship between the breach in the standard of care and the patient's injuries Damages:there are permanent and substantial damages to the patient as a result of the breach in the standard of care Commitment Criteria Person has a diagnosed psychiatric disorder Person is harmful to self or others as a consequence of the disorder Person is unaware or unwilling to accept the nature and severity of the disorder Treatment is likely to improve functioning Primary Prevention Aimed at decreasing the incidence (number of new cases) of mental disorders (prevention) Secondary Prevention Aimed at decreasing prevalence (number of existing cases) of mental disorders (screening) Tertiary Prevention Aimed at decreasing the disability and severity of a mental disorder (rehab) Ethnicity Self identified race, tribe, or nation with which a person or group identifies and which greatly influences beliefs and behaviors Schizophrenia accounts for ____% of US homelessness 15-45% Sexual Identity How people identify psychologically on a continuum between female and male and to whom they are sexually or affectionately attracted Gender Identity A person's identity along a continuum between normative constructs of masculinity and femininity PICO P-patient, population, problem I-intervention C-comparison O-outcome Internal validity When the independent variable (treatment) caused a change in the dependent variable (outcome) External validity When the sample is representative of the population and the results can be generalized Mean Average of scores Standard deviation Indication of the possible deviations from the mean Variance How the values are dispersed around the mean; the larger the variance, the larger the dispersion of scores Inferential statistics Numerical values that enable one to reach conclusions that extend beyond the immediate data alone; generated by quantitative research designs t test Assesses whether the means of 2 groups are statistically different from each other Analysis of Variance (ANOVA) Tests the difference among 3 or more groups Pearson's r correlation Tests the relationship between 2 variables Probability Likelihood of an event occurring; lies between 0 and 1; impossible event has probability of 0 and certain event has probability of 1 p value level of significance describes probability of a particular result occurring by chance alone How is countertransference usually dealt with Supervisory process and in talking to coworkers about the issues Erikson: Infancy 0-1 Trust vs Mistrust Erikson: Early childhood 1-3 Autonomy vs Shame and Doubt Erikson: Late childhood 3-6 Initiative vs Guilt Erikson: School age 6-12 Industry vs Inferiority Erikson: Adolescence 12-20 Identity vs Role Confusion Erikson: Early adulthood 20-35 Intimacy vs Isolation Erikson: Middle adulthood 35-65 Generativity vs Self Absorption or Stagnation Erikson: Late adulthood over 65 Integrity vs Despair Principle of Psychic Determinism Even apparently meaningless, random, or accidental behavior is actually motivated by underlying unconscious mental content Freud Oral Stage 0-18 mths; sucking, chewing, feeding, crying (schizophrenia, substance abuse, paranoia) Freud Anal Stage 18 mths-3 years; sphincter control, activities of expulsion and retention (Depressive) Freud Phallic stage 3-6; Exhibitionism, masturbation, oedipal, castration anxiety, female fear of lost maternal love (sexual identity disorders) Freud Latency stage 6-puberty; peer relationships, learning, motor skills development, socialization (inability to form social relationships) Freud genital stage puberty forward; integration and synthesis of behaviors from early stages, primary genital based sexuality (Sexual perversion disorders) Id primary drives or instincts, urges (hunger, sex, aggression) largely unconscious pleasure principle, immediate satisfaction present at birth "I want" Ego external reality rational mind; responsible for logical and abstract thinking adaptation reality principle defense mechanisms "I think, I evaluate" Superego ego ideal sense of conscience or right vs wrong aspirations, ideals, moral values guilt and shame "I should or ought" Denial Avoidance of unpleasant realities by unconsciously ignoring their existence Projection unconscious rejection of emotionally unacceptable personal attributes, beliefs, or actions by attributing them to other people, situations, or events Regression return to more comfortable thoughts, behaviors, or feelings used in earlier stages of development in response to current conflict, stress, or threat Reaction formation often called overcompensation; unacceptable feelings, thoughts, or behaviors are pushed from conscious awareness by displaying and acting on the opposite feeling, thought or behavior Rationalization justification of illogical, unreasonable ideas, feelings, or actions by developing an acceptable explanation that satisfies the person Undoing behaviors that attempt to make up for or undo an unacceptable action, feeling, or impulse Intellectualization attempts to master current stressor or conflict by expansion of knowledge, explanation, or understanding