PMHNP Boards Questions and answers

A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical examination is unremarkable. Laboratory results are within normal limits except for a markedly elevated alkaline phosphatase level. The psychiatric-mental health nurse practitioner interprets the findings as normally occurring during a rapid adolescent growth spurt Laboratory findings for a patient with an alcohol use disorder indicate increased liver function values and: increased MCV and elevated triglyceride levels. A new patient arrives at the office for treatment for depression. The patient reports taking simvastatin (Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatric-mental health nurse practitioner eliminates fluoxetine (Prozac), based on the knowledge that the combination can lead to increased plasma levels of the statin, resulting in an increased risk of muscle damage and rhabdomyolysis. The nurse practitioner's reason is that: one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor. A 28-year-old patient who is psychotic arrives at the clinic with family members but refuses to meet if the family members are present. The psychiatric-mental health nurse practitioner asks the family members to leave for the appointment. The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement at a community mental health clinic. The effective strategy for evaluating the clinic's services is to: use a survey to elicit patient satisfaction responses. The psychiatric-mental health nurse practitioner evaluates a new adult patient via telemedicine. The patient has questions about a new medication that he or she recently started. The nurse practitioner decides to provide psychoeducation and to: e-mail drug information and resources Any court of law that evaluates the standards of care provided by a psychiatric-mental health nurse practitioner considers what a reasonably prudent health care provider would do. The psychiatric-mental health nurse practitioner and a team of local mental health professionals are asked to provide crisis counseling service, after a gunman recently took a class hostage at a local elementary school, wounded several students, and then shot himself. In preparing for this assignment, the nurse practitioner recognizes that: a child's developmental stage will influence his or her response to catastrophic stress Which community-based program is a tertiary level intervention? Partial hospitalization program that provides intensive group therapy for rehabilitation. A 32-year-old female patient informs the psychiatric-mental health nurse practitioner that she is three months pregnant. She has been stable on fluoxetine (Prozac) for the last two years. The patient asks whether she may safely continue this medication during her pregnancy. The nurse practitioner responds: "Let's review the risks and benefits of continuing or discontinuing Prozac for you and your baby." Established clinical guidelines suggest that suicidality is decreased by treating patients who have borderline personality disorder with: dialectical behavioral therapy. A six-year-old patient with autistic spectrum disorder has not responded to six months of psychosocial interventions and continues to demonstrate aggressive tendencies toward a younger sibling. The psychiatric-mental health nurse practitioner prescribes: risperidone (Risperdal) 0.25 mg once a day. The psychiatric-mental health nurse practitioner working in a crisis stabilization unit evaluates a patient verbalizing suicidal thoughts after being sexually assaulted. Before processing through the traumatic event, the nurse practitioner first attempts to provide an environment of safety. The psychiatric-mental health nurse practitioner uses a cognitive-behavioral approach to help a patient address self-defeating behaviors. After identifying the stressor that causes the inappropriate behavior, the initial strategy is to explore: rational and irrational beliefs about the stressor. A patient who has borderline personality disorder experiences intense anxiety when the psychiatric-mental health nurse practitioner goes on vacation. The most appropriate explanation for this reaction is that the patient: has not developed object constancy. An initial psychiatric evaluation of a patient reveals a normal mental status and appropriate behavior, despite a parent's reports of "disobedience, poor grades, and laziness." To further assess the patient's functioning, the psychiatric-mental health nurse practitioner: meets with the parent and patient together to explore the discrepant report. The psychiatric-mental health nurse practitioner is employed in a newly created attending role on a psychiatric inpatient unit. To promote an interprofessional environment, the nurse practitioner: assigns a role for all staff members in improving patient outcomes. The psychiatric-mental health nurse practitioner sees a 12-year-old patient who takes lisdexamfetamine (Vyvanse) 50 mg daily for attention-deficit hyperactivity disorder. The nurse practitioner observes a tic, which the parents report began after the patient began taking the psychostimulant, and it has been increasing in severity. Both the parents and the school report that the medication is helpful. The nurse practitioner: discontinues the psychostimulant, prescribes guanfacine extended release (Intuniv), and monitors the patient.