PURPLE BOOK PMHNP 100 MULTIPLE
CHOICE QUESTIONS W/ANSWERS
ANCC
h1. The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing: Scope and
Standards of Practice is to
A. Define the role and actions for the NP
Establish the legal authority for the prescription of psychotropic
B. medications
C. Define the legal statutes of the role of the PMHNP
D. Define the differences between the physician role and the NP role - Correct Answer: A. The ANA's
Psychiatric-Mental Health Nursing: Scope and Standards of Practice defines the role and actions of the
nurse practitioner.
2) Primary prevention care practices are an essential aspect of the PMHNP role. Which of the following is
the best example of a primary prevention care strategy for community behavioral health?
a) Aftercare program for chronically mentally ill clients recently discharged from the hospital
b) Court-ordered counseling for abusive parents
c) 24-hour crisis hotlines
d) Parenting skills classes for pregnant adolescents - Correct Answer: D. Information reduces incidence of
disease.
3
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 - B.
Identifies the trend of ensuring the protection of individual civil liberties for psychiatric clients.
4
Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to take any
of his ordered medication because he believes "Jesus Christ told me I am the prophet and must fast for a
year." Your actions should be based on your knowledge of which of the following?
,a) Psychiatric clients cannot refuse treatment
b) Psychiatric clients do not always know what is good for them
c) Psychiatric clients can refuse treatment
d) Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore, the nurse's
best clinical judgment should guide actions - C. As with any client, psychiatric clients can refuse
treatment un- less a legal process resulting in involuntary commitment or mandatory court order for
treatment has been obtained.
5. Which of the following statements best reflects the difference between the nurse-client (N-C)
relationship and a social relationship?
a) In the N-C relationship, the primary focus is on the client and the client's needs.
b) Goals in the N-C relationship are deliberately left vague and unspoken so that the client can work on
any issue.
c) In the N-C relationship, the nurse is solely responsible for making the relationship work.
d) In the N-C relationship, there is no place for social interaction. - A. Social relationships are mutual
interpersonal relationships in which the needs of both parties are addressed. The N-C relationship is
most con- cerned with meeting the needs of the client.
6. A community has an unusually high incidence of depression and drug use among the teen- age
population. The public health nurses decide to address this problem, in part, by modifying the
environment and strengthening the capacities of families to prevent the development of new cases of
depression and drug use. What is this is an example of?
a) Primary prevention
b) Secondary prevention
c) Tertiary prevention
d) Protective factorial prevention - A. This action focuses on interventions designed to reduce the
incidence of new cases of disease.
7
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes to leave because
"this place can't help me." The best nursing action that reflects the legal right of this client is
a) Discharge the client
b) Explain that the client cannot leave until you can complete further assessment
c) Allow the client to leave but have her sign forms stating she is leaving against medical advice
d) Immediately start the paperwork to commit the client and to allow you to treat her against her wishes
- Correct Answer: B. Almost every state allows for a brief period of detainment to as- sess a client for
,dangerousness to self or others before allowing the client to leave a hospital setting, even if the
admission was voluntary.
8
In many characteristics that are known to be helpful in relationship-building. Which of the fol- lowing is
an essential part of building a therapeutic relationship? forming a therapeutic relationship with clients,
the PMHNP must consider developing
a) Collecting a family history
b) Like-mindedness
c) Authenticity
d) Accuracy in assessment - C. Authenticity. Being genuine, honest, and respectful are essential elements
in establishing a working relationship with any client. Like-mindednessis not a part of the therapeutic
relationship. Although an important aspect of the PMHNP role, collecting a family history and accuracy in
assessment does not in and of itself facilitate relationship-building.
9
According to the DSM-5, which of the following is true? (Ch. 3)
a) A mental disorder is equivalent to the need for treatment.
b) Diagnostic criteria are used to inform clinical judgment.
c) Socially deviant behavior is considered a mental disorder.
d) A culturally expected response to a stressor is not a mental disorder. - Correct Answer: D. All DSM-5
disorders need to be made taking a person's culture into account. A cultural expression of a response to
grief, loss, or stress is not con- sidered a DSM-5 diagnosis.
10
Mrs. French has been in individual therapy for 3 months. She has shown much growth and improvement
in her functioning and insight and is to discontinue services within the next few weeks. In the next
session, after you discuss service termination, she suddenly begins to demonstrate the original
symptoms that had brought her to treatment initially. She is now hesitant to discharge, wants to
continue services, and is displaying an increase in regressive defense mechanisms. What is the best
explanation for Ms. French's behavior?
a) An exacerbation of her symptoms related to stress
b) The normal cyclic nature of chronic mental health symptoms
c) A sign of normal resistance to termination seen in the termination phase of therapy
d) A sign of pathological attachment to the therapist that must be addressed - C. Clients frequently
display resistance and regression at the termination of a meaningful therapeutic process. The PMHNP is
responsible for planning an effective termination and monitoring clients during the termination period.
, 11
A client is displaying low self-esteem, poor self-control, self-doubt, and a high level of de- pendency.
These behaviors indicate developmental failure of which of the following stages of development:
a) Infancy
b) Early childhood
c) hLate hchildhood
d) hSchool hage h- hCorrect hAnswer: hB. hThese hsigns hindicate hdevelopmental hfailure hof hearly hchildhood.
12
hMr. hThompson hhas hbeen hforgetful hlately, hfor hexample, hforgetting hwhere hhe hhas hplaced hhis hkeys hor
hwhat htime happointments hare hscheduled, hand hhe hhas hstated hthat hhe hthinks hthese hare hjust hrandom
hbehaviors hthat hhave hno hparticular hmeaning. hWhich hFreudian-based hpsychodynamic hprinciple
hassumes hthat hall hbehavior hand hactions hare hpurposeful?
a) hPleasure hprinciple
b) hPsychic hdeterminism hprinciple
c) hReality hprinciple
d) hUnconsciousness hprinciple h- hB. hThe hpsychic hdeterminism hprinciple hstates hthat hall hbehavior hhas
hpurpose hand hmeaning, hoften hunconscious hin hnature, hand hthat hno hbehaviors hoccur hrandomly hor hby
hcoincidence.
13
1) hAn hexample hof ha hmature, hhealthy hdefense hmechanism his
a) hDenial
b) hb. hRationalization
c) hRepression
d) hSuppression h- hCorrect hAnswer: hD. hSuppression his hthe honly hdefense hmechanism hlisted hin hwhich
hthe hclient hchannels hconflicting henergies hinto hgrowth-promoting hactivities.
14
Mr. hJohnson his ha h54-year-old hclient hyou hhave hbeen hseeing hfor hseveral hweeks hin htherapy. hWhile
hdiscussing hhis hcurrent hconcerns hof hmarital hstress, hhe hlies hon hthe hfloor hand hassumes hthe hfetal
hposition. hThis his hmost hlikely han hexample hof
a) hImmature hregressive hdefense hmechanism
b) hDenial hof hreality
CHOICE QUESTIONS W/ANSWERS
ANCC
h1. The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing: Scope and
Standards of Practice is to
A. Define the role and actions for the NP
Establish the legal authority for the prescription of psychotropic
B. medications
C. Define the legal statutes of the role of the PMHNP
D. Define the differences between the physician role and the NP role - Correct Answer: A. The ANA's
Psychiatric-Mental Health Nursing: Scope and Standards of Practice defines the role and actions of the
nurse practitioner.
2) Primary prevention care practices are an essential aspect of the PMHNP role. Which of the following is
the best example of a primary prevention care strategy for community behavioral health?
a) Aftercare program for chronically mentally ill clients recently discharged from the hospital
b) Court-ordered counseling for abusive parents
c) 24-hour crisis hotlines
d) Parenting skills classes for pregnant adolescents - Correct Answer: D. Information reduces incidence of
disease.
3
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 - B.
Identifies the trend of ensuring the protection of individual civil liberties for psychiatric clients.
4
Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to take any
of his ordered medication because he believes "Jesus Christ told me I am the prophet and must fast for a
year." Your actions should be based on your knowledge of which of the following?
,a) Psychiatric clients cannot refuse treatment
b) Psychiatric clients do not always know what is good for them
c) Psychiatric clients can refuse treatment
d) Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore, the nurse's
best clinical judgment should guide actions - C. As with any client, psychiatric clients can refuse
treatment un- less a legal process resulting in involuntary commitment or mandatory court order for
treatment has been obtained.
5. Which of the following statements best reflects the difference between the nurse-client (N-C)
relationship and a social relationship?
a) In the N-C relationship, the primary focus is on the client and the client's needs.
b) Goals in the N-C relationship are deliberately left vague and unspoken so that the client can work on
any issue.
c) In the N-C relationship, the nurse is solely responsible for making the relationship work.
d) In the N-C relationship, there is no place for social interaction. - A. Social relationships are mutual
interpersonal relationships in which the needs of both parties are addressed. The N-C relationship is
most con- cerned with meeting the needs of the client.
6. A community has an unusually high incidence of depression and drug use among the teen- age
population. The public health nurses decide to address this problem, in part, by modifying the
environment and strengthening the capacities of families to prevent the development of new cases of
depression and drug use. What is this is an example of?
a) Primary prevention
b) Secondary prevention
c) Tertiary prevention
d) Protective factorial prevention - A. This action focuses on interventions designed to reduce the
incidence of new cases of disease.
7
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes to leave because
"this place can't help me." The best nursing action that reflects the legal right of this client is
a) Discharge the client
b) Explain that the client cannot leave until you can complete further assessment
c) Allow the client to leave but have her sign forms stating she is leaving against medical advice
d) Immediately start the paperwork to commit the client and to allow you to treat her against her wishes
- Correct Answer: B. Almost every state allows for a brief period of detainment to as- sess a client for
,dangerousness to self or others before allowing the client to leave a hospital setting, even if the
admission was voluntary.
8
In many characteristics that are known to be helpful in relationship-building. Which of the fol- lowing is
an essential part of building a therapeutic relationship? forming a therapeutic relationship with clients,
the PMHNP must consider developing
a) Collecting a family history
b) Like-mindedness
c) Authenticity
d) Accuracy in assessment - C. Authenticity. Being genuine, honest, and respectful are essential elements
in establishing a working relationship with any client. Like-mindednessis not a part of the therapeutic
relationship. Although an important aspect of the PMHNP role, collecting a family history and accuracy in
assessment does not in and of itself facilitate relationship-building.
9
According to the DSM-5, which of the following is true? (Ch. 3)
a) A mental disorder is equivalent to the need for treatment.
b) Diagnostic criteria are used to inform clinical judgment.
c) Socially deviant behavior is considered a mental disorder.
d) A culturally expected response to a stressor is not a mental disorder. - Correct Answer: D. All DSM-5
disorders need to be made taking a person's culture into account. A cultural expression of a response to
grief, loss, or stress is not con- sidered a DSM-5 diagnosis.
10
Mrs. French has been in individual therapy for 3 months. She has shown much growth and improvement
in her functioning and insight and is to discontinue services within the next few weeks. In the next
session, after you discuss service termination, she suddenly begins to demonstrate the original
symptoms that had brought her to treatment initially. She is now hesitant to discharge, wants to
continue services, and is displaying an increase in regressive defense mechanisms. What is the best
explanation for Ms. French's behavior?
a) An exacerbation of her symptoms related to stress
b) The normal cyclic nature of chronic mental health symptoms
c) A sign of normal resistance to termination seen in the termination phase of therapy
d) A sign of pathological attachment to the therapist that must be addressed - C. Clients frequently
display resistance and regression at the termination of a meaningful therapeutic process. The PMHNP is
responsible for planning an effective termination and monitoring clients during the termination period.
, 11
A client is displaying low self-esteem, poor self-control, self-doubt, and a high level of de- pendency.
These behaviors indicate developmental failure of which of the following stages of development:
a) Infancy
b) Early childhood
c) hLate hchildhood
d) hSchool hage h- hCorrect hAnswer: hB. hThese hsigns hindicate hdevelopmental hfailure hof hearly hchildhood.
12
hMr. hThompson hhas hbeen hforgetful hlately, hfor hexample, hforgetting hwhere hhe hhas hplaced hhis hkeys hor
hwhat htime happointments hare hscheduled, hand hhe hhas hstated hthat hhe hthinks hthese hare hjust hrandom
hbehaviors hthat hhave hno hparticular hmeaning. hWhich hFreudian-based hpsychodynamic hprinciple
hassumes hthat hall hbehavior hand hactions hare hpurposeful?
a) hPleasure hprinciple
b) hPsychic hdeterminism hprinciple
c) hReality hprinciple
d) hUnconsciousness hprinciple h- hB. hThe hpsychic hdeterminism hprinciple hstates hthat hall hbehavior hhas
hpurpose hand hmeaning, hoften hunconscious hin hnature, hand hthat hno hbehaviors hoccur hrandomly hor hby
hcoincidence.
13
1) hAn hexample hof ha hmature, hhealthy hdefense hmechanism his
a) hDenial
b) hb. hRationalization
c) hRepression
d) hSuppression h- hCorrect hAnswer: hD. hSuppression his hthe honly hdefense hmechanism hlisted hin hwhich
hthe hclient hchannels hconflicting henergies hinto hgrowth-promoting hactivities.
14
Mr. hJohnson his ha h54-year-old hclient hyou hhave hbeen hseeing hfor hseveral hweeks hin htherapy. hWhile
hdiscussing hhis hcurrent hconcerns hof hmarital hstress, hhe hlies hon hthe hfloor hand hassumes hthe hfetal
hposition. hThis his hmost hlikely han hexample hof
a) hImmature hregressive hdefense hmechanism
b) hDenial hof hreality
