PMHNP ANCC EXAM REVIEW QUESTIONS WITH COMPLETE AND APPROVED ANSWERS

PMHNP ANCC EXAM REVIEW QUESTIONS WITH COMPLETE
AND APPROVED ANSWERS.


1) The purpose of the American Nurses Association's Psychiatric-Mental Health
t t t t t t t t t




Nursing:
Scope and Standards of Practice is to
t t t t t t




A) Define the role and actions for the NP t t t t t t t




B) Establish the legal authority for the prescription of psychotropic medications
t t t t t t t t t




C) Define the legal statutes of the role of the PMHNP t t t t t t t t t




D) Define the differences between the physician role and the NP role --
t t t t t t t t t t t t




Correct Answer ✔✔ A. The ANAs Psych-Mental Health Nursing Scope and t t t t t t t t t t t




Standards of Practice defines the role and actions of the nurse practitioner. t t t t t t t t t t t




2) The trend in legal rulings on cases involving mental illness over the past 25 years has
t t t t t t t t t t t t t t t t




been to t




A) Encourage juries to find defendants not guilty by reason of insanity t t t t t t t t t t




B) Protect the person's freedoms or rights when he or she is committed to a
t t t t t t t t t t t t t t




mental hospital t




C) Place increasing trust in mental health professionals to make good and
t t t t t t t t t t t




ethical decisions t




D) Decrease the "red tape" associated with commitments so that commitments t t t t t t t t t




are faster and easier -- Correct Answer ✔✔ B. Identifies the trend of
t t t t t t t t t t t t t t




ensuring the protection of individual civil liberties for psychiatric clients.
t t t t t t t t t




3) Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic
t t t t t t t t




symptoms, refuses to take any of his ordered medication because he believes "Jesus
t t t t t t t t t t t t t




Christ told me I am the prophet and must fast for a year." Your actions should be
t t t t t t t t t t t t t t t t t




based on your knowledge of which of the following?
t t t t t t t t




A) Psychiatric clients cannot refuse treatment t t t t




B) Psychiatric clients do not always know what is good for them t t t t t t t t t t




C) Psychiatric clients can refuse treatment t t t t

, D) Psychiatric clients cannot be trusted to make good healthcare decisions and, t t t t t t t t t t t




therefore, the nurse's best clinical judgment should guide actions -- Correct t t t t t t t t t t t




Answer ✔✔ C. As with any client, psychiatric clients can refuse treatment t t t t t t t t t t t t




unless a legal process resulting in involuntary commitment or mandatory
t t t t t t t t t t




court order for treatment has been obtained. t t t t t t




4) Which of the following statements best reflects the difference between the nurse-
t t t t t t t t t t t




client (N-C) relationship and a social relationship?
t t t t t t




A) In the N-C relationship, the primary focus is on the client and the client's
t t t t t t t t t t t t t t




needs.
B) Goals in the N-C relationship are deliberately left vague and unspoken so
t t t t t t t t t t t t




that the client can work on any issue. t t t t t t t




C) In the N-C relationship, the nurse is solely responsible for making the
t t t t t t t t t t t t




relationship work. t




D) In the N-C relationship, there is no place for social interaction. -- Correct
t t t t t t t t t t t t t




Answer ✔✔ A. Social relationships are mutual interpersonal relationships in t t t t t t t t t t




which the needs of both parties are addressed. The N-C relationship is most
t t t t t t t t t t t t t




concerned with meeting the needs of the client. t t t t t t t




5) A community has an unusually high incidence of depression and drug use among the
t t t t t t t t t t t t t t




teenage population. The public health nurses decide to address this problem, in
t t t t t t t t t t t t




part, by modifying the environment and strengthening the capacities of families to
t t t t t t t t t t t t




prevent the development of new cases of depression and drug use. What is this is
t t t t t t t t t t t t t t t




an example of?
t t




A) Primary prevention t




B) Secondary prevention t




C) Tertiary prevention t




D) Protective factorial prevention -- Correct Answer ✔✔ A. This action t t t t t t t t t t




focuses on interventions designed to reduce the incidence of new cases of t t t t t t t t t t t t




disease.

6) Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she
t t t t t t t t t t t t t t




wishes to leave because "this place can't help me." The best nursing action that
t t t t t t t t t t t t t t




reflects the legal right of this client is
t t t t t t t




A) Discharge the client t t




B) Explain that the client cannot leave until you can complete further t t t t t t t t t t t




assessment

, C) Allow the client to leave but have her sign forms stating she is leaving against
t t t t t t t t t t t t t t t




medical advice t




D) Immediately start the paperwork to commit the client and to allow you to t t t t t t t t t t t t t




treat her against her wishes -- Correct Answer ✔✔ B. Almost every state
t t t t t t t t t t t t t




allows for a brief for a period detainment to assess a client for
t t t t t t t t t t t t t




dangerousness to self or others before allowing the client to leave a hospital t t t t t t t t t t t t t




setting, even if the admission was voluntary. t t t t t t




7) In forming a therapeutic relationship with clients, the PMHNP must consider
t t t t t t t t t t t




developing many characteristics that are known to be helpful in relationship-
t t t t t t t t t t




building. Which of the following is an essential part of building a therapeutic
t t t t t t t t t t t t t




relationship?
A) Collecting a family history t t t




B) Like-mindedness
C) Authenticity
D) Accuracy in assessment -- Correct Answer ✔✔ C. Authenticity. Being t t t t t t t t t t




genuine, honest, and respectful are essential elements in establishing at t t t t t t t t t




working relationship with any client. Like-mindedness is not a part of the
t t t t t t t t t t t t




therapeutic relationship. Although an important aspect of the PMHNP role, t t t t t t t t t t




collecting a family history and accuracy in assessment does not in and of itself t t t t t t t t t t t t t




facilitate relationship building.
t t t




8) According to the DSM-5, which of the following is true? (Ch. 3)
t t t t t t t t t t t




A) A mental disorder is equivalent to the need for treatment.
t t t t t t t t t




B) Diagnostic criteria are used to inform clinical judgment. t t t t t t t




C) Socially deviant behavior is considered a mental disorder. t t t t t t t




D) A culturally expected response to a stressor is not a mental disorder. --
t t t t t t t t t t t t t




Correct Answer ✔✔ D. All DSM-5 disorders need to be made taking a t t t t t t t t t t t t t




person's culture into account. A cultural expression of a response to grief, t t t t t t t t t t t t




loss, or stress is not considered a DSM-5 diagnosis.
t t t t t t t t




9) Mrs. French has been in individual therapy for 3 months. She has shown much
t t t t t t t t t t t t t t




growth and improvement in her functioning and insight and is to discontinue
t t t t t t t t t t t t




services within the next few weeks. In the next session, after you discuss service
t t t t t t t t t t t t t t




termination, she suddenly begins to demonstrate the original symptoms that had
t t t t t t t t t t t




brought her to treatment initially. She is now hesitant to discharge, wants to
t t t t t t t t t t t t t

, continue services, and is displaying an increase in regressive defense mechanisms.
t t t t t t t t t t t




What is the best explanation for Ms. French's behavior?
t t t t t t t t




A) An exacerbation of her symptoms related to stress
t t t t t t t




B) The normal cyclic nature of chronic mental health symptoms
t t t t t t t t




C) A sign of normal resistance to termination seen in the termination phase of
t t t t t t t t t t t t t




therapy
D) A sign of pathological attachment to the therapist that must be addressed --
t t t t t t t t t t t t t




Correct Answer ✔✔ C. Clients frequently display resistance and regression t t t t t t t t t t




at the termination of a meaningful therapeutic process. The PMHNP is
t t t t t t t t t t t




responsible for planning an effective termination and monitoring clients t t t t t t t t t




during the termination period. t t t




10) A client is displaying low self-esteem, poor self-control, self-doubt, and a high level
t t t t t t t t t t t t t




of dependency. These behaviors indicate developmental failure of which of the
t t t t t t t t t t t




following stages of development: t t t




A) Infancy
B) Early childhood t




C) Late childhood t




D) School age -- Correct Answer ✔✔ B. These signs indicate developmental t t t t t t t t t t t




failure of early childhood. t t t




11) Mr. Thompson has been forgetful lately, for example, forgetting where he has
t t t t t t t t t t t t




placed his keys or what time appointments are scheduled, and he has stated that he
t t t t t t t t t t t t t t t




thinks these are just random behaviors that have no particular meaning. Which
t t t t t t t t t t t t




Freudian-based psychodynamic principle assumes that all behavior and actions are t t t t t t t t t t




purposeful?
A) Pleasure principle t




B) Psychic determinism principle t t




C) Reality principle t




D) Unconsciousness principle -- Correct Answer ✔✔ B. The psychic t t t t t t t t t




determinism principle states that all behavior has purpose and meaning, t t t t t t t t t t




often unconscious in nature, and that no behaviors occur randomly or by
t t t t t t t t t t t t




coincidence.

12) An example of a mature, healthy defense mechanism is
t t t t t t t t




A) Denial
B) Rationalization