A newly graduated nurse practitioner (NP) wants to open a private psychiatric practice in her
hometown. She wants to find out about the laws that cover her responsibility and the legal
liability that this practice will encounter for her as an independent psychiatric nurse practitioner.
Her best source of information is:
A. The State Statues on Nursing or Advanced Nursing Practice
B. Her city statutes
C. Local Psychiatric Nurse Practitioners in practice
D. The American Academy of Nurse practitioners - ANS A. The State Statues on Nursing or
Advanced Nursing Practice
Which of the following best depicts the Psychiatric-Mental Health Nurse Practitioner in a
grassroots mental health advocacy role?
A. Attending a town hall meeting to seek timely police response to rising domestic violence
crisis calls.
B. Working on the campaign of an individual running for the state senate.
C. Assisting with depression screening at a health fair in a local shopping mall
D. Meeting states legislators during RN lobbying day organized by the state nurses' association
- ANS A. Attending a town hall meeting to seek timely police response to rising domestic
violence crisis calls.
During a medication follow-up appointment at student mental health clinic, a 20 y/o college
sophomore with depression and history of binge drinking disclosed that she has been struggling
with recurrent intrusive thoughts of overdose. She recently broke up with her boyfriend when
she learned that he was sleeping with her closest girlfriend. She admits taking a handful of her
sertraline prescribed by the Psychiatric-mental Health Nurse Practitioner last weekend and was
frustrated that it only made her sleep for a day. She's angry and ambivalent about the future,
unwilling to make any promise not to harm herself, and has made veiled threats to "pay back
both of them for cheating" (referring to her ex-boyfriend and girlfriend). What is the most
appropriate intervention at this juncture?
A. Counsel the student that she would regret hurting herself and can move beyond this broken
relationship
B. Ask the student to promise - ANS D. Ask the student if she will agree to voluntary admission
and arrange involuntary admission is necessary
Per the Health Insurance Portability and Accountability Act (HIPAA), a nurse practitioner (NP)
who is in an independent, single practitioner practice is considered a "Covered Entity" because:
A. Writers information and generates protected health information
B. The NP transmits protected health information in electronic forms
C. May accidentally release protected health information
D. Maintains charts with patient information that contains protected health information - ANS B.
The NP transmits protected health information in electronic forms
The Nurse Practitioner (NP) attends a local meeting where allocation of resources for
healthcare will be discussed. One of the stakeholders has a pamphlet that describes the types
,of healthcare providers available to help persons in need of health care. The NP notices that
Nurse Practitioners are labeled as "Paraprofessionals". In the meeting, the NP askes the
organization responsible for the pamphlet why they have identified the Nurse Practitioners as
paraprofessionals when a Nurse Practitioner is by law working as 85-90% of the same capacity
as a Medical Doctor. The NP goes on to explain what a Nurse Practitioner does in various areas
of practice. This is an example of:
A. Promoting nurse practitioners in the community
B. Public education on the NP scope and standards of practice
C. Correcting misinformation that deliberately misleads the public
D. Advocating for the role and value of the Nurse Practitioner. - ANS D. Advocating for the role
and value of the Nurse Practitioner.
Your patient wants to communicate with you through email. You have a secure email account
that is encrypted and will protect health information as required by the Health Insurance
Portability and Accountability Act (HIPAA). Your patient does not have an encrypted email
account. You reply is:
A. I do not like to communicate through email I would prefer to talk to you in person or over the
telephone only
B. I can encrypt our email communications to be sure that your protected health information
(PHI) is unavailable to others and protect you
C. I have no problems with you communicating with me through my personal email
D. In order to communicate back and forth, you will have to find a way to encrypt you're
protected health information (PHI) - ANS D. In order to communicate back and forth, you will
have to find a way to encrypt you're protected health information (PHI)
As an individual advanced practitioner, you cannot afford to have a standalone Electronic
Health Record (HER) system to keep all of your patient's health information on a computer
based system. How could you problem-solve this dilemma?
A. Process your notes and patient records in a secure electronic system with a template for
patient information and interactions, supporting quick access within your network
B. Process your notes and patient records on a laptop that you are able to transport between
your office and home office. You always have the records available if needed
C. Process your notes manually and keep them in a locked file. The records are available for
copy and distribution at any time.
D. Process your patient records manually, in your current fashion. You are keeping a full record
according to HIPAA. - ANS A. Process your notes and patient records in a secure electronic
system with a template for patient information and interactions, supporting quick access within
your network
The nurse practitioner (NP) sees an opportunity to help her patient who duffers from anxiety
and hypertension by utilizing a medication that can treat both issues. She talks to her patient
about using Atenolol 25mg ½ tab po Q HS to manage his hypertension and his chronic anxiety.
To promote both the patient's continued health and collaboration, the NP:
,A. Faxes a copy of her care notes to the Primary Care Provider (PCP) to inform the PCP of her
plan of care
B. Telephones the Primary Care Provider's office and leaves a message about the change in
medication
C. Tells the patient to let his Primary Care Provider know about the change in medication
D. Telephones the patient's Primary Care Provider to discuss the use of the Atenolol before
starting the medication - ANS D. Telephones the patient's Primary Care Provider to discuss the
use of the Atenolol before starting the medication
A frail 76 y/o woman with Alzheimer's type dementia in a skilled nursing facility has been
increasingly agitated, combative, and has struck out at other patients in the dining room and at
staff attempting to care for her. What would be the most appropriate initial intervention by the
consulting Psychiatric-Mental Health Nurse Practitioner who receives a call from the nursing
staff requesting medication and restraint orders?
A. Order close observation by staff in quiet area secluded from other patients until you can
evaluate in person
B. Order soft wrist and vest restraints until you can evaluate in person
C. Order short-acting benzodiazepine and close observation until you can evaluate in person
D. Order low-dose atypical antipsychotic and soft vest restraint until you can evaluate in person
- ANS A. Order close observation by staff in quiet area secluded from other patients until you
can evaluate in person
You frequently use your iPhone/smart phone to connect with your office, the pharmacy and
patients. These multifunction devices assist you in your practice. What needs to happen to the
protected/private health information on your phone after you conclude a healthcare interaction?
A. You document an abbreviated note of the phone conversation
B. You document that you had a telephone interaction only
C. You document it briefly, only if it is important
D. You document it fully in the patient record as a patient interaction - ANS D. You document it
fully in the patient record as a patient interaction
A Psychiatric-Mental Nurse Practitioner practices in a state requiring a collaborating
psychiatrist. The Psychiatric-Mental Health Nurse Practitioner review all new and complex cases
with the psychiatrist on a monthly basis. A young adult patient with recurrent depression has
been under the care of the Psychiatric-Mental Health Nurse Practitioner for 3 months when she
commits suicide. The family sues for wrongful death. Who is legally responsible for this patient's
care in a court of law?
A. Equal responsibility of Psychiatric-Mental Health Nurse Practitioner and psychiatrist
B. Psychiatrist
C. Primary responsibility of Psychiatric-Mental health Nurse Practitioner and secondary
responsibility of psychiatrist
D. Psychiatric-Mental Health Nurse Practitioner - ANS D. Psychiatric-Mental Health Nurse
Practitioner
, The Nurse Practitioner (NP) is seeing a patient for both psychiatric and chemical dependency
illnesses. The patient wants the NP to send medical records to his General Practitioner. The NP
tells the patient that because of Federal Law 42 CFR he must:
A. Sign two separate releases of information due to the special protected nature of chemical
dependency information
B. Sign once combined release that does not mention his chemical dependency illness due to
its special protected nature
C. Sign two separate releases due to the special protected nature of psychiatric information
D. Sign one combined release that designated that he is being treated for both chemical
dependency and psychiatric illnesses - ANS A. Sign two separate releases of information due
to the special protected nature of chemical dependency information
You see a patient for a routine medication visit. At the end of the session, the patient asks
questions and the session ends up 50 minutes in length. You normally charge for the 30-minute
appointment, but instead you charge for the 1-hour appointment. The 1-hour appointment
included a full body assessment that you did not perform. This is violation is known as:
A. Up-coding
B. Over-coding
C. Down-coding
D. Super-coding - ANS A. Up-coding
The nurse practitioner (NP) is on an airplane and the flight attendant asks if there is a medical
professional on the flight. The NP agrees to help. The NP is presented with a young woman
who is suffering from a severe panic attack. The woman is nauseated and lying on the floor of
the plane. The woman has trouble communicating much more than she is upset, afraid and her
husband is a few airplane stops away at an air force base where she is headed. The woman's
pulse is 89 and regular, her respirations are 18 and regular. The woman occasionally pants and
vomits some pale brown liquid. You provide information to the flight medical doctor on call. At
the destination, the flight attendant offers to give you some Alprazolam 0.5mg to give to the
patient. You:
A. Give her the alprazolam to help her calm down until you get to the destination. Then, she can
go to the hospital.
B. Give her the alprazolam so that she calm down a - ANS D. Do not give the medication.
Instead, wait until the plane lands and a full evaluation can be completed at the local hospital
A 45 y/o woman with Type 1 Bipolar Disorder experiencing an acute episode of depression
with psychotic features requires a temporary leave of absence from her job as an administrative
assistant to a school principal. The patient has signed a release of information for the
Psychiatric-mental Health Nurse Practitioner to disclose full mental health records to the
principal and the human resources department to facilitate her gradual return to work. The
patient fears that she will lose her job due to her psychiatric disorder. What is the most
appropriate information the Psychiatric-Mental Health Nurse Practitioner can provide in this
situation?
hometown. She wants to find out about the laws that cover her responsibility and the legal
liability that this practice will encounter for her as an independent psychiatric nurse practitioner.
Her best source of information is:
A. The State Statues on Nursing or Advanced Nursing Practice
B. Her city statutes
C. Local Psychiatric Nurse Practitioners in practice
D. The American Academy of Nurse practitioners - ANS A. The State Statues on Nursing or
Advanced Nursing Practice
Which of the following best depicts the Psychiatric-Mental Health Nurse Practitioner in a
grassroots mental health advocacy role?
A. Attending a town hall meeting to seek timely police response to rising domestic violence
crisis calls.
B. Working on the campaign of an individual running for the state senate.
C. Assisting with depression screening at a health fair in a local shopping mall
D. Meeting states legislators during RN lobbying day organized by the state nurses' association
- ANS A. Attending a town hall meeting to seek timely police response to rising domestic
violence crisis calls.
During a medication follow-up appointment at student mental health clinic, a 20 y/o college
sophomore with depression and history of binge drinking disclosed that she has been struggling
with recurrent intrusive thoughts of overdose. She recently broke up with her boyfriend when
she learned that he was sleeping with her closest girlfriend. She admits taking a handful of her
sertraline prescribed by the Psychiatric-mental Health Nurse Practitioner last weekend and was
frustrated that it only made her sleep for a day. She's angry and ambivalent about the future,
unwilling to make any promise not to harm herself, and has made veiled threats to "pay back
both of them for cheating" (referring to her ex-boyfriend and girlfriend). What is the most
appropriate intervention at this juncture?
A. Counsel the student that she would regret hurting herself and can move beyond this broken
relationship
B. Ask the student to promise - ANS D. Ask the student if she will agree to voluntary admission
and arrange involuntary admission is necessary
Per the Health Insurance Portability and Accountability Act (HIPAA), a nurse practitioner (NP)
who is in an independent, single practitioner practice is considered a "Covered Entity" because:
A. Writers information and generates protected health information
B. The NP transmits protected health information in electronic forms
C. May accidentally release protected health information
D. Maintains charts with patient information that contains protected health information - ANS B.
The NP transmits protected health information in electronic forms
The Nurse Practitioner (NP) attends a local meeting where allocation of resources for
healthcare will be discussed. One of the stakeholders has a pamphlet that describes the types
,of healthcare providers available to help persons in need of health care. The NP notices that
Nurse Practitioners are labeled as "Paraprofessionals". In the meeting, the NP askes the
organization responsible for the pamphlet why they have identified the Nurse Practitioners as
paraprofessionals when a Nurse Practitioner is by law working as 85-90% of the same capacity
as a Medical Doctor. The NP goes on to explain what a Nurse Practitioner does in various areas
of practice. This is an example of:
A. Promoting nurse practitioners in the community
B. Public education on the NP scope and standards of practice
C. Correcting misinformation that deliberately misleads the public
D. Advocating for the role and value of the Nurse Practitioner. - ANS D. Advocating for the role
and value of the Nurse Practitioner.
Your patient wants to communicate with you through email. You have a secure email account
that is encrypted and will protect health information as required by the Health Insurance
Portability and Accountability Act (HIPAA). Your patient does not have an encrypted email
account. You reply is:
A. I do not like to communicate through email I would prefer to talk to you in person or over the
telephone only
B. I can encrypt our email communications to be sure that your protected health information
(PHI) is unavailable to others and protect you
C. I have no problems with you communicating with me through my personal email
D. In order to communicate back and forth, you will have to find a way to encrypt you're
protected health information (PHI) - ANS D. In order to communicate back and forth, you will
have to find a way to encrypt you're protected health information (PHI)
As an individual advanced practitioner, you cannot afford to have a standalone Electronic
Health Record (HER) system to keep all of your patient's health information on a computer
based system. How could you problem-solve this dilemma?
A. Process your notes and patient records in a secure electronic system with a template for
patient information and interactions, supporting quick access within your network
B. Process your notes and patient records on a laptop that you are able to transport between
your office and home office. You always have the records available if needed
C. Process your notes manually and keep them in a locked file. The records are available for
copy and distribution at any time.
D. Process your patient records manually, in your current fashion. You are keeping a full record
according to HIPAA. - ANS A. Process your notes and patient records in a secure electronic
system with a template for patient information and interactions, supporting quick access within
your network
The nurse practitioner (NP) sees an opportunity to help her patient who duffers from anxiety
and hypertension by utilizing a medication that can treat both issues. She talks to her patient
about using Atenolol 25mg ½ tab po Q HS to manage his hypertension and his chronic anxiety.
To promote both the patient's continued health and collaboration, the NP:
,A. Faxes a copy of her care notes to the Primary Care Provider (PCP) to inform the PCP of her
plan of care
B. Telephones the Primary Care Provider's office and leaves a message about the change in
medication
C. Tells the patient to let his Primary Care Provider know about the change in medication
D. Telephones the patient's Primary Care Provider to discuss the use of the Atenolol before
starting the medication - ANS D. Telephones the patient's Primary Care Provider to discuss the
use of the Atenolol before starting the medication
A frail 76 y/o woman with Alzheimer's type dementia in a skilled nursing facility has been
increasingly agitated, combative, and has struck out at other patients in the dining room and at
staff attempting to care for her. What would be the most appropriate initial intervention by the
consulting Psychiatric-Mental Health Nurse Practitioner who receives a call from the nursing
staff requesting medication and restraint orders?
A. Order close observation by staff in quiet area secluded from other patients until you can
evaluate in person
B. Order soft wrist and vest restraints until you can evaluate in person
C. Order short-acting benzodiazepine and close observation until you can evaluate in person
D. Order low-dose atypical antipsychotic and soft vest restraint until you can evaluate in person
- ANS A. Order close observation by staff in quiet area secluded from other patients until you
can evaluate in person
You frequently use your iPhone/smart phone to connect with your office, the pharmacy and
patients. These multifunction devices assist you in your practice. What needs to happen to the
protected/private health information on your phone after you conclude a healthcare interaction?
A. You document an abbreviated note of the phone conversation
B. You document that you had a telephone interaction only
C. You document it briefly, only if it is important
D. You document it fully in the patient record as a patient interaction - ANS D. You document it
fully in the patient record as a patient interaction
A Psychiatric-Mental Nurse Practitioner practices in a state requiring a collaborating
psychiatrist. The Psychiatric-Mental Health Nurse Practitioner review all new and complex cases
with the psychiatrist on a monthly basis. A young adult patient with recurrent depression has
been under the care of the Psychiatric-Mental Health Nurse Practitioner for 3 months when she
commits suicide. The family sues for wrongful death. Who is legally responsible for this patient's
care in a court of law?
A. Equal responsibility of Psychiatric-Mental Health Nurse Practitioner and psychiatrist
B. Psychiatrist
C. Primary responsibility of Psychiatric-Mental health Nurse Practitioner and secondary
responsibility of psychiatrist
D. Psychiatric-Mental Health Nurse Practitioner - ANS D. Psychiatric-Mental Health Nurse
Practitioner
, The Nurse Practitioner (NP) is seeing a patient for both psychiatric and chemical dependency
illnesses. The patient wants the NP to send medical records to his General Practitioner. The NP
tells the patient that because of Federal Law 42 CFR he must:
A. Sign two separate releases of information due to the special protected nature of chemical
dependency information
B. Sign once combined release that does not mention his chemical dependency illness due to
its special protected nature
C. Sign two separate releases due to the special protected nature of psychiatric information
D. Sign one combined release that designated that he is being treated for both chemical
dependency and psychiatric illnesses - ANS A. Sign two separate releases of information due
to the special protected nature of chemical dependency information
You see a patient for a routine medication visit. At the end of the session, the patient asks
questions and the session ends up 50 minutes in length. You normally charge for the 30-minute
appointment, but instead you charge for the 1-hour appointment. The 1-hour appointment
included a full body assessment that you did not perform. This is violation is known as:
A. Up-coding
B. Over-coding
C. Down-coding
D. Super-coding - ANS A. Up-coding
The nurse practitioner (NP) is on an airplane and the flight attendant asks if there is a medical
professional on the flight. The NP agrees to help. The NP is presented with a young woman
who is suffering from a severe panic attack. The woman is nauseated and lying on the floor of
the plane. The woman has trouble communicating much more than she is upset, afraid and her
husband is a few airplane stops away at an air force base where she is headed. The woman's
pulse is 89 and regular, her respirations are 18 and regular. The woman occasionally pants and
vomits some pale brown liquid. You provide information to the flight medical doctor on call. At
the destination, the flight attendant offers to give you some Alprazolam 0.5mg to give to the
patient. You:
A. Give her the alprazolam to help her calm down until you get to the destination. Then, she can
go to the hospital.
B. Give her the alprazolam so that she calm down a - ANS D. Do not give the medication.
Instead, wait until the plane lands and a full evaluation can be completed at the local hospital
A 45 y/o woman with Type 1 Bipolar Disorder experiencing an acute episode of depression
with psychotic features requires a temporary leave of absence from her job as an administrative
assistant to a school principal. The patient has signed a release of information for the
Psychiatric-mental Health Nurse Practitioner to disclose full mental health records to the
principal and the human resources department to facilitate her gradual return to work. The
patient fears that she will lose her job due to her psychiatric disorder. What is the most
appropriate information the Psychiatric-Mental Health Nurse Practitioner can provide in this
situation?
