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1. The best way for a PMHNP to manage strong countertransference is to: A. Terminate the client immediately B. Ignore the feelings C. Share the reactions in detail with the client D. Seek supervision or consultation and reflect on its meaning Correct Answer: D. Seek supervision or consultation and reflect on its meaning Rationale: Consultation helps the therapist understand the reaction and use it constructively. Abrupt termination may harm the client, ignoring feelings risks acting out a...

1. A client says, 'You're just like my father, always judging me.' The therapist's best response is: A. 'I'm nothing like your father.' B. 'Tell me more about what feels judgmental here.' C. 'You're being unfair.' D. 'Let's change the subject.' Correct Answer: B. 'Tell me more about what feels judgmental here.' Rationale: Exploring the transference reveals how past relationships shape current perceptions. Defending or changing the subject...

1. A boundary crossing differs from a boundary violation in that a crossing: A. Is always unethical B. Is a departure from usual practice that may be harmless or helpful, while a violation harms or exploits the client C. Involves sexual contact D. Is illegal in all states Correct Answer: B. Is a departure from usual practice that may be harmless or helpful, while a violation harms or exploits the client Rationale: Accepting a small holiday card may be a benign crossing, while dual relati...

1. Combined oral contraceptives work primarily by: A. Killing sperm B. Preventing ovulation C. Blocking the fallopian tubes D. Causing abortion Correct Answer: B. Preventing ovulation Rationale: Estrogen and progestin suppress the LH surge and thicken cervical mucus. Spermicides kill sperm, and tubal ligation blocks the tubes. They do not kill sperm, block the tubes or end an established pregnancy, which distinguishes them from spermicides, sterilization and abortion. 2. Human chorionic...

1. Fertility awareness methods rely on identifying: A. Signs of ovulation such as basal body temperature rise and cervical mucus changes B. Pregnancy symptoms C. Breast size D. Weight changes Correct Answer: A. Signs of ovulation such as basal body temperature rise and cervical mucus changes Rationale: Clear, stretchy mucus and a temperature rise after ovulation help identify fertile days. These methods require consistent tracking. Pregnancy symptoms, breast size and weight do not reliab...

1. The placenta functions to: A. Block all medications B. Produce amniotic fluid only C. Provide the fetus with maternal blood directly D. Exchange gases and nutrients, remove waste and produce hormones Correct Answer: D. Exchange gases and nutrients, remove waste and produce hormones Rationale: Maternal and fetal blood do not normally mix, and many drugs cross the placenta. It produces hCG, progesterone and estrogen. The placenta does not block all drugs, does not produce most amniotic ...

1. Chorioamnionitis presents with: A. Hypothermia B. Fetal bradycardia only C. Painless bleeding D. Maternal fever, fetal tachycardia, uterine tenderness and foul-smelling amniotic fluid Correct Answer: D. Maternal fever, fetal tachycardia, uterine tenderness and foul-smelling amniotic fluid Rationale: Infection of the membranes requires antibiotics and often expedited delivery. Prolonged rupture increases risk. Infection causes fever rather than hypothermia and fetal tachycardia rather ...

1. Monozygotic (identical) twins develop from: A. Two separate ova fertilized by two sperm B. One ovum fertilized by two sperm C. One fertilized ovum that splits D. Two ova from different cycles Correct Answer: C. One fertilized ovum that splits Rationale: Identical twins share genetic material. Dizygotic twins come from two ova and are more common with fertility treatment. Two separate ova produce fraternal twins, and fertilization by two sperm does not produce healthy identical twins. ...

Stage 2 hypertension according to ACC/AHA guidelines is a blood pressure of: A. 120 to 129 systolic with diastolic below 80 B. 140/90 mm Hg or higher C. 130 to 139 or 80 to 89 D. Below 120/80 Correct Answer: B. 140/90 mm Hg or higher Rationale: Stage 1 is 130 to 139/80 to 89, elevated is 120 to 129 with diastolic under 80 and normal is below 120/80. Stage 2 usually requires medication. 2. Beta blockers such as metoprolol should be held if the client has

1. Separation anxiety is most pronounced in: A. Newborns B. Adolescents C. School-age children D. Older infants and toddlers (about 6-30 months) Correct Answer: D. Older infants and toddlers (about 6-30 months) Rationale: Protest, despair and detachment phases occur during separation, so encouraging parental presence and rooming-in reduces distress. Newborns have not yet formed this attachment response, and school-age children and adolescents tolerate separation better because they under...

1. After kidney transplant, a child must take: A. Lifelong immunosuppressive medications B. Antibiotics for 1 week only C. No medications D. Insulin Correct Answer: A. Lifelong immunosuppressive medications Rationale: Lifelong immunosuppression keeps the immune system from attacking the new kidney, so adherence prevents rejection. One week of antibiotics, no medications or insulin will not prevent rejection, which requires daily immunosuppression. 2. Hypospadias is: A. A urethral openi...

1. Object permanence, the understanding that objects exist when out of sight, typically develops around: A. 2 months B. 3 years C. 8-9 months D. 6 years Correct Answer: C. 8-9 months Rationale: It explains why separation anxiety intensifies in later infancy: the infant knows the parent exists but is not present. At 2 months infants do not search for hidden objects, and by 3 to 6 years the concept is long established. 2. Child life specialists help by: A. Prescribing medication B. Usi...

1. The leading cause of death in children ages 1-4 in the US includes: A. Cancer only B. Heart disease C. Unintentional injuries such as drowning D. Infections only Correct Answer: C. Unintentional injuries such as drowning Rationale: Injury prevention is a major focus of anticipatory guidance. Cancer, heart disease and infections cause fewer deaths in this age group than drowning, motor vehicle crashes and other injuries. 2. Safe sleep recommendations for infants include: A. Placing in...

1. Pain management after orthopedic surgery in children includes: A. Withholding opioids B. Only distraction C. Scheduled analgesics and nonpharmacologic measures D. Waiting for the child to ask Correct Answer: C. Scheduled analgesics and nonpharmacologic measures Rationale: Children may not report pain consistently. Withholding opioids, relying only on distraction or waiting for the child to ask leaves pain undertreated. 2. Sports injury prevention for adolescents includes: A. Training...

1. Mindfulness-based therapies help clients by: A. Increasing nonjudgmental awareness of the present moment B. Suppressing thoughts C. Avoiding feelings D. Replacing medications entirely Correct Answer: A. Increasing nonjudgmental awareness of the present moment Rationale: Mindfulness reduces rumination and relapse in depression. Suppressing or avoiding thoughts tends to increase distress, while mindful awareness reduces rumination. 2. Incarceration of people with mental illness is a con...

Galen NSG 3450 Nursing Practice - Mental Health: Practice Test 2 (Units 8-13) - Questions with Correct Answers 100 questions 1. Tobacco cessation medications include: A. Nicotine replacement therapy, varenicline and bupropion B. Benzodiazepines C. Antipsychotics D. Lithium Correct Answer: A. Nicotine replacement therapy, varenicline and bupropion Rationale: Combination NRT is effective. Benzodiazepines and antipsychotics are not cessation aids. Combining counseling with medication give...

1. Mental health is best described as: A. A state of well-being in which a person can cope with normal stresses, work productively and contribute to the community B. The complete absence of any psychiatric symptoms C. Always feeling happy D. Never needing support from others Correct Answer: A. A state of well-being in which a person can cope with normal stresses, work productively and contribute to the community Rationale: This WHO-based definition emphasizes coping and functioning rathe...

1. Maslow's hierarchy suggests that a client in acute psychosis who is not eating should first have: A. Physiological needs, such as nutrition and safety, met B. Self-actualization goals addressed C. Esteem needs addressed through group therapy D. Insight-oriented therapy Correct Answer: A. Physiological needs, such as nutrition and safety, met Rationale: Basic physiological and safety needs come first. Higher needs such as esteem and self-actualization become relevant once survival n...

1. The AIMS (Abnormal Involuntary Movement Scale) is used to monitor: A. Depression B. Tardive dyskinesia C. Anxiety D. Cognition Correct Answer: B. Tardive dyskinesia Rationale: Tardive dyskinesia can be permanent. Depression, anxiety and cognition are measured with other tools. 2. SNRIs such as venlafaxine and duloxetine may cause: A. Hypotension only B. Weight loss always C. Increased blood pressure D. Bradycardia Correct Answer: C. Increased blood pressure Rationale: Monitor BP...