2026/2027
NR 668 CEA Exam 2026/2027 Advanced
Test Bank Review with Case Studies, Exam
Strategies, and Practice Quizzes
Question 1:
Which activity best reflects the leadership competency expected of an Advanced
Practice Registered Nurse (APRN)?
A. Modifying treatment plans based on individual patient needs
B. Developing age-appropriate care plans
C. Evaluating the use of seclusion practices
D. Participating in community programs that promote mental health awareness
Correct Answer: D. Participating in community programs that promote mental
health awareness
Rationale:
Leadership competency in APRNs extends beyond direct patient care and includes
influencing population health outcomes and public health initiatives. Participating in
community-focused programs demonstrates advocacy, leadership, and prevention-
oriented thinking. Options A and B reflect clinical competencies, while option C
relates to quality and safety oversight rather than leadership at a broader systems level.
Question 2:
Which requirement legally allows a Psychiatric-Mental Health Nurse Practitioner
(PMHNP) to practice within a state?
A. Graduation from an accredited program
B. Licensure
C. Certification
D. Credentialing
Correct Answer: B. Licensure
Rationale:
Licensure is the legal authority granted by a state that permits a healthcare
professional to practice. Graduation and certification demonstrate competence but do
not grant legal permission to practice independently. Credentialing is an
organizational process used by institutions, not a legal requirement for practice.
Question 3:
,2026/2027
A PMHNP is asked to evaluate patients across the lifespan. Which document should
be consulted to determine if this is legally permissible?
A. Hospital bylaws
B. Collaborating physician agreement
C. Scope of practice guidelines
D. State Nurse Practice Act
Correct Answer: D. State Nurse Practice Act
Rationale:
The Nurse Practice Act defines legal scope, population focus, and practice authority
within a state. While scope of practice guidelines provide general frameworks, the
Nurse Practice Act is the authoritative legal document. Hospital bylaws and physician
collaboration agreements cannot override state law.
Question 4:
The integration of best research evidence with clinical expertise and patient
preferences is known as:
A. Research utilization
B. Quality improvement
C. Evidence-based practice
D. Clinical research
Correct Answer: C. Evidence-based practice
Rationale:
Evidence-based practice (EBP) combines research evidence, clinical expertise, and
patient values to guide decision-making. Research utilization focuses only on
applying findings, while quality improvement evaluates system performance rather
than integrating evidence into care.
Question 5:
A nurse fails to reposition a patient, resulting in a pressure ulcer. This is best
classified as:
A. Battery
B. Malpractice
C. Negligence
D. Assault
Correct Answer: C. Negligence
Rationale:
Negligence involves failure to meet the standard of care, resulting in harm. In this
,2026/2027
case, the nurse omitted a required intervention (repositioning). Battery involves
unwanted physical contact, while malpractice is a broader legal term encompassing
professional negligence.
Question 6:
Which function is NOT the responsibility of an Institutional Review Board (IRB)?
A. Ensuring equitable participant selection
B. Regulating study funding
C. Minimizing risks to participants
D. Monitoring adverse events
Correct Answer: B. Regulating study funding
Rationale:
IRBs are responsible for protecting human subjects, including evaluating risks,
ensuring ethical recruitment, and monitoring safety. They do not control funding
decisions, which are handled by sponsors or institutions.
Question 7:
Recognition of cultural distress syndromes such as khyal attacks should prompt the
clinician to consider:
A. Only anxiety disorders
B. Only trauma-related disorders
C. Only somatic disorders
D. Multiple possible psychiatric diagnoses
Correct Answer: D. Multiple possible psychiatric diagnoses
Rationale:
Cultural syndromes often present with overlapping symptoms across anxiety, trauma,
and somatic disorders. Recognizing cultural context prevents misdiagnosis and
supports accurate formulation. Limiting interpretation to one category may lead to
incomplete care.
Question 8:
Dhat syndrome is most commonly associated with individuals from:
A. East Asia
B. Africa
C. India and Pakistan
D. Europe
, 2026/2027
Correct Answer: C. India and Pakistan
Rationale:
Dhat syndrome is a culturally specific condition associated with beliefs about semen
loss causing weakness and psychological distress. It is primarily reported in South
Asian populations, particularly India and Pakistan.
Question 9:
A patient believes their genitals are shrinking despite reassurance. This is known as:
A. Zar
B. Taijin kyofusho
C. Koro
D. Amok
Correct Answer: C. Koro
Rationale:
Koro is a culture-bound syndrome involving intense anxiety about genital retraction.
It is distinct from other syndromes like amok (violent dissociation) or taijin kyofusho
(social anxiety related to offending others).
Question 10:
Which factor is least likely to influence the therapeutic alliance?
A. Beliefs
B. Religion
C. Gender roles
D. Urban setting
Correct Answer: D. Urban setting
Rationale:
Therapeutic alliance is influenced by cultural beliefs, values, and identity factors.
While environment may affect access to care, it does not directly shape interpersonal
therapeutic dynamics like beliefs and gender roles do.
Question 11:
Which statistical test is used to compare means across three or more groups?
A. t-test
B. Pearson correlation
C. Probability testing
D. ANOVA
NR 668 CEA Exam 2026/2027 Advanced
Test Bank Review with Case Studies, Exam
Strategies, and Practice Quizzes
Question 1:
Which activity best reflects the leadership competency expected of an Advanced
Practice Registered Nurse (APRN)?
A. Modifying treatment plans based on individual patient needs
B. Developing age-appropriate care plans
C. Evaluating the use of seclusion practices
D. Participating in community programs that promote mental health awareness
Correct Answer: D. Participating in community programs that promote mental
health awareness
Rationale:
Leadership competency in APRNs extends beyond direct patient care and includes
influencing population health outcomes and public health initiatives. Participating in
community-focused programs demonstrates advocacy, leadership, and prevention-
oriented thinking. Options A and B reflect clinical competencies, while option C
relates to quality and safety oversight rather than leadership at a broader systems level.
Question 2:
Which requirement legally allows a Psychiatric-Mental Health Nurse Practitioner
(PMHNP) to practice within a state?
A. Graduation from an accredited program
B. Licensure
C. Certification
D. Credentialing
Correct Answer: B. Licensure
Rationale:
Licensure is the legal authority granted by a state that permits a healthcare
professional to practice. Graduation and certification demonstrate competence but do
not grant legal permission to practice independently. Credentialing is an
organizational process used by institutions, not a legal requirement for practice.
Question 3:
,2026/2027
A PMHNP is asked to evaluate patients across the lifespan. Which document should
be consulted to determine if this is legally permissible?
A. Hospital bylaws
B. Collaborating physician agreement
C. Scope of practice guidelines
D. State Nurse Practice Act
Correct Answer: D. State Nurse Practice Act
Rationale:
The Nurse Practice Act defines legal scope, population focus, and practice authority
within a state. While scope of practice guidelines provide general frameworks, the
Nurse Practice Act is the authoritative legal document. Hospital bylaws and physician
collaboration agreements cannot override state law.
Question 4:
The integration of best research evidence with clinical expertise and patient
preferences is known as:
A. Research utilization
B. Quality improvement
C. Evidence-based practice
D. Clinical research
Correct Answer: C. Evidence-based practice
Rationale:
Evidence-based practice (EBP) combines research evidence, clinical expertise, and
patient values to guide decision-making. Research utilization focuses only on
applying findings, while quality improvement evaluates system performance rather
than integrating evidence into care.
Question 5:
A nurse fails to reposition a patient, resulting in a pressure ulcer. This is best
classified as:
A. Battery
B. Malpractice
C. Negligence
D. Assault
Correct Answer: C. Negligence
Rationale:
Negligence involves failure to meet the standard of care, resulting in harm. In this
,2026/2027
case, the nurse omitted a required intervention (repositioning). Battery involves
unwanted physical contact, while malpractice is a broader legal term encompassing
professional negligence.
Question 6:
Which function is NOT the responsibility of an Institutional Review Board (IRB)?
A. Ensuring equitable participant selection
B. Regulating study funding
C. Minimizing risks to participants
D. Monitoring adverse events
Correct Answer: B. Regulating study funding
Rationale:
IRBs are responsible for protecting human subjects, including evaluating risks,
ensuring ethical recruitment, and monitoring safety. They do not control funding
decisions, which are handled by sponsors or institutions.
Question 7:
Recognition of cultural distress syndromes such as khyal attacks should prompt the
clinician to consider:
A. Only anxiety disorders
B. Only trauma-related disorders
C. Only somatic disorders
D. Multiple possible psychiatric diagnoses
Correct Answer: D. Multiple possible psychiatric diagnoses
Rationale:
Cultural syndromes often present with overlapping symptoms across anxiety, trauma,
and somatic disorders. Recognizing cultural context prevents misdiagnosis and
supports accurate formulation. Limiting interpretation to one category may lead to
incomplete care.
Question 8:
Dhat syndrome is most commonly associated with individuals from:
A. East Asia
B. Africa
C. India and Pakistan
D. Europe
, 2026/2027
Correct Answer: C. India and Pakistan
Rationale:
Dhat syndrome is a culturally specific condition associated with beliefs about semen
loss causing weakness and psychological distress. It is primarily reported in South
Asian populations, particularly India and Pakistan.
Question 9:
A patient believes their genitals are shrinking despite reassurance. This is known as:
A. Zar
B. Taijin kyofusho
C. Koro
D. Amok
Correct Answer: C. Koro
Rationale:
Koro is a culture-bound syndrome involving intense anxiety about genital retraction.
It is distinct from other syndromes like amok (violent dissociation) or taijin kyofusho
(social anxiety related to offending others).
Question 10:
Which factor is least likely to influence the therapeutic alliance?
A. Beliefs
B. Religion
C. Gender roles
D. Urban setting
Correct Answer: D. Urban setting
Rationale:
Therapeutic alliance is influenced by cultural beliefs, values, and identity factors.
While environment may affect access to care, it does not directly shape interpersonal
therapeutic dynamics like beliefs and gender roles do.
Question 11:
Which statistical test is used to compare means across three or more groups?
A. t-test
B. Pearson correlation
C. Probability testing
D. ANOVA
