ANCC 25 Practice Questions fully solved.

A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical examination is unremarkable. Laboratory results are within normal limits except for a markedly elevated alkaline phosphatase level. The psychiatric-mental health nurse practitioner: a) interprets the findings as normally occurring during a rapid adolescent growth spurt. b) obtains a rheumatoid profile because elevated alkaline phosphatase is a sign of early rheumatic fever. c) orders a repeat blood test. d) suspects that the patient has acute pancreatitis. A. interprets the findings as normally occurring during a rapid adolescent growth spurt. Laboratory findings for a patient with an alcohol use disorder indicate increased liver function values and: a) a decreased mean corpuscular volume (MCV) and normal triglyceride levels. b) elevated potassium and chloride levels. c) increased MCV and elevated triglyceride levels. d) increased urine and serum creatinine levels. C. increased MCV and elevated triglyceride levels. A new patient arrives at the office for treatment for depression. The patient reports taking simvastatin (Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatric-mental health nurse practitioner eliminates fluoxetine (Prozac), based on the knowledge that the combination can lead to increased plasma levels of the statin, resulting in an increased risk of muscle damage and rhabdomyolysis. The nurse practitioner's reason is that: a) both medications are CYP450 3A4 inhibitors. b) both medications are CYP450 3A4 substrates. c) one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inducer. d) one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor. D. one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor. A 28-year-old patient who is psychotic arrives at the clinic with family members but refuses to meet if the family members are present. The psychiatric-mental health nurse practitioner: a) allows the family members to stay for the appointment. b) asks the family members and the patient to leave. c) asks the family members to leave for the appointment. d) speaks with the family members after the appointment. C. asks the family members to leave for the appointment. The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement at a community mental health clinic. The effective strategy for evaluating the clinic's services is to: a) analyze the data from epidemiological studies. b) conduct a root cause analysis. c) interview patient families. d) use a survey to elicit patient satisfaction responses. D. a survey to elicit patient satisfaction responses. The psychiatric-mental health nurse practitioner evaluates a new adult patient via telemedicine. The patient has questions about a new medication that he or she recently started. The nurse practitioner decides to provide psychoeducation and to: a) e-mail drug information and resources. b) encourage the patient to seek information on the internet. c) have a phone conference with a family member. d) refer patient to a local primary care provider. A. e-mail drug information and resources. Any court of law that evaluates the standards of care provided by a psychiatric-mental health nurse practitioner: a) compares the actions to the standard of care provided by a psychiatrist. b) considers what a reasonably prudent health care provider would do. c) evaluates patient satisfaction data. d) reviews the nurse practitioner's charts for similar patients. B. considers what a reasonably prudent health care provider would do. The psychiatric-mental health nurse practitioner and a team of local mental health professionals are asked to provide crisis counseling service, after a gunman recently took a class hostage at a local elementary school, wounded several students, and then shot himself. In preparing for this assignment, the nurse practitioner recognizes that: a) a child's developmental stage will influence his or her response to catastrophic stress. b) a child's lack of an emotional response to a catastrophic event is a predictor of negative long-term consequences. c) it is necessary for the child's guardian to be present. d) the meaning of the event is more important to the child than whether he or she suffered physical harm. A. a child's developmental stage will influence his or her response to catastrophic stress. Which community-based program is a tertiary level intervention? a) Educational sessions at the local community mental health center. b) National Association of Mental Illness meetings that provide education and support. c) Partial hospitalization program that provides intensive group therapy for rehabilitation. d) Twelve-step organization support meetings, such as Alcoholics Anonymous. C. Partial hospitalization program that provides intensive group therapy for rehabilitation. A 32-year-old female patient informs the psychiatric-mental health nurse practitioner that she is three months pregnant. She has been stable on fluoxetine (Prozac) for the last two years. The patient asks whether she may safely continue this medication during her pregnancy. The nurse practitioner responds: a) "Cognitive-behavioral therapy has proven to be successful during pregnancy with no risk to the fetus, so let's discontinue your Prozac." b) "Let's review the risks and benefits of continuing or discontinuing Prozac for you and your baby." c) "Prozac is a category B drug, which means that it's safe for you to continue on this medication during your pregnancy." d) "This medication is unsafe for your baby, so we'll wean you off this medication during your pregnancy." B. "Let's review the risks and benefits of continuing or discontinuing Prozac for you and your baby." Established clinical guidelines suggest that suicidality is decreased by treating patients who have borderline personality disorder with: a) eye movement desensitization reprocessing. b) cognitive-behavioral therapy. c) dialectical behavioral therapy. d) interpersonal therapy. C. dialectical behavioral therapy. A six-year-old patient with autistic spectrum disorder has not responded to six months of psychosocial interventions and continues to demonstrate aggressive tendencies toward a younger sibling. The psychiatric-mental health nurse practitioner prescribes: a) carbamazepine (Tegretol) 200 mg once a day. b) haloperidol (Haldol) 2 mg once a day. c) risperidone (Risperdal) 0.25 mg once a day. d) venlafaxine ER (Effexor XR) 37.5 mg once a day.) C. risperidone (Risperdal) 0.25 mg once a day. The psychiatric-mental health nurse practitioner working in a crisis stabilization unit evaluates a patient verbalizing suicidal thoughts after being sexually assaulted. Before processing through the traumatic event, the nurse practitioner first attempts to: a) provide an environment of safety. b) incorporate psychoeducation to address emotional dysregulation. c) promote cultivation of coping strategies to enhance distress tolerance. d) provide intense psychotherapy. A. provide an environment of safety. The psychiatric-mental health nurse practitioner uses a cognitive-behavioral approach to help a patient address self-defeating behaviors. After identifying the stressor that causes the inappropriate behavior, the initial strategy is to explore: a) alternative positive responses to the stressor. b) negative consequences of the responses to the stressor. c) possible outcomes of alternative responses. d) rational and irrational beliefs about the stressor. D. rational and irrational beliefs about the stressor.