ANCC IQ Domain 2: Advanced Practice Skills (49 questions with rationales)
A patient comes into your office inn a full manic episode. This patient has a
diagnosis of Bipolar and Alcohol Use Disorder, moderate. You have a
report from the patient's chemical dependency counselor indicating that
inpatient chemical dependency counseling is needed. Your patient has
been on the fence about inpatient chemical dependency treatment in the
past. You assess the patient and find a strong odor of alcohol, auditory and
visual hallucinations, flight of ideas, lack of sleep for 3 days, suicidal
ideations without a firm plan, and plans to drive to another state to gamble.
The patient's brother who accompanies him corroborates this information.
In order to best treat this patient you:
a. Admit him to the dual diagnosis chemical dependency unit with an order
for the collection of laboratory values.
b. Admit him to the inpatient chemical dependency program.
c. Send the patient home with his brother and a prescription for a new
antipsychotic medication.
d. Admit him to the local psychiatric unit, with an order for the collection of
laboratory values. D
Appraisal of the patient's suicidal ideation, plan, method, intent, and
access to implement plan would be documented in which part of the
standard psychiatric evaluation?
,a. History of Presenting Illness
b. Review of Systems
c. Diagnosis
d. Mental Status Exam D
Violence directed toward women by an intimate partner is a serious health
problem worldwide. Which of the following women has the greatest risk
factors for being the victim of violence?
a. 26 years old, recently separated, Asian American woman living in
Boston, Massachusetts
b. 42 years old, divorced, Caucasian woman dating a recently divorced man
in Denver, Colorado
c. 17 years old, single, Native American woman living with employed
boyfriend in Galena, Alaska
d. 35 years old, pregnant, African American woman living with her husband
in suburb of Dallas, Texas C
Which of the following statements would be most likely to be effective in
changing sexual behavior when counseling a sexually active 15-year-old
adolescent girl?
a. Always use condoms when having sex.
b. Use this sample condom
c. Require your partner to use a condom
d. Always carry condoms in your purse. B
, A PMHNP is working in an integrated care clinic and his family nurse
practitioner colleague asks for a consult. The family nurse practitioner asks
the PMHNP what antidepressant to start for a patient who has a score of 15
on the PHQ-9. What is the appropriate response?
a. A score of 15 on the PHQ9 indicates moderate depression, so the patient
should be started on a selective serotonin norepinephrine reuptake
inhibitor.
b. A score of 15 on the PHQ9 indicates severe depression, so you should
start a SSRI and an atypical antipsychotic
c. A score of 15 on the PHQ9 indicates moderate depression, so y9ou can
refer the patient to therapy and start an antidepressant.
d. A score of 15 on the PHQ9 indicates possible moderate depression, but a
follow-up interview is required to assess for depression. I can see this
patient today and further assess for depression and the appropriate
treatment. D
A 10-year-old child lost her father to an unexpected heart attack. Normally
confident, sociable and an excellent student, her teachers and mother
report that she has withdrawn, become disinterested in schoolmates and
schoolwork, and easily becomes tearful if anyone mentions her father.
What non-pharmacological intervention would be most helpful at this time
to facilitate her grieving and loss?
a. Bibliotherapy
A patient comes into your office inn a full manic episode. This patient has a
diagnosis of Bipolar and Alcohol Use Disorder, moderate. You have a
report from the patient's chemical dependency counselor indicating that
inpatient chemical dependency counseling is needed. Your patient has
been on the fence about inpatient chemical dependency treatment in the
past. You assess the patient and find a strong odor of alcohol, auditory and
visual hallucinations, flight of ideas, lack of sleep for 3 days, suicidal
ideations without a firm plan, and plans to drive to another state to gamble.
The patient's brother who accompanies him corroborates this information.
In order to best treat this patient you:
a. Admit him to the dual diagnosis chemical dependency unit with an order
for the collection of laboratory values.
b. Admit him to the inpatient chemical dependency program.
c. Send the patient home with his brother and a prescription for a new
antipsychotic medication.
d. Admit him to the local psychiatric unit, with an order for the collection of
laboratory values. D
Appraisal of the patient's suicidal ideation, plan, method, intent, and
access to implement plan would be documented in which part of the
standard psychiatric evaluation?
,a. History of Presenting Illness
b. Review of Systems
c. Diagnosis
d. Mental Status Exam D
Violence directed toward women by an intimate partner is a serious health
problem worldwide. Which of the following women has the greatest risk
factors for being the victim of violence?
a. 26 years old, recently separated, Asian American woman living in
Boston, Massachusetts
b. 42 years old, divorced, Caucasian woman dating a recently divorced man
in Denver, Colorado
c. 17 years old, single, Native American woman living with employed
boyfriend in Galena, Alaska
d. 35 years old, pregnant, African American woman living with her husband
in suburb of Dallas, Texas C
Which of the following statements would be most likely to be effective in
changing sexual behavior when counseling a sexually active 15-year-old
adolescent girl?
a. Always use condoms when having sex.
b. Use this sample condom
c. Require your partner to use a condom
d. Always carry condoms in your purse. B
, A PMHNP is working in an integrated care clinic and his family nurse
practitioner colleague asks for a consult. The family nurse practitioner asks
the PMHNP what antidepressant to start for a patient who has a score of 15
on the PHQ-9. What is the appropriate response?
a. A score of 15 on the PHQ9 indicates moderate depression, so the patient
should be started on a selective serotonin norepinephrine reuptake
inhibitor.
b. A score of 15 on the PHQ9 indicates severe depression, so you should
start a SSRI and an atypical antipsychotic
c. A score of 15 on the PHQ9 indicates moderate depression, so y9ou can
refer the patient to therapy and start an antidepressant.
d. A score of 15 on the PHQ9 indicates possible moderate depression, but a
follow-up interview is required to assess for depression. I can see this
patient today and further assess for depression and the appropriate
treatment. D
A 10-year-old child lost her father to an unexpected heart attack. Normally
confident, sociable and an excellent student, her teachers and mother
report that she has withdrawn, become disinterested in schoolmates and
schoolwork, and easily becomes tearful if anyone mentions her father.
What non-pharmacological intervention would be most helpful at this time
to facilitate her grieving and loss?
a. Bibliotherapy
