PMHNP ANCC Review Questions
The purpose of the American Nurses Association's Psychiatric-Mental Health
Nursing:
Scope and Standards of Practice is to
a. Define the role and actions for the NP
b. Establish the legal authority for the prescription of psychotropic medications
c. Define the legal statutes of the role of the PMHNP
d. Define the differences between the physician role and the NP role
A. The ANAs Psych-Mental Health Nursing Scope and Standards of Practice defines
the role and actions of the nurse practitioner.
D. Information reduces incidence of disease.
Primary prevention care practices are an essential aspect of the PMHNP role. Which of
the following is the best example of a primary prevention care strategy for community
behavioral health?
a. Aftercare program for chronically mentally ill clients recently discharged from the
hospital
b. Court-ordered counseling for abusive parents
c. 24-hour crisis hotlines
d. Parenting skills classes for pregnant adolescents
The trend in legal rulings on cases involving mental illness over the past 25 years
has been to
a. Encourage juries to find defendants not guilty by reason of insanity
b. Protect the person's freedoms or rights when he or she is committed to a
mental hospital
c. Place increasing trust in mental health professionals to make good and ethical
decisions
d. Decrease the "red tape" associated with commitments so that commitments
are faster and easier
B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric
clients.
Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic
symptoms, refuses to take any of his ordered medication because he believes
"Jesus Christ told me I am the prophet and must fast for a year." Your actions
should be based on your knowledge of which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare decisions and,
therefore, the nurse's best clinical judgment should guide actions
C. As with any client, psychiatric clients can refuse treatment unless a legal process
resulting in involuntary commitment or mandatory court order for treatment has been
obtained.
Which of the following statements best reflects the difference between the nurse-
client (N-C) relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the client's needs.
,b. Goals in the N-C relationship are deliberately left vague and unspoken so that
the client can work on any issue.
c. In the N-C relationship, the nurse is solely responsible for making the
relationship work.
d. In the N-C relationship, there is no place for social interaction.
A. Social relationships are mutual interpersonal relationships in which the needs of both
parties are addressed. The N-C relationship is most concerned with meeting the needs
of the client.
A community has an unusually high incidence of depression and drug use among
the teenage population. The public health nurses decide to address this problem,
in part, by modifying the environment and strengthening the capacities of
families to prevent the development of new cases of depression and drug use.
What is this is an example of?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Protective factorial prevention
A. This action focuses on interventions designed to reduce the incidence of new cases
of disease.
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she
wishes to leave because "this place can't help me." The best nursing action that
reflects the legal right of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further assessment
c. Allow the client to leave but have her sign forms stating she is leaving against
medical advice
d. Immediately start the paperwork to commit the client and to allow you to treat
her against her wishes
B. Almost every state allows for a brief for a period detainment to assess a client for
dangerousness to self or others before allowing the client to leave a hospital setting,
even if the admission was voluntary.
In forming a therapeutic relationship with clients, the PMHNP must consider
developing many characteristics that are known to be helpful in relationship-
building. Which of the following is an essential part of building a therapeutic
relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment
C. Authenticity. Being genuine, honest, and respectful are essential elements in
establishing a working relationship with any client. Like-mindedness is not a part of the
therapeutic relationship. Although an important aspect of the PMHNP role, collecting a
family history and accuracy in assessment does not in and of itself facilitate relationship
building.
According to the DSM-5, which of the following is true? (Ch. 3)
a. A mental disorder is equivalent to the need for treatment.
, b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a mental disorder.
D. All DSM-5 disorders need to be made taking a person's culture into account. A
cultural expression of a response to grief, loss, or stress is not considered a DSM-5
diagnosis.
Mrs. French has been in individual therapy for 3 months. She has shown much
growth and improvement in her functioning and insight and is to discontinue
services within the next few weeks. In the next session, after you discuss service
termination, she suddenly begins to demonstrate the original symptoms that had
brought her to treatment initially. She is now hesitant to discharge, wants to
continue services, and is displaying an increase in regressive defense
mechanisms. What is the best explanation for Ms. French's behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health symptoms
c. A sign of normal resistance to termination seen in the termination phase of
therapy
d. A sign of pathological attachment to the therapist that must be addressed
C. Clients frequently display resistance and regression at the termination of a
meaningful therapeutic process. The PMHNP is responsible for planning an effective
termination and monitoring clients during the termination period.
A client is displaying low self-esteem, poor self-control, self-doubt, and a high
level of dependency. These behaviors indicate developmental failure of which of
the following stages of development:
a. Infancy
b. Early childhood
c. Late childhood
d. School age
B. These signs indicate developmental failure of early childhood.
Mr. Thompson has been forgetful lately, for example, forgetting where he has
placed his keys or what time appointments are scheduled, and he has stated that
he thinks these are just random behaviors that have no particular meaning.
Which Freudian-based psychodynamic principle assumes that all behavior and
actions are purposeful?
a. Pleasure principle
b. Psychic determinism principle
c. Reality principle
d. Unconsciousness principle
B. The psychic determinism principle states that all behavior has purpose and meaning,
often unconscious in nature, and that no behaviors occur randomly or by coincidence.
An example of a mature, healthy defense mechanism is
a. Denial
b. Rationalization
c. Repression
d. Suppression
The purpose of the American Nurses Association's Psychiatric-Mental Health
Nursing:
Scope and Standards of Practice is to
a. Define the role and actions for the NP
b. Establish the legal authority for the prescription of psychotropic medications
c. Define the legal statutes of the role of the PMHNP
d. Define the differences between the physician role and the NP role
A. The ANAs Psych-Mental Health Nursing Scope and Standards of Practice defines
the role and actions of the nurse practitioner.
D. Information reduces incidence of disease.
Primary prevention care practices are an essential aspect of the PMHNP role. Which of
the following is the best example of a primary prevention care strategy for community
behavioral health?
a. Aftercare program for chronically mentally ill clients recently discharged from the
hospital
b. Court-ordered counseling for abusive parents
c. 24-hour crisis hotlines
d. Parenting skills classes for pregnant adolescents
The trend in legal rulings on cases involving mental illness over the past 25 years
has been to
a. Encourage juries to find defendants not guilty by reason of insanity
b. Protect the person's freedoms or rights when he or she is committed to a
mental hospital
c. Place increasing trust in mental health professionals to make good and ethical
decisions
d. Decrease the "red tape" associated with commitments so that commitments
are faster and easier
B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric
clients.
Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic
symptoms, refuses to take any of his ordered medication because he believes
"Jesus Christ told me I am the prophet and must fast for a year." Your actions
should be based on your knowledge of which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare decisions and,
therefore, the nurse's best clinical judgment should guide actions
C. As with any client, psychiatric clients can refuse treatment unless a legal process
resulting in involuntary commitment or mandatory court order for treatment has been
obtained.
Which of the following statements best reflects the difference between the nurse-
client (N-C) relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the client's needs.
,b. Goals in the N-C relationship are deliberately left vague and unspoken so that
the client can work on any issue.
c. In the N-C relationship, the nurse is solely responsible for making the
relationship work.
d. In the N-C relationship, there is no place for social interaction.
A. Social relationships are mutual interpersonal relationships in which the needs of both
parties are addressed. The N-C relationship is most concerned with meeting the needs
of the client.
A community has an unusually high incidence of depression and drug use among
the teenage population. The public health nurses decide to address this problem,
in part, by modifying the environment and strengthening the capacities of
families to prevent the development of new cases of depression and drug use.
What is this is an example of?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Protective factorial prevention
A. This action focuses on interventions designed to reduce the incidence of new cases
of disease.
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she
wishes to leave because "this place can't help me." The best nursing action that
reflects the legal right of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further assessment
c. Allow the client to leave but have her sign forms stating she is leaving against
medical advice
d. Immediately start the paperwork to commit the client and to allow you to treat
her against her wishes
B. Almost every state allows for a brief for a period detainment to assess a client for
dangerousness to self or others before allowing the client to leave a hospital setting,
even if the admission was voluntary.
In forming a therapeutic relationship with clients, the PMHNP must consider
developing many characteristics that are known to be helpful in relationship-
building. Which of the following is an essential part of building a therapeutic
relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment
C. Authenticity. Being genuine, honest, and respectful are essential elements in
establishing a working relationship with any client. Like-mindedness is not a part of the
therapeutic relationship. Although an important aspect of the PMHNP role, collecting a
family history and accuracy in assessment does not in and of itself facilitate relationship
building.
According to the DSM-5, which of the following is true? (Ch. 3)
a. A mental disorder is equivalent to the need for treatment.
, b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a mental disorder.
D. All DSM-5 disorders need to be made taking a person's culture into account. A
cultural expression of a response to grief, loss, or stress is not considered a DSM-5
diagnosis.
Mrs. French has been in individual therapy for 3 months. She has shown much
growth and improvement in her functioning and insight and is to discontinue
services within the next few weeks. In the next session, after you discuss service
termination, she suddenly begins to demonstrate the original symptoms that had
brought her to treatment initially. She is now hesitant to discharge, wants to
continue services, and is displaying an increase in regressive defense
mechanisms. What is the best explanation for Ms. French's behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health symptoms
c. A sign of normal resistance to termination seen in the termination phase of
therapy
d. A sign of pathological attachment to the therapist that must be addressed
C. Clients frequently display resistance and regression at the termination of a
meaningful therapeutic process. The PMHNP is responsible for planning an effective
termination and monitoring clients during the termination period.
A client is displaying low self-esteem, poor self-control, self-doubt, and a high
level of dependency. These behaviors indicate developmental failure of which of
the following stages of development:
a. Infancy
b. Early childhood
c. Late childhood
d. School age
B. These signs indicate developmental failure of early childhood.
Mr. Thompson has been forgetful lately, for example, forgetting where he has
placed his keys or what time appointments are scheduled, and he has stated that
he thinks these are just random behaviors that have no particular meaning.
Which Freudian-based psychodynamic principle assumes that all behavior and
actions are purposeful?
a. Pleasure principle
b. Psychic determinism principle
c. Reality principle
d. Unconsciousness principle
B. The psychic determinism principle states that all behavior has purpose and meaning,
often unconscious in nature, and that no behaviors occur randomly or by coincidence.
An example of a mature, healthy defense mechanism is
a. Denial
b. Rationalization
c. Repression
d. Suppression
