ANCC – PMHNP Sample Test
Questions And Answers
A patient with borderline personality disorder experiences intense anxiety when an adult
psychiatric and mental health nurse practitioner goes on vacation. The best explanation
for this reaction is that the patient:
A. has failed to develop clear ego boundaries.
B. has failed to master object constancy.
C. is employing primitive idealization.
D. is employing projective identification. - Answer B. has failed to master object
constancy
2. A patient has been taking escitalopram (Lexapro) 10 mg daily for four weeks. Initially,
the patient reported depression and suicidal thoughts. The patient's sleep, appetite,
energy, and appearance have now begun to improve. Which statement applies to this
patient?
A. The medication should be discontinued.
B. The medication should be increased.
C. The patient's risk for suicide is not a concern.
D. The patient's suicide potential is increased. - Answer D. The patient's suicide
potential is increased.
3. Which behavior reflects existentially oriented therapy?
A. Attempting to understand a patient's subjective world
B. Challenging a patient's irrational beliefs
C. Developing specific plans for change
D. Establishing general group goals - Answer A. Attempting to understand a patient's
subjective world
4. Serving as a member on a crisis team, an adult psychiatric and mental health nurse
practitioner provides crisis intervention to the survivors of a plane crash. Forty-eight
hours after the accident, the survivors describe vivid flashbacks, startle reactions, and
disrupted sleep patterns. The nurse practitioner responds by:
A. advising the survivors to consider using a hypnotic medication for a brief period.
B. educating the survivors about prodromal symptoms of posttraumatic stress disorder.
C. encouraging the survivors to rest during the day.
D. suggesting that the survivors join a posttrauma support group. - Answer B. educating
the survivors about prodromal symptoms of posttraumatic stress disorder.
, 5. An adult psychiatric and mental health nurse practitioner uses the interpersonal
therapy model with a patient to establish a therapeutic alliance based upon empathy
and trust. The nurse practitioner recognizes the patient's readiness to terminate therapy
when the patient demonstrates:
A. an understanding that leaving a significant other may be painful, but also presents an
opportunity for growth.
B. breathing and muscle relaxation exercises that decrease muscle tension and anxiety.
C. free association, and considers the nurse practitioner's interpretation of the patient's
dreams.
D. new adaptive skills and responses after completing "homework assignments." -
Answer A. an understanding that leaving a significant other may be painful, but also
presents an opportunity for growth.
6. An Hispanic patient informs an adult psychiatric and mental health nurse practitioner
during a wellness visit that he or she occasionally uses hot chili juice to relieve a
"nervous condition." The patient denies any complaints related to this practice. The
nurse practitioner's response is to:
A. actively discourage the patient from continuing this treatment.
B. offer a medication to treat the nervous condition.
C. suggest an alternative food to relieve the nervous condition.
D. view this as a self-care ritual that needs to be preserved. - Answer D. view this as a
self-care ritual that needs to be preserved.
7. Before an older adult patient initiates pharmacotherapy with a medication that is
cleared by the kidneys, an adult psychiatric and mental health nurse practitioner
assesses the patient's:
A. blood urea nitrogen level.
B. creatinine clearance.
C. specific gravity.
D. urinary sediment. - Answer B. creatinine clearance.
8. An adult psychiatric and mental health nurse practitioner uses a cognitive-behavioral
approach to help an adolescent patient change self-defeating behaviors. After
identifying the initial stressor that is causing the inappropriate behavior, the therapeutic
intervention is to identify:
A. alternative positive responses to the stressor.
B. negative consequences of the behavioral response to the stressor.
C. possible outcomes of alternative responses.
D. rational and irrational beliefs about the stressor. - Answer D. rational and irrational
beliefs about the stressor.
9. Which characteristic of fluoxetine (Prozac) provides the greatest degree of safety for
patients who have severe depression?
A. Greater efficacy than tricyclic antidepressants
B. Less potential for drug interaction
C. Less potential for injury with intentional overdose
Questions And Answers
A patient with borderline personality disorder experiences intense anxiety when an adult
psychiatric and mental health nurse practitioner goes on vacation. The best explanation
for this reaction is that the patient:
A. has failed to develop clear ego boundaries.
B. has failed to master object constancy.
C. is employing primitive idealization.
D. is employing projective identification. - Answer B. has failed to master object
constancy
2. A patient has been taking escitalopram (Lexapro) 10 mg daily for four weeks. Initially,
the patient reported depression and suicidal thoughts. The patient's sleep, appetite,
energy, and appearance have now begun to improve. Which statement applies to this
patient?
A. The medication should be discontinued.
B. The medication should be increased.
C. The patient's risk for suicide is not a concern.
D. The patient's suicide potential is increased. - Answer D. The patient's suicide
potential is increased.
3. Which behavior reflects existentially oriented therapy?
A. Attempting to understand a patient's subjective world
B. Challenging a patient's irrational beliefs
C. Developing specific plans for change
D. Establishing general group goals - Answer A. Attempting to understand a patient's
subjective world
4. Serving as a member on a crisis team, an adult psychiatric and mental health nurse
practitioner provides crisis intervention to the survivors of a plane crash. Forty-eight
hours after the accident, the survivors describe vivid flashbacks, startle reactions, and
disrupted sleep patterns. The nurse practitioner responds by:
A. advising the survivors to consider using a hypnotic medication for a brief period.
B. educating the survivors about prodromal symptoms of posttraumatic stress disorder.
C. encouraging the survivors to rest during the day.
D. suggesting that the survivors join a posttrauma support group. - Answer B. educating
the survivors about prodromal symptoms of posttraumatic stress disorder.
, 5. An adult psychiatric and mental health nurse practitioner uses the interpersonal
therapy model with a patient to establish a therapeutic alliance based upon empathy
and trust. The nurse practitioner recognizes the patient's readiness to terminate therapy
when the patient demonstrates:
A. an understanding that leaving a significant other may be painful, but also presents an
opportunity for growth.
B. breathing and muscle relaxation exercises that decrease muscle tension and anxiety.
C. free association, and considers the nurse practitioner's interpretation of the patient's
dreams.
D. new adaptive skills and responses after completing "homework assignments." -
Answer A. an understanding that leaving a significant other may be painful, but also
presents an opportunity for growth.
6. An Hispanic patient informs an adult psychiatric and mental health nurse practitioner
during a wellness visit that he or she occasionally uses hot chili juice to relieve a
"nervous condition." The patient denies any complaints related to this practice. The
nurse practitioner's response is to:
A. actively discourage the patient from continuing this treatment.
B. offer a medication to treat the nervous condition.
C. suggest an alternative food to relieve the nervous condition.
D. view this as a self-care ritual that needs to be preserved. - Answer D. view this as a
self-care ritual that needs to be preserved.
7. Before an older adult patient initiates pharmacotherapy with a medication that is
cleared by the kidneys, an adult psychiatric and mental health nurse practitioner
assesses the patient's:
A. blood urea nitrogen level.
B. creatinine clearance.
C. specific gravity.
D. urinary sediment. - Answer B. creatinine clearance.
8. An adult psychiatric and mental health nurse practitioner uses a cognitive-behavioral
approach to help an adolescent patient change self-defeating behaviors. After
identifying the initial stressor that is causing the inappropriate behavior, the therapeutic
intervention is to identify:
A. alternative positive responses to the stressor.
B. negative consequences of the behavioral response to the stressor.
C. possible outcomes of alternative responses.
D. rational and irrational beliefs about the stressor. - Answer D. rational and irrational
beliefs about the stressor.
9. Which characteristic of fluoxetine (Prozac) provides the greatest degree of safety for
patients who have severe depression?
A. Greater efficacy than tricyclic antidepressants
B. Less potential for drug interaction
C. Less potential for injury with intentional overdose
