ANCC PMHNP PSYCH-MENTAL HEALTH NP EXAM
LATEST 2022-2024 (TEST 1 ,2,& 3 ) QS & ANS PLUS
RATIONALE (TEST 1-3 LATEST VERSIONS 100 QS
AND ANS EACH) | NEW VERSION ALREADY GRADED
A
TEST 1
Your patient, whose wife died a few months ago, appears to be very unkempt and
apathetic. Although several months have passed since his wife's death he has not
progressed at all through his grieving. You assess this condition as which of the
following?
disenfranchised grief
panic disorder
complicated grief
physiologic grief - -Correct Answer:
complicated grief
RATIONALE: A person has uncomplicated grief when he or she has normal physical,
psychological, cognitive and spiritual responses to the death of a significant other. But
when the person shows persistent maladaptive behaviors such as not taking care of
personal hygiene and/or appearance and does not progress through the mourning
process, this is complicated grief.
If a patient has had a myocardial infarction, which of the following atypical
antidepressants should not be prescribed within the recovery phase?
Trazodone
Duloxetine
Bupropion
Desvenlafaxine - -Correct Answer:
Trazodone
,RATIONALE: If a patient has had a myocardial infarction, during the recovery phase,
the patient should not be prescribed this medication. Trazodone (Desyrel) can cause
the patient to develop orthostatic hypotension and priapism.
To get your teaching ideas and concepts across to a poor reader which of the following
would be most appropriate?
Use longer sentences.
Use abstract concepts.
Discourage questioning.
Use examples and review. - -Correct Answer:
Use examples and review.
RATIONALE: To get the idea across to a poor reader use examples and review. The
other choices are not helpful. You should use short sentences and easy to read layouts;
be concrete rather than abstract; and teach them how to ask questions about their
health. Also, tell context first and use visual, use common words and examples, and
explain meaning.
A 21-year old woman presents with complaints of milky discharge from her breasts. She
doesn't have any other symptoms and is not pregnant, nor has been before. She tells
the nurse about each medication that she takes. Which of these drugs may be
implicated as the cause of the symptom?
aspirin
Lamotrigine
Risperidone
sertraline - -Correct Answer:
Risperidone
RATIONALE: Risperidone can cause the greatest prolactin elevation among atypical
psychotics. A milky white discharge known as galactorrhea could be a sign of an
underlying condition. The fact that the woman takes Risperidone, an atypical
antipsychotic, would likely point to the cause and should be switched with one less likely
to have that same side effect.
Which of the following would be considered one of the main things that is responsible
for about 2/3 of psychiatric hospital readmissions?
Not sufficient care.
Medication noncompliance
Biophysical assessments
None of the above - -Correct Answer:
Medication noncompliance
RATIONALE: Medication noncompliance is a major problem with the psychiatric mental
health patients. The home health nurses assists by helping the patients
to see the relationship between their compliance with their medication regimen and
control of their symptoms.
,Which of the following would be considered an important form of communication that
can help to promote consistency in the care of the patient at the
same time that it justifies their stay in the hospital?
Review of care.
Documentation
Verbal reporting
None of the above - -Correct Answer:
Documentation
RATIONALE: The other 3 options above are incorrect.
One of the most important aspects of nursing is documentation. Documentation can
promote consistency in the care of the patient and is also used to help justify the patient
remaining in the hospital.
Effects of an overdose of LSD (Lysergic acid diethylamide) can include all of the
following except?
Vomiting
Respiratory failure
Hypertensive crisis
Seizures - -Correct Answer:
Hypertensive crisis
RATIONALE: Hypertensive crisis would be considered a symptom of PCP overdose.
Vomiting, respiratory failure and seizures would be considered an effect
of LSD overdose.
Symptoms of serotonin syndrome include all of the following EXCEPT:
insomnia
nausea
loss of coordination
sweating or shivering with goose bumps - -Correct Answer:
nausea
Symptoms of serotonin syndrome can present in patients that have drug combinations
that are contraindicated. They can vary from restlessness and agitation to tremors,
chills, headaches, and insomnia as well as loss of coordination. Nausea has not been
implicated in serotonin syndrome.
What is the rate of suicide attempts for patients having dissociative identity disorder?
30%
45%
70%
60% - -Correct Answer:
70%
, RATIONALE: People with dissociative identity disorder have one of the highest risks for
suicide. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-
5),more than 70% of outpatients with DID have attempted suicide, and multiple suicide
attempts are common.
Of the following, which would not be considered a phase of schizophrenia treatment?
Maintenance
Acute
Cognitive
Stabilization - -Correct Answer:
Cognitive
RATIONALE: Cognitive is not one of the three phases of schizophrenia treatment.
The three phases are:
Phase 1: acute
Phase 2: stabilization
Phase 3: maintenance
The patient should be monitored for effects of psychotropic medications which can
impact cardiac rhythms. Which of the following could be a potential
cardiac side effect?
A prolonged QT interval
Narrowing of the QRS
Both A and B
None of the above - -Correct Answer:
A prolonged QT interval
RATIONALE: With antipsychotic drugs, the triclyclic action can cause problems. These
medications can cause a widening of the QRS or a prolonged QT interval.
This is a measure of the ventricular repolarization.
Sullivan described three developmental cognitive modes of experience and believed
that mental disorders are related to the persistence of one of the early modes. The
mode that begins in early childhood as the child begins to connect experiences in
sequence is which of the following?
prototaxic mode
parataxic mode
syntaxic mode
composite mode - -Correct Answer:
parataxic mode
RATIONALE: The parataxic mode begins in early childhood. The child may not make
logical sense of the experiences and may see them as coincidence or chance events.
The child seeks to relieve anxiety by repeating familiar experiences, although he or she
may not understand what he or she is doing.
LATEST 2022-2024 (TEST 1 ,2,& 3 ) QS & ANS PLUS
RATIONALE (TEST 1-3 LATEST VERSIONS 100 QS
AND ANS EACH) | NEW VERSION ALREADY GRADED
A
TEST 1
Your patient, whose wife died a few months ago, appears to be very unkempt and
apathetic. Although several months have passed since his wife's death he has not
progressed at all through his grieving. You assess this condition as which of the
following?
disenfranchised grief
panic disorder
complicated grief
physiologic grief - -Correct Answer:
complicated grief
RATIONALE: A person has uncomplicated grief when he or she has normal physical,
psychological, cognitive and spiritual responses to the death of a significant other. But
when the person shows persistent maladaptive behaviors such as not taking care of
personal hygiene and/or appearance and does not progress through the mourning
process, this is complicated grief.
If a patient has had a myocardial infarction, which of the following atypical
antidepressants should not be prescribed within the recovery phase?
Trazodone
Duloxetine
Bupropion
Desvenlafaxine - -Correct Answer:
Trazodone
,RATIONALE: If a patient has had a myocardial infarction, during the recovery phase,
the patient should not be prescribed this medication. Trazodone (Desyrel) can cause
the patient to develop orthostatic hypotension and priapism.
To get your teaching ideas and concepts across to a poor reader which of the following
would be most appropriate?
Use longer sentences.
Use abstract concepts.
Discourage questioning.
Use examples and review. - -Correct Answer:
Use examples and review.
RATIONALE: To get the idea across to a poor reader use examples and review. The
other choices are not helpful. You should use short sentences and easy to read layouts;
be concrete rather than abstract; and teach them how to ask questions about their
health. Also, tell context first and use visual, use common words and examples, and
explain meaning.
A 21-year old woman presents with complaints of milky discharge from her breasts. She
doesn't have any other symptoms and is not pregnant, nor has been before. She tells
the nurse about each medication that she takes. Which of these drugs may be
implicated as the cause of the symptom?
aspirin
Lamotrigine
Risperidone
sertraline - -Correct Answer:
Risperidone
RATIONALE: Risperidone can cause the greatest prolactin elevation among atypical
psychotics. A milky white discharge known as galactorrhea could be a sign of an
underlying condition. The fact that the woman takes Risperidone, an atypical
antipsychotic, would likely point to the cause and should be switched with one less likely
to have that same side effect.
Which of the following would be considered one of the main things that is responsible
for about 2/3 of psychiatric hospital readmissions?
Not sufficient care.
Medication noncompliance
Biophysical assessments
None of the above - -Correct Answer:
Medication noncompliance
RATIONALE: Medication noncompliance is a major problem with the psychiatric mental
health patients. The home health nurses assists by helping the patients
to see the relationship between their compliance with their medication regimen and
control of their symptoms.
,Which of the following would be considered an important form of communication that
can help to promote consistency in the care of the patient at the
same time that it justifies their stay in the hospital?
Review of care.
Documentation
Verbal reporting
None of the above - -Correct Answer:
Documentation
RATIONALE: The other 3 options above are incorrect.
One of the most important aspects of nursing is documentation. Documentation can
promote consistency in the care of the patient and is also used to help justify the patient
remaining in the hospital.
Effects of an overdose of LSD (Lysergic acid diethylamide) can include all of the
following except?
Vomiting
Respiratory failure
Hypertensive crisis
Seizures - -Correct Answer:
Hypertensive crisis
RATIONALE: Hypertensive crisis would be considered a symptom of PCP overdose.
Vomiting, respiratory failure and seizures would be considered an effect
of LSD overdose.
Symptoms of serotonin syndrome include all of the following EXCEPT:
insomnia
nausea
loss of coordination
sweating or shivering with goose bumps - -Correct Answer:
nausea
Symptoms of serotonin syndrome can present in patients that have drug combinations
that are contraindicated. They can vary from restlessness and agitation to tremors,
chills, headaches, and insomnia as well as loss of coordination. Nausea has not been
implicated in serotonin syndrome.
What is the rate of suicide attempts for patients having dissociative identity disorder?
30%
45%
70%
60% - -Correct Answer:
70%
, RATIONALE: People with dissociative identity disorder have one of the highest risks for
suicide. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-
5),more than 70% of outpatients with DID have attempted suicide, and multiple suicide
attempts are common.
Of the following, which would not be considered a phase of schizophrenia treatment?
Maintenance
Acute
Cognitive
Stabilization - -Correct Answer:
Cognitive
RATIONALE: Cognitive is not one of the three phases of schizophrenia treatment.
The three phases are:
Phase 1: acute
Phase 2: stabilization
Phase 3: maintenance
The patient should be monitored for effects of psychotropic medications which can
impact cardiac rhythms. Which of the following could be a potential
cardiac side effect?
A prolonged QT interval
Narrowing of the QRS
Both A and B
None of the above - -Correct Answer:
A prolonged QT interval
RATIONALE: With antipsychotic drugs, the triclyclic action can cause problems. These
medications can cause a widening of the QRS or a prolonged QT interval.
This is a measure of the ventricular repolarization.
Sullivan described three developmental cognitive modes of experience and believed
that mental disorders are related to the persistence of one of the early modes. The
mode that begins in early childhood as the child begins to connect experiences in
sequence is which of the following?
prototaxic mode
parataxic mode
syntaxic mode
composite mode - -Correct Answer:
parataxic mode
RATIONALE: The parataxic mode begins in early childhood. The child may not make
logical sense of the experiences and may see them as coincidence or chance events.
The child seeks to relieve anxiety by repeating familiar experiences, although he or she
may not understand what he or she is doing.
