ANCC IQ Domain 2: Advanced
Practice Skills Exam
Questions with Complete
Solutions
When child, adult partner, or elder abuse is suspected, the PMHNP needs to conduct an abuse
assessment screen in privacy, away from the partner, the child's parents or guardians, or the elder
person's relative or companion. Simple, direct questions in a nonjudgmental interview are indicated.
Which of the following would be an appropriate abuse screening question?
a. Within the past year, have you been hit, slapped, kicked or otherwise physically hurt by someone?
b. Within the past year, has anyone ever forced you to do something by threatening you with a gun?
c. Within the past year, have you ever threatened or tried to commit suicide to escape the abuse?
d. Within the past year, has anyone ever threatened to kill you? - Correct Answers: Within the past year,
have you been hit, slapped, kicked or otherwise physically hurt by someone?
Rationale: This response is one of four items on a standardized abuse assessment screen. The other
items are part of a danger assessment that may be used following a positive response to one of the
abuse assessment screening questions.
A patient was started on an antipsychotic medication two weeks ago and is now experiencing the
following symptoms: inability to sit still, pacing, and feelings of restlessness. he does not complain of any
anxiety or being worried about anything in particular. Which of the following rating scales would be the
most appropriate to assess these symptoms?
a. Simpson Angus EPS Scale
b. Barnes Akathisia Rating Scale (BARS)
c. Dyskinesia Identification System Condensed User Scale (DISCUS)
d. Abnormal Involuntary Movement Scale (AIMS) - Correct Answers: Answer: the BARS.
Rationale: The patient is experiencing symptoms consistent with Akathisia. The BARS can be very useful
in systematically assessing patients in identifying akathisia, assess its severity, and monitor change in
symptoms.
,A female client has gradually assumed increasing responsibility for the care of her aging parents. Her
mother was diagnosed with Alzheimer's type dementia three years ago and is increasingly disoriented to
her home surroundings. Her father insists on keeping her mother at home to provide care until she dies.
What is the first priority in counseling this couple and their caretaking adult daughter?
a. Caregiver strain
b. Patient and family education
c. Anticipatory guidance
d. Patient safety - Correct Answers: Answer: D. Patient safety
Although all four are improtant aspects related to care, patient safety must take pririty before the other
three responses. In counseling about safety issues regarding risk for wandering, leaving stove burner on
unattended, slips or falls, the PMHNP can introduce the other areas of education, anticipatory guidance,
and community resources.
A 67-year-old Vietnamese immigrant, who has been a resident in the U.S. for 3 years, comes to your
clinic for an evaluation. Her first language is Vietnamese, but she does speak some English. She has
problems with reading and writing, as she did not finish high school, or earn a GED (General Educational
Development) equivalency. As the PMHNP, what is your priority disparity to address with this patient?
a. Age
b. Health literacy
c. Reading level
d. Race - Correct Answers: B. Health Literacy
Rationale: Adults meeting the following criteria are most liekely to have limited health literacy, which
has been related to health outcomes: one, over age 65 from racial and ethnic groups other than white;
two, recent refugees and immigrants; three, less than a high school degree or GED; four, low income;
and five, non-native speaker of English.
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. Diagnosis
c. Mental Status Exam
d. Review of Systems - Correct Answers: Answer: Mental Status Exam
, Rationale: Current suicidal ideation, plan, method, intent, and access to implement plan is documented
in the Mental Status Exam under the section for thought content.
Which of the following screening tests has high sensitivity and specificity for identifying cognitive
impairment in older adults while requiring the least amount of time to administer in a clinical setting?
a. Dementia Rating Scale
b. Mini-Mental Status Exam
c. Global Deterioration Scale
d. Clock Drawing Test - Correct Answers: The Clock Drawing Test (CDT) is highly correlated with the Mini-
Mental Status Exam (MMSE), the Global Deterioration Scale, and the Dementia Rating Scale, yet takes
minimum amount of time to administer (2-4 minutes). It is well-suited for clinical practice settings to
screen and monitor progression of cognitive decline in older adults.
Which of the following lifestyle factors poses the greatest risk for depression, irritability, liver problems,
and hypertension in a college student?
a. Marijuana use
b. Binge drinking
c. Cocaine use
d. Anabolic steroid use - Correct Answers: Anabolic steroid use poses the greatest risk of the four
lifestyle drug use patterns. Anabolic steroid use is associated with increased irritability and aggression,
euphoria, increased energy, sexual arousal, mood swings, distractibility, forgetfulness, and confusion.
With time, anabolic steroid use is associated with increased risk for heart attacks, strokes, blood clotting,
cholesterol changes, hypertension, depressed mood, fatigue, restlessness. loss of appetite, insomnia,
reduced libido, muscle and joint pain, and severe liver problems, including hepatic cancer. Males can
have reduced sperm production, shrinking of the testes, and difficulty or pain urinating. There can be
breast enlargement in men and masculinization of women's bodies. Both sexes can experience hair loss
and acne. Intravenous or intramuscular use of the drug and needle sharing puts users at risk for HIV,
hepatitis B and C, and endocarditis.
A 14-year-old girl admitted to a psychiatric unit following an overdose on alcohol and benzodiazepines
after the breakup of a relationship has made seductive comments to her roommate, which is upsetting
her roommate. In assessing the girl's behavior toward her roommate, the Psychiatric-Mental Health
Nurse Practitioner needs to include the topic of sexual orientation. What is the best introductory
approach to this tc
Practice Skills Exam
Questions with Complete
Solutions
When child, adult partner, or elder abuse is suspected, the PMHNP needs to conduct an abuse
assessment screen in privacy, away from the partner, the child's parents or guardians, or the elder
person's relative or companion. Simple, direct questions in a nonjudgmental interview are indicated.
Which of the following would be an appropriate abuse screening question?
a. Within the past year, have you been hit, slapped, kicked or otherwise physically hurt by someone?
b. Within the past year, has anyone ever forced you to do something by threatening you with a gun?
c. Within the past year, have you ever threatened or tried to commit suicide to escape the abuse?
d. Within the past year, has anyone ever threatened to kill you? - Correct Answers: Within the past year,
have you been hit, slapped, kicked or otherwise physically hurt by someone?
Rationale: This response is one of four items on a standardized abuse assessment screen. The other
items are part of a danger assessment that may be used following a positive response to one of the
abuse assessment screening questions.
A patient was started on an antipsychotic medication two weeks ago and is now experiencing the
following symptoms: inability to sit still, pacing, and feelings of restlessness. he does not complain of any
anxiety or being worried about anything in particular. Which of the following rating scales would be the
most appropriate to assess these symptoms?
a. Simpson Angus EPS Scale
b. Barnes Akathisia Rating Scale (BARS)
c. Dyskinesia Identification System Condensed User Scale (DISCUS)
d. Abnormal Involuntary Movement Scale (AIMS) - Correct Answers: Answer: the BARS.
Rationale: The patient is experiencing symptoms consistent with Akathisia. The BARS can be very useful
in systematically assessing patients in identifying akathisia, assess its severity, and monitor change in
symptoms.
,A female client has gradually assumed increasing responsibility for the care of her aging parents. Her
mother was diagnosed with Alzheimer's type dementia three years ago and is increasingly disoriented to
her home surroundings. Her father insists on keeping her mother at home to provide care until she dies.
What is the first priority in counseling this couple and their caretaking adult daughter?
a. Caregiver strain
b. Patient and family education
c. Anticipatory guidance
d. Patient safety - Correct Answers: Answer: D. Patient safety
Although all four are improtant aspects related to care, patient safety must take pririty before the other
three responses. In counseling about safety issues regarding risk for wandering, leaving stove burner on
unattended, slips or falls, the PMHNP can introduce the other areas of education, anticipatory guidance,
and community resources.
A 67-year-old Vietnamese immigrant, who has been a resident in the U.S. for 3 years, comes to your
clinic for an evaluation. Her first language is Vietnamese, but she does speak some English. She has
problems with reading and writing, as she did not finish high school, or earn a GED (General Educational
Development) equivalency. As the PMHNP, what is your priority disparity to address with this patient?
a. Age
b. Health literacy
c. Reading level
d. Race - Correct Answers: B. Health Literacy
Rationale: Adults meeting the following criteria are most liekely to have limited health literacy, which
has been related to health outcomes: one, over age 65 from racial and ethnic groups other than white;
two, recent refugees and immigrants; three, less than a high school degree or GED; four, low income;
and five, non-native speaker of English.
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. Diagnosis
c. Mental Status Exam
d. Review of Systems - Correct Answers: Answer: Mental Status Exam
, Rationale: Current suicidal ideation, plan, method, intent, and access to implement plan is documented
in the Mental Status Exam under the section for thought content.
Which of the following screening tests has high sensitivity and specificity for identifying cognitive
impairment in older adults while requiring the least amount of time to administer in a clinical setting?
a. Dementia Rating Scale
b. Mini-Mental Status Exam
c. Global Deterioration Scale
d. Clock Drawing Test - Correct Answers: The Clock Drawing Test (CDT) is highly correlated with the Mini-
Mental Status Exam (MMSE), the Global Deterioration Scale, and the Dementia Rating Scale, yet takes
minimum amount of time to administer (2-4 minutes). It is well-suited for clinical practice settings to
screen and monitor progression of cognitive decline in older adults.
Which of the following lifestyle factors poses the greatest risk for depression, irritability, liver problems,
and hypertension in a college student?
a. Marijuana use
b. Binge drinking
c. Cocaine use
d. Anabolic steroid use - Correct Answers: Anabolic steroid use poses the greatest risk of the four
lifestyle drug use patterns. Anabolic steroid use is associated with increased irritability and aggression,
euphoria, increased energy, sexual arousal, mood swings, distractibility, forgetfulness, and confusion.
With time, anabolic steroid use is associated with increased risk for heart attacks, strokes, blood clotting,
cholesterol changes, hypertension, depressed mood, fatigue, restlessness. loss of appetite, insomnia,
reduced libido, muscle and joint pain, and severe liver problems, including hepatic cancer. Males can
have reduced sperm production, shrinking of the testes, and difficulty or pain urinating. There can be
breast enlargement in men and masculinization of women's bodies. Both sexes can experience hair loss
and acne. Intravenous or intramuscular use of the drug and needle sharing puts users at risk for HIV,
hepatitis B and C, and endocarditis.
A 14-year-old girl admitted to a psychiatric unit following an overdose on alcohol and benzodiazepines
after the breakup of a relationship has made seductive comments to her roommate, which is upsetting
her roommate. In assessing the girl's behavior toward her roommate, the Psychiatric-Mental Health
Nurse Practitioner needs to include the topic of sexual orientation. What is the best introductory
approach to this tc
