PMHNP ANCC REVIEW QUESTIONS
AND ANSWERS
The01purpose01of01the01American01Nurses01Association's01Psychiatric-
Mental01Health01Nursing:
Scope01and01Standards01of01Practice01is01to
a.01Define01the01role01and01actions01for01the01NP
b.01Establish01the01legal01authority01for01the01prescription01of01psychotropic01medication
s
c.01Define01the01legal01statutes01of01the01role01of01the01PMHNP
d.01Define01the01differences01between01the01physician01role01and01the01NP01role01-
01ans-A.01The01ANAs01Psych-
Mental01Health01Nursing01Scope01and01Standards01of01Practice01defines01the01role01and
01actions01of01the01nurse01practitioner.
D.01Information01reduces01incidence01of01disease.01-01ans-
Primary01prevention01care01practices01are01an01essential01aspect01of01the01PMHNP01rol
e.01Which01of01the01following01is01the01best01example01of01a01primary01prevention01care0
1strategy01for01community01behavioral01health?
a.01Aftercare01program01for01chronically01mentally01ill01clients01recently01discharged01fro
m01the01hospital
b.01Court-ordered01counseling01for01abusive01parents
c.0124-hour01crisis01hotlines
d.01Parenting01skills01classes01for01pregnant01adolescents
The01trend01in01legal01rulings01on01cases01involving01mental01illness01over01the01past012
501years01has01been01to
a.01Encourage01juries01to01find01defendants01not01guilty01by01reason01of01insanity
b.01Protect01the01person's01freedoms01or01rights01when01he01or01she01is01committed01to0
1a01mental01hospital
c.01Place01increasing01trust01in01mental01health01professionals01to01make01good01and01e
thical01decisions
d.01Decrease01the01"red01tape"01associated01with01commitments01so01that01commitment
s01are01faster01and01easier01-01ans-
B.01Identifies01the01trend01of01ensuring01the01protection01of01individual01civil01liberties01fo
r01psychiatric01clients.
Mr.01Smithers,01an01involuntarily01hospitalized01patient01experiencing01psychotic01sympt
oms,01refuses01to01take01any01of01his01ordered01medication01because01he01believes01"J
,esus01Christ01told01me01I01am01the01prophet01and01must01fast01for01a01year."01Your01acti
ons01should01be01based01on01your01knowledge01of01which01of01the01following?
a.01Psychiatric01clients01cannot01refuse01treatment
b.01Psychiatric01clients01do01not01always01know01what01is01good01for01them
c.01Psychiatric01clients01can01refuse01treatment
d.01Psychiatric01clients01cannot01be01trusted01to01make01good01healthcare01decisions01a
nd,01therefore,01the01nurse's01best01clinical01judgment01should01guide01actions01-01ans-
C.01As01with01any01client,01psychiatric01clients01can01refuse01treatment01unless01a01legal
01process01resulting01in01involuntary01commitment01or01mandatory01court01order01for01tr
eatment01has01been01obtained.
Which01of01the01following01statements01best01reflects01the01difference01between01the01n
urse-client01(N-C)01relationship01and01a01social01relationship?
a.01In01the01N-
C01relationship,01the01primary01focus01is01on01the01client01and01the01client's01needs.
b.01Goals01in01the01N-
C01relationship01are01deliberately01left01vague01and01unspoken01so01that01the01client01ca
n01work01on01any01issue.
c.01In01the01N-
C01relationship,01the01nurse01is01solely01responsible01for01making01the01relationship01wo
rk.
d.01In01the01N-C01relationship,01there01is01no01place01for01social01interaction.01-01ans-
A.01Social01relationships01are01mutual01interpersonal01relationships01in01which01the01nee
ds01of01both01parties01are01addressed.01The01N-
C01relationship01is01most01concerned01with01meeting01the01needs01of01the01client.
A01community01has01an01unusually01high01incidence01of01depression01and01drug01use01
among01the01teenage01population.01The01public01health01nurses01decide01to01address01t
his01problem,01in01part,01by01modifying01the01environment01and01strengthening01the01ca
pacities01of01families01to01prevent01the01development01of01new01cases01of01depression01
and01drug01use.01What01is01this01is01an01example01of?
a.01Primary01prevention
b.01Secondary01prevention
c.01Tertiary01prevention
d.01Protective01factorial01prevention01-01ans-
A.01This01action01focuses01on01interventions01designed01to01reduce01the01incidence01of0
1new01cases01of01disease.
Mrs.01Kemp01is01voluntarily01admitted01to01the01hospital.01After012401hours,01she01states
01she01wishes01to01leave01because01"this01place01can't01help01me."01The01best01nursing0
1action01that01reflects01the01legal01right01of01this01client01is
a.01Discharge01the01client
b.01Explain01that01the01client01cannot01leave01until01you01can01complete01further01assess
ment
c.01Allow01the01client01to01leave01but01have01her01sign01forms01stating01she01is01leaving0
1against01medical01advice
, d.01Immediately01start01the01paperwork01to01commit01the01client01and01to01allow01you01to
01treat01her01against01her01wishes01-01ans-
B.01Almost01every01state01allows01for01a01brief01for01a01period01detainment01to01assess01
a01client01for01dangerousness01to01self01or01others01before01allowing01the01client01to01lea
ve01a01hospital01setting,01even01if01the01admission01was01voluntary.
In01forming01a01therapeutic01relationship01with01clients,01the01PMHNP01must01consider01
developing01many01characteristics01that01are01known01to01be01helpful01in01relationship-
building.01Which01of01the01following01is01an01essential01part01of01building01a01therapeutic
01relationship?
a.01Collecting01a01family01history
b.01Like-mindedness
c.01Authenticity
d.01Accuracy01in01assessment01-01ans-
C.01Authenticity.01Being01genuine,01honest,01and01respectful01are01essential01elements01
in01establishing01a01working01relationship01with01any01client.01Like-
mindedness01is01not01a01part01of01the01therapeutic01relationship.01Although01an01importa
nt01aspect01of01the01PMHNP01role,01collecting01a01family01history01and01accuracy01in01a
ssessment01does01not01in01and01of01itself01facilitate01relationship01building.
According01to01the01DSM-5,01which01of01the01following01is01true?01(Ch.013)
a.01A01mental01disorder01is01equivalent01to01the01need01for01treatment.
b.01Diagnostic01criteria01are01used01to01inform01clinical01judgment.
c.01Socially01deviant01behavior01is01considered01a01mental01disorder.
d.01A01culturally01expected01response01to01a01stressor01is01not01a01mental01disorder.01-
01ans-D.01All01DSM-
501disorders01need01to01be01made01taking01a01person's01culture01into01account.01A01cult
ural01expression01of01a01response01to01grief,01loss,01or01stress01is01not01considered01a01
DSM-501diagnosis.
Mrs.01French01has01been01in01individual01therapy01for01301months.01She01has01shown01
much01growth01and01improvement01in01her01functioning01and01insight01and01is01to01disco
ntinue01services01within01the01next01few01weeks.01In01the01next01session,01after01you01di
scuss01service01termination,01she01suddenly01begins01to01demonstrate01the01original01sy
mptoms01that01had01brought01her01to01treatment01initially.01She01is01now01hesitant01to01d
ischarge,01wants01to01continue01services,01and01is01displaying01an01increase01in01regres
sive01defense01mechanisms.01What01is01the01best01explanation01for01Ms.01French's01be
havior?
a.01An01exacerbation01of01her01symptoms01related01to01stress
b.01The01normal01cyclic01nature01of01chronic01mental01health01symptoms
c.01A01sign01of01normal01resistance01to01termination01seen01in01the01termination01phase0
1of01therapy
d.01A01sign01of01pathological01attachment01to01the01therapist01that01must01be01addresse
d01-01ans-
C.01Clients01frequently01display01resistance01and01regression01at01the01termination01of01
AND ANSWERS
The01purpose01of01the01American01Nurses01Association's01Psychiatric-
Mental01Health01Nursing:
Scope01and01Standards01of01Practice01is01to
a.01Define01the01role01and01actions01for01the01NP
b.01Establish01the01legal01authority01for01the01prescription01of01psychotropic01medication
s
c.01Define01the01legal01statutes01of01the01role01of01the01PMHNP
d.01Define01the01differences01between01the01physician01role01and01the01NP01role01-
01ans-A.01The01ANAs01Psych-
Mental01Health01Nursing01Scope01and01Standards01of01Practice01defines01the01role01and
01actions01of01the01nurse01practitioner.
D.01Information01reduces01incidence01of01disease.01-01ans-
Primary01prevention01care01practices01are01an01essential01aspect01of01the01PMHNP01rol
e.01Which01of01the01following01is01the01best01example01of01a01primary01prevention01care0
1strategy01for01community01behavioral01health?
a.01Aftercare01program01for01chronically01mentally01ill01clients01recently01discharged01fro
m01the01hospital
b.01Court-ordered01counseling01for01abusive01parents
c.0124-hour01crisis01hotlines
d.01Parenting01skills01classes01for01pregnant01adolescents
The01trend01in01legal01rulings01on01cases01involving01mental01illness01over01the01past012
501years01has01been01to
a.01Encourage01juries01to01find01defendants01not01guilty01by01reason01of01insanity
b.01Protect01the01person's01freedoms01or01rights01when01he01or01she01is01committed01to0
1a01mental01hospital
c.01Place01increasing01trust01in01mental01health01professionals01to01make01good01and01e
thical01decisions
d.01Decrease01the01"red01tape"01associated01with01commitments01so01that01commitment
s01are01faster01and01easier01-01ans-
B.01Identifies01the01trend01of01ensuring01the01protection01of01individual01civil01liberties01fo
r01psychiatric01clients.
Mr.01Smithers,01an01involuntarily01hospitalized01patient01experiencing01psychotic01sympt
oms,01refuses01to01take01any01of01his01ordered01medication01because01he01believes01"J
,esus01Christ01told01me01I01am01the01prophet01and01must01fast01for01a01year."01Your01acti
ons01should01be01based01on01your01knowledge01of01which01of01the01following?
a.01Psychiatric01clients01cannot01refuse01treatment
b.01Psychiatric01clients01do01not01always01know01what01is01good01for01them
c.01Psychiatric01clients01can01refuse01treatment
d.01Psychiatric01clients01cannot01be01trusted01to01make01good01healthcare01decisions01a
nd,01therefore,01the01nurse's01best01clinical01judgment01should01guide01actions01-01ans-
C.01As01with01any01client,01psychiatric01clients01can01refuse01treatment01unless01a01legal
01process01resulting01in01involuntary01commitment01or01mandatory01court01order01for01tr
eatment01has01been01obtained.
Which01of01the01following01statements01best01reflects01the01difference01between01the01n
urse-client01(N-C)01relationship01and01a01social01relationship?
a.01In01the01N-
C01relationship,01the01primary01focus01is01on01the01client01and01the01client's01needs.
b.01Goals01in01the01N-
C01relationship01are01deliberately01left01vague01and01unspoken01so01that01the01client01ca
n01work01on01any01issue.
c.01In01the01N-
C01relationship,01the01nurse01is01solely01responsible01for01making01the01relationship01wo
rk.
d.01In01the01N-C01relationship,01there01is01no01place01for01social01interaction.01-01ans-
A.01Social01relationships01are01mutual01interpersonal01relationships01in01which01the01nee
ds01of01both01parties01are01addressed.01The01N-
C01relationship01is01most01concerned01with01meeting01the01needs01of01the01client.
A01community01has01an01unusually01high01incidence01of01depression01and01drug01use01
among01the01teenage01population.01The01public01health01nurses01decide01to01address01t
his01problem,01in01part,01by01modifying01the01environment01and01strengthening01the01ca
pacities01of01families01to01prevent01the01development01of01new01cases01of01depression01
and01drug01use.01What01is01this01is01an01example01of?
a.01Primary01prevention
b.01Secondary01prevention
c.01Tertiary01prevention
d.01Protective01factorial01prevention01-01ans-
A.01This01action01focuses01on01interventions01designed01to01reduce01the01incidence01of0
1new01cases01of01disease.
Mrs.01Kemp01is01voluntarily01admitted01to01the01hospital.01After012401hours,01she01states
01she01wishes01to01leave01because01"this01place01can't01help01me."01The01best01nursing0
1action01that01reflects01the01legal01right01of01this01client01is
a.01Discharge01the01client
b.01Explain01that01the01client01cannot01leave01until01you01can01complete01further01assess
ment
c.01Allow01the01client01to01leave01but01have01her01sign01forms01stating01she01is01leaving0
1against01medical01advice
, d.01Immediately01start01the01paperwork01to01commit01the01client01and01to01allow01you01to
01treat01her01against01her01wishes01-01ans-
B.01Almost01every01state01allows01for01a01brief01for01a01period01detainment01to01assess01
a01client01for01dangerousness01to01self01or01others01before01allowing01the01client01to01lea
ve01a01hospital01setting,01even01if01the01admission01was01voluntary.
In01forming01a01therapeutic01relationship01with01clients,01the01PMHNP01must01consider01
developing01many01characteristics01that01are01known01to01be01helpful01in01relationship-
building.01Which01of01the01following01is01an01essential01part01of01building01a01therapeutic
01relationship?
a.01Collecting01a01family01history
b.01Like-mindedness
c.01Authenticity
d.01Accuracy01in01assessment01-01ans-
C.01Authenticity.01Being01genuine,01honest,01and01respectful01are01essential01elements01
in01establishing01a01working01relationship01with01any01client.01Like-
mindedness01is01not01a01part01of01the01therapeutic01relationship.01Although01an01importa
nt01aspect01of01the01PMHNP01role,01collecting01a01family01history01and01accuracy01in01a
ssessment01does01not01in01and01of01itself01facilitate01relationship01building.
According01to01the01DSM-5,01which01of01the01following01is01true?01(Ch.013)
a.01A01mental01disorder01is01equivalent01to01the01need01for01treatment.
b.01Diagnostic01criteria01are01used01to01inform01clinical01judgment.
c.01Socially01deviant01behavior01is01considered01a01mental01disorder.
d.01A01culturally01expected01response01to01a01stressor01is01not01a01mental01disorder.01-
01ans-D.01All01DSM-
501disorders01need01to01be01made01taking01a01person's01culture01into01account.01A01cult
ural01expression01of01a01response01to01grief,01loss,01or01stress01is01not01considered01a01
DSM-501diagnosis.
Mrs.01French01has01been01in01individual01therapy01for01301months.01She01has01shown01
much01growth01and01improvement01in01her01functioning01and01insight01and01is01to01disco
ntinue01services01within01the01next01few01weeks.01In01the01next01session,01after01you01di
scuss01service01termination,01she01suddenly01begins01to01demonstrate01the01original01sy
mptoms01that01had01brought01her01to01treatment01initially.01She01is01now01hesitant01to01d
ischarge,01wants01to01continue01services,01and01is01displaying01an01increase01in01regres
sive01defense01mechanisms.01What01is01the01best01explanation01for01Ms.01French's01be
havior?
a.01An01exacerbation01of01her01symptoms01related01to01stress
b.01The01normal01cyclic01nature01of01chronic01mental01health01symptoms
c.01A01sign01of01normal01resistance01to01termination01seen01in01the01termination01phase0
1of01therapy
d.01A01sign01of01pathological01attachment01to01the01therapist01that01must01be01addresse
d01-01ans-
C.01Clients01frequently01display01resistance01and01regression01at01the01termination01of01
