Psychiatric-Mental Health Nurse Practitioner
Clinical Scenarios and Evidence-Based Practice
Review
A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical examination
is unremarkable. Laboratory results are within normal limits except for a markedly elevated alkaline
phosphatase level. The psychiatric-mental health nurse practitioner - ✔✔interprets the findings as
normally occurring during a rapid adolescent growth spurt
Laboratory findings for a patient with an alcohol use disorder indicate increased liver function values
and: - ✔✔increased MCV and elevated triglyceride levels.
A new patient arrives at the office for treatment for depression. The patient reports taking simvastatin
(Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatric-mental health nurse
practitioner eliminates fluoxetine (Prozac), based on the knowledge that the combination can lead to
increased plasma levels of the statin, resulting in an increased risk of muscle damage and
rhabdomyolysis. The nurse practitioner's reason is that: - ✔✔one medication is a CYP450 3A4 substrate
and one is a CYP450 3A4 inhibitor.
A 28-year-old patient who is psychotic arrives at the clinic with family members but refuses to meet if
the family members are present. The psychiatric-mental health nurse practitioner - ✔✔asks the family
members to leave for the appointment.
The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement at a
community mental health clinic. The effective strategy for evaluating the clinic's services is to: - ✔✔use
a survey to elicit patient satisfaction responses.
The psychiatric-mental health nurse practitioner evaluates a new adult patient via telemedicine. The
patient has questions about a new medication that he or she recently started. The nurse practitioner
decides to provide psychoeducation and to: - ✔✔e-mail drug information and resources
Any court of law that evaluates the standards of care provided by a psychiatric-mental health nurse
practitioner - ✔✔considers what a reasonably prudent health care provider would do.
, The psychiatric-mental health nurse practitioner and a team of local mental health professionals are
asked to provide crisis counseling service, after a gunman recently took a class hostage at a local
elementary school, wounded several students, and then shot himself. In preparing for this assignment,
the nurse practitioner recognizes that: - ✔✔a child's developmental stage will influence his or her
response to catastrophic stress
Which community-based program is a tertiary level intervention? - ✔✔Partial hospitalization program
that provides intensive group therapy for rehabilitation.
A 32-year-old female patient informs the psychiatric-mental health nurse practitioner that she is three
months pregnant. She has been stable on fluoxetine (Prozac) for the last two years. The patient asks
whether she may safely continue this medication during her pregnancy. The nurse practitioner
responds: - ✔✔"Let's review the risks and benefits of continuing or discontinuing Prozac for you and
your baby."
Established clinical guidelines suggest that suicidality is decreased by treating patients who have
borderline personality disorder with: - ✔✔dialectical behavioral therapy.
A six-year-old patient with autistic spectrum disorder has not responded to six months of psychosocial
interventions and continues to demonstrate aggressive tendencies toward a younger sibling. The
psychiatric-mental health nurse practitioner prescribes: - ✔✔risperidone (Risperdal) 0.25 mg once a day.
The psychiatric-mental health nurse practitioner working in a crisis stabilization unit evaluates a patient
verbalizing suicidal thoughts after being sexually assaulted. Before processing through the traumatic
event, the nurse practitioner first attempts to - ✔✔provide an environment of safety.
The psychiatric-mental health nurse practitioner uses a cognitive-behavioral approach to help a patient
address self-defeating behaviors. After identifying the stressor that causes the inappropriate behavior,
the initial strategy is to explore: - ✔✔rational and irrational beliefs about the stressor.
A patient who has borderline personality disorder experiences intense anxiety when the psychiatric-
mental health nurse practitioner goes on vacation. The most appropriate explanation for this reaction is
that the patient: - ✔✔has not developed object constancy.
Clinical Scenarios and Evidence-Based Practice
Review
A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical examination
is unremarkable. Laboratory results are within normal limits except for a markedly elevated alkaline
phosphatase level. The psychiatric-mental health nurse practitioner - ✔✔interprets the findings as
normally occurring during a rapid adolescent growth spurt
Laboratory findings for a patient with an alcohol use disorder indicate increased liver function values
and: - ✔✔increased MCV and elevated triglyceride levels.
A new patient arrives at the office for treatment for depression. The patient reports taking simvastatin
(Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatric-mental health nurse
practitioner eliminates fluoxetine (Prozac), based on the knowledge that the combination can lead to
increased plasma levels of the statin, resulting in an increased risk of muscle damage and
rhabdomyolysis. The nurse practitioner's reason is that: - ✔✔one medication is a CYP450 3A4 substrate
and one is a CYP450 3A4 inhibitor.
A 28-year-old patient who is psychotic arrives at the clinic with family members but refuses to meet if
the family members are present. The psychiatric-mental health nurse practitioner - ✔✔asks the family
members to leave for the appointment.
The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement at a
community mental health clinic. The effective strategy for evaluating the clinic's services is to: - ✔✔use
a survey to elicit patient satisfaction responses.
The psychiatric-mental health nurse practitioner evaluates a new adult patient via telemedicine. The
patient has questions about a new medication that he or she recently started. The nurse practitioner
decides to provide psychoeducation and to: - ✔✔e-mail drug information and resources
Any court of law that evaluates the standards of care provided by a psychiatric-mental health nurse
practitioner - ✔✔considers what a reasonably prudent health care provider would do.
, The psychiatric-mental health nurse practitioner and a team of local mental health professionals are
asked to provide crisis counseling service, after a gunman recently took a class hostage at a local
elementary school, wounded several students, and then shot himself. In preparing for this assignment,
the nurse practitioner recognizes that: - ✔✔a child's developmental stage will influence his or her
response to catastrophic stress
Which community-based program is a tertiary level intervention? - ✔✔Partial hospitalization program
that provides intensive group therapy for rehabilitation.
A 32-year-old female patient informs the psychiatric-mental health nurse practitioner that she is three
months pregnant. She has been stable on fluoxetine (Prozac) for the last two years. The patient asks
whether she may safely continue this medication during her pregnancy. The nurse practitioner
responds: - ✔✔"Let's review the risks and benefits of continuing or discontinuing Prozac for you and
your baby."
Established clinical guidelines suggest that suicidality is decreased by treating patients who have
borderline personality disorder with: - ✔✔dialectical behavioral therapy.
A six-year-old patient with autistic spectrum disorder has not responded to six months of psychosocial
interventions and continues to demonstrate aggressive tendencies toward a younger sibling. The
psychiatric-mental health nurse practitioner prescribes: - ✔✔risperidone (Risperdal) 0.25 mg once a day.
The psychiatric-mental health nurse practitioner working in a crisis stabilization unit evaluates a patient
verbalizing suicidal thoughts after being sexually assaulted. Before processing through the traumatic
event, the nurse practitioner first attempts to - ✔✔provide an environment of safety.
The psychiatric-mental health nurse practitioner uses a cognitive-behavioral approach to help a patient
address self-defeating behaviors. After identifying the stressor that causes the inappropriate behavior,
the initial strategy is to explore: - ✔✔rational and irrational beliefs about the stressor.
A patient who has borderline personality disorder experiences intense anxiety when the psychiatric-
mental health nurse practitioner goes on vacation. The most appropriate explanation for this reaction is
that the patient: - ✔✔has not developed object constancy.
