2026/2027
R 668 CEA Exam 2026/2027
N
Comprehensive Study Guide for Final
Exam Preparation, Practice Questions, and
Clinical Review
Question 1:
Which of the following activities best demonstrates the leadership competency of an
Advanced Practice Registered Nurse (APRN)?
A. Modifying a patient’s treatment plan based on clinical response
B. Developing an age-appropriate care plan
C. Participating in a community-based mental health promotion program
D. Evaluating the use of seclusion in inpatient settings
Correct Answer: C. Participating in a community-based mental health
promotion program
Rationale:
Leadership competency in APRNs extends beyond individual patient care to
influencing broader population health outcomes. Participating in community-focused
programs aimed at promoting mental health and reducing risk reflects leadership
through advocacy, collaboration, and public health engagement. Options A and B
reflect clinical competencies, while D relates more to quality and safety evaluation.
Leadership involves systems-level thinking and proactive engagement in improving
health outcomes at the community level.
Question 2:
Which of the following legally permits a Psychiatric Mental Health Nurse Practitioner
(PMHNP) to practice within a state?
A. Graduation from an accredited program
B. Licensure
C. Credentialing
D. Certification
Correct Answer: B. Licensure
Rationale:
Licensure is the legal authorization granted by a state regulatory body that allows a
nurse practitioner to practice. While graduation (A) and certification (D) are essential
steps, they do not independently grant legal authority. Credentialing (C) is an
,2026/2027
institutional process used by employers or insurers to verify qualifications. Only
licensure provides the legal right to practice within a state’s jurisdiction.
Question 3:
A PMHNP is unsure whether they can treat patients across the lifespan in a
psychiatric emergency department. Which document should be consulted to determine
legal scope?
A. Hospital bylaws
B. Collaborating physician agreement
C. PMHNP scope of practice guidelines
D. State Nurse Practice Act
Correct Answer: D. State Nurse Practice Act
Rationale:
The Nurse Practice Act defines the legal scope of practice for nurses within a specific
state. It determines what services can be provided and to which populations. While
scope of practice guidelines (C) provide general frameworks, the Nurse Practice Act
is legally binding. Hospital bylaws (A) and collaborative agreements (B) may
influence practice but cannot override state law.
Question 4:
The integration of best research evidence with clinical expertise and patient values is
known as:
A. Research utilization
B. Quality improvement
C. Evidence-based practice
D. Clinical research
Correct Answer: C. Evidence-based practice
Rationale:
Evidence-based practice (EBP) involves combining current research evidence, clinical
expertise, and patient preferences to guide healthcare decisions. Research utilization
(A) is a component of EBP but focuses specifically on applying findings. Quality
improvement (B) aims to enhance processes, and clinical research (D) generates new
knowledge rather than applying it.
Question 5:
A nurse fails to reposition a patient, resulting in a stage I pressure ulcer. This situation
is best classified as:
,2026/2027
A. Battery
B. Violation of orders
C. Negligence
D. Lack of consent
Correct Answer: C. Negligence
Rationale:
Negligence refers to the failure to provide the standard of care expected, resulting in
harm to the patient. Repositioning is a basic nursing responsibility to prevent pressure
injuries. Battery (A) involves intentional harmful contact, while lack of consent (D)
relates to autonomy violations. This case clearly demonstrates a lapse in duty of care.
Question 6:
Which of the following is NOT a responsibility of an Institutional Review Board
(IRB)?
A. Ensuring equitable subject selection
B. Regulating funding for studies
C. Evaluating risks and benefits
D. Minimizing risks to participants
Correct Answer: B. Regulating funding for studies
Rationale:
The IRB is responsible for protecting human research participants by reviewing study
protocols, ensuring ethical conduct, and minimizing risks. It evaluates risks, benefits,
and equitable selection of subjects. However, it does not regulate or control study
funding, which is managed by sponsors or institutions.
Question 7:
A Cambodian patient presents with symptoms consistent with “Khyal attacks.” Which
DSM-5 diagnoses may be associated?
A. Panic disorder only
B. PTSD only
C. Agoraphobia only
D. All of the above
Correct Answer: D. All of the above
Rationale:
Khyal attacks are a cultural syndrome seen in Cambodian populations involving
panic-like symptoms, anxiety, PTSD features, and somatic complaints. Recognizing
cultural concepts of distress is critical for accurate diagnosis and culturally competent
, 2026/2027
care. Limiting the diagnosis to a single disorder would overlook the complexity of this
presentation.
Question 8:
Dhat syndrome is most commonly associated with individuals from which region?
A. China and Southeast Asia
B. India and Pakistan
C. Australia and Fiji
D. Eastern Europe
Correct Answer: B. India and Pakistan
Rationale:
Dhat syndrome is a culturally bound condition prevalent in South Asia, particularly
India and Pakistan. It involves anxiety and somatic symptoms attributed to semen loss.
Recognizing this cultural belief is essential to avoid misdiagnosis and to provide
culturally sensitive care.
Question 9:
A patient believes his genitals are retracting into his body despite reassurance. This
condition is known as:
A. Zar
B. Taijin kyofusho
C. Koro
D. Kuru
Correct Answer: C. Koro
Rationale:
Koro is a culture-bound syndrome characterized by the fear that one’s genitals are
retracting into the body, leading to death. It is most commonly reported in Asian
cultures. The other options represent different cultural syndromes unrelated to this
presentation.
Question 10:
Which factor does NOT typically influence cultural care and the therapeutic alliance?
A. Religious beliefs
B. Gender roles
C. Cultural values
D. Urban setting
R 668 CEA Exam 2026/2027
N
Comprehensive Study Guide for Final
Exam Preparation, Practice Questions, and
Clinical Review
Question 1:
Which of the following activities best demonstrates the leadership competency of an
Advanced Practice Registered Nurse (APRN)?
A. Modifying a patient’s treatment plan based on clinical response
B. Developing an age-appropriate care plan
C. Participating in a community-based mental health promotion program
D. Evaluating the use of seclusion in inpatient settings
Correct Answer: C. Participating in a community-based mental health
promotion program
Rationale:
Leadership competency in APRNs extends beyond individual patient care to
influencing broader population health outcomes. Participating in community-focused
programs aimed at promoting mental health and reducing risk reflects leadership
through advocacy, collaboration, and public health engagement. Options A and B
reflect clinical competencies, while D relates more to quality and safety evaluation.
Leadership involves systems-level thinking and proactive engagement in improving
health outcomes at the community level.
Question 2:
Which of the following legally permits a Psychiatric Mental Health Nurse Practitioner
(PMHNP) to practice within a state?
A. Graduation from an accredited program
B. Licensure
C. Credentialing
D. Certification
Correct Answer: B. Licensure
Rationale:
Licensure is the legal authorization granted by a state regulatory body that allows a
nurse practitioner to practice. While graduation (A) and certification (D) are essential
steps, they do not independently grant legal authority. Credentialing (C) is an
,2026/2027
institutional process used by employers or insurers to verify qualifications. Only
licensure provides the legal right to practice within a state’s jurisdiction.
Question 3:
A PMHNP is unsure whether they can treat patients across the lifespan in a
psychiatric emergency department. Which document should be consulted to determine
legal scope?
A. Hospital bylaws
B. Collaborating physician agreement
C. PMHNP scope of practice guidelines
D. State Nurse Practice Act
Correct Answer: D. State Nurse Practice Act
Rationale:
The Nurse Practice Act defines the legal scope of practice for nurses within a specific
state. It determines what services can be provided and to which populations. While
scope of practice guidelines (C) provide general frameworks, the Nurse Practice Act
is legally binding. Hospital bylaws (A) and collaborative agreements (B) may
influence practice but cannot override state law.
Question 4:
The integration of best research evidence with clinical expertise and patient values is
known as:
A. Research utilization
B. Quality improvement
C. Evidence-based practice
D. Clinical research
Correct Answer: C. Evidence-based practice
Rationale:
Evidence-based practice (EBP) involves combining current research evidence, clinical
expertise, and patient preferences to guide healthcare decisions. Research utilization
(A) is a component of EBP but focuses specifically on applying findings. Quality
improvement (B) aims to enhance processes, and clinical research (D) generates new
knowledge rather than applying it.
Question 5:
A nurse fails to reposition a patient, resulting in a stage I pressure ulcer. This situation
is best classified as:
,2026/2027
A. Battery
B. Violation of orders
C. Negligence
D. Lack of consent
Correct Answer: C. Negligence
Rationale:
Negligence refers to the failure to provide the standard of care expected, resulting in
harm to the patient. Repositioning is a basic nursing responsibility to prevent pressure
injuries. Battery (A) involves intentional harmful contact, while lack of consent (D)
relates to autonomy violations. This case clearly demonstrates a lapse in duty of care.
Question 6:
Which of the following is NOT a responsibility of an Institutional Review Board
(IRB)?
A. Ensuring equitable subject selection
B. Regulating funding for studies
C. Evaluating risks and benefits
D. Minimizing risks to participants
Correct Answer: B. Regulating funding for studies
Rationale:
The IRB is responsible for protecting human research participants by reviewing study
protocols, ensuring ethical conduct, and minimizing risks. It evaluates risks, benefits,
and equitable selection of subjects. However, it does not regulate or control study
funding, which is managed by sponsors or institutions.
Question 7:
A Cambodian patient presents with symptoms consistent with “Khyal attacks.” Which
DSM-5 diagnoses may be associated?
A. Panic disorder only
B. PTSD only
C. Agoraphobia only
D. All of the above
Correct Answer: D. All of the above
Rationale:
Khyal attacks are a cultural syndrome seen in Cambodian populations involving
panic-like symptoms, anxiety, PTSD features, and somatic complaints. Recognizing
cultural concepts of distress is critical for accurate diagnosis and culturally competent
, 2026/2027
care. Limiting the diagnosis to a single disorder would overlook the complexity of this
presentation.
Question 8:
Dhat syndrome is most commonly associated with individuals from which region?
A. China and Southeast Asia
B. India and Pakistan
C. Australia and Fiji
D. Eastern Europe
Correct Answer: B. India and Pakistan
Rationale:
Dhat syndrome is a culturally bound condition prevalent in South Asia, particularly
India and Pakistan. It involves anxiety and somatic symptoms attributed to semen loss.
Recognizing this cultural belief is essential to avoid misdiagnosis and to provide
culturally sensitive care.
Question 9:
A patient believes his genitals are retracting into his body despite reassurance. This
condition is known as:
A. Zar
B. Taijin kyofusho
C. Koro
D. Kuru
Correct Answer: C. Koro
Rationale:
Koro is a culture-bound syndrome characterized by the fear that one’s genitals are
retracting into the body, leading to death. It is most commonly reported in Asian
cultures. The other options represent different cultural syndromes unrelated to this
presentation.
Question 10:
Which factor does NOT typically influence cultural care and the therapeutic alliance?
A. Religious beliefs
B. Gender roles
C. Cultural values
D. Urban setting
