PMHNP ANCC Review Questions
1. The purpose of the American Nurses Association's Psychiatric-Mental Health
Nursing:
Scope and Standards of Practice is to
a. Define the role and actions for the NP
b. Establish the legal authority for the prescription of psychotropic medica-tions
c. Define the legal statutes of the role of the PMHNP
d. Define the differences between the physician role and the NP role: A. The ANAs
Psych-Mental Health Nursing Scope and Standards of Practice defines the role and actions
of the nurse practitioner.
2. D. Information reduces incidence of disease.: Primary prevention care
practices are an
essential aspect of the PMHNP role. Which of the following is the best
example of a primary prevention care strategy for community behavioral
health?
a. Aftercare program for chronically mentally ill clients recently discharged from the
hospital
b.Court-ordered counseling for abusive parents
c. 24-hour crisis hotlines
d.Parenting skills classes for pregnant adolescents
3. The trend in legal rulings on cases involving mental illness over the past 25
years has been to
a. Encourage juries to find defendants not guilty by reason of insanity
b. Protect the person's freedoms or rights when he or she is committed to a
mental hospital
c. Place increasing trust in mental health professionals to make good and ethical decisions
d. Decrease the "red tape" associated with commitments so that commitments
are faster and easier: B. Identifies the trend of ensuring the protection of individual civil
liberties for psychiatric clients.
, PMHNP ANCC Review Questions
4. Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic
symptoms, refuses to take any of his ordered medication because he believes
"Jesus Christ told me I am the prophet and must fast for a year." Your actions
should be based on your knowledge of which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore,
the nurse's best clinical judgment should guide actions: C. As with any
client, psychiatric clients can refuse treatment unless a legal process resulting in
involuntary commitment or mandatory court order for treatment has been obtained.
5. Which of the following statements best reflects the difference between the
nurse-client (N-C) relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the client's
needs.
b. Goals in the N-C relationship are deliberately left vague and unspoken so that the
client can work on any issue.
c. In the N-C relationship, the nurse is solely responsible for making the rela-tionship
work.
d. In the N-C relationship, there is no place for social interaction.: A. Social relationships
are mutual interpersonal relationships in which the needs of both parties are addressed.
The N-C relationship is most concerned with meeting the needs of the client.
6. A community has an unusually high incidence of depression and drug use
among the teenage population. The public health nurses decide to address
this problem, in part, by modifying the environment and strengthening the
capacities of families to prevent the development of new cases of depression
and drug use. What is this is an example of?
a. Primary prevention
b. Secondary prevention
, PMHNP ANCC Review Questions
c. Tertiary prevention
d. Protective factorial prevention: A. This action focuses on interventions designed to
reduce the incidence of new cases of disease.
7. Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states
she wishes to leave because "this place can't help me." The best nursing action
that reflects the legal right of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further assess-ment
c. Allow the client to leave but have her sign forms stating she is leaving against medical
advice
d. Immediately start the paperwork to commit the client and to allow you to
treat her against her wishes: B. Almost every state allows for a brief for a period
detainment to assess a client for dangerousness to self or others before allowing the
client to leave a hospital setting, even if the admission was voluntary.
8. In forming a therapeutic relationship with clients, the PMHNP must
consider developing many characteristics that are known to be helpful in
relationship-building. Which of the following is an essential part of building a
therapeutic relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment: C. Authenticity. Being genuine, honest, and respectful are
essential elements in establishing a working relationship with any client. Like-
mindedness is not a part of the therapeutic relationship. Although an important aspect
of the PMHNP role, collecting a family history and accuracy in assessment does not in
and of itself facilitate relationship building.
9. According to the DSM-5, which of the following is true? (Ch. 3)
a. A mental disorder is equivalent to the need for treatment.
, PMHNP ANCC Review Questions
b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a mental disorder.: D. All
DSM-5 disorders need to be made taking a person's culture into account. A cultural
expression of a response to grief, loss, or stress is not considered a DSM-5 diagnosis.
10. Mrs. French has been in individual therapy for 3 months. She has shown
much growth and improvement in her functioning and insight and is to
discontinue services within the next few weeks. In the next session, after you
discuss service termination, she suddenly begins to demonstrate the original
symptoms that had brought her to treatment initially. She is now hesitant to
discharge, wants to continue services, and is displaying an increase in
regressive defense mechanisms. What is the best explanation for Ms. French's
behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health symptoms
c. A sign of normal resistance to termination seen in the termination phase of
therapy
d. A sign of pathological attachment to the therapist that must be addressed: C. Clients
frequently display resistance and regression at the termination of a meaningful
therapeutic process. The PMHNP is responsible for planning an effective termination
and monitoring clients during the termination period.
11. A client is displaying low self-esteem, poor self-control, self-doubt, and a
high level of dependency. These behaviors indicate developmental failure of
which of the following stages of development:
a. Infancy
b. Early childhood
c. Late childhood
d. School age: B. These signs indicate developmental failure of early childhood.
1. The purpose of the American Nurses Association's Psychiatric-Mental Health
Nursing:
Scope and Standards of Practice is to
a. Define the role and actions for the NP
b. Establish the legal authority for the prescription of psychotropic medica-tions
c. Define the legal statutes of the role of the PMHNP
d. Define the differences between the physician role and the NP role: A. The ANAs
Psych-Mental Health Nursing Scope and Standards of Practice defines the role and actions
of the nurse practitioner.
2. D. Information reduces incidence of disease.: Primary prevention care
practices are an
essential aspect of the PMHNP role. Which of the following is the best
example of a primary prevention care strategy for community behavioral
health?
a. Aftercare program for chronically mentally ill clients recently discharged from the
hospital
b.Court-ordered counseling for abusive parents
c. 24-hour crisis hotlines
d.Parenting skills classes for pregnant adolescents
3. The trend in legal rulings on cases involving mental illness over the past 25
years has been to
a. Encourage juries to find defendants not guilty by reason of insanity
b. Protect the person's freedoms or rights when he or she is committed to a
mental hospital
c. Place increasing trust in mental health professionals to make good and ethical decisions
d. Decrease the "red tape" associated with commitments so that commitments
are faster and easier: B. Identifies the trend of ensuring the protection of individual civil
liberties for psychiatric clients.
, PMHNP ANCC Review Questions
4. Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic
symptoms, refuses to take any of his ordered medication because he believes
"Jesus Christ told me I am the prophet and must fast for a year." Your actions
should be based on your knowledge of which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore,
the nurse's best clinical judgment should guide actions: C. As with any
client, psychiatric clients can refuse treatment unless a legal process resulting in
involuntary commitment or mandatory court order for treatment has been obtained.
5. Which of the following statements best reflects the difference between the
nurse-client (N-C) relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the client's
needs.
b. Goals in the N-C relationship are deliberately left vague and unspoken so that the
client can work on any issue.
c. In the N-C relationship, the nurse is solely responsible for making the rela-tionship
work.
d. In the N-C relationship, there is no place for social interaction.: A. Social relationships
are mutual interpersonal relationships in which the needs of both parties are addressed.
The N-C relationship is most concerned with meeting the needs of the client.
6. A community has an unusually high incidence of depression and drug use
among the teenage population. The public health nurses decide to address
this problem, in part, by modifying the environment and strengthening the
capacities of families to prevent the development of new cases of depression
and drug use. What is this is an example of?
a. Primary prevention
b. Secondary prevention
, PMHNP ANCC Review Questions
c. Tertiary prevention
d. Protective factorial prevention: A. This action focuses on interventions designed to
reduce the incidence of new cases of disease.
7. Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states
she wishes to leave because "this place can't help me." The best nursing action
that reflects the legal right of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further assess-ment
c. Allow the client to leave but have her sign forms stating she is leaving against medical
advice
d. Immediately start the paperwork to commit the client and to allow you to
treat her against her wishes: B. Almost every state allows for a brief for a period
detainment to assess a client for dangerousness to self or others before allowing the
client to leave a hospital setting, even if the admission was voluntary.
8. In forming a therapeutic relationship with clients, the PMHNP must
consider developing many characteristics that are known to be helpful in
relationship-building. Which of the following is an essential part of building a
therapeutic relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment: C. Authenticity. Being genuine, honest, and respectful are
essential elements in establishing a working relationship with any client. Like-
mindedness is not a part of the therapeutic relationship. Although an important aspect
of the PMHNP role, collecting a family history and accuracy in assessment does not in
and of itself facilitate relationship building.
9. According to the DSM-5, which of the following is true? (Ch. 3)
a. A mental disorder is equivalent to the need for treatment.
, PMHNP ANCC Review Questions
b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a mental disorder.: D. All
DSM-5 disorders need to be made taking a person's culture into account. A cultural
expression of a response to grief, loss, or stress is not considered a DSM-5 diagnosis.
10. Mrs. French has been in individual therapy for 3 months. She has shown
much growth and improvement in her functioning and insight and is to
discontinue services within the next few weeks. In the next session, after you
discuss service termination, she suddenly begins to demonstrate the original
symptoms that had brought her to treatment initially. She is now hesitant to
discharge, wants to continue services, and is displaying an increase in
regressive defense mechanisms. What is the best explanation for Ms. French's
behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health symptoms
c. A sign of normal resistance to termination seen in the termination phase of
therapy
d. A sign of pathological attachment to the therapist that must be addressed: C. Clients
frequently display resistance and regression at the termination of a meaningful
therapeutic process. The PMHNP is responsible for planning an effective termination
and monitoring clients during the termination period.
11. A client is displaying low self-esteem, poor self-control, self-doubt, and a
high level of dependency. These behaviors indicate developmental failure of
which of the following stages of development:
a. Infancy
b. Early childhood
c. Late childhood
d. School age: B. These signs indicate developmental failure of early childhood.
