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Exam Code : PMHNP-BC
Exam Name : ANCC Adult Psychiatric-Mental Health Nurse Practitioner
Vendor Name :
"Nursing"

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Question: 1

Which of the following therapeutic approaches emphasizes the importance of the therapeutic relationship, empathy, and unconditional positive regard for the patient?

1. Cognitive Behavioral Therapy

2. Motivational Interviewing

3. Interpersonal Therapy

4. Humanistic Therapy
   
   Answer: D

Explanation: The therapeutic approach that emphasizes the importance of the therapeutic relationship, empathy, and unconditional positive regard for the patient is Humanistic Therapy. Humanistic Therapy, also known as person- centered therapy, focuses on the individual's unique experience and inherent capacity for self-growth and self-actualization. It emphasizes the therapist's genuine empathy and unconditional positive regard for the patient, creating a safe and non-judgmental environment for exploration and personal growth. Options A, C, and D represent different therapeutic approaches but do not specifically emphasize the therapeutic relationship and unconditional positive regard to the same extent as Humanistic Therapy.

Question: 2

A patient with a history of bipolar disorder is prescribed lithium carbonate as a mood stabilizer. The nurse practitioner educates the patient about the importance of maintaining a consistent intake of dietary sodium. Which of the following statements best explains the rationale behind this education?

1. Sodium intake can enhance the effectiveness of lithium carbonate.

2. Sodium intake can reduce the side effects of lithium carbonate.

3. Sodium intake can interact with lithium carbonate and cause toxicity.

4. Sodium intake can decrease the therapeutic effects of lithium carbonate.
   
   Answer: C

Explanation: Sodium intake can interact with lithium carbonate and cause toxicity. High levels of sodium can increase the excretion of lithium, leading to reduced therapeutic levels and potentially rendering the medication less effective. Additionally, excessive sodium intake can increase the risk of lithium toxicity.

Question: 3

A patient with a history of substance use disorder is being assessed by the psychiatric-mental health nurse practitioner. Which screening tool would be most appropriate for evaluating the patient's substance use?

1. PHQ-9

2. GAD-7

3. Drug Abuse Screening Test (DAST)

4. Vanderbilt ADHD
   
   Answer: C

Explanation: The most appropriate screening tool for evaluating the patient's substance use is the Drug Abuse Screening Test (DAST). The DAST is specifically designed to assess the presence and severity of drug abuse or dependence. It consists of a series of questions that inquire about various aspects of substance use, including frequency, consequences, and negative effects. Options A, B, and C are not suitable for evaluating substance use, as they are screening tools for depression (PHQ-9), generalized anxiety disorder (GAD-7), and attention deficit hyperactivity disorder (Vanderbilt ADHD),

respectively.

Question: 4

Which of the following theories explores the influence of genetics and gene- drug interactions on individual responses to psychotropic medications?

1. Cognitive Behavioral Therapy

2. Transtheoretical Model

3. Psychogenomics

4. Humanistic Therapy

Answer: C

Explanation: The theory that explores the influence of genetics and gene-drug interactions on individual responses to psychotropic medications is psychogenomics. Psychogenomics combines the fields of genomics and psychopharmacology to study how genetic variations can impact individual responses to medications used in psychiatric treatment. It examines how genetic factors can influence pharmacokinetics (how drugs are absorbed, distributed, metabolized, and eliminated) and pharmacodynamics (how drugs interact with their targets in the body) of psychotropic medications. Options A, B, and D represent different therapeutic approaches and are not specifically focused on genetics and gene-drug interactions.

Question: 5

Which of the following mental health screening tools is commonly used to assess symptoms of depression?

1. GAD-7

2. PHQ-9

3. Vanderbilt ADHD

4. AUDIT

Answer: B

Explanation: The mental health screening tool commonly used to assess symptoms of depression is the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 consists of nine questions that assess the presence and severity of depressive symptoms over the past two weeks. It is widely used in clinical practice to screen for depression and monitor treatment response. Options B and C are screening tools for generalized anxiety disorder (GAD-7) and attention deficit hyperactivity disorder (Vanderbilt ADHD), respectively. Option D (AUDIT) is a screening tool for assessing alcohol use disorders, not depression.

Question: 6

A patient presents with symptoms of depression and reports a history of alcohol use disorder. The nurse practitioner is considering an antidepressant medication and wants to avoid potential interactions with alcohol. Which of the following antidepressants would be the most appropriate choice?

1. Bupropion (Wellbutrin)

2. Venlafaxine (Effexor)

3. Amitriptyline (Elavil)

4. Sertraline (Zoloft)
   
   Answer: A

Explanation: Bupropion (Wellbutrin) would be the most appropriate choice. It is an antidepressant that does not significantly interact with alcohol and does not potentiate its effects. This makes it a safer option for individuals with a

history of alcohol use disorder.

Question: 7

Which of the following screening tools is commonly used to assess symptoms of generalized anxiety disorder?

1. GAD-7

2. PHQ-9

3. Vanderbilt ADHD

4. AUDIT

Answer: A

Explanation: The screening tool commonly used to assess symptoms of generalized anxiety disorder (GAD) is the Generalized Anxiety Disorder-7 (GAD-7) scale. The GAD-7 consists of seven questions that assess the presence and severity of anxiety symptoms over the past two weeks. It is a widely used tool in clinical practice to screen for GAD and monitor treatment response. Options A and D are screening tools for depression (PHQ-9) and alcohol use disorders (AUDIT), respectively. Option C (Vanderbilt ADHD) is a screening tool for attention deficit hyperactivity disorder, not generalized anxiety disorder.

Question: 8

A patient with attention-deficit/hyperactivity disorder (ADHD) is prescribed methylphenidate (Ritalin). The nurse practitioner should monitor the patient for which of the following potential adverse effects?

1. Hypotension and bradycardia

2. Sedation and drowsiness

3. Weight gain and increased appetite

4. Increased blood pressure and heart rate
   
   Answer: D

Explanation: The nurse practitioner should monitor the patient for increased blood pressure and heart rate. Methylphenidate is a stimulant medication commonly used in the treatment of ADHD. One of the potential adverse effects of stimulant medications is an increase in blood pressure and heart rate. Regular monitoring is essential to ensure patient safety.

Question: 9

Which of the following theories emphasizes the importance of identifying the patient's stage of readiness to change in order to tailor interventions effectively?

1. Cognitive Behavioral Therapy

2. Lewin's Change Theory

3. Transtheoretical Model

4. Humanistic Therapy

Answer: C

Explanation: The theory that emphasizes the importance of identifying the patient's stage of readiness to change in order to tailor interventions effectively is the Transtheoretical Model. This model, also known as the stages of change model, describes the different stages individuals go through when making behavioral changes. It recognizes that individuals may be at different stages of readiness for change, ranging from precontemplation to maintenance. By identifying the patient's stage, interventions can be tailored to their specific needs and level of motivation. Options B, C, and D are not specifically focused on stages of change but rather represent different therapeutic approaches.

Question: 10

Which of the following therapeutic approaches focuses on empowering patients to actively participate in their own recovery process and develop skills for managing their mental health?

1. Motivational Interviewing

2. Humanistic Therapy

3. Interpersonal Therapy

4. Cognitive Behavioral Therapy
   
   Answer: D

Explanation: The therapeutic approach that focuses on empowering patients to actively participate in their own recovery process and develop skills for managing their mental health isCognitive Behavioral Therapy (CBT). CBT is a goal-oriented and structured form of therapy that helps individuals identify and challenge negative thoughts and beliefs, develop coping strategies, and learn new skills to change behavior patterns. It emphasizes the active role of the patient in their own recovery and encourages them to take responsibility for their thoughts, feelings, and actions. Options B, C, and D represent different therapeutic approaches but do not specifically emphasize active patient participation and skill development to the same extent as CBT.

Question: 11

A patient with schizophrenia is taking risperidone (Risperdal) and develops symptoms such as high fever, altered mental status, muscle rigidity, and autonomic dysfunction. The nurse practitioner suspects neuroleptic malignant syndrome (NMS). Which of the following actions should be the nurse practitioner's priority?

1. Administer a benzodiazepine to manage symptoms.

2. Discontinue the risperidone immediately.

3. Administer dantrolene to reverse muscle rigidity.

4. Transfer the patient to the emergency department for immediate evaluation.

Answer: B

Explanation: The nurse practitioner's priority should be to discontinue the risperidone immediately. Neuroleptic malignant syndrome (NMS) is a potentially life-threatening condition associated with the use of antipsychotic medications, such as risperidone. Discontinuing the medication is crucial to prevent further complications and ensure patient safety.

Question: 12

According to the DSM-5-TR diagnostic criteria, which of the following is a characteristic feature of Major Depressive Disorder?

1. Presence of at least one manic episode.

2. Recurrent, intrusive thoughts or images causing distress.

3. Excessive worry and apprehension about various events or activities.

4. Depressed mood or loss of interest or pleasure in nearly all activities.
   
   Answer: D

Explanation: According to the DSM-5-TR diagnostic criteria, a characteristic feature of Major Depressive Disorder is the presence of a depressed mood or loss of interest or pleasure in nearly all activities (anhedonia) for at least two weeks. This represents a significant change from the person's usual functioning and is accompanied by additional symptoms, such as changes in appetite, sleep disturbances, feelings of worthlessness or guilt, psychomotor agitation or retardation, fatigue or loss of energy, difficulty concentrating, and recurrent

thoughts of death or suicidal ideation. Option A describes a characteristic feature of Bipolar Disorder. Option B describes intrusive thoughts characteristic of Obsessive-Compulsive Disorder. Option C describes excessive worry characteristic of Generalized Anxiety Disorder.

Question: 13

A patient presents to the psychiatric-mental health nurse practitioner with suicidal ideation. What is the appropriate management approach for this psychiatric emergency?

1. Provide immediate hospitalization for safety.

2. Assess the patient's risk and develop a safety plan.

3. Prescribe antipsychotic medication to stabilize mood.

4. Refer the patient to a psychotherapist for long-term treatment.

Answer: B

Explanation: The appropriate management approach for a patient presenting with suicidal ideation is to assess the patient's risk and develop a safety plan. It is crucial to evaluate the severity of the suicidal ideation, the patient's intent and plan, and the presence of any protective factors. Developing a safety plan involves collaboratively identifying strategies and resources to manage the patient's immediate safety and support their ongoing well-being. Hospitalization (option A) may be necessary in cases of high risk or imminent danger, but it should be considered based on the individual patient's circumstances. Options C and D are not appropriate initial management approaches for a psychiatric emergency involving suicidal ideation.

Question: 14

A patient with post-traumatic stress disorder (PTSD) has been receiving

prolonged exposure therapy as part of their treatment. The nurse practitioner explains to the patient that the goal of this therapy is to:

1. Teach the patient relaxation techniques to manage anxiety and stress symptoms.

2. Provide emotional support and validation to the patient during the recovery process.

3. Identify and challenge maladaptive thoughts and beliefs related to the traumatic event.

4. Gradually expose the patient to traumatic memories and stimuli to reduce fear and avoidance.

Answer: D

Explanation: The goal of prolonged exposure therapy is to gradually expose the patient to traumatic memories and stimuli to reduce fear and avoidance. This form of therapy is based on the principle of extinction, where repeated exposure to feared stimuli in a safe and controlled environment helps to reduce the associated fear response. By confronting and processing traumatic memories, the patient can experience a reduction in PTSD symptoms and improve their overall functioning.

Question: 15

A patient with major depressive disorder is started on escitalopram (Lexapro). The nurse practitioner plans to assess the patient's response to the medication. Which of the following assessment tools would be most appropriate for this purpose?

1. Hamilton Rating Scale for Depression (HAM-D)

2. Beck Depression Inventory (BDI)

3. Montgomery-Ã…sberg Depression Rating Scale (MADRS)

4. Patient Health Questionnaire-9 (PHQ-9)

Answer: D

Explanation: The most appropriate assessment tool to assess the patient's response to escitalopram (Lexapro) would be the Patient Health Questionnaire- 9 (PHQ-9). The PHQ-9 is a commonly used self-report questionnaire designed to measure the severity of depressive symptoms. It can help evaluate the effectiveness of treatment and monitor changes in symptoms over time.

Question: 16

A patient with generalized anxiety disorder (GAD) is prescribed buspirone (BuSpar). The nurse practitioner provides education to the patient about the medication. Which of the following statements accurately represents an important aspect of buspirone therapy?

1. Buspirone has a rapid onset of action and provides immediate relief of anxiety symptoms.

2. Buspirone should be taken consistently and not as needed for acute anxiety episodes.

3. Buspirone requires regular monitoring of liver function tests.

4. Buspirone can be habit-forming and has a high potential for abuse.
   
   Answer: B

Explanation: Buspirone should be taken consistently and not as needed for acute anxiety episodes. Unlike some other medications used for anxiety, such as benzodiazepines, buspirone is not intended for immediate relief of symptoms or as a PRN (as needed) medication. It requires regular, consistent dosing to achieve its anxiQuestion 8:

A patient with a history of schizophrenia is prescribed clozapine (Clozaril). The nurse practitioner emphasizes the importance of regular blood monitoring for

which of the following potential adverse effects?

1. Liver function abnormalities

2. Renal function abnormalities

3. Hematological abnormalities

4. Cardiac abnormalities
   
   Answer: C

Explanation: The nurse practitioner emphasizes the importance of regular blood monitoring for hematological abnormalities. Clozapine is associated with a potentially serious adverse effect called agranulocytosis, which is a significant decrease in the number of white blood cells. Regular blood monitoring, including monitoring of white blood cell count, is necessary to detect this condition early and ensure patient safety.

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