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PMHNP-BC Actual Questions


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Nursing


PMHNP-BC


ANCC Adult Psychiatric-Mental Health Nurse Practitioner


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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


    terpersonal Therapy umanistic Therapy


    wer: D


    anation: The therapeutic approach that emphasizes the importance of t peutic relationship, empathy, and unconditional positive regard for th nt is Humanistic Therapy. Humanistic Therapy, also known as person ered therapy, focuses on the individual's unique experience and inhere city for self-growth and self-actualization. It emphasizes the therapist' ine empathy and unconditional positive regard for the patient, creatin nd non-judgmental environment for exploration and personal growth ons A, C, and D represent different therapeutic approaches but do not fically emphasize the therapeutic relationship and unconditional posit

    d to the same extent as Humanistic Therapy.


    stion: 2

  2. Motivational Interviewing

  3. In

  4. H


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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

ced therapeutic levels and potentially rendering the medication less tive. Additionally, excessive sodium intake can increase the risk of lit ity.


stion: 3


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


HQ-9 AD-7

rug Abuse Screening Test (DAST) anderbilt ADHD


wer: C


anation: The most appropriate screening tool for evaluating the patien

Explanation: Sodium intake can interact with lithium carbonate and cause toxicity. High levels of sodium can increase the excretion of lithium, leading to redu

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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?


ranstheoretical Model sychogenomics umanistic Therapy


wer: C


anation: The theory that explores the influence of genetics and gene-d actions on individual responses to psychotropic medications is hogenomics. Psychogenomics combines the fields of genomics and hopharmacology to study how genetic variations can impact individua onses to medications used in psychiatric treatment. It examines how g rs can influence pharmacokinetics (how drugs are absorbed, distribut bolized, and eliminated) and pharmacodynamics (how drugs interact w targets in the body) of psychotropic medications. Options A, B, and sent different therapeutic approaches and are not specifically focused tics and gene-drug interactions.

  1. Cognitive Behavioral Therapy

  2. T

  3. P

  4. H


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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


9 consists of nine questions that assess the presence and severity of essive symptoms over the past two weeks. It is widely used in clinical ice to screen for depression and monitor treatment response. Options C are screening tools for generalized anxiety disorder (GAD-7) and tion deficit hyperactivity disorder (Vanderbilt ADHD), respectively. on D (AUDIT) is a screening tool for assessing alcohol use disorders, ession.


stion: 6


tient presents with symptoms of depression and reports a history of al isorder. The nurse practitioner is considering an antidepressant medic ants to avoid potential interactions with alcohol. Which of the follow epressants would be the most appropriate choice?


upropion (Wellbutrin) enlafaxine (Effexor) mitriptyline (Elavil)

Explanation: The mental health screening tool commonly used to assess symptoms of depression is the Patient Health Questionnaire-9 (PHQ-9). The PHQ-

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  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?


HQ-9

anderbilt ADHD UDIT


wer: A


anation: The screening tool commonly used to assess symptoms of ralized anxiety disorder (GAD) is the Generalized Anxiety Disorder-7 D-7) scale. The GAD-7 consists of seven questions that assess the pre everity of anxiety symptoms over the past two weeks. It is a widely u n clinical practice to screen for GAD and monitor treatment response. ons A and D are screening tools for depression (PHQ-9) and alcohol u ders (AUDIT), respectively. Option C (Vanderbilt ADHD) is a screen or attention deficit hyperactivity disorder, not generalized anxiety

der.


stion: 8

  1. GAD-7

  2. P

  3. V

  4. A


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Que


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

mulant medications is an increase in blood pressure and heart rate. Re toring is essential to ensure patient safety.


stion: 9


ch of the following theories emphasizes the importance of identifying nt's stage of readiness to change in order to tailor interventions effecti


ognitive Behavioral Therapy ewin's Change Theory ranstheoretical Model umanistic Therapy


wer: C


anation: The theory that emphasizes the importance of identifying the nt's stage of readiness to change in order to tailor interventions effecti

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 sti gular

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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?


umanistic Therapy terpersonal Therapy ognitive Behavioral Therapy


wer: D


anation: The therapeutic approach that focuses on empowering patient ely participate in their own recovery process and develop skills for aging their mental health isCognitive Behavioral Therapy (CBT). CB oriented and structured form of therapy that helps individuals identify enge negative thoughts and beliefs, develop coping strategies, and lea

kills to change behavior patterns. It emphasizes the active role of the nt in their own recovery and encourages them to take responsibility fo thoughts, feelings, and actions. Options B, C, and D represent differe peutic approaches but do not specifically emphasize active patient cipation and skill development to the same extent as CBT.


stion: 11

  1. Motivational Interviewing

  2. H

  3. In

  4. C


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Que


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.


anation: The nurse practitioner's priority should be to discontinue the ridone immediately. Neuroleptic malignant syndrome (NMS) is a ntially life-threatening condition associated with the use of antipsycho cations, such as risperidone. Discontinuing the medication is crucial t ent further complications and ensure patient safety.


stion: 12


ording to the DSM-5-TR diagnostic criteria, which of the following is acteristic feature of Major Depressive Disorder?


resence of at least one manic episode.

ecurrent, intrusive thoughts or images causing distress.

xcessive worry and apprehension about various events or activities. epressed mood or loss of interest or pleasure in nearly all activities.


wer: D

Answer: B Expl

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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


dal ideation. What is the appropriate management approach for this hiatric emergency?


rovide immediate hospitalization for safety. ssess the patient's risk and develop a safety plan.

rescribe antipsychotic medication to stabilize mood.

efer the patient to a psychotherapist for long-term treatment.


wer: B


anation: The appropriate management approach for a patient presentin uicidal ideation is to assess the patient's risk and develop a safety pla ucial to evaluate the severity of the suicidal ideation, the patient's inte lan, and the presence of any protective factors. Developing a safety p ves collaboratively identifying strategies and resources to manage the

nt's immediate safety and support their ongoing well-being. pitalization (option A) may be necessary in cases of high risk or immi

A patient presents to the psychiatric-mental health nurse practitioner with suici

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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.

    matic event.

    radually expose the patient to traumatic memories and stimuli to redu nd avoidance.


    wer: D


    anation: The goal of prolonged exposure therapy is to gradually expos nt to traumatic memories and stimuli to reduce fear and avoidance. T of therapy is based on the principle of extinction, where repeated exp ared stimuli in a safe and controlled environment helps to reduce the ciated fear response. By confronting and processing traumatic memori atient can experience a reduction in PTSD symptoms and improve the all functioning.


    stion: 15


    tient with major depressive disorder is started on escitalopram (Lexap urse practitioner plans to assess the patient's response to the medicati

  3. Identify and challenge maladaptive thoughts and beliefs related to the trau

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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



stion: 16


tient with generalized anxiety disorder (GAD) is prescribed buspirone par). The nurse practitioner provides education to the patient about th cation. Which of the following statements accurately represents an rtant aspect of buspirone therapy?


uspirone has a rapid onset of action and provides immediate relief of ety symptoms.

uspirone should be taken consistently and not as needed for acute anxi odes.

uspirone requires regular monitoring of liver function tests. uspirone can be habit-forming and has a high potential for abuse.


wer: B


anation: Buspirone should be taken consistently and not as needed for

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.


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Ans Expl

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


    anation: The nurse practitioner emphasizes the importance of regular b toring for hematological abnormalities. Clozapine is associated with a ntially serious adverse effect called agranulocytosis, which is a signifi ease in the number of white blood cells. Regular blood monitoring, ding monitoring of white blood cell count, is necessary to detect this ition early and ensure patient safety.

  4. Cardiac abnormalities Answer: C

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