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Quiz Session - Attempts With Random Questions

AANPCB PMHNP-C Exam Questions

Page 5 of 60

81.

What term is defined as tension between what one wants to do and what is morally right?

  • Ethical conflict

  • Ethical dilemma

  • Ethics

  • Professional ethics

Correct answer: Ethical conflict

Ethical conflict is defined as the tension between what one wants to do and what is morally right.

Ethical dilemmas are conflicts between different ethical perspectives, not a conflict between the desire to not follow an ethical principle and the obligation to adhere to it. Ethics is the branch of knowledge that deals with moral principles. Professional ethics refers to the branch of knowledge that deals with moral behavior when in a professional role.

82.

PMH-NPs understand the use of facilitating interventions to elicit the best response to a psychiatric interview. Which of the following would be considered an obstructive intervention and generally not helpful in achieving best-practice outcomes?

  • Compound questions

  • Reinforcement

  • Reflection

  • Reassurance

Correct answer: Compound questions

Compound questions are considered obstructive interventions because they are difficult for patients, as more than one answer is required. 

Reinforcement, reflection, and reassurance are all considered to be facilitating interventions.

83.

Which of the following national nursing associations certifies psychiatric-mental health nurse practitioners?

  • American Academy of Nurse Practitioners (AANP)

  • American Psychiatric Nurses Association (APNA)

  • National League for Nursing (NLN)

  • National Nurses United (NNU)

Correct answer: American Academy of Nurse Practitioners (AANP)

The American Academy of Nurse Practitioners (AANP) is the certifying body for psychiatric-mental health nurse practitioners.

84.

Which of the following is an example of a psychological preventive factor that protects someone from developing a psychiatric disorder?

  • Healthy ego defenses

  • Healthy nutritional status

  • Low-stress occupation

  • Higher socioeconomic status

Correct answer: Healthy ego defenses

Healthy ego defenses are an example of a psychological preventive factor. Preventive factors protect a person from developing a psychiatric condition. They fall into three categories: biological, psychological, and social.

Biological preventive factors are:

  • No history of mental illness in the family
  • Healthy nutritional status
  • Good general health

Psychological preventive factors are:

  • Good self-esteem
  • Good self-concept
  • Internal locus of control
  • Healthy ego defenses

Social preventive factors are:

  • Low-stress occupation
  • Higher socioeconomic status
  • Higher level of education

85.

Which statement most accurately describes an individual with antisocial personality disorder?

  • They show no remorse for their behavior

  • They frantically try to avoid real or imagined abandonment

  • They have a restricted emotional range

  • They fear embarrassment and appear shy

Correct answer: They show no remorse for their behavior

Patients with antisocial personality disorder exhibit criminal behavior beginning in childhood, such as truancy, fighting, destructiveness, and theft. They often default on debts, behave irresponsibly, and act recklessly. They show no remorse for their behavior.

Patients with schizoid personality disorder care little for social relationships, have a restricted emotional range, and appear indifferent to criticism or praise.

Patients with borderline personality disorder exhibit impulsivity, self-harm, inappropriate anger, and affective instability. They feel empty and bored, and they frantically try to avoid abandonment. 

Patients with avoidant personality disorder are timid and easily wounded by criticism from others. They fear embarrassment and hesitate to form interpersonal relationships.

86.

What is the most commonly used clinician-administered anxiety rating scale for assessing both somatic and cognitive anxiety symptoms?

  • Hamilton Anxiety Scale

  • Beck Anxiety Inventory

  • Liebowitz Social Anxiety Scale

  • GAD-7 Scale

Correct answer: Hamilton Anxiety Scale

The Hamilton Anxiety Scale (HAM-A) is the most commonly used clinician-administered anxiety rating scale. It is best used in the evaluation of anxiety severity and tracking the efficacy of anxiety treatments over time. The HAM-A is based on various domains of anxiety including anxious mood, fears, sleep disturbance, somatic complaints, tension, and observed behavior. The severity of each domain is ranked from 0 (not present) to 4 (severe). Scoring is as follows:

  • Score of 14-17: Mild anxiety
  • Score of 18-24: Moderate anxiety
  • Score of 25-30: Severe anxiety

87.

In 2001, the Institute of Medicine published Crossing the Quality Chasm: A New Health System for the 21st Century. This report identified six goals for quality improvement in health care: safe, effective, patient-centered, timely, efficient, and equitable. 

Which goal can be described as providing care that is respectful of and responsive to individual patient preferences?

  • Patient-centered

  • Timely

  • Effective

  • Safe

Correct answer: Patient-centered 

Crossing the Quality Chasm: A New Health System for the 21st Century identified six goals for the quality improvement of health care:

  • Safe: Avoiding injuries to patients from the care intended to help them.
  • Effective: Providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit.
  • Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.
  • Timely: Reducing waits and sometimes harmful delays for both those who receive and those who provide care.
  • Efficient: Avoiding the waste of equipment, supplies, ideas, and energy.
  • Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

88.

Which of the following is an accurate statement regarding gene expression and disease?

  • Single nucleotide polymorphisms (SNPs) describe single-base changes in DNA

  • Increased penetrance of a gene decreases the risk of a disease

  • Variable expression of a gene for a disorder does not occur at the cellular level

  • Single-gene disorders are common in psychiatric diagnoses

Correct answer: Single nucleotide polymorphisms (SNPs) describe single-base changes in DNA

Genes are risk factors that make a person vulnerable to developing a particular condition when combined with other factors.  

Reduced penetrance of a gene decreases the chances of disease in a person who is or may be at genetic risk. Variable expression of a gene occurs at the cellular level. Multifactorial causes are the most common.

89.

Target symptoms of antidepressant treatment include which of the following?

  • Impaired memory

  • Mania

  • Hypomania

  • Paranoia

Correct answer: Impaired memory

Target symptoms of antidepressant treatment include depressed mood, sleep/rest disturbance, anxiety, irritability, impaired concentration, impaired memory, appetite disturbance, agitation, anhedonia, and impaired energy and motivation.

Patients suffering from bipolar-like disorders often present with mania or hypomania, symptoms that are not targeted by antidepressant treatment.

Patients suffering from schizophrenia often present with paranoia, symptoms that are not targeted by antidepressant treatment.

90.

Which of the following strategies for reducing homelessness would be least likely to have a lasting effect on the long-term goal of reducing homelessness?

  • Urgent and acute treatment of mentally ill homeless individuals

  • Outreach

  • Integrated care

  • Prevention

Correct answer: Urgent and acute treatment of symptoms of homeless individuals who are mentally ill

Although urgent and acute treatment of symptoms of homeless individuals is a part of treatment, it has little to no lasting effect when this is the only treatment provided, as it is not sustainable and not supportive of the long-term goal of reducing homelessness.

Strategies for reducing homelessness include the following:

  • Outreach: Introducing services to homeless persons with serious mental illness in various settings; building an empathetic, consistent, and caring relationship to provide treatment
  • Integrated care: Treatment combining mental health and medical care to improve overall functioning in the community; providing colocation of mental health and primary care at a single site
  • Supportive services in housing: Moving homeless persons with serious mental illness directly to independent housing with support and intensive attention
  • Prevention: Beginning with discharge planning in inpatient settings, provide resources for mental health care, housing, transitioning service, and follow-up

91.

What term describes when an insurance company does not pay a bill because certain required conditions were not met?

  • Denying the claim

  • Pre-approval

  • Claim

  • Benefit

Correct answer: Denying the claim

Denying the claim is when an insurance company does not pay a bill because certain required conditions were not met. 

The claim is a request to the insurance company to pay benefits for a loss. The benefit is the amount the insurance company pays when the insured suffers a loss. Pre-approval is the requirement set forth by an insurance company to authorize certain care before it is provided.

92.

Which of the following statements is incorrect regarding a patient's right to communication while psychiatrically hospitalized?

  • Patients are not allowed access to telephone calls or mail

  • Patients have the right to private telephone calls

  • Patients' incoming mail should not be opened by hospital staff

  • Patients' outgoing mail should not be opened by hospital staff

Correct answer: Patients are not allowed access to telephone calls or mail 

In general, patients have the right to free and open communication with the outside world; however, this right varies slightly by region, and nurse practitioners should check their local jurisdiction for explicit rulings. Most medical organizations agree that hospitalized patients should be allowed private telephone calls, and neither their outgoing nor their incoming mail should be opened by staff.

93.

Aromatherapy is a complementary and alternative therapy that is used to improve the mind-body connection. Why is aromatherapy in psychiatry used for olfactory stimulation?

  • To elicit feelings or memories during psychotherapy

  • To regulate autonomic physiologic functions

  • To alter brain chemistry by changing the release of neurohormones and neurotransmitters

  • To produce physiological effects

Correct answer: To elicit feelings or memories during psychotherapy

Aromatherapy is a form of olfactory stimulation used to elicit feelings or memories during psychotherapy.

Biofeedback regulates autonomic physiologic body functions. Acupressure and acupuncture alter brain chemistry through neurohormones and neurotransmitters. Herbal medicine is plant medicine that produces physiological effects.

94.

What factor is most likely to hinder or constrain growth for a nurse practitioner?

  • Growing competition in the job market for nurse practitioners

  • Industry emphasis on integrating services of the nurse practitioner

  • Decreasing stigmatization

  • Emergence of the nurse practitioner role in health care

Correct answer: Growing competition in the job market for nurse practitioners

Other factors that hinder and constrict growth are as follows:

  • Reimbursement struggles with Medicare and private insurance companies
  • Overlapping scope of practice with other NPs
  • Increased concerns over reimbursement fraud and abuse
  • Scope of practice and the need for formal supervision by or collaboration with a physician

Factors that foster or facilitate growth are as follows:

  • Consumer demand for services
  • Acceptance of the advanced practice nursing role
  • Emergence of the PMHNP role
  • Decreasing stigmatization
  • Emphasis on integrated healthcare services

95.

What directs the structure of proteins produced in the body?

  • Exons

  • Introns

  • The Golgi apparatus

  • Vesicles

Correct answer: Exons

Exons are the genetic component of DNA that is translated, ultimately providing the coding information for the structure of proteins in the body. Introns are sections of mRNA that are initially copied but excised prior to translation. The Golgi apparatus and vesicles are not involved in directing the structure of proteins.

96.

What is the difference between pharmacokinetics and pharmacodynamics?

  • Pharmacokinetics is the study of what the body does to drugs, and pharmacodynamics is the study of what drugs do to the body

  • Pharmacokinetics is the study of what drugs do and how they do it, and pharmacodynamics is the study of target sites for drug actions

  • Pharmacokinetics is the study of absorption, distribution, metabolism, and excretion; and pharmacodynamics is the study of what the body does to drugs

  • Pharmacokinetics is the study of drug receptors and enzymes, and pharmacodynamics is the study of the mechanism of action of drugs

Correct answer: Pharmacokinetics is the study of what the body does to drugs, and pharmacodynamics is the study of what drugs do to the body

  • Pharmacology is the study of what drugs do and how they do it.
  • Pharmacokinetics is the study of what the body does to drugs, including absorption, distribution, metabolism, and excretion.
  • Pharmacodynamics is the study of what drugs do to the body, including target sites for drug actions such as receptors, ion channels, enzymes, and carrier proteins.

97.

Who should receive a shingles vaccination?

  • Anyone over the age of 50

  • Anyone between the ages of 30 and 50 who has never had the chickenpox

  • Anyone over the age of 50 who has had the chickenpox

  • Adults aged 18 and older who have received the chickenpox vaccine

Correct answer: Anyone over the age of 50

Shingles, also known as herpes zoster, is an inflammatory condition where a virus produces painful vesicular eruptions along the nerves from one or more dorsal root ganglia. The shingles vaccine is recommended for anyone older than 50 whether or not they recall having had chickenpox, which is caused by the same virus as shingles.

In May 2006, the Food and Drug Administration (FDA) approved a VZV vaccine (Zostavax) for use in people 60 and older who have had chickenpox. In March 2011, the FDA extended the approval to include adults ages 50-59. A new shingles vaccine called Shingrix was licensed by the FDA in 2017 for adults aged 50 and older.

The shingles vaccine should not be given to:

  • People with a weakened immune system
  • People with HIV, AIDS, or a T-cell count below 200
  • Patients being treated with high-dose steroids

98.

What term accurately describes a request to the insurance company to pay benefits for a loss?

  • Claim

  • Benefit

  • Pre-approval

  • Denying the claim

Correct answer: Claim

A claim is a request to the insurance company to pay benefits for a loss. 

A benefit is an amount the insurance company pays when the insured suffers a loss. Pre-approval is the requirement set forth by an insurance company to approve certain care before it is provided. Denying the claim is when an insurance company does not pay a bill because certain required conditions were not met.

99.

Who established the first nurse practitioner program?

  • Loretta Ford and Henry Silver

  • Florence Nightingale and Hildegard Peplau

  • Jean Watson and Margaret Newman

  • Dorothea Orem and Martha Rogers

Correct answer: Loretta Ford and Henry Silver

In 1965, Dr. Loretta Ford (a public health nurse) and Dr. Henry Silver (a pediatrician) established the first nurse practitioner program at the University of Colorado. This program educated pediatric nurse practitioners with a focus on disease prevention and health promotion. Over the next decade, nurse practitioner schools proliferated across the country. Today, there are over 205,000 nurse practitioners.

100.

A skilled psychiatric interviewer should use person-centered communication. The focus should be on understanding the person and helping them tell their story. Which of the following is an essential component of excellent care?

  • Goals in the treatment plans should be based on the patient's goals, which could be different than the psychiatrist's goals

  • The psychiatric care provider must carefully acknowledge the patient's goals, but the care plan should reflect psychiatric goals, such as decreasing hallucinations

  • When patient goals and psychiatric goals vary widely, it is important to create goals for patient teaching regarding psychiatric diagnoses

  • Rephrase the patient's goals in psychiatric terms to increase understanding and subsequent compliance with the treatment plan

Correct answer: Goals in the treatment plan should be based on the patient's goals, which could be different than the psychiatrist's goals

Psychiatric interviews should be person-centered and not disorder-based. The focus should be on understanding the person and helping them tell their story. The resulting treatment plan should reflect the patient's goals. The patient should be explicitly encouraged to identify their goals and aspirations in their own words.

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