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Quiz Session - Attempts With Random Questions

AANPCB PMHNP-C Exam Questions

Page 7 of 60

121.

When is a nurse practitioner's scope of practice legally the most secure?

  • When the scope of practice is defined by a statute

  • When the scope of practice is defined by a regulation

  • When the scope of practice is defined by a physician who can delegate tasks to a nurse practitioner

  • When the scope of practice is defined by a law prohibiting the practice of medicine without a license

Correct answer: When the scope of practice is defined by a statute 

A nurse practitioner's scope of practice is legally the most secure when it is clearly defined by a statute. Physicians' organizations often try to prevent nurse practitioners from providing patient care by pointing to state law and asking for a strict interpretation. When a nurse practitioner's scope of practice is clearly defined by statute, it is most secure against physician special interest groups.

122.

Tanner stages define physical measurement in the development of primary and secondary sex characteristics in both females and males. What is stage 2 of female breast development?

  • Breast bud stage with elevation of the breast and papilla

  • Projection of papilla and recession of areola

  • Areola and papilla form a secondary mound above the level of the breast

  • Prepubertal

Correct answer: Breast bud stage with elevation of the breast and papilla

Tanner stages define physical measurement in the development of primary and secondary sex characteristics in both females and males.

Tanner stages of breast development are as follows:

  • Stage 1: Prepubertal
  • Stage 2: Breast bud stage with elevation of breast and papilla
  • Stage 3: Further enlargement of breast and areola
  • Stage 4: Areola and papilla form a secondary mound above the level of the breast
  • Stage 5: Projection of papilla related to recession of areola

123.

Which medication has black box warnings of hepatotoxicity and pancreatitis?

  • Valproic acid

  • Valium

  • Klonopin

  • Prozac

Correct answer: Valproic acid

Black box warnings are indications by the FDA of potential serious side effects and should be considered in the treatment planning of patients. Valproic acid has black box warnings for hepatoxicity and pancreatitis.

124.

Which of the following statements made by an NP student regarding a PMHNP's role in an interdisciplinary treatment team requires correction?

  • "A nurse practitioner is not considered a full partner in health care."

  • "A nurse practitioner is educated to lead interdisciplinary teams."

  • "A nurse practitioner has equal input in evaluating and advocating for the redesign of the healthcare system."

  • "A nurse practitioner can translate research into practice."

Correct answer: "A nurse practitioner is not considered a full partner in health care."

A nurse practitioner is educated to lead interdisciplinary treatment teams. When working with a team of physicians, a nurse practitioner is considered a full partner in health care. Nurse practitioners have equal input in designing, implementing, evaluating, and advocating for redesigning the U.S. healthcare system. A nurse practitioner can translate research into practice.

125.

Which of the following statements is inaccurate regarding PTSD in young children?

  • Young children are less likely to experience PTSD due to their inability to form accurate memories regarding the event

  • It is common for children with PTSD to have nightmares

  • Sometimes children with PTSD or trauma exhibit repetitive play themes of trauma

  • Children with PTSD or trauma can exhibit disorganized or agitated behavior

Correct answer: Young children are less likely to experience PTSD due to their inability to form accurate memories regarding the event

PTSD can occur at any age, including childhood. PTSD manifests differently in children than in adults. PTSD can present as agitated or disorganized behavior. Play themes can show aspects of trauma. Nightmares are common. In some cases, a traumatic event happens to a loved one and not to the child.

126.

You are a nurse practitioner treating a seven-year-old male. His mother explains, “My son’s teacher is concerned about him because he is not able to finish his in-class schoolwork. I just don’t know what to do.” The patient reportedly fails to give attention in class, gets distracted often, is disorganized with his assignments, constantly loses his homework, talks out of turn and distracts other students, and interrupts when other students answer a question. Given this information, you decide to order labs to ensure there is not another medical cause for his academic performance. 

What lab findings would support a diagnosis of attention deficit hyperactivity disorder (ADHD)?

  • There are no lab findings specific to ADHD

  • Aplastic anemia

  • Leukocytosis

  • Thrombocytopenia

Correct answer: There are no lab findings specific to ADHD

There are no specific diagnostic and laboratory findings supporting a diagnosis of ADHD. The presence of aplastic anemia, leukocytosis, or thrombocytopenia would not be anticipated with ADHD.

127.

Which of the following conditions is least likely to produce similar symptoms to a panic attack?

  • Major depressive disorder

  • Hyperthyroidism

  • Pheochromocytosis

  • Cocaine use

Correct answer: Major depressive disorder

While major depressive disorder (MDD) may be closely related to panic attacks, it does not have symptoms that are similar to panic attacks.

Symptoms that produce symptoms similar to panic attacks can include hyperthyroidism, pheochromocytosis, and cocaine use.

128.

Delirium etiologies that should be ruled out include all but which of the following?

  • Parkinson's disease

  • Nutritional deficiencies

  • Perfusion issues related to significant anemia

  • Constipation

Correct answer: Parkinson's disease

Parkinson's disease is a dementia differential. Nutritional deficiencies, perfusion issues related to significant anemia, constipation, and nutritional deficiencies are all possible etiologies of delirium.

129.

A newborn baby is diagnosed with phenylketonuria (PKU). Which of the following is the main treatment for PKU?

  • Special diet

  • Surgery

  • Medication

  • Gene therapy

Correct answer: Special diet

Phenylketonuria is a genetic disorder in which the body cannot process phenylalanine, an amino acid found in many foods. The main treatment for PKU is a special diet that is low in phenylalanine and high in tyrosine. This diet typically starts as soon as PKU is diagnosed, usually through a newborn screening test.

130.

What term best describes the process of neuronal membrane threshold sensitivity dysfunction?

  • Kindling

  • GABA deregulation

  • Increased noradrenergic activity

  • Dependence

Correct answer: Kindling

Kindling is the process of neuronal membrane threshold sensitivity dysfunction. 

GABA deregulation and increased noradrenergic activity can play a role in the dysfunction of neuronal membrane threshold sensitivity but are not the terms that best describe the phenomenon. Dependence is caused by neuronal membrane threshold sensitivity changes but does not best describe the phenomenon.

131.

A Psychiatric Mental Health Nurse Practitioner (PMHNP) is conducting a clinical interview with a patient who is seeking treatment for anxiety. The PMHNP uses open-ended questions to gather information about the patient's symptoms and experiences. 

Which of the following statements about the use of open-ended questions in clinical interviewing is most accurate?

  • Open-ended questions are useful in psychiatric interviews because they allow the patient to provide detailed, personal information about their experiences

  • Open-ended questions are not useful in psychiatric interviews because they do not provide specific information

  • Open-ended questions should only be used to gather information about a patient's symptoms and should not be used to explore the patient's feelings or thoughts

  • Open-ended questions should only be used in the initial stages of the interview and should not be used throughout the interview process

Correct answer: Open-ended questions are useful in psychiatric interviews because they allow the patient to provide detailed, personal information about their experiences

Open-ended questions are a key tool in clinical interviewing, as they allow patients to provide detailed, personal information about their experiences. Open-ended questions are especially useful in psychiatric interviews because they allow patients to describe their symptoms in their own words and provide insight into their thoughts and feelings. This can help the PMHNP to understand the patient's perspective and to make a more accurate assessment of their condition and treatment needs.

132.

During an initial psychiatric interview, a patient makes frequent tangential references to certain issues, has peculiar speech mannerisms, and makes frequent "slips of the tongue." The nurse practitioner makes a note of these for exploration in future sessions. 

Which cognitive process in the patient's presentation needs to be explored better to understand their needs? 

  • Unconscious processes

  • Anxiety symptoms

  • Embarrassment

  • Cultural biases

Correct answer: Unconscious processes

Unconscious processes must be considered to understand the provider-patient relationship. The majority of mental activity remains outside of conscious awareness. Unconscious processes may be suggested by tangential references, slips of the tongue, or prefacing statements with qualifiers such as "to be honest."

133.

A PMHNP is assessing a patient who has difficulty comprehending language. Which of the following types of aphasia is the patient most likely experiencing?

  • Wernicke's aphasia

  • Broca's aphasia

  • Global aphasia

  • Anomic aphasia

Correct answer: Wernicke's aphasia

Wernicke's aphasia, also known as receptive aphasia, is a type of language disorder in which an individual has difficulty comprehending meaningful language. Individuals with Wernicke's aphasia may produce fluent speech devoid of content and may also have difficulty understanding spoken or written language.

Broca's aphasia is a type of language disorder in which an individual has difficulty producing language, but their comprehension is largely intact. Global aphasia is a type of language disorder in which an individual has severe difficulty producing and understanding language. Anomic aphasia is a type of language disorder in which an individual has difficulty finding words and may have difficulty with word retrieval, but their comprehension is largely intact.

134.

In almost all cultures, what is the most commonly used intoxicating substance?

  • Alcohol

  • Cannabis

  • Opioids

  • Hypnotics

Correct answer: Alcohol

In almost all cultures, alcohol is the most commonly used intoxicating substance. About 3.8% of all global deaths and 4.6% of global disability-adjusted life-years are due to alcohol. About 80% of adults in the United States consume alcohol at some point in their lives, and 65% of adults are current drinkers.

About 3.6% of the world's population has an alcohol use disorder, although this varies in different parts of the globe:

  • 1.1% of those in the African region have an alcohol use disorder
  • 5.2% in the American region
  • 10.9% in the European region

135.

A PMHNP is working with a child experiencing difficulty with abstract thinking and problem-solving who met all other stages of cognitive development. According to Jean Piaget's cognitive theory, in which stage of development is this child?

  • Concrete operational stage

  • Sensorimotor stage

  • Preoperational stage

  • Formal operational stage

Correct answer: Concrete operational stage

Jean Piaget's cognitive theory describes four stages of cognitive development in children. According to this theory, children in the concrete operational stage (typically 7 to 11 years of age) have a more developed ability to think logically and systematically, but they still struggle with abstract thinking and problem-solving.

The sensorimotor stage (birth to 2 years of age) is characterized by developing sensory and motor abilities. The preoperational stage (2 to 7 years of age) is characterized by the development of symbols, language, and mental representations. Abstract and hypothetical thinking development characterize the formal operational stage (11 years and older).

136.

A 17-year-old male patient with autism and bipolar disorder has been prescribed Depakote for the management of severe aggression toward himself and others. Since he started Depakote, these behaviors have decreased, but the patient now presents with daytime fatigue and lethargy. Blood work reveals therapeutic Depakote levels but high ammonia. Adding the Depakote resulted in a significant decrease in aggression and was thought to be overall helpful. 

What action could be taken to mitigate the elevated ammonia and retain the benefits of the Depakote?

  • Add the amino acid L-carnitine to reduce ammonia levels

  • Reduce the Depakote dose and monitor

  • Monitor ammonia and liver enzymes, as ammonia levels rise with initial dosing and stabilize as the body acclimates

  • Prescribe a vegetarian diet to reduce dietary sources of ammonia

Correct answer: Add the amino acid L-carnitine to reduce ammonia levels

Valproic acid can create elevated ammonia levels, which can provoke symptoms ranging from fatigue to coma. When valproic acid levels are therapeutic and thought to be helpful for prescribed symptoms, the addition of l-carnitine can help lower ammonia levels. If this intervention is not effective, the dose may need to be reduced, or the medication may need to be stopped. 

137.

A PMHNP is working with an individual who reports minimal stress at their job and no money concerns. What type of preventative factors are these descriptors?

  • Social preventative factors

  • Biological preventative factors

  • Psychological preventative factors

  • Environmental preventative factors

Correct answer: Social preventative factors

Preventative factors describe factors that help prevent the risk of mental illness. Social preventative factors can include a low-stress occupation, higher socioeconomic status, or higher level of education. Biological factors may include no family history of mental illness or good general health. Psychological factors can include healthy self-esteem or an internal locus of control. 

There is no category for environmental preventative factors, as these would most likely fall within the other categories.

138.

A person who is proficient in the use of software, hardware selection, and computer maintenance possesses which skill?

  • Computer competency

  • Biomedical engineering

  • Information literacy

  • Information competency

Correct answer: Computer competency

Computer competency is the ability to demonstrate proficiency with software applications, such as Microsoft Word, Excel, and PowerPoint, and knowledge of computer terminology, hardware selection, and simple maintenance functions. 

Biomedical engineering is developing new devices and technologies to improve human health. While those skilled in biomedical engineering often have computer competency, these terms are not related. 

Information literacy involves recognizing when information is needed and being able to efficiently locate and use it. Information competency is often used as a synonym for information literacy.

139.

Magnesium is responsible for neuromuscular activity and excitability. A decreased level of magnesium in the body is linked to which of the following illnesses?

  • Alcoholism

  • Hypothyroidism

  • Hyperthyroidism

  • Renal failure

Correct answer: Alcoholism

Alcoholism is linked to decreased levels of magnesium in the body.

Other diseases linked to increased magnesium levels:

  • Addison's disease
  • Diabetic ketoacidosis
  • Dehydration

Hypothyroidism, hyperthyroidism, and renal failure are all linked to hypermagnesemia. 

140.

States vary in the initials they designate to nurse practitioners. Which of the following is an incorrect example of these designated initials?

  • NPP (non-physician provider)

  • ARNP (advanced registered nurse practitioner)

  • CRNP (certified registered nurse practitioner)

  • APRN (advanced practice registered nurse)

Correct answer: NPP (non-physician provider)

States vary in the initials they designate to nurse practitioners. The following are examples of initials used to designate nurse practitioners across the United States:

  • ARNP (advanced registered nurse practitioner)
  • CRNP (certified registered nurse practitioner)
  • APRN (advanced practice registered nurse)
  • RNP (registered nurse practitioner)
  • ANP (advanced nurse practitioner)
  • CNP (certified nurse practitioner)
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