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Quiz Session - Attempts With Random Questions

AANPCB PMHNP-C Exam Questions

Page 8 of 60

141.

Problems with the frontal lobe are most likely to lead to which of the following?

  • Personality changes

  • Visual field defects

  • Aphasia and amnesia

  • Sensory-perceptual disturbances

Correct answer: Personality changes

Problems with the frontal lobe can lead to personality, emotional, and intellectual changes.

Problems with the temporal lobe can lead to aphasia and amnesia. Problems with the occipital lobe can lead to visual field defects. Problems with the parietal lobe can lead to sensory-perceptual disturbances and agnosia.

142.

Which statement accurately defines internal validity?

  • When the independent variable causes a change in the dependent variable

  • When the sample is representative of the population and the results can be generalized

  • The likelihood of an event occurring

  • How the values are dispersed around the mean

Correct answer: When the independent variable causes a change in the dependent variable 

Internal validity occurs when the independent variable causes a change in the dependent variable. External validity occurs when the sample is representative of the population and the results can be generalized. 

Probability is the likelihood of an event occurring. Variance describes how the values are dispersed around the mean.

143.

A PMHNP is seeing a patient with a history of depression and suicide attempts. Which of the following factors should the PMHNP consider the most critical in their risk assessment for this patient?

  • Access to lethal means

  • Family history of mental illness

  • Recent stressors and life events

  • Compliance with previous treatment

Correct answer: Access to lethal means

Access to lethal means, such as firearms or medication, is a strong predictor of suicide risk and should be given priority in the risk assessment process.

Family history, recent stressors, and treatment compliance are all important factors to consider, but access to lethal means should be assessed and addressed first in order to reduce the immediate risk to the patient.

144.

Systemic effects of hypernatremia include which of the following?

  • Thirst

  • Confusion

  • Apprehension

  • Lethargy

Correct answer: Thirst

Thirst is a potential systemic effect of hypernatremia. Systemic effects of hyponatremia can include confusion, apprehension, and lethargy.

145.

A PMHNP is working with a patient who has a history of alcohol use disorder. The PMHNP is considering using the Alcohol Use Disorders Identification Test (AUDIT) tool to assess the patient's level of alcohol use. Which items are most likely to be included in the AUDIT tool?

  • Patient's alcohol consumption over the past year

  • Patient's history of drug use

  • Patient's level of physical activity

  • Patient's history of alcohol-related legal problems

Correct answer: Patient's alcohol consumption over the past year

The AUDIT tool is used to screen for harmful or hazardous alcohol use and identify individuals with an alcohol-use disorder. The tool includes questions about the frequency and quantity of alcohol consumption, alcohol-related problems, and dependence symptoms. The PMHNP should be familiar with the use of the AUDIT tool and understand how to use the results to guide further evaluation and treatment for alcohol use disorders.

The patient's history of drug use, level of physical activity, and alcohol-related legal problems can be important considerations in the overall assessment of the patient but are not typically included in the AUDIT tool.

146.

Which statement accurately describes external validity?

  • When the sample is representative of the population and the results can be generalized

  • The likelihood of an event occurring

  • Indication of the possible deviations from the mean

  • When the independent variable causes a change in the dependent variable

Correct answer: When the sample is representative of the population and the results can be generalized

  • External validity: When the sample is representative of the population and the results can be generalized
  • Internal validity: When the independent variable causes a change in the dependent variable (this definition does not take into consideration the ability to generalize results)
  • Probability: The likelihood of an event occurring
  • Standard deviation: Indication of the possible deviations from the mean

147.

A client has been diagnosed with an enzyme deficiency disorder known to cause intellectual disability. Which of the following disorders causes a deficiency in hexosaminidase A, which is related to the development of intellectual disability?

  • Tay-Sachs disease

  • Lesch-Nyhan syndrome

  • Sickle cell disease

  • Hemophilia

Correct answer: Tay-Sachs disease

Tay-Sachs disease, also known as GM2 gangliosidosis, is an enzyme deficiency disorder that can cause intellectual disability. Tay-Sachs disease is caused by a deficiency of hexosaminidase A, which leads to the accumulation of a fatty substance in the brain.

148.

What is the difference between a delusion and an illusion?

  • A delusion is a false belief despite contrary evidence, and an illusion is a false perception of a real stimulus

  • A delusion is a belief that things will not improve, and an illusion is the belief that one will not be able to change the course of events

  • A delusion is the feeling of being far away from oneself, and an illusion is a sense that one's environment has changed

  • A delusion is a false auditory perception, and an illusion is a false visual perception

Correct answer: A delusion is a false belief despite contrary evidence, and an illusion is a false perception of a real stimulus

Patients with psychiatric conditions may experience a wide variety of abnormalities of thought content, including hallucinations, delusions, illusions, hopelessness, helplessness, depersonalization, and derealization.

  • Hallucinations: False sensory perceptions without stimuli present; they can be tactile, olfactory, gustatory, auditory, or visual
  • Delusions: False beliefs that are firmly maintained despite contrary evidence
  • Illusions: False perceptions of real stimuli
  • Hopelessness: A belief that things will not improve
  • Helplessness: A belief that one will not be able to change the course of events
  • Depersonalization: Feeling far away or disconnected from oneself
  • Derealization: A sense that one's environment has changed

149.

A 57-year-old man is admitted to the hospital. Initially, he was cooperative with treatment, but now he appears agitated and is asking to leave. His wife says that over the past year, his personality has changed. Your physical examination reveals memory impairment, asterixis, palmar erythema, peripheral edema, and a large ecchymotic area on his left elbow. 

What is the most likely diagnosis?

  • Hepatic encephalopathy

  • Human immunodeficiency virus

  • Hyperthyroidism

  • Conversion disorder

Correct answer: Hepatic encephalopathy

Hepatic encephalopathy is the loss of brain function when a damaged liver does not remove toxins from the blood. It is difficult to diagnose and can present in a variety of ways. 

Asterixis is characteristic of hepatic encephalopathy, but not diagnostic. Other signs may include ecchymosis, peripheral edema, ascites formation, palmar erythema, and spider angiomas. Family members and friends may state that the patient's personality has changed and that their cognitive abilities have deteriorated.

150.

Which of the following statements is incorrect regarding a person's culture?

  • Culture groups human beings by physiognomy

  • Culture involves learned beliefs and behaviors

  • Some cultures have syndromes that are not necessarily linked to psychiatric illnesses

  • Culture can be influenced by climate

Correct answer: Culture groups human beings by physiognomy 

Race, not culture, is a concept by which human beings are grouped primarily by physiognomy.

Culturally competent care includes the following concepts:

  • Culture has learned beliefs and behaviors
  • Culture includes inherited characteristics such as racial, social, ethnic, and religious beliefs
  • Cultures have syndromes that are not necessarily linked to psychiatric illnesses
  • Culture can be influenced by the following:
    • Family
    • Ethnicity
    • Community
    • Environment, such as:
      • Climate
      • Social contacts
      • Housing and surroundings
      • Altitude
      • Temperature
      • Air pollution
      • Fluoride in the water
      • Water quality
      • Crime
      • Poverty
      • Transportation available

151.

Which statement accurately describes "with melancholic features," a specifier used in the diagnosis of mood disorders?

  • These patients feel worse in the morning, and they experience decreased appetite, weight loss, and agitation

  • These patients eat a lot, gain weight, sleep excessively, and have a feeling of being sluggish or paralyzed

  • These patients have high levels of tension, restlessness, worry, and fear

  • These patients have experienced at least four mood episodes in the past year

Correct answer: These patients feel worse in the morning, and they experience decreased appetite, weight loss, and agitation

Specifiers are special descriptions added to a patient's diagnosis to provide more information. Specifiers help characterize the condition and describe its overall course. Specifiers used to describe mood disorders include the following:  

  • With atypical features: These patients eat a lot and gain weight, sleep excessively, and have a feeling of being sluggish or paralyzed. They are also sensitive to rejection.
  • With melancholic features: These patients feel worse in the morning than in the afternoon, and they experience decreased appetite, weight loss, and agitation. They also tend to feel excessively guilty and have trouble making decisions.
  • With anxious distress: These patients have high levels of tension, restlessness, worry, and fear.
  • With catatonic features: These patients exhibit either motor hyperactivity or inactivity.
  • With mixed features: These patients are experiencing a mixture of both manic and depressive symptoms.
  • With peripartum onset: These patients develop a mood episode during pregnancy or within a month of having their baby.
  • With psychotic features: These patients develop delusions or hallucinations along with their mood symptoms.
  • With rapid cycling: These patients have experienced at least four mood episodes in the past year.
  • With a seasonal pattern: These patients regularly become ill at a certain time of the year.

152.

A PMHNP is working with a patient who has a history of poor interpersonal relationships and frequently experiences feelings of loneliness and social isolation. According to Harry Stack Sullivan's interpersonal theory, which of the following is the primary cause of the patient's difficulties?

  • Failure to establish satisfying relationships

  • Inability to meet basic needs

  • Poor social skills

  • Lack of positive self-regard

Correct answer: Failure to establish satisfying relationships

Harry Stack Sullivan's interpersonal theory suggests that the primary motive of human behavior is the satisfaction of interpersonal needs. These needs arise from early experiences and shape the development of personality. According to Sullivan, the individual's personality is shaped by their interactions with others, and difficulties in interpersonal relationships can lead to emotional distress and psychological problems.

153.

What term describes a scientific study that gathers multiple studies and analyzes them to draw a larger conclusion?

  • Systematic review

  • Correlational study

  • Observational study

  • Randomized controlled trial

Correct answer: Systematic review 

A systematic review is a scientific study that gathers multiple studies and analyzes them to draw a larger conclusion. The term systematic refers to methodical order and planning. When conducting a systematic review, the researcher uses transparent and structured steps in order to avoid bias and increase confidence in the findings. There are two main types of systematic reviews; they differ in the type of research they analyze and how they analyze it.

  • Meta-analysis: a scientific study that statistically analyzes a collection of quantitative studies. These studies use statistics to discover patterns that would be otherwise undetectable.
  • Meta-synthesis: a scientific study that analyzes a collection of qualitative studies. The researchers reveal meaning by summarizing the results in a narrative format.

154.

A PMHNP working in a psychiatric hospital is considering using seclusion and restraint for a patient exhibiting violent, aggressive behavior. Which of the following best describes an appropriate indication of the use of seclusion and restraint in this situation?

  • To protect staff and other patients from harm by limiting the patient's ability to act out violently

  • To punish the patient for their behavior and discourage future acts of violence

  • To protect the patient from harm by limiting their mobility and access to dangerous objects

  • To encourage the patient to comply with treatment and follow hospital rules

Correct answer: To protect staff and other patients from harm by limiting the patient's ability to act out violently

The use of seclusion and restraint is a controversial practice in mental health care and should only be used when necessary. An appropriate indication for using seclusion and restraint is when the patient poses an immediate danger of harm to themselves or others and alternative interventions have failed or are not feasible.

The use of seclusion and restraint is not intended as a punishment or a means of encouraging compliance with treatment or hospital rules). While seclusion and restraint may limit the patient's mobility and access to dangerous objects, the primary goal is to protect staff and other patients from harm.

155.

Outcomes management uses variance data to change a system of healthcare practice. Which of the following is least likely to be a source of variance?

  • Patient survey

  • Practitioner behavior 

  • Severity of patient illness

  • Practice patterns of care delivery

Correct answer: Patient survey

Outcomes management is the use of aggregate variance data to change a system of healthcare practice. Variance is any event that alters patient progress toward expected outcomes. Sources of variance include practitioner behavior (competency), the severity of illness (with high-risk patients), and practice patterns that either expedite care or inhibit the delivery of care.

Patient surveys are unique to each patient and do not provide variance of practice. The patient is not considered a source of variance when it comes to outcomes management. The focus in outcomes management is system-based and concerned with how the system of care can be improved for better patient outcomes.

156.

Which of the following is a valid screening tool used for the early detection of attention deficit/hyperactivity disorder (ADHD) specifically?

  • Conners 3rd Edition (Conners 3)

  • Children's Depression Inventory (CDI)

  • Behavior Assessment System for Children (BASC)

  • Child Behavior Checklist (CBCL)

Correct answer: Conners 3rd Edition (Conners 3)

The Conners 3rd Edition (Conners 3) is a valid screening tool that is commonly used for the early detection of ADHD. It is a comprehensive tool that includes parent, teacher, and self-report rating scales. It measures a wide range of ADHD symptoms, including hyperactivity, impulsivity, and inattention. The Conners 3 is a reliable tool for the early detection of ADHD and is often used in both clinical and educational settings.

The Children's Depression Inventory (CDI) is a screening tool used to identify symptoms of depression in children and adolescents. The Behavior Assessment System for Children (BASC) is a comprehensive tool used to assess a wide range of emotional and behavioral problems in children and adolescents. The Child Behavior Checklist (CBCL) is a tool used to identify a broad range of emotional and behavioral problems in children and adolescents.

157.

Statistically, gambling disorder is most prevalent among which of the following ethnic/racial groups?

  • African Americans

  • European Americans

  • Asian Americans

  • Hispanic Americans

Correct answer: African Americans

Gambling disorder is more prevalent in African Americans than in European, Asian, or Hispanic Americans. Indigenous populations also experience high rates of gambling disorder. Males are more likely to develop this disorder than females.

Males with gambling disorder:

  • Are more likely to wager on cards, sports, and horse races
  • Tend to begin gambling earlier in life
  • Tend to develop the disorder over a quicker period
  • Are less likely to seek treatment

Females with gambling disorder:

  • Are more likely to gamble with slot machines and bingo games
  • Are more likely to have a comorbid psychiatric condition such as depressive, bipolar, or anxiety disorder
  • Tend to develop the disorder progressively over time
  • Are more likely to seek treatment

158.

Which of the following types of family therapy is most likely to rely on miracle questioning, scaling, and exception-finding questions?

  • Solution-focused therapy

  • Structural family therapy

  • Family systems therapy

  • Strategic therapy

Correct answer: Solution-focused therapy

Solution-focused therapy is based on the effective resolution of problems using personal resources and strengths. Techniques include miracle questions, scaling, and exception-finding questions. 

Structural family therapy is focused on providing a structural change in family dynamics to manage problems more effectively. Family systems therapy is designed to increase each member of the family's awareness of each other's role. Strategic family therapy views symptoms as metaphors and teaches the family new ways to behave to reduce problem behaviors. 

159.

Which psychiatric condition is characterized by at least one hypomanic episode and at least one major depressive episode?

  • Bipolar II disorder

  • Bipolar I disorder

  • Cyclothymic disorder

  • Schizoaffective disorder

Correct answer: Bipolar II disorder

Around 25% of those diagnosed with a mood disorder experience manic or hypomanic episodes. Almost all patients who experience a manic or hypomanic episode also experience periods of depression. The severity and duration of the highs and lows differentiate the types of bipolar disorder:

  • Bipolar I disorder: These patients experience at least one manic episode and may or may not experience a major depressive episode.
  • Bipolar II disorder: These patients experience at least one hypomanic episode and at least one major depressive episode.
  • Cyclothymic disorder: These patients experience mood swings, but they are not severe enough to be called major depressive episodes or manic episodes.

Schizoaffective disorder is a psychotic disorder characterized by patients experiencing symptoms of schizophrenia along with either depression or mania.

160.

Graduates from the first nurse practitioner program were educated in what medical specialty?

  • Pediatrics

  • Family medicine

  • Psychiatry

  • Women's health

Correct answer: Pediatrics

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.

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