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College Admission American Nurses Credentialing Center: Adult Psychiatric-Mental Health Nurse Practitioner-Board Certified Sample Questions (Q434-Q439):
NEW QUESTION # 434
A client presents to the ER after a suicide attempt by cutting his wrists. You show that you understand the importance of client safety by first doing which of the following?
- A. Obtaining accurate vital signs
- B. Restraining the client to prevent further self-harm
- C. Assessing the client for immediate self-harm ideation
- D. Assessing the client for potential self-harm instruments he may be hiding on his body
Answer: A
Explanation:
The most important first assessment in this scenario is ensuring that the client's homeostasis is not compromised. He is at risk for blood loss and rapid decompensation, given that he cut his wrists.
Assessing the client for ideation and contraband is important, but not the most immediate concern.
Restraining the client against his will could potentially be considered assault and battery depending on the client's status. There is no indication that he is requiring restraints in this scenario.
NEW QUESTION # 435
Which of the following would be an appropriate early intervention strategy for a community mental health clinic to target personality disorders?
- A. Refer all new and expectant parents to medical social work
- B. Monitor families with a known history of mental illness
- C. Provide education and guidance to new and expectant parents through groups, community education, and social outreach
- D. Screen for instability in homes that could increase stressors
Answer: C
Explanation:
There are currently no agreed-upon prevention strategies for personality disorders. Community and parent education would focus on the importance of providing a stable home life during childhood and adolescence and role-modeling healthy moods, actions, and reactions to life events. Providing education to all new and expectant parents on the importance of stability and security in the home in all ways (e.g., emotional and mental health, finances, food, and housing) is a well-rounded strategy.
NEW QUESTION # 436
Which of the following medications for the treatment of a patient with major depressive disorder is a PMHNP allowed to prescribe?
- A. Antidepressants
- B. Insulin
- C. Narcotics
- D. Antihypertensives
Answer: A
Explanation:
According to the American Nurses Association (ANA), psychiatric nurse practitioners are licensed and certified to diagnose and treat mental health conditions, including prescribing medication. PMHNPs can prescribe a wide range of psychopharmacological agents, including antidepressants, mood stabilizers, and antipsychotics.
NEW QUESTION # 437
Which of the following is an issue outside of the four key issues contributing to the poor quality of care in the United States healthcare system, as identified in the Institute of Medicine's Crossing the Quality Chasm?
- A. Challenges to the implementation of healthcare technology
- B. An increase in chronic conditions
- C. An inefficient and disorganized delivery system
- D. A lack of physician leadership
Answer: D
Explanation:
In 2001, the Institute of Medicine published Crossing the Quality Chasm: A New Health System for the 21st Century. This report identified four key issues contributing to poor quality of care and undesirable patient outcomes:
1. The complexity of knowledge, skills, interventions, and treatment required to deliver care
2. The increase in chronic conditions
3. An inefficient, disorganized delivery system
4. Challenges to greater implementation of information technology
In this report, the Institute of Medicine emphasized the need for healthcare providers to actively collaborate, exchange information, and make provisions for care coordination because the needs of any person or population are beyond the expertise of any single health profession.
NEW QUESTION # 438
A patient with a history of depression and hypertension presents with a sudden headache, increased blood pressure, and palpitations. The patient's medication regimen includes Marplan. The patient reports consuming a large amount of aged cheese before the onset of symptoms. The PMHNP's next action should be which of the following?
- A. Administer propranolol to lower blood pressure
- B. Administer nifedipine to lower blood pressure
- C. Administer epinephrine to raise blood pressure
- D. Administer meperidine for headache pain management
Answer: A
Explanation:
Marplan is a monoamine oxidase inhibitor (MAOI). The patient is likely experiencing a tyramine crisis, where ingesting tyramine-rich foods, such as aged cheese, can cause a sudden release of norepinephrine, leading to a hypertensive crisis. Propranolol is a beta-blocker that can help lower blood pressure and prevent the further release of norepinephrine.
Nifedipine is a calcium channel blocker that can lower blood pressure but may not be as effective as a beta-blocker. Epinephrine raises blood pressure, so it would not be appropriate to administer it in a hypertensive crisis. Meperidine may temporarily relieve headache pain but does not address the underlying cause of the crisis.
NEW QUESTION # 439
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