PMHNP Exam Reported Questions
What is dissemination? – CORRECT ANSWER Getting the research
information out to those who need to know it!
Publication – highest level
Presenting at National Conference
Presenting at Local Conference
Journal Club where one person reviews an article
What does a 17 on MMSE mean? – CORRECT ANSWER Moderate
cognitive impairment
What is Tegretol in the CYP450 system? – CORRECT ANSWER Inducer
–>will lower dose of Lamictal and BCP’s
What do BCP’s do to Lamictal? – CORRECT ANSWER Inducer – will
lower dose of Lamictal
What is a Type I research error? – CORRECT ANSWER There IS a
difference but you say there isn’t a difference.
What is a Type II research error? – CORRECT ANSWER There is NO
difference but you say there is a difference.
What is pseudo-dementia? – CORRECT ANSWER Cognitive
impairment secondary to depression that clears when treated in the elderly.
Dementia won’t improve.
Is it normal for a 1 month old to have a palmar grasp? – CORRECT ANSWER
Yes.
What is a drug 1/2 life? – CORRECT ANSWER The time it takes for 50%
of a drug to be eliminated from the body.
What 3 atypicals can be used with teens? – CORRECT ANSWER
Zyprexa, Abilify, Seroquel – low doses
What is a risk of using Tramadol? – CORRECT ANSWER Serotonin
Syndrome as it is very serotonergic.
What is the allele seen in Asians that increase the risk of SJS? – CORRECT
ANSWER HLAB-1502
When might you see toxic epidermal necrolysis? – CORRECT ANSWER
With worsening of SJS
How many generations do you include for a genogram? – CORRECT ANSWER
1st degree – mother, father, siblings
2nd degree – grandparents & cousins
3rd degree –
What does messenger RNA code for? – CORRECT ANSWER Amino
Acids
What is epigenetics? – CORRECT ANSWER Factors that affect genes –
environmental, smoking, stress, etc…
What part of the brain is involved with OCD? – CORRECT ANSWER
Basal Ganglia
Occipito-Frontal
What happens to the brain during adolescence? – CORRECT ANSWER
Dendritic pruning
Emotions are controlled by amygdala
By adulthood, PFC involved as well
When do males typically present with schizophrenia? – CORRECT ANSWER
10-25 yo
ANCC Certification PMHNP
Chapter 7
Mood Disorders – CORRECT ANSWER Most common psych illnesses
Primary characteristic is persistent disturbance in mood – CORRECT ANSWER
Major Depressive Disorder
Often occurs without precipitating event – CORRECT ANSWER MDD
Object loss theory – CORRECT ANSWER Fairbairn, Winnicott & guntrip
Aggression turned inward theory of MDD – CORRECT ANSWER Freud
Cognitive Theory – CORRECT ANSWER Beck
Learned Helplessness-Hopelessness Theory – CORRECT ANSWER Seligman
Genetic predisposition – CORRECT ANSWER Strong genetic load for
depression for child of depressed parent -having 3 fold increase in lifetime risk of
MDD & 40% chance of depressive episode before age 18.
Endocrine dysfunction Theory – CORRECT ANSWER Probably related to
etiology of MDD
Sleep disturbances, appetite disturbances, libido disturbances, lethargy,
anhedonia are neurovegitative symptoms that are related to functions of the –
CORRECT ANSWER Hypothalamus and pituitary gland secretions
Endocrine dysfunction and pregnancy – CORRECT ANSWER A high incidence of
postpartum mood disturbances is suggested with this
Hypothalamic-pituitary-adrenal axis (HPA) – CORRECT ANSWER A theory of
MDD, may be a result of an abnormal stress response related to dysregulation of
this system
HPA axis – CORRECT ANSWER Controls the physiological response to stress
and is composed of interconnective feedback pathways between the
hypothalamus, pituitary gland, and adrenal gland.
Hypothalamus releases – CORRECT ANSWER corticotropin-releasing hormone
(CRH)
Adrenocorticotropin hormone (ACTH) – CORRECT ANSWER Released by
pituitary in response to CRH by hypothalamus
Cortisol – CORRECT ANSWER Released by adrenal glands in response to ACTH
by pituitary gland
Hyperactivity of the HPA axis – CORRECT ANSWER Demonstrated to be
present in individuals with MDD. May also have elevated cortisol levels
Elevated cortisol levels – CORRECT ANSWER Over time damages the CNS by
altering neurotransmission and electrical signal conduction. Cortisol over time can
cause changes in size and function of brain tissue
ANCC PMHNP
Psychoanalytic theory – CORRECT ANSWER Oral , anal, phallic, latency, and
genital stages
PsychoDYNAMIC or Individual: Adler – CORRECT ANSWER Recognized
inferiority as driving force; strive for superiority; motivation is through social
relatedness
PsychoDYNAMIC or Individual Theory: Adler – CORRECT ANSWER Assume
responsibility for growth
Live a purposeful life
Consciousness raising
Intrapersonal conflicts
Birth Order
Existential: Frankl, May, Yalom – CORRECT ANSWER Stresses human
EXISTENCE, choice, freedom and responsibility:Logotherapy: therapy through
meaning
Person-centered: Carl Rogers: personality theory and psychotherapy – CORRECT
ANSWER UNCONDITIONAL POSITIVE REGARD, relationship
genuineness, accurate empathy, self-actualization
Humanistic Psychology and Heirarchy of Needs – CORRECT ANSWER
Abraham Maslow
Person-centered – CORRECT ANSWER Carl Rogers
the conscious mind; the unconscious mind; conflict model between conscious and
unconscious forces
WHAT therapist? – CORRECT ANSWER Freud
Fritz Perls – CORRECT ANSWER GESTALT Theorist
Gestalt – CORRECT ANSWER the process of forming wholeness Here and
Now
Empty Chair Technique
Fritz Perls
“You do your thing, Ill do mine”
Operant Conditioning – CORRECT ANSWER behaviors are influenced by their
consequences. for example punishment. Skinner theorist
Cognitive: Albert Ellis – CORRECT ANSWER Irrational beliefs that occur in
response to some triggering event that leads to negative emotions, anxiety or
depression “cognitive distortions”
REBT and confrontation
Cognitive: BECK – CORRECT ANSWER Must, should, ought
to …Catastrophizing, over generalizing, dichotomous thinking. IE panic attack “I’m
having a heart attack.”
Guided collaboration on cognitive distortions.
Interpersonal therapy – CORRECT ANSWER Klerman and Weissman, Peplau
Stack-sullivan
IP therapy – CORRECT ANSWER quality of attachment in early life bears on
quality of IP relationships later.
Sample Test Questions ANCC –
PMHNP
A patient with borderline personality disorder experiences intense anxiety when
an adult psychiatric and mental health nurse practitioner goes on vacation. The
best explanation for this reaction is that the patient:
A. has failed to develop clear ego boundaries.
B. has failed to master object constancy.
C. is employing primitive idealization.
D. is employing projective identification. – CORRECT ANSWER B. has failed to
master object constancy
- A patient has been taking escitalopram (Lexapro) 10 mg daily for four weeks.
Initially, the patient reported depression and suicidal thoughts. The patient’s
sleep, appetite, energy, and appearance have now begun to improve. Which
statement applies to this patient?
A. The medication should be discontinued.
B. The medication should be increased.
C. The patient’s risk for suicide is not a concern.
D. The patient’s suicide potential is increased. – CORRECT ANSWER D. The
patient’s suicide potential is increased. - Which behavior reflects existentially oriented therapy?
A. Attempting to understand a patient’s subjective world
B. Challenging a patient’s irrational beliefs
C. Developing specific plans for change
D. Establishing general group goals – CORRECT ANSWER A. Attempting to
understand a patient’s subjective world - Serving as a member on a crisis team, an adult psychiatric and mental health
nurse practitioner provides crisis intervention to the survivors of a plane crash.
Forty-eight hours after the accident, the survivors describe vivid flashbacks,
startle reactions, and disrupted sleep patterns. The nurse practitioner responds
by:
A. advising the survivors to consider using a hypnotic medication for a brief
period.
B. educating the survivors about prodromal symptoms of posttraumatic stress
disorder.
C. encouraging the survivors to rest during the day.
D. suggesting that the survivors join a posttrauma support group. – CORRECT
ANSWER B. educating the survivors about prodromal symptoms of
posttraumatic stress disorder. - An adult psychiatric and mental health nurse practitioner uses the
interpersonal therapy model with a patient to establish a therapeutic alliance
based upon empathy and trust. The nurse practitioner recognizes the patient’s
readiness to terminate therapy when the patient demonstrates:
A. an understanding that leaving a significant other may be painful, but also
presents an opportunity for growth.
B. breathing and muscle relaxation exercises that decrease muscle tension and
anxiety.
C. free association, and considers the nurse practitioner’s interpretation of the
patient’s dreams.
D. new adaptive skills and responses after completing “homework assignments.” –
CORRECT ANSWER A. an understanding that leaving a significant other may be
painful, but also presents an opportunity for growth. - An Hispanic patient informs an adult psychiatric and mental health nurse
practitioner during a wellness visit that he or she occasionally uses hot chili juice
PRACTICE QUESTIONS PMHNP
2023
what term describes a scientific study that gathers multiple studies and analyzes
them to draw a larger conclusion? – CORRECT ANSWER systematic
review
borderline personality disorder falls under which cluster of personality disorder
traits? – CORRECT ANSWER B
a 36 year old caucasian male arrives for his usual monthly medication
appointment. diagnosed with schizophrenia & has been stabilized on haldol for 9
years. today he states he has an inner feeling of restlessness & inability to remain
still. what type of E.P.S is suspected? – CORRECT ANSWER akathisia
which part of medicare provides optional coverage for beneficiaries? – CORRECT
ANSWER part c
the cerebrum contains all of the following areas of the brain except one. cerebral
cortex, brainstem, limbic system, or hypothalamus – CORRECT ANSWER
brainstem
in a family systems context, what is the definition of morphogenesis? – CORRECT
ANSWER a family’s tendency to adapt to change when changes are
necessary.
how does the body remove both serotonin and norepinephrine from the synaptic
cleft? – CORRECT ANSWER an active re-uptake process
a 53 year old menopausal woman presents with complaints of anhedonia,
depressed mood, & vasomotor symptoms. what medication effectively treats
both vasomotor symptoms and depression? – CORRECT ANSWER
desvenlafaxine/pristiq
it is an S.N.R.I.
which personality disorder is most likely to have fantasies of success? – CORRECT
ANSWER narcissistic
who should receive a shingles vaccine? – CORRECT ANSWER anyone
over the age of 60 who has had chickenpox
some states use the umbrella term advanced practice nurse to refer to all of the
following except which one? nurse anesthetists, certified nurse midwife, mid-level
providers, or nurse practitioners – CORRECT ANSWER mid-level
providers
eating disorders are characterized by what? – CORRECT ANSWER
disordered patterns of eating, accompanied by distress, disparagement,
preoccupation, & a distorted perception of one’s body shape
the federal government offered financial awards to encourage hospitals to
implement meaningful use. the financial awards are tied to specific objectives
related to the effective use of electronic health records. give 3 examples of this. –
CORRECT ANSWER 1. electronic prescribing
- electronic medication interaction checks
- computerized provider order entry
for an act to be considered criminal, it must have 2 components: actus reus &
mens rea. what is actus reus? – CORRECT ANSWER voluntary conduct
which complementary & alternative medicine technique is based on manipulating
the flow of energy throughout the body? – CORRECT ANSWER
acupuncture
who authored the report crossing the quality chasm, which emphasized the need
for inter professional collaboration in order to improve the quality of health care?
- CORRECT ANSWER institute of medicine
is a durable power of attorney limited to terminal illness only? – CORRECT
ANSWER no
what term describes a system where the insurer is not only the payer but also the
provider of care? – CORRECT ANSWER managed care
what term best describes a public agency that uses its bargaining power to
negotiate competitive prices for health insurance from the private insurance
market? – CORRECT ANSWER health alliance
freud would argue that adults who use ‘biting’ sarcasm as a defense mechanism
are fixated in which psychosexual stage of development? – CORRECT ANSWER
oral
what term is used to describe patients who injure themselves by self-mutilation
but who do not wish to die? – CORRECT ANSWER parasuicide
what most accurately describes an individual with avoidant personality disorder? –
CORRECT ANSWER these patients are timid and easily wounded by
criticism from others
what are 3 reasons for homelessness? – CORRECT ANSWER mental
illness, poverty, & inadequate public assistance
what is the primary goal of the AMA’s scope of practice partnership initiative? –
CORRECT ANSWER to limit patients’ choice of which health care provider
they can see for treatment