Advanced Assessment in Psychiatric Nursing Final Exam Questions
Course Introduction
This course offers an in-depth exploration of advanced assessment techniques specific to psychiatric nursing practice. Students will develop expertise in conducting comprehensive mental health evaluations, utilizing evidence-based screening tools, diagnostic interviews, and culturally sensitive approaches. Emphasis is placed on formulating differential diagnoses, integrating findings from psychosocial histories, mental status examinations, and standardized assessment measures. The course also covers legal and ethical considerations, interprofessional collaboration, and the role of the psychiatric nurse in assessment and treatment planning, equipping students to deliver high-quality, client-centered mental health care in diverse clinical settings.
Recommended Textbook
Psychiatric Advanced Practice Nursing 1st Edition by Perese
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19 Chapters
203 Verified Questions
203 Flashcards
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Chapter 1: Theoretical Framework of Practice
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Sample Questions
Q1) The primary relevance of Bowlby's attachment theory for psychiatric advanced practice nurses is that
A) Toddlers develop primitive defense mechanisms such as denial.
B) Toddlers develop an inner working model of how adults will respond to them.
C) Toddlers face the psychosocial task of autonomy versus shame.
D) Toddlers develop a fear of engulfment and enmeshment.
Answer: B
Q2) Temperament-a genetically influenced early form of personality-describes an infant's pattern of central nervous system responses and behaviors. Among the different types of temperament, which one is associated with more impairment of brain functioning and, in the absence of positive, nurturing parenting, is a risk factor for later development of psychiatric disorders?
A) Easy
B) Slow-to-warm-up/inhibited
C) Mixed
D) Difficult
Answer: D
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Chapter 2: Neurobiological Theory of Psychiatric Disorders:
Brain Functioning, Brain Development and Prenatal and
Perinatal Factors Disrupting Brain Development
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Q1) The brain structure that is believed to have a gating/filtering function and is the area of the brain through which all sensory information passes en route to various cortical areas is which of the following:
A) Brainstem
B) Reticular activating system
C) Thalamus
D) Hypothalamus
Answer: C
Q2) The principal excitatory neurotransmitter in the central nervous system is
A) Gamma-aminobuytric acid (GABA)
B) Serotonin
C) Glutamate
D) Acetylcholine
Answer: C
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Chapter 3: Postnatal Influences on Development of
Psychopathology
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Q1) Among children who use an accommodating response to maltreatment, there is increased likelihood of impaired capacity for
A) Controlling impulsivity
B) Knowing their own feelings and emotions
C) Showing regressive behaviors
D) Integrating memories of pain and fear
Answer: B
Q2) In the biopsychosocial theory of the development of psychiatric disorders, it is proposed that psychiatric disorders are due to a combination of
A) Exposure to adverse experiences and a large social support network
B) Compromised brain development and adverse experiences
C) Small family size and challenging learning experiences
D) Democratic parenting style and limited financial resources
Answer: B
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Chapter 4: Communicating, Interviewing and Assessing
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Q1) To encourage the patient to talk freely during the interview, the clinician
A) Uses direct questioning
B) Explains behavior/brain interaction theory
C) Takes notes conscientiously
D) Provides empathetic response.
Q2) During the initial assessment of a patient with schizophrenia, in response to the question "What brought you to the clinic today?" a patient's response of "the van" is an example of
A) Poverty of speech
B) Concrete thinking
C) Oppositional behavior
D) Tangentiality
Q3) Open-ended questions
A) Are useful in obtaining direct responses
B) Define the focus of interest
C) Are useful in the beginning of an interview
D) Define the boundaries of the therapeutic alliance
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Chapter 5: Case Formulation and Diagnosis, Differential
Diagnoses and Developing a Biopsychosocial Plan of Care
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Q1) The primary purpose of a biopsychosocial case formulation is to
A) Predict response to different treatment modalities
B) Organize key facts around a cause, the source of the problem
C) Provide information required for reimbursement
D) Determine the level of care required
Q2) In the problem-oriented method of case formulation, the patient's problems are defined as a solvable target of treatment. Which of the following is an example of a problem-oriented case formulation description?
A) "Lack of interpersonal communication skills"
B) "Due to early childhood conflicts"
C) "Due to use of immature defense mechanisms"
D) "Caused by stigma and discrimination"
Q3) In a biopsychosocial case formulation, social contributions would be considered to be
A) Genetic influences and adverse circumstances of birth
B) Substance use and medical disorders
C) Cognitive deficits and dysregulation of emotions
D) Religious/cultural factors and living situations
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Chapter 6: Psychopharmacotherapy
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Q1) The tricyclic antidepressant class of medications can be characterized by all of the following properties except
A) Long half-life
B) Inexpensive cost
C) Safety in overdose
D) High rate of side effects
Q2) Which of the following reactions is indicative of a dystonic reaction?
A) Oculogyric crisis and spasms of the back muscles
B) Tongue thrusting and lip-smacking movements
C) Pill-rolling hand movement and mask-like facial expression
D) Urinary retention and orthostatic hypotension
Q3) The older typical antipsychotic medications would be expected to be most effective for which of the following target symptoms?
A) Social isolation
B) Apathy
C) Hallucinations
D) Lack of motivation
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Chapter 7: Psychotherapies
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Q1) The core principle of relational therapies that include psychodynamic psychotherapy and interpersonal psychotherapy is that current problems reflect
A) Learned behavioral responses
B) Failure to integrate life experiences
C) Problems with relationships with others
D) Distorted perceptions of ability to cope
Q2) In supportive therapy, the focus is on
A) Strengthening self-esteem and ego functioning
B) Promoting insight
C) Remediating cognitive functioning
D) Exposure and response prevention
Q3) Which of the following criteria would preclude the use of brief dynamic therapy?
A) Adequate ego strengths
B) Psychological problems in multiple domains
C) Use of mature defense mechanisms
D) Adequate ability to process information
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Chapter 8: Psychosocial Interventions
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Q1) Remedial psychosocial interventions include
A) Psychological first aid and reminiscence therapy
B) Social rhythms therapy and sleep therapy
C) Case management and intensive case management
D) Cognitive restructuring and vocational rehabilitation
Q2) The primary goal of compensatory interventions is to help patients improve coping through the use of all of the following except
A) Brief dynamic therapy
B) Social skills training
C) Stress management
D) Problem-solving therapy
Q3) Selection of level of case management for a patient is influenced by the A) Type of psychiatric disorder
B) Degree of impairment of functioning
C) Legal status of the patient
D) Presence of a comorbid substance-related disorder
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Chapter 9: Response to Stressors: Bridging Normal
Responses and Psychiatric Disorders
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Q1) In general, the treatment of choice for adjustment disorder is A) Pharmacotherapy
B) Light therapy
C) Psychotherapy
D) Electroconvulsive therapy
Q2) An important evidence-based finding about adjustment disorder among adolescents and young adults is that
A) Pharmacotherapy is the frontline for treatment.
B) The course of adjustment disorder is brief, with good outcomes.
C) There is a short time between thoughts of suicide and carrying out suicide.
D) Academic functioning is well preserved.
Q3) Adjustment disorder is often associated with
A) Symptoms of dissociation
B) Time lost from work
C) Flashbacks and nightmares
D) Delusions of persecution
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Chapter 10: Phobias, Generalized Anxiety Disorder, Social
Anxiety Disorder and Panic Disorder
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Q1) For a patient with GAD and a history of substance abuse, one of the primary reasons for choosing buspirone (Buspar) is because it
A) Inhibits reuptake of serotonin
B) Is effective for somatic complaints-sweaty palms, shortness of breath, etc.
C) Does not cause dependency
D) Has a strong antidepressant effect
Q2) In GAD, which of the following is true?
A) GAD is rare in older adults.
B) Worrying may be associated with the belief that it keeps the family safe.
C) Worrying is usually limited to one type of worry, such as locking doors.
D) Worrying is usually accompanied by ritualistic behaviors.
Q3) It can be said that in the fear system, the amygdala
A) Serves as a response center for danger and fear
B) Imprints the time and place of an event
C) Evaluates the event in relation to memories of previous experiences
D) Releases hormones that start a cascade of neurohormones and neurotransmitters that prepare the body to respond to a threat
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Chapter 11: Acute Stress Disorder and Posttraumatic Stress Disorder
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Sample Questions
Q1) The current frontline treatment for acute stress disorder is
A) Mood stabilizer medications
B) Interpersonal psychotherapy
C) Antianxiety medications
D) Trauma-focused cognitive behavioral therapy
Q2) Three days ago, a woman was raped by a man who drove her home from a party. She notified the police and the man was arrested. She has memory loss related to the rape and feels depressed and lethargic. Which of the following would be the most immediate beneficial intervention?
A) Providing an opportunity to confront her assailant
B) Providing medication
C) Referring her to a support group
D) Creating a safe environment
Q3) Following exposure to a traumatic event, post-traumatic stress disorder occurs more often
A) Among men
B) Among individuals who have experienced prior traumas
C) Among individuals with high levels of education
D) Among those who are married or in a stable relationship
Page 13
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Obsessive-Compulsive Spectrum Disorders
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Q1) In obsessive-compulsive disorder, patients are likely to experience
A) Obsessions as ego-syntonic
B) Extreme worrying about everyday concerns such as being late
C) Specific worries about the sight of blood
D) Obsessions of symmetry and need to have things just right
Q2) Obsessions are often accompanied by compulsive behaviors. Which of the following is not true?
A) Obsession of contamination is linked with excessive cleaning.
B) Obsession of pathological doubt is linked with hoarding.
C) Obsession of symmetry is linked with arranging things until they are perfect.
D) Somatic obsession is linked with checking the body for signs of illness.
Q3) For one-third to one-half of patients with OCD, the onset of the symptoms is
A) After the age of 30 years
B) In the 30s and 40s
C) During childhood or adolescence
D) In middle age
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Chapter 13: Depressive Disorders
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Sample Questions
Q1) The patient says that she has been feeling sad and having difficulty sleeping over the past 6 weeks. She says she has lost her appetite and has lost about 10 lb. This is the first time she has felt this way and she cannot recall any specific unsetting event. Given this minimal information, an initial diagnosis might be
A) Adjustment disorder with depression
B) Seasonal affective disorder
C) Major depression, single episode
D) Major depression with catatonic features
Q2) Electroconvulsive therapy has been found to be effective in which of the following conditions?
A) Depression with melancholic features
B) Dysthymia
C) Seasonal affective disorder
D) Atypical depression
Q3) Compared with unipolar depression, the depressed phase of bipolar disorder
A) Has a later onset
B) Has a more gradual onset
C) Carries a greater risk for suicide
D) Is less frequently accompanied by psychotic symptoms in younger patients
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Chapter 14: Bipolar Disorder
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Q1) In the prodromal phase of bipolar disorder, patients' behaviors often include
A) Putting their affairs in order
B) Sleeping more than usual
C) Increased talkativeness
D) A decrease of social activities
Q2) In treatment of the acute phase of mania, the focus is on
A) Protecting the patient's biopsychosocial safety
B) Educating the patient about social rhythms theory
C) Interventions that address impairment of vocational functioning
D) Interventions for self-management of finances
Q3) Disruptions of social rhythms
A) Are related to changes of zeitgerbers (time givers)
B) Occur after the onset of bipolar disorder
C) Are related to anticipation
D) Occur rarely in the general population
Q4) The heritability of bipolar disorder is
A) Very low, 25% to 30%
B) Low, 45% to 60%
C) Moderate, 65% to 75%
D) High, 80% to 90%
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Chapter 15: Schizophrenia and Schizoaffective Disorder
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Q1) When used for treatment of a patient with schizophrenia, typical antipsychotics could be expected to be most effective for which of the following symptoms?
A) Social isolation
B) Ineffective individual coping
C) Hallucinations
D) Lack of ability to make decisions
Q2) A patient who has just been started on Haldol 5 mg po bid is complaining of a sudden painful stiff neck and jaw muscles. This is most likely
A) Akinesia
B) Akathisia
C) Dystonia
D) Somatization
Q3) Men with schizophrenia have
A) An older age of onset
B) Fewer negative symptoms
C) A more favorable premorbid history
D) A less favorable course
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Chapter 16: Delirium and Dementia
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Q1) Which of the following symptoms is a core feature of frontal-temporal dementia?
A) Speech and language problems
B) Visual hallucinations
C) Confusion and disorientation
D) Loss of balance and falls
Q2) Which of the following is known to be a risk for cognitive decline?
A) Being a widow or widower
B) Retirement or relocation
C) Reduced income or increased expenses
D) Loneliness and social isolation
Q3) Regarding alcohol withdrawal delirium or delirium tremens, which of the following is true?
A) Symptoms may include hypersomnia and lack of energy.
B) Symptoms may include agitation and abnormal perceptions.
C) Symptom onset often begins with elevated mood.
D) Symptoms often begin within 12 hours of cessation of drinking.
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Chapter 17: Dual Diagnosis
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Sample Questions
Q1) Symptoms of alcohol withdrawal
A) Are most severe 8 to 10 hours after last drink
B) Are most severe 24 to 28 hours after last drink
C) Include hallucinations among 50% of individuals
D) Are evidenced as delirium tremens 2 weeks after the last drink
Q2) The areas of the brain considered to be most involved in the development of substance abuse are the
A) Brainstem and reticular activating system
B) Thalamus and hypothalamus
C) Ventral tegmental area and nucleus accumbens
D) Cerebellum and olfactory bulb
Q3) The common pathway of reinforcement and reward that is believed to be involved in substance-related disorders is the
A) Mesocortical dopamine pathway
B) Mesolimbic dopamine pathway
C) Tuberinfundibular dopamine pathway
D) Nigrostriatal dopamine pathway
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Chapter 18: Personality Disorders
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Sample Questions
Q1) Patients with histrionic personality disorder frequently manifest which of the following?
A) Use of their appearance to be the center of attention
B) Belief that they have clairvoyance
C) Perfectionism
D) Fear of criticism and rejection by others
Q2) Conrad, a 26-year-old male, is being treated for cuts after being arrested for breaking the windows in the home of his girlfriend, who has just told him that they are through. He has a history of having been physically abused by his father, setting fires as a child, treatment for substance abuse, and arrest for stealing a car. Which of the following personality disorders might the clinician consider?
A) Narcissistic
B) Paranoid
C) Antisocial
D) Histrionic
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Chapter 19: Prevention of Psychiatric Disorders
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Q1) In prevention of suicide among adults, the most effective intervention is
A) Screening of all patients for suicidal ideation by primary care clinicians
B) Providing debriefing after traumatic events
C) Restricting access to lethal means such as handguns and pesticides
D) Increasing public education programs about suicide
Q2) Preventive interventions that have been found to be associated with a sustained reduction of late-life depression include
A) Life review and reminiscence therapy
B) Exposure and response prevention therapy
C) Social skills training
D) Problem-solving therapy
Q3) At this time, in the prevention of schizophrenia, the focus is on
A) Preventing adverse circumstances of birth
B) Promoting childhood resilience
C) Preventing prodromal symptoms from converting to schizophrenia
D) Preventing late-onset schizophrenia
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