Advanced Assessment in Psychiatric Nursing
Test Questions
Course Introduction
Advanced Assessment in Psychiatric Nursing is designed to equip students with the skills necessary to conduct comprehensive mental health assessments across the lifespan. The course emphasizes the integration of theoretical knowledge with clinical practice, focusing on advanced assessment techniques, psychiatric interviewing, risk assessments, and the use of standardized tools for diagnosing mental health disorders. Students will learn to incorporate cultural, developmental, and psychosocial factors into their evaluations, critically analyze assessment data, and communicate findings effectively within interdisciplinary teams. The course prepares graduates for leadership roles in mental health care settings, fostering the ability to develop individualized care plans and advocate for evidence-based interventions.
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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Page 2
Chapter 1: Theoretical Framework of Practice
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Sample Questions
Q1) 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
Q2) Which attachment pattern is more likely to be found among children who have been abused?
A) Secure
B) Inhibited
C) Disorganized
D) Avoidant
Answer: C
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Page 3
Brain Functioning, Brain Development and Prenatal and
Perinatal Factors Disrupting Brain Development
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Sample Questions
Q1) This area of the brain is called a system and is made up of the rim of the medial (innermost) portions of the frontal, parietal, and temporal lobes and overlies the brainstem. It is involved with emotions and is referred to as the
A) Ventricular system
B) Limbic system
C) Reticular activating system
D) Blood-brain barrier system
Answer: B
Q2) Which of the lobes of the brain is primarily involved in auditory hallucinations?
A) Occipital lobe
B) Parietal lobe
C) Frontal lobe
D) Temporal lobe
Answer: D
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4
Chapter 3: Postnatal Influences on Development of
Psychopathology
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Sample Questions
Q1) Among children who have experienced chronic exposure to family violence, it has been found that
A) The children may lack capacity for emotional self-regulation.
B) Most of the children are able to integrate their experiences into a positive inner model of the world.
C) As adolescents, they have lower rates of aggressive behavior problems.
D) The rate of adult psychopathology is the same as that of the general population.
Answer: A
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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Sample Questions
Q1) 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
Q2) Validation is a communication strategy used to
A) Let the patient know that his or her feelings are reasonable.
B) Evaluate change in symptoms or behaviors.
C) Prompt the patient to continue talking.
D) Elicit more information about a response.
Q3) During an initial assessment, the relevant features of communication are its ability to
A) Promote a therapeutic alliance and increase understanding.
B) Prompt a disclosure of past successes and failures.
C) Bring about changes in behavior.
D) Educate the patient about what is important to disclose.
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Chapter 5: Case Formulation and Diagnosis, Differential
Diagnoses and Developing a Biopsychosocial Plan of Care
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Sample Questions
Q1) A predisposing event would be all of the following except
A) Early prolonged separation from the mother
B) Having been born unwanted
C) Recent arrests or incarcerations
D) History of childhood neglect or abuse
Q2) A precipitating event might be
A) Financial losses or loss of housing
B) Chronic health problems
C) Childhood separations and anxiety disorders
D) Genetic influences and premature birth
Q3) 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"
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Page 7
Chapter 6: Psychopharmacotherapy
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Sample Questions
Q1) In treating a patient with depression for whom you want to increase norepinephrine, which of the following antidepressants would you choose because it specifically increases levels of norepinephrine?
A) Reboxetine (Vestra)
B) Fluoxetine (Prozac)
C) Phenelzine (Nardil)
D) Venlafaxine (Effexor)
Q2) A patient has been taking haloperidol (Haldol) IM, an antipsychotic drug, for years. You notice that he is grinding his teeth and smacking his lips frequently. You think that he may have
A) Tardive dyskinesia
B) Gustatory hallucinations
C) Spasms of the jaw
D) Parkinsonian symptoms
Q3) TCAs are effective in treatment of depression because they block
A) Reuptake of serotonin and dopamine
B) Reuptake of serotonin and norepinephrine
C) Action of monoamine oxidase enzyme
D) Histamine receptors
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Page 8
Chapter 7: Psychotherapies
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Sample Questions
Q1) The primary purpose of psychotherapy is to facilitate changes by the patient in order to
A) Reduce symptoms of distress
B) Address identified problems
C) Reduce burden on the family
D) Improve vocational functioning
Q2) In cognitive therapy, therapists focuses on patients'
A) Use of immature defense mechanisms
B) Learned behavior of helplessness
C) Automatic negative thoughts
D) Attachment patterns
Q3) Among the following disorders, which one would most likely be amenable to brief dynamic therapy?
A) Bipolar disorder
B) Substance dependence
C) Psychotic disorder
D) Avoidant personality disorder
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Chapter 8: Psychosocial Interventions
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Sample Questions
Q1) Support groups differ from self-help groups by
A) Use of a drop-in approach
B) Professional leadership
C) Theory of empowerment
D) Emphasis on mastery
Q2) The primary goal of psychological first aid is to
A) Provide a debriefing opportunity
B) Help the patient come to terms with the traumatic event
C) Promote material assistance
D) Educate victims of the possible sequelae such as post-traumatic stress disorder
Q3) As administrator of a mental health care agency, you know that augmenting pharmacotherapy with psychosocial interventions will produce better outcomes than pharmacotherapy alone. To target loneliness and social isolation, which of the following would be the most likely choice?
A) Psychological first aid
B) Psychoeducation
C) Compeer
D) Social rhythms therapy
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Chapter 9: Response to Stressors: Bridging Normal
Responses and Psychiatric Disorders
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Sample Questions
Q1) 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.
Q2) The process of allostasis includes
A) Mobilization of energy, activation of cognition, and behavioral changes
B) Reduction of production of cortisol
C) Decreased levels of norepinephrine
D) Development of a state of exhaustion
Q3) The response of exposure to stressors
A) Is the same response in all humans
B) Is the same for males and females
C) Is followed by homeostasis
D) Is buffered by the presence of three or more social contacts
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Chapter 10: Phobias, Generalized Anxiety Disorder, Social Anxiety
Disorder and Panic Disorder
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Sample Questions
Q1) Susan, a 35-year-old single female who has a history of panic attacks that interfere with her working, has become afraid to go out alone and prefers to have a family member stay with her at home at all times. The most appropriate diagnosis based on this limited information is
A) Schizophrenia with delusions
B) Panic disorder with agoraphobia
C) Avoidant personality disorder
D) Social anxiety disorder
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) Types of specific phobias include all of the following except
A) Blood, injury, or injection
B) Public speaking
C) Situational phobias-elevators, bridges
D) Environmental phobias-storms, water
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Chapter 11: Acute Stress Disorder and Posttraumatic Stress Disorder
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Sample Questions
Q1) The model of psychotherapy that is most effective for acute post-traumatic stress disorder is
A) Supportive psychotherapy
B) Exposure therapy
C) Stress inoculation therapy
D) Debriefing therapy
Q2) 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
Q3) Which mental status variation are you most likely to expect for a client diagnosed as having post-traumatic stress disorder?
A) Thought: delusions of grandeur
B) Perceptual: derealization and depersonalization
C) Memory: impaired recent memory
D) Mood: inappropriate, silly
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Obsessive-Compulsive
Spectrum Disorders
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Sample Questions
Q1) 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
Q2) In obsessive-compulsive disorder, obsession/compulsion symptom cluster types include all of the following except
A) Dirt and contamination
B) Counting and checking
C) Lying and stealing
D) Hoarding and collecting, saving
Q3) 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.
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Page 14
Chapter 13: Depressive Disorders
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Sample Questions
Q1) A patient says that she has been becoming increasingly depressed following the birth of her first child 4 months ago. She had an episode of depression in her 20s but recovered. Now, she is becoming more despondent, crying, and sleeping a lot. She fears that she may hurt the baby if she does not get treatment. A possible diagnosis is
A) Major depressive disorder with melancholic features
B) Major depressive disorder with psychotic features
C) Dysthymia with superimposed major depression (double depression)
D) Major depressive disorder with postpartum onset
Q2) A young adult who works as a court reporter describes herself as being depressed most of the time and says she has been that way since her teens. She denies any weight loss or sleep disturbances. She describes problems with concentration, difficulty making decisions, and lack of energy that are causing her problems at work. Which of the following is the most likely diagnosis?
A) Dysthymia
B) Major depressive disorder with seasonal pattern
C) Major depressive disorder with atypical features
D) Major depressive disorder with melancholic features
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Chapter 14: Bipolar Disorder
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Sample Questions
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) 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%
Q4) The course of bipolar disorder is characterized by
A) Difficulty achieving good vocational functioning
B) Patient adherence to treatment
C) Infrequent recurrences
D) Good interpersonal and social functioning
Page 16
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Chapter 15: Schizophrenia and Schizoaffective Disorder
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Sample Questions
Q1) 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
Q2) A patient states that she hears voices telling her that she should kill herself. The psychiatric advanced practice nurse states that the patient is
A) Experiencing delusions
B) Experiencing hallucinations
C) Experiencing an aura
D) Experiencing a dissociative state
Q3) 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
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Chapter 16: Delirium and Dementia
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Sample Questions
Q1) 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.
Q2) In the early stages of dementia, frontal-temporal dementia is more likely than Alzheimer's-type dementia to be characterized by
A) Deficits in executive functioning
B) Problems with memory
C) Personality changes
D) Losing things
Q3) The most significant finding that suggests a diagnosis of delirium is
A) Rapid onset of symptoms that differ from baseline functioning
B) Slow, progressive onset of symptoms that differ from baseline
C) Difficulty in finding the right word to express an idea
D) Delusions of grandiosity
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18
Chapter 17: Dual Diagnosis
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Sample Questions
Q1) It is known that high levels of alcohol consumption
A) Exacerbate psychiatric symptoms
B) Improve circulation
C) Reduce the risk for developing dementia
D) Reduce the risk of suicide among older adults
Q2) 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
Q3) Current treatment approaches for dual diagnosis or co-occurring disorders focuses on
A) Identifying primary disorders and treating them first
B) Treating psychiatric disorders and substance-related disorders separately
C) Treating all co-occurring disorders as primary disorders
D) Treating psychiatric disorders first
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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) Impulsivity and suicidality are often associated with borderline personality disorder. Which of the following pharmacological interventions is frequently used to reduce impulsivity and suicidality?
A) Tricyclic antidepressants
B) Benzodiazepines
C) Selective serotonin reuptake inhibitors
D) Monoamine oxidase inhibitors
Q3) The affective instability associated with some of the personality disorders is most frequently treated with which one of the following classes of psychotropic medications?
A) Antipsychotics
B) Selective serotonin reuptake inhibitors
C) Anxiolytics
D) Psychostimulants
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Page 20
Chapter 19: Prevention of Psychiatric Disorders
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Sample Questions
Q1) A factor that has frequently been associated with children's increased risk of experiencing maltreatment is
A) Having two or more children in the family
B) Having a parent with mental illness and substance abuse
C) Having grandparents living with the family
D) Having a limited family budget for leisure activities
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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