Advanced Practice in Psychiatric-Mental Health Nursing
Pre-Test Questions
Course Introduction
This course delves into the assessment, diagnosis, and management of complex psychiatric disorders across the lifespan, emphasizing evidence-based interventions in diverse settings. Students explore advanced psychopharmacology, psychotherapy modalities, and culturally competent care tailored to individuals, families, and populations. Through case studies and clinical experiences, learners strengthen their abilities in therapeutic communication, interdisciplinary collaboration, crisis intervention, and ethical decision-making, preparing them for leadership roles as advanced practice psychiatric-mental health nurses.
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) Freud's drive theory proposes that individuals are motivated by
A) Basic drives for survival and reproduction.
B) Need to reduce anxiety.
C) Need to resolve interpersonal conflicts.
D) Basic drives for altruism.
Answer: A
Q2) 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
Q3) It is believed that recovery can be promoted in children by all of the following except
A) Teaching problem-solving skills
B) Providing social support
C) Limiting challenging experiences
D) Providing structure to daily life
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) It is known that childhood exposure to maltreatment
A) Is associated with increased rates of physical and psychiatric disorders
B) Occurs in 10% of U.S. children
C) Is most often exposure to sexual abuse
D) Usually involves a perpetrator who is unknown to the child
Answer: A
Q2) Premature birth disrupts brain development in specific areas. Disruption of brain development in the sensorimotor area is thought to be associated with later development of
A) Cerebral palsy
B) Language impairment
C) Hearing impairment
D) Depression
Answer: A
Q3) Cell synaptogenesis refers to
A) Birth of new neuronal cells
B) Migration of neurons
C) Programmed cell death
D) Establishment of connections between neurons
Answer: D
Page 5
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Chapter 4: Communicating, Interviewing and Assessing
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Sample Questions
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) In a biopsychosocial assessment, which of the following questions might be used to assess the social domain?
A) Did any medical conditions precipitate the psychiatric symptoms?
B) Did the patient have any childhood attentional problems or school phobia?
C) Has the patient ever attempted suicide or harmed himself?
D) Have the symptoms affected the patient's social and work functioning?
Q3) Closed-ended questions
A) Are used to gather specific information
B) Allow the patient to talk without interruption
C) Are characterized by the use of reflection
D) Are used to obtain difficult or emotionally laden material
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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) Effective case formulation outcomes are stated
A) In terms of behaviors that must be changed
B) As incorporating efforts of others to achieve goal
C) In broad terms such as life satisfaction
D) As directly related to patients' identified problem or problems
Q2) The primary function of a biopsychosocial case formulation is to
A) Generate an understanding of the person as a whole
B) Identify comorbid medical illnesses
C) Assess the maturity of the patient's defense mechanisms
D) Determine patient's level of social support
Q3) 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
Q4) 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
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Chapter 6: Psychopharmacotherapy
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Sample Questions
Q1) Antidepressants are used with caution in which of the following disorders?
A) Major depression with atypical features
B) Adjustment disorder with depression
C) Bipolar disorders
D) Dysthymia
Q2) Because of the severe problems caused by chronic extrapyramidal side effects (EPSs), patients receiving long-term use of antipsychotics must be carefully monitored for the development of EPS symptoms. One of the most commonly used screeners is
A) Beck's inventory scale
B) Ham-D scale
C) Zung scale
D) AIMS scale
Q3) A patient has been treated for the past several years with fluphenazine (Prolixin). You notice that he is drooling and has a tremor and slight pill-rolling movement of the fingers. These are the extrapyramidal symptoms known as
A) Anticholinergic effects
B) Pseudoparkinsonism
C) Tardive dyskinesia
D) Dystonic reaction
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Page 8
Chapter 7: Psychotherapies
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Sample Questions
Q1) 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
Q2) 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
Q3) Which of the following statements provides the most appropriate comment about therapists' sharing of personal information with patients?
A) Sharing may be used to enhance trust or show interest.
B) Sharing may be used to show that the therapist has similar difficulties.
C) Sharing may include offering friendship outside of sessions.
D) Sharing may be used to reduce therapists' discomfort with silence in the session.
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9
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) 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
Q3) 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
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Chapter 9: Response to Stressors: Bridging Normal
Responses and Psychiatric Disorders
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Sample Questions
Q1) The key feature of adjustment disorder is
A) An anxiety response to a social event such as speaking in public
B) The response to a known stressor that occurs within 3 months of the stressor
C) A response to an event that is catastrophic, such as witnessing a murder
D) Pervasive anxiety related to a fear of being trapped in an enclosed place
Q2) Complicated grief differs from normal grief by the presence of
A) Emotions of anger and regret
B) Persistent longing and yearning for the deceased
C) Physical symptoms of headaches and indigestion
D) Problems with concentration and planning
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
Q4) 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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Sample Questions
Q1) 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
Q2) Medical disorders that should be considered as differential diagnoses of panic disorder include all of the following except
A) Hyperthyroidism
B) Hypothyroidism
C) Mitral valve prolapse
D) Hyperparathyroidism
Q3) In considering maintenance treatment for a patient with GAD who is anxious, agitated, and irritable and has sleep problems, which medication(s) might you select?
A) Bupropion (Wellbutrin)
B) A dopamine agonist
C) Paroxetine (Paxil) or sertraline (Zoloft)
D) Alprazolam (Xanax)
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Page 12
Chapter 11: Acute Stress Disorder and Posttraumatic Stress Disorder
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Sample Questions
Q1) 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
Q2) Which one of the following exposure treatments for post-traumatic stress disorder has been found to be effective among veterans with chronic post-traumatic stress disorder that has not responded to other forms of treatment?
A) Cognitive behavioral therapy
B) Eye movement desensitization and reprocessing therapy
C) Structured writing therapy
D) Virtual reality exposure therapy
Q3) The key feature of acute stress disorder is the presence of
A) Sleep disturbances
B) Symptoms of dissociation
C) Increased arousal
D) Recurrent, intrusive thoughts
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Chapter 12: Obsessive-Compulsive Disorder and
Obsessive-Compulsive
Spectrum Disorders
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Sample Questions
Q1) 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
Q2) On clinical presentation, patients with OCD tend to
A) Be eager to discuss their symptoms
B) Have good insight into their obsessions and compulsions
C) Describe a sudden intrusion of unwanted distressful thoughts and the need to do something to reduce their distress
D) Be aware of the influence of their symptoms on their families
Q3) It can be said of the obsession of hoarding that it is associated with
A) A fear of making a wrong decision in discarding things that might be needed in the future
B) Abnormalities of the fear/anxiety circuitry
C) A feeling that hoarding is ego-syntonic
D) Less severe symptoms and impairment of functioning than other obsessions
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Chapter 13: Depressive Disorders
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Sample Questions
Q1) Core symptoms of complicated grief include experiencing which of the following symptoms more than 6 months after the death?
A) Feeling that life has no meaning without the deceased
B) Prominent self-blaming thoughts for not having prevented the death
C) Dissociative states in which the deceased is believed to be present
D) All of the above
Q2) Which of the following is a frontline treatment for insomnia in depressed elderly individuals?
A) Sleep hygiene
B) Benzodiazepines
C) Zolpidem
D) Trazodone
Q3) 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
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Chapter 14: Bipolar Disorder
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Sample Questions
Q1) Compared with unipolar depression, the depressed phase of bipolar disorder is associated with
A) A greater degree of insomnia
B) More melancholic features
C) Greater weight loss
D) More symptoms of anxiety and tearfulness
Q2) 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
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%
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Chapter 15: Schizophrenia and Schizoaffective Disorder
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Sample Questions
Q1) A patient who is being evaluated in the emergency room says that she is a mother deity, the earth mother god who is all-powerful. The psychiatric advanced practice nurse states that the patient is
A) Experiencing a delusion
B) Experiencing a hallucination
C) Experiencing impaired impulse control
D) Experiencing an acute stress reaction
Q2) An atypical antipsychotic would be expected to work better than a typical antipsychotic for which of the following symptoms?
A) Hallucinations
B) Delusions
C) Paranoia
D) Cognitive dysfunction
Q3) 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
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Page 17
Chapter 16: Delirium and Dementia
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Sample Questions
Q1) The neurotransmitters most widely accepted to be dysregulated in delirium are
A) Norepinephrine and acetylcholine
B) Norepinephrine and serotonin
C) Serotonin and acetylcholine
D) Dopamine and acetylcholine
Q2) In mild cognitive impairment there is likely to be
A) Social and vocational disability
B) Impairment of activities of daily living
C) Deficits of memory
D) Wandering and disorientation
Q3) 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
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18
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) Which of the following brain nuclei is involved with pleasure and addiction?
A) Red nucleus
B) Hypothalamus
C) Substantia nigra
D) Nucleus accumbens
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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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) Temperament, which is one component of personality,
A) Has a 50% heritability
B) Achieves stability by age 16 years
C) Includes the trait of spirituality
D) Is associated with insight learning
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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Chapter 19: Prevention of Psychiatric Disorders
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Sample Questions
Q1) Evidence suggests that prevention of psychiatric disorders should focus on which of the following stages of life?
A) Middle age (ages 35 to 45 years)
B) Young adulthood (ages 20 to 30 years)
C) Adolescence
D) Early childhood
Q2) Some childhood disorders persist in the same form into adulthood, but some may increase the risk for other psychiatric disorders. Which of the following childhood disorders increases risk for other psychiatric disorders?
A) Anxiety disorder
B) Depression
C) Oppositional-defiant disorder
D) Specific phobias
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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