Purple Book Practice Test 90 Questions with Verified Answers
The purpose of the ANA's Psychiatric-Mental Health Nursing Scope and Standards of Practice
... [Show More] is to define ____ of the NP. - CORRECT ANSWER the role and actions
Example of ___ prevention:parenting skills classes for pregnant adolescents, vaccines, or strengthening the capacities of families to prevent the development of new cases of depression and drug use. - CORRECT ANSWER primary
The trend in legal cases in the past 25 years is that rulings protect ____. - CORRECT ANSWER the patient's freedoms or rights while committed to a mental hospital.
Psychiatric patients ___legally refuse treatment. - CORRECT ANSWER can
In the nurse-client relationship, the focus in on ___. - CORRECT ANSWER the needs of the client
If a patient voluntarily admits to a hospital for psychiatric care and then wants to leave before a full assessment can be completed, can a patient voluntarily leave? - CORRECT ANSWER Most states allow for a brief period of detainment to assess a client for dangerousness to self or others even if hospital admission was voluntary.
Authenticity, being genuine, honest, and respectful are an essential part of building a ___ relationship. - CORRECT ANSWER therapeutic
A culturally expected response to a stressor ____ a mental disorder. - CORRECT ANSWER is not
During the termination phase, a patient suddenly starts to display an increase in regressive defense mechanisms. This is a sign of ____. - CORRECT ANSWER normal resistance in the termination phase . of therapy
A client displaying low self-esteem, poor self-control, self-doubt, and a high level of dependency indicates a failure in which state of development: - CORRECT ANSWER early childhood
The Freudian principle ____ states that all behavior has purpose and meaning, often unconscious in nature, and that no behaviors occur randomly or by coincidence. - CORRECT ANSWER psychic determinism
Suppression is a ____ defense mechanism. It channels conflicting energies into ____ promoting energies. Denial, rationalization, and repression are not. - CORRECT ANSWER healthy, growth
Lying on the floor assuming a fetal position is an example of a immature ___ defense mechanism. - CORRECT ANSWER regressive
Defense mechanisms are a function of the ___ to resolve a ____. - CORRECT ANSWER ego, conflict
___ are groups of doctors or other health care providers who voluntarily come together and assume the care provided to Medicare patients. - CORRECT ANSWER Accountable Care Organizations (ACOs)
Healthcare economics is concerned with fair distribution of resources and allocation of these concepts: ____ (making risk and benefit decisions about how care resources are allocated) and ____ (ensuring there is a fair distribution of the resources). - CORRECT ANSWER equity and efficiency
For a malpractice suit to be filed, these four elements need to present: ____ of care, breach of ____, ____, and injury must be related to the ____. - CORRECT ANSWER duty, standard of care, injury, breach of standard of care
The ___ has a position statement that nurses are responsible for developing health care settings that include ___ culture initiatives understanding that human error can cause error and harm by creating an open and fair environnment. - CORRECT ANSWER ANA, just
Neurotransmitters in the CNS function as a ___ medium. - CORRECT ANSWER communication
Serotonin is produced in the ___ of the brain. Dopamine is produced in the ___ of the brain. - CORRECT ANSWER raphe nuclei, substantia nigra
Changes in appetite, feeling fatigued, problems with sleep-rest cycle, and changes in libido has to do with the ___. - CORRECT ANSWER hypotthalamus
If a client has a pacemaker, the patient needs a ____ instead of an MRI. - CORRECT ANSWER PET scan
The primary excitatory neurotransmitter is ____. - CORRECT ANSWER glutamate
Problems with working memory, planning and prioritizing, insight into problems, and impulse control have to do with problems in the ___ lobe. - CORRECT ANSWER frontal
___ identification is the identification of specific, precise, and individualized symptoms reasonably expected to improve with medication. - CORRECT ANSWER Target symptom
The goal of the psychiatric assessment/interview process is to ____ and develop an appropriate ____. - CORRECT ANSWER identify the needs of the client, treatment plan
If a client wants to talk in a private place in a psychiatric hospital, choose a place quiet, but public enough to get ____ should it be required during the assessment. The PMHNP should ____ the milieu as an aspect of assessment. - CORRECT ANSWER assistance, control
"This is the third time now that you have been late for our sessions. I am wondering how committed you are to our working on your problems." is an example of which communication technique? - CORRECT ANSWER recognizing
A child under the age of ____ would not likely be able to understand the abstract meaning of the proverb "People who live in glass houses should not throw stones." - CORRECT ANSWER 11-16
If a client asks what he should do, the most therapeutic response would be ____. - CORRECT ANSWER "Maybe that depends on what you are trying to accomplish" (focus on the client's goals)
The most therapeutic response if a client says "life at home would be simpler if I wasn't there anymore." - CORRECT ANSWER "Tell me what you mean by 'it would be simpler if you just weren't there anymore.'"
If a client stops taking an antidepressant because "it does no good" without giving it adequate time to work, the PMHNP should first ____. - CORRECT ANSWER ask the client how to help him/her
If a client recently attempted suicide by overdose, an appropriate lab test to order would be: ____. - CORRECT ANSWER liver function tests
A client with a longstanding history of depression and chronic renal failure that comes in with increased depression, mild confusion, irritability, and overall apathy is having symptoms of ____ and a ____ lab test should be ordered. - CORRECT ANSWER electrolyte imbalance, comprehensive metabolic panel
Beta blockers such as propranolol can ___ depression. - CORRECT ANSWER exacerbate
The reason older adults are more sensitive to issues of psychotropic drug toxicity is ____. - CORRECT ANSWER decreased protein binding
Teratogenic effect of divalproex: ____, lithium: ____ - CORRECT ANSWER spina bifida, Epstein anomaly
___ is the study of what the body does to drugs. - CORRECT ANSWER Pharmacokinetics
The reason a client may start to need 4 pills of Klonopin to produce the same result that 1 pill initially produced is development of ____. - CORRECT ANSWER tolerance
Group therapy is beneficial because it increases social skills, is cost-effective, and enable participants to acquire the ___ factors. - CORRECT ANSWER curative
___ therapy helps clients recognize and change their automatic thoughts and distorted thinking. - CORRECT ANSWER Cognitive behavioral
Paradoxical directives such as "for one hour per day, worry extremely well" is used in ___ therapy. - CORRECT ANSWER strategic
Balance of stability in the family that returns despite its dysfunction is known as ____. - CORRECT ANSWER homeostasis
Miracle questions are part of ____ therapy. - CORRECT ANSWER solution-focused
To monitor effectiveness of treatment for depression, the PMHNP may administer a ____. - CORRECT ANSWER standardized rating scale for depression
The reason SSRIs are often first line treatments for depression is ____. - CORRECT ANSWER they are safest in overdose for suicidal clients
If a patient is brought into the ER for suicide by cutting the wrists, the first assessment to be done is ____ to ensure medical stability. - CORRECT ANSWER vital signs
Ataque de nervios is a culture-bound syndrome should be treated by ____. - CORRECT ANSWER brief supportive therapy with a Latino therapist
According to the DSM, alcohol use disorder is present if a person consumes alcohol ___, is unsuccessful in ____, and spends an excessive amount of time obtaining, using, and recovering from alcohol. - CORRECT ANSWER in larger amounts over time, cutting back
A therapeutic response if a patient keeps coming in late or misses several appointments:____ This will help understand the patient's expectations in a non-judgmental manner. - CORRECT ANSWER "Help me understand what is going on so we can figure out how to proceed."
In treating anxiety in older adults, drugs that are highly ___ are more unpredictable than drugs that are mostly ____. - CORRECT ANSWER oxidized, conjugated
Tossing and turning and a sense of not sleeping deeply is often caused by ____ in adult. - CORRECT ANSWER obstructive sleep apnea
A psychiatric patient has elevated blood pressure and has not been taking blood pressure medication, what should the PMHNP do? - CORRECT ANSWER Call the PCP, explain the situation, and coordinate the client getting an appointment and med refills if needed
Engaging in a project to determine whether standard of care was met is a ____ initiative. - CORRECT ANSWER quality improvement
The legal system makes determination whether a person is ___. Practitioner can assess and make a determination about a person's ___ to make medical decisions. - CORRECT ANSWER competent, capacity
Clients who are legally competent have the ability to make medical decisions and maintain individual ____. - CORRECT ANSWER autonomy
Does a client have a duty to report accounts of child abuse? - CORRECT ANSWER yes
MMSE exam scores
Total: ___
25-30 is questionable significance
20-25: ____
____: moderate impairment
____ or lower: severe impairment - CORRECT ANSWER 30, mild impairment, 10-20, 10
The initial focus of a crisis assessment is: ____. - CORRECT ANSWER safety of the client and others
Having the client hold out her arms and stick out her tongue to assess for tremors assesses the ___ cranial nerve. - CORRECT ANSWER hypoglossal
Thinking the television is sending you messages is known as ____. - CORRECT ANSWER ideas of reference
Yalom's curative factor instilled during AA and NA meetings is ____. - CORRECT ANSWER hope
____ behavior is a therapeutic factor in group therapy. Group members begin to nmodel aspects of other members of the group and group leaders. - CORRECT ANSWER Imitative
Skills training and exposure is an important element in ____ therapy. It focuses on cognitive and behavioral techniques, ____ including meditation, and ___ regulation. - CORRECT ANSWER DBT, mindfulness, and emotional
DBT involves the tension between ____ and ____. It involves examining and discussing opposing ideas to find the truth. - CORRECT ANSWER radical acceptance, change
According to ___, when a person is traumatized the thoughts and feelings get tied together and the process of therapy is to unlock the two. - CORRECT ANSWER transactional analysis (TA)
Schizophrenia symptoms that result in limited social interactions, liking to be alone, not dating or having a desire to are ___ symptoms. - CORRECT ANSWER negative
Before starting an antipsychotic, what labs should be done? - CORRECT ANSWER serum glucose or A1c, lipid profile, weight, BMI, blood pressure, waist circumference, and family history of cardiovascular disease
____ and ____ hallucinations are more likely to be related to organic illness. - CORRECT ANSWER Gustatory and tactile
The ____ receptor antagonist properties (in addition to blocking of D2 receptors) differentiate atypical antipsychotics from first-generation or typical antipsychotics. - CORRECT ANSWER 5HT2A
When WBC are below ____ and ANC below ____, Clozaril must be discontinued. It can be resumed once the ANC normalizes above that number. - CORRECT ANSWER 2000, 1000
____ causes memory problems and confusion in clients with a history of TBI. - CORRECT ANSWER Benzodiazepines
Staying active in physical and mental activities is neuroprotective and helps prevent ___ in old age. - CORRECT ANSWER dementia
___ therapy is used to treat AIDS dementia complex. - CORRECT ANSWER Antiretroviral
There is a high rate of ___ at 1 year post hospitalization for delirium. - CORRECT ANSWER mortality
When a person is in the ___ stage of change, interventions should be affirming and reflecting. - CORRECT ANSWER contemplation
Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scale
____: absent or minimal withdrawal
____: mild withdrawal
____: moderate withdrawal
____: severe withdrawal - CORRECT ANSWER 0-9, 10-15, 16-20, 21-67
Opioid withdrawal symptoms can be treated with central alpha agonists such as ___. - CORRECT ANSWER Clonidine (Catapres)
A person intoxicated on ____ exhibits distorted perceptions, increased relaxation and sensitivity to external stimuli, and loss of coordination. - CORRECT ANSWER cannabis
Defense mechanisms commonly used by persons with obsessive-compulsive personality disorder are ____, ____, and intellectualization. - CORRECT ANSWER rationalization, isolation
After a patient complements the PMHNP on his/her car, an appropriate response that helps the provider understand the meaning of the client's statement would be: - CORRECT ANSWER "Sounds like having expensive things is important to you."
Psychotherapy for a client with a personality disorder should focus on changing ____ relationships and use of immature ____. - CORRECT ANSWER dysfunctional, defense mechanisms
Persons with fixed false beliefs such as someone with paranoid personality disorder ____ have these beliefs challenged. However, it is okay to help the person find proof of meaning and explain any questions in a matter-of-fact manner. - CORRECT ANSWER should not
Persons who develop antisocial personality disorder are often raised in families with high rates of ____ (resulting in unpredictability, lack of rules and order, and chaos). - CORRECT ANSWER alcohol use disorders
A personality disorder is coded with a major ___ in the DSM-5. - CORRECT ANSWER psychiatric disorder
Important education when prescribing an SSRI to a child or young adult up to age 24 is: - CORRECT ANSWER black box warning about increased suicidality in this population
Before starting a stimulant medication, family history for ___ should be assessed and if positive for conduction problems, order an ECG before prescribing. American Academy ofChild and Adolescent Psychiatry practice parameters require physical exam, pulse, weight, height and ___ prior to starting a stimulant. - CORRECT ANSWER cardiovascular disease, blood pressure
A loss of language skills, decrease in head growth, along with stereotypic motions of the hands, often licking and slapping are signs of ___. It occurs almost exclusively in ____. - CORRECT ANSWER Rett syndrome, girls
Indiviiduals with the eating disorder ____ often maintain normal weight (or overweight), may be socially extroverted or attention seeking. - CORRECT ANSWER bulimia nervosa
Pediatric clients with comorbid ADHD and ____ often have excessive talking, increased activity, and distractibility. - CORRECT ANSWER bipolar disorder [Show Less]