PMHNP Bundled Exams with Verified Solutions (All Graded A+)

PMHNP Certification Exam Questions
and Answers Already Passed
Tarasoff Principle ✔✔1976 – duty to warn victims of potential harm from client
Deontological Theory ✔✔Ethical theory that states an action is judged as good or bad based on
the act itself regardless of the consequences
Teleological Theory ✔✔Ethical theory that states an action is judged as good or bad based on the
consequence or outcome
Virtue ethics ✔✔ethical theory that states actions are chosen based on the moral virtues (eg.
honesty, courage, compassion, wisdom, gratitude, self-respect) or the character of the person
making the decision
Erikson’s developmental stage infancy age range ✔✔birth-1 year
Erikson’s developmental stage infancy developmental tasks ✔✔trust vs. mistrust
Erikson’s developmental stage infancy indications of developmental mastery ✔✔Ability to form
meaningful relationships, hope about the future trust in others
Erikson’s developmental stage infancy indication of developmental failure ✔✔poor relationships,
lack of future hope, suspicious of others
Erikson’s developmental stage early childhood age ✔✔1-3 yo
Erikson’s developmental stage early childhood developmental task ✔✔autonomy vs. shame and
doubt

Erikson’s developmental stage early childhood indications of developmental mastery ✔✔selfcontrol, self-esteem, willpower
Erikson’s developmental stage early childhood indications of developmental failure ✔✔poor selfcontrol, low self esteem, self-doubt, lack of independence
Erikson’s developmental stage late childhood age ✔✔3-6yo
Erikson’s developmental stage late childhood developmental task ✔✔initiative vs guilt
Erikson’s developmental stage late childhood indications of developmental mastery ✔✔selfdirected behavior, goal formation, sense of purpose
Erikson’s developmental stage late childhood indications of developmental failure ✔✔lack of selfinitiated behavior, lack of goal orientation
Erikson’s developmental stage school-age ages ✔✔6-12yo
Erikson’s developmental stage school-age developmental task ✔✔industry vs. inferiority
Erikson’s developmental stage school-age indications of developmental mastery ✔✔ability to
work; sense of competency and achievement
Erikson’s developmental stage school-age indications of developmental failure ✔✔sense of
inferiority, difficulty with working, learning
Erikson’s developmental stage adolescence ages ✔✔12-20yo

Erikson’s developmental stage adolescence developmental task ✔✔identity vs role confusion
Erikson’s developmental stage adolescence indications of developmental mastery ✔✔personal
sense of identity
Erikson’s developmental stage adolescence indications of developmental failure ✔✔identity
confusion, poor self-identification in group settings
Erikson’s developmental stage early adulthood ages ✔✔20-35 years
Erikson’s developmental stage early adulthood developmental task ✔✔intimacy vs isolation
Erikson’s developmental stage early adulthood indications of developmental mastery
✔✔committed relationships, capacity to love
Erikson’s developmental stage early adulthood indications of developmental failure ✔✔emotional
isolation, egocentrism
Erikson’s developmental stage middle adulthood ages ✔✔35-65 yo
Erikson’s developmental stage middle adulthood developmental task ✔✔generativity vs. selfabsorption or stagnation
Erikson’s developmental stage middle adulthood indications of developmental mastery ✔✔ability
to give time and talents to others, ability to care for others
Erikson’s developmental stage middle adulthood indications of developmental failure ✔✔selfabsorption, inability to row and change as a person, inability to care for others

Erikson’s developmental stage late adulthood age ✔✔>65yo
Erikson’s developmental stage late adulthood developmental task ✔✔integrity vs despair
Erikson’s developmental stage late adulthood indications of developmental mastery ✔✔fulfilment
and comfort with life, willingness to face death, insight and balanced perspective on life’s events
Erikson’s developmental stage late adulthood indications of developmental failure ✔✔bitterness,
sense of dissatisfaction with life, despair over impending death
Psychodynamic (Psychoanalytic) Theory ✔✔-Sigmund Freud
-all bx is purposeful and meaningful
-principle of psychic determinism
-most mental activity is unconscious
-conscious behaviors and choices are affected by unconscious mental content
-childhood experiences shape adult personality
-instincts, urges, or fantasies function as drives that motivate thoughts, feelings, and bx
-Id, Ego, Superego
-conflict is experienced consciously as anxiety
Principle of psychic determinism ✔✔Even apparently meaningless, random, or accidental
behavior is actually motivated by underlying unconscious mental content
Intellectual disability typical age onset ✔✔infancy- usually evident at birth
ADHD typical age onset ✔✔early childhood (per DSM by age 12)
Schizophrenia typical age onset ✔✔18-25 for men
25-35 for women

PMHNP certification Exam Questions
and Answers with Verified Solutions
Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age, male, white, depression) ✔✔D.
68 y/o single white male with depression *5 risk factors (age, male, white, depression)
Count the risk factors
When interview teenagers (16 y/o) that arrive with their parents what should you do? ✔✔interview
them separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is confidential. Parents
may be upset but remember you are advocating for the child.
Which Ethnic group has the highest rate of suicide? ✔✔Native Americans
Example A patient is being treated for schizophrenia with olanzapine. Which of the following is
the most common side effect of olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor antagonism
C. Increased Lipids
D. Metabolic Syndrome ✔✔D. Metabolic Syndrome (UMBRELLA ANSWER)
Which antipsychotics have the least weight gain? ✔✔Latuda, Abilify, (also least sedating),
Geodon-if patient has metabolic syndrome consider switching to one of the medications above. Or
if the patient is overly sedated try switching to ABILIFY

Which mood stabilizer have the least weight gain? ✔✔Lamictal
-But remember all mood stabilizers cause some weight gain
When presented with a question about typical vs atypical antipsychotic the answer is usually to
start of a ✔✔atypical
A client presents with complains of changes in appetite, feeling fatigued, problems with sleep-rest
cycle, and changes in libido. What is the neuroanatomical area of the brain that is responsible for
the normal regulation of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus ✔✔Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
When a patient is hesitant to participate in treatment you should encourage? ✔✔Bring a support
person like a husband
Thyroid-Stimulating hormone normal level ✔✔0.5-5.0 Mu/L
When T4 and T3 are high and TSH is low what is the diagnosis ✔✔HYPERTHYROIDISM, TSH
secretion decreases: TSH LOW à key symptoms HEAT INTOLERANCE
Key symptoms of Heat Intolerance ✔✔Hyperthyroidism
When T4 and T3 are Low and TSH is high what is the diagnosis ✔✔(HYPOTHYROIDISM) TSH
secretion increased: TSH HIGH à COLD INTERANCE
Key symptoms of Cold Intolerance ✔✔Hypothyroidism

Hyperthyroid can mimic ✔✔Mania
Hypothyroid can mimic ✔✔Depression
A patient on depakote complains of RUQ pain and has reddish/brown urine ✔✔Hepatoxicity
-Check LFTs
Signs of Depakote toxicity ✔✔Disorientation, confusion, lethargy
You suspect depakote toxicity what do you do? ✔✔Check
-LFT
-Ammonia
-Depakote Level
What herbal supplement can cause hepatoxicity? ✔✔Kava Kava
When taking Kava Kava in combinations with other medications you should caution about
✔✔Risk of Hepatoxicity and Sedation
TCAs carry a risk of ✔✔Hepatotoxicity
Signs of Stevens-Johnson Syndrome ✔✔-fever, mouth pain, swelling, burning eyes, blisters, skin
pain
two psychotropics known to cause steven johnson syndrome ✔✔lamictal and tegretol
What nationality is most suseptible of getting steven johnson? ✔✔Asians

When treating asians with tegretal screen for? ✔✔HLAB-1502 Allele
What two medications cause agranulocytosis? ✔✔Clozaril & Tegretal
Agranulocytosis when to discontinue medication ✔✔Less than 1000
When monitoring for agranulocytosis in patients look for s/s of what? ✔✔Infection
-Fever, sore throat, fatigue, chills
Before starting any mood stabilizer in a female of childbearing age be sure to check? ✔✔HCG
Which two medications may decrease the risk of suicide? ✔✔clozaril and lithium
Medications that increase lithium level ✔✔NSAID-ibuprofen, INDOCIN
THIAZIDES-hydrochlorithiazide ACE INHIBITORS-lisinopril
Ace inhibitors are treatment of choice for? ✔✔Heart Failure
Certain medications are known to increase lithium level, but HOW? ✔✔by reducing renal
clearance
When educating a patient about lithium teach them about ✔✔Hyponatremia
Dehydration-hot days, exercise
Normal Lithium Level ✔✔0.6-1.2
Lithium Toxicity ✔✔1.5 or above
Discontinue and re-order lithium level

PMHNP Exam Reported Questions
Latest Update with Complete Solutions
What is dissemination? ✔✔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? ✔✔Moderate cognitive impairment
What is Tegretol in the CYP450 system? ✔✔Inducer –>will lower dose of Lamictal and BCP’s
What do BCP’s do to Lamictal? ✔✔Inducer – will lower dose of Lamictal
What is a Type I research error? ✔✔There IS a difference but you say there isn’t a difference.
What is a Type II research error? ✔✔There is NO difference but you say there is a difference.
What is pseudo-dementia? ✔✔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? ✔✔Yes.
What is a drug 1/2 life? ✔✔The time it takes for 50% of a drug to be eliminated from the body.
What 3 atypicals can be used with teens? ✔✔Zyprexa, Abilify, Seroquel – low doses

What is a risk of using Tramadol? ✔✔Serotonin Syndrome as it is very serotonergic.
What is the allele seen in Asians that increase the risk of SJS? ✔✔HLAB-1502
When might you see toxic epidermal necrolysis? ✔✔With worsening of SJS
How many generations do you include for a genogram? ✔✔1st degree – mother, father, siblings
2nd degree – grandparents & cousins
3rd degree –
What does messenger RNA code for? ✔✔Amino Acids
What is epigenetics? ✔✔Factors that affect genes – environmental, smoking, stress, etc…
What part of the brain is involved with OCD? ✔✔Basal Ganglia
Occipito-Frontal
What happens to the brain during adolescence? ✔✔Dendritic pruning
Emotions are controlled by amygdala
By adulthood, PFC involved as well
When do males typically present with schizophrenia? ✔✔10-25 yo
When do females typically present with schizophrenia? ✔✔25-35 yo
What does Erythromycin to trileptal? ✔✔You will need to decreases the level because
Trileptal(inducer) and erythromycin is a inhibitor
ACE Inhibitors are the drug of choice for what? ✔✔Heart Failure

HTN
What are some psychiatric side effects seen with some asthma drugs ✔✔Leukotriene receptor
agonists – singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression,
insomnia, SI, tremor
What should you watch for with Tegretol? ✔✔Agranulocytosis and Hyponatremia
What are the 3 CK muscle enzyme tests? ✔✔CKBB, CKMM, CKMB
Which one of the 3 muscle enzymes are related to cardiac muscle damage? ✔✔CKMB
What is the risk of a seriously elevated CKMB? ✔✔Polymyositis
Rhabdo
What is a normal CKMB? ✔✔0.3 mcg/L
What psychoactives does Detrol interact with? ✔✔Topamax
KCL
Zonegran
What CN are you assessing when you have the patient shrug their shoulders? ✔✔CN XI – Spinal
Accessory
What do you see in labs with HIV & Dementia? ✔✔CD4 <200
Viral Load is high
<20% get it with antiretroviral treatment
What is the scoring with the Beck Depression Inventory? ✔✔Self-Report – 0-63
0-13 – minimal

14-19 – mild
20-28 – moderate
29-63 – severe
What is sensitivity? ✔✔Helps rule-out disease = True Positive = Snout
What is specificity? ✔✔Helps rule-in disease = True Negative = Spin
What does a sed rate measure? ✔✔Inflammation (ESR – Erythrocyte Sedimentation Rate) =
distance in mm RBC’s have descended in 1 hour.
What is a normal sed rate or ESR? ✔✔0-22 males
0-29 females
What is a retic count? ✔✔Measures % of reticulocytes in blood (immature RBC’s) Indicates
whether enough RBC’s are being produced by bone marrow.
What does a decreased retic count indicate? ✔✔Anemia – acute or chronic bleeding
What does an increased retic count indicate? ✔✔Bone marrow disorder or Vitamin Deficiency
What does an abnormal retic ount indicate in general? ✔✔Doesn’t diagnose anything. First step is
ID source of the issue.
What happens when you mix tegretol and macrolides? ✔✔Increase tegretol levels.
What happens if a pregnant women takes Accutane? ✔✔Birth defects.

ANCC PMHNP QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS
Purpose of Dopamine ✔✔Inhibition of prolactin production
Sleep
Learning
Attention
Pleasure and reward
Movement
Memory
Mood
What term best describes the reelationship between an individual’s health and a number of other
variables, including the amoutn of healthcare consumed? ✔✔Health production function- math
expression that shows the relationship between an individual’s health and a number of other
variables.
How much time should you allow for Celexa to provide its initial therapeutic effect and the patient
to see an improvement in symptoms? ✔✔4-6 weeks
Clients have what rights? ✔✔Right to privacy and confidentiality
Right to least restrictive treatment measures
Right to consent and withdraw consent at any given time
Which inferential statistic determines whether the means of 2 groups are statistically different from
each other? ✔✔t-test
enables one to reach conclusions that extend beyond the immediate data alone

(ANOVA tests the difference among 3 or more groups, Pearson’s r correlation- tests the
relationship between 2 variables, probability-likelihood, p value- probability of a particular result
occurring by chance)
What symptoms would a patient exhibit if they were experiencing an excess serotonin?
✔✔Restlessness, agitation, myoclonus, vital sign abnormalilties
What term descries a colletion of individuals who coordinate lobbying efforts around a common
interest and seek to influence policymakers? ✔✔Special interest group.
What are 3 phases of a therapeutic relationship between NP and pt? ✔✔1. Intro

2. Working3. Termination
   The following describes what stage of a therapeutic relationship? Clarifying patient expectations,
   ID goals, treatment plan, preventative healthcare, measuring outcomes of care, reprioritizing plan
   ✔✔Working phase
   Which type of family therapy uses genograms, structural mapping, emphasizes understanding to
   produce change in the family structure. ✔✔Structural family therapy
   Symptoms of exess GABA ✔✔excess sleepiness, increased blood pressure, shallow breathing
   Symptoms of insufficient GABA ✔✔Sz, trouble concentrating, insomnia, depression, anxiety
   A Hamilton Anxiety score of 14-17 indicates what? ✔✔Mild Anxiety
   A Hamilton Anxiety score of 18-24 indicates what? ✔✔Moderate Anxiety
   A Hamilton Anxiety score of 25-30 indicates what? ✔✔Severe Anxiety

When would you not use seclusion and restraint? ✔✔Extremely unstable medical or psychiatric
conditions
Delirious or demented patients unable to tolerate decreased stimulation
Overtly suicidal patients
When should you use seclusions and restraint? ✔✔Prevent significant disruption to treatment
program or physical surroundings
Decrease sensory overstimulation
What is the difference between pharmacokinetics, and pharmaodynamics? ✔✔pharmacokinetics
is whatthe body does to drugs, pharmacodynamics is what the drug does to the body
Problems with the frontal lobe could lead to what ✔✔personality changes
problems with the temporal lobe can lead to ✔✔aphasia and amnesia
problems with the occipital lobe can lead to ✔✔visual field defects
problems with the parietal lobe can lead to ✔✔densory perceptual disturbances and agnosia
This type of advanced nurse evaluates, diagnoses, and treats a wide range of medical conditions
✔✔nurse practitioner
This type of advanced practice nurse consults researches educates and coordinates care
✔✔Clinical nurse specialist
This type of advnaced practice nurse provides well-woman gyno care, management pregnancy,
child birth, antipartum post partum. ✔✔Nurse midwife

Sample Test Questions ANCC – PMHNP
Latest Update Already Passed
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. ✔✔B. has failed to master object constancy

2. 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. ✔✔D. The patient’s suicide potential is increased.
3. 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 ✔✔A. Attempting to understand a patient’s subjective world
4. 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. ✔✔B. educating the survivors
about prodromal symptoms of posttraumatic stress disorder.

5. 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.” ✔✔A. an
   understanding that leaving a significant other may be painful, but also presents an opportunity for
   growth.
6. 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 to relieve a “nervous condition.” The
   patient denies any complaints related to this practice. The nurse practitioner’s response is to:
   A. actively discourage the patient from continuing this treatment.
   B. offer a medication to treat the nervous condition.
   C. suggest an alternative food to relieve the nervous condition.
   D. view this as a self-care ritual that needs to be preserved. ✔✔D. view this as a self-care ritual
   that needs to be preserved.
7. Before an older adult patient initiates pharmacotherapy with a medication that is cleared by the
   kidneys, an adult psychiatric and mental health nurse practitioner assesses the patient’s:
   A. blood urea nitrogen level.
   B. creatinine clearance.
   C. specific gravity.
   D. urinary sediment. ✔✔B. creatinine clearance.

ANCC PMHNP Exam Prep Questions and
Answers Already Passed
mesocortical pathway ✔✔executive function: attention, focus, depression
nigrostriatal pathway ✔✔from substantia nigra (brainstem) to striatum (muscles): Parkinson’s
mesolimbic pathway ✔✔projects to nucleus accumbens (part of limbic system). Pleasure, reward,
positive symptoms of schizophrenia: Addiction, gambling
Tuberoinfundibular pathway ✔✔regulation of prolactin (acts on pituitary). Hypersexuality in
mania
Dopamine ✔✔produced in substania nigra and VTA. D2 & D4 receptors most important. Elevated
in the mesolimbic pathway associated with pleasure and psychosis. Antispychotics block
dopamine. travels through mesocoritcal, mesolimbic, nigrostriatal, and tuberinfundibular
pathways
Serotonin ✔✔5-HT. produced in raphe nucleus. emotion, impulses, dreams. 5HT2A receptors =
atypical antipsychotics.
Norepinephrine ✔✔produced in locus coeruleus. arousal and vigilance
GABA ✔✔inhibitory. produces calm in conjunction with benzodiazepines.
ACTH ✔✔motor control, learning, memory, sleep, and dreams. Helps with balance. Decrease in
Alzheimer’s disease

hypothalamus-pituitary-adrenal axis (HPA) ✔✔CRH, ACTH, then cortisol. Worsens with stress
and depression
hypothalamus-pituitary-thyroid (HPT) ✔✔TRH, TSH, T4. Hypothyroid causes depression, weight
gain, slow metabolism. Hyperthyroid is opposite.
hypothalamus-pituitary-gonadal (HPG) ✔✔GnRH, FSH, LH. Malfunctions cause infertility
problems.
gray matter ✔✔neurons are found
frontal lobe ✔✔executive function, voluntary movement, speech (Broca’s area)
Temporal lobe ✔✔memory, cognition, speech, emotions (aka limbic area)
parietal lobe ✔✔receive and process sensory input
Wernicke’s area ✔✔temporal and parietal lobes; speech
amygdala ✔✔fear response.
hippocampus ✔✔memory. Make up limbic system with amydgala
HIPAA ✔✔1. education about privacy protection, 2. access to own medical records, 3. request
amendment to health information to which they object, 4. require permission for disclosure of
medical issues
forensic nursing ✔✔based on crime committed and investigational aspects

Test Bank for PMHNP Boards 2022 Questions and
Answers Already Passed
What is true of interprofessionality? ✔✔All health professionals have individual professional
competencies
What is the significance of an experimental p-value of 0.05 ✔✔There is a 5% chance of a similar
result occurring by chance alone
What percentage of children with oppositional defiance disorder will develop conduct disorder?
✔✔30%
In the DSM-5, selective mutism is now considered what type of disorder? ✔✔anxiety disorder
Symptoms of selective mutism must persist for at least ✔✔1 month
Common competencies ✔✔overlap more than one health care professional, although not
necessarily all health care professionals, and are competencies expected of all health care
professionals
Complementary competencies ✔✔enhance the qualities of other professions in provision of care
Collaborative competencies ✔✔those that each individual profession must possess to work with
others, including those who practice within different specialties within a profession.
Interpersonal collaboration is _ centered ✔✔patient
Cognitive therapy is recommended for patients that have ✔✔negative cognitive distortions
irrational beliefs

faulty conceptions
Humanistic Therapy focuses on assisting patients with ✔✔self-actualization and self-directed
growth
Behavioral Therapy focuses on ✔✔changing maladaptive behaviors through the use of behavioral
modification techniques
Existential therapy is for ✔✔reflection on life
confronting self
120 who got diarrhea ate lettuce. 80 with diarrhea did not eat lettuce. 40 without diarrhea ate
lettuce. 160 without diarrhea ate lettuce. What is the odds ratio of eating lettuce and developing
diarrhea? ✔✔6 ((120X160)/(80×40))
The New Freedom Commission on Mental Health (NFCMH) released a report that suggested
✔✔implementation a national campaign to reduce the stigma of seeking care
Focusing on promoting recovery and building resilience
The efficacy of mental health treatments was found to be well documented in ✔✔influential report
issued by US Surgeon General in 1999
State of high negative emotion and pessimism ✔✔neuroticism
Commonly known as an optimistic outlook on life They are are outgoing, like social interaction,
respond to external rewards, have more active dopamine networks, and are responsive to positive
reinforcement. ✔✔Extraversion (high levels protect from psychiatric illness)
Introverts are more likely to be motivated and more likely to respond to
reinforcement ✔✔internally

negative (more likely to interact with internal motivation/self-image)
Interpersonal trait of cooperation, easy going nature. Tend to have smooth relationships often at
the expense of self-assertion ✔✔Agreeableness
Associated with self-control and a focused, organized approach to life. Are achievement-oriented
goal setters who can delay immediate gratification to obtain their long term desired outcome. They
are considered responsible, reliable, and dependable. ✔✔conscientiousness
In behavioral couples therapy, the initial sessions are spent doing a functional analysis of behavior
(FAB). What is true about FAB? ✔✔FAB is concerned only with observable stimuli connected
to operant behavior
FAB is based on operant conditioning (identifying antecedent stimuli, operant behaviors, and
consequent stimuli)
The goal of FAB is modifying willful operant behavior
Gestalt theory deals with , not ✔✔perceptual psychology
behavior
Medication that can delay ejaculation in patients with premature ejaculation ✔✔Paroxetine (and
other SSRIs)
(others include:
Topical anesthetic
Tramadol
Phosphodiesterase-5 inhibitors)
First line treatment for lithium induced diabetes insipidus ✔✔Amiloride (K potassium diuretic)
in addition to dc lithium when possible.

Ways to reduce polyuria associated with lithium toxicity ✔✔reduce lithium dose to minimum
effective dose
take once daily at night (may be 5-30% lower than when given in divided doses over the day)
Encourage adequate fluid intake
What is true about ECT in Parkinson’s disease ✔✔it’s more likely to cause transient delirium
(worsened dyskinesias induced by l-dopa)
Lithium effects with Parkison’s disease ✔✔may worsen tremor
nonselective MAOIs decrease the efficacy of _ and increase the risk of a ___ ✔✔ldopa products
hypertensive crisis
Selegiline is selective for ✔✔MAO-B
(after 10mg there is an increase in risk of serotonin syndrome if given with other meds that increase
serotonin)
SSRI’s can _ Parkinsonism tremor ✔✔worsen (and decrease ‘off time’)
Process describes the mechanism by which the hippocampus stores memories ✔✔long-term
potentiation
loss of memory relating to a particular category of information (inability to recall important
autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with
ordinary forgetting) ✔✔systematized amnesia
Lack of memories from a circumscribed period of time, usually immediately following a traumatic
event ✔✔localized amnesia

PMHNP Boards Questions and Answers
with Complete Solutions
A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical
examination is unremarkable. Laboratory results are within normal limits except for a markedly
elevated alkaline phosphatase level. The psychiatric-mental health nurse practitioner ✔✔interprets
the findings as normally occurring during a rapid adolescent growth spurt
Laboratory findings for a patient with an alcohol use disorder indicate increased liver function
values and: ✔✔increased MCV and elevated triglyceride levels.
A new patient arrives at the office for treatment for depression. The patient reports taking
simvastatin (Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatricmental health nurse practitioner eliminates fluoxetine (Prozac), based on the knowledge that the
combination can lead to increased plasma levels of the statin, resulting in an increased risk of
muscle damage and rhabdomyolysis. The nurse practitioner’s reason is that: ✔✔one medication is
a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor.
A 28-year-old patient who is psychotic arrives at the clinic with family members but refuses to
meet if the family members are present. The psychiatric-mental health nurse practitioner ✔✔asks
the family members to leave for the appointment.
The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement
at a community mental health clinic. The effective strategy for evaluating the clinic’s services is
to: ✔✔use a survey to elicit patient satisfaction responses.
The psychiatric-mental health nurse practitioner evaluates a new adult patient via telemedicine.
The patient has questions about a new medication that he or she recently started. The nurse
practitioner decides to provide psychoeducation and to: ✔✔e-mail drug information and resources

Any court of law that evaluates the standards of care provided by a psychiatric-mental health nurse
practitioner ✔✔considers what a reasonably prudent health care provider would do.
The psychiatric-mental health nurse practitioner and a team of local mental health professionals
are asked to provide crisis counseling service, after a gunman recently took a class hostage at a
local elementary school, wounded several students, and then shot himself. In preparing for this
assignment, the nurse practitioner recognizes that: ✔✔a child’s developmental stage will influence
his or her response to catastrophic stress
Which community-based program is a tertiary level intervention? ✔✔Partial hospitalization
program that provides intensive group therapy for rehabilitation.
A 32-year-old female patient informs the psychiatric-mental health nurse practitioner that she is
three months pregnant. She has been stable on fluoxetine (Prozac) for the last two years. The
patient asks whether she may safely continue this medication during her pregnancy. The nurse
practitioner responds: ✔✔”Let’s review the risks and benefits of continuing or discontinuing
Prozac for you and your baby.”
Established clinical guidelines suggest that suicidality is decreased by treating patients who have
borderline personality disorder with: ✔✔dialectical behavioral therapy.
A six-year-old patient with autistic spectrum disorder has not responded to six months of
psychosocial interventions and continues to demonstrate aggressive tendencies toward a younger
sibling. The psychiatric-mental health nurse practitioner prescribes: ✔✔risperidone (Risperdal)
0.25 mg once a day.
The psychiatric-mental health nurse practitioner working in a crisis stabilization unit evaluates a
patient verbalizing suicidal thoughts after being sexually assaulted. Before processing through the
traumatic event, the nurse practitioner first attempts to ✔✔provide an environment of safety.

ANCC Review Questions (PMHNP IQ)
Already Passed
What direct-acting dopamine receptor agonist is recommended to be used in the treatments of
neuroleptic malignant syndrome (NMS) fo help lower the dopamine blockade? ✔✔Bromocriptine
(Parlodel) is the recommended direct acting dopamine receptor agonist to help decrease the
dopamine blockade. Danrolene (Dantrium) is a muscle relaxant. Benzotropine (Cogentin) and
Trihexyphenidyl (Artane) are anticholinergic medications used for extrapyramidal side effects
(EPS).
Mr. Smith is a 56 year old white male who has been successfully treated on Selegiline for over 4
years. Mr. Smith is going in for elective surgical procedure. Which medication is strictly
contraindicated with Selegiline? ✔✔Meperidine is strictly prohibited when a patient is treated on
a monoamine oxidase inhibitor (MAOI) due to the risk of hypertensive crisis and death.
A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP to take which of the
following actions? ✔✔Institute twice-weekly complete blood count with differentials and monitor
closely.
The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to 3,000 or
granulocytes of 1,000 to 1,500 for agranulocytosis and severely compromised immune system. At
a WBC of 4,000, the recommendation is to closely monitor CBC with differential twice a week
while patient may continue clozapine in the absence of any other signs or symptoms.
A patient with a diagnosis of schizophrenia has a history of suicidal ideation and suicide attempts.
The PMHNP should consider which antipsychotic medication that is the only antipsychotic to
reduce the risk of suicide in schizophrenia? ✔✔Clozaril (clozapine) is the only known
antipsychotic medication that had been shown to reduce the risk of suicide in patients diagnosed
with schizophrenia.

A patient being treated for major depressive disorder and on sertraline (Zoloft), 150 mg po daily
for the past 16 years, presents to the psychiatric mental health practitioner for an outpatient followup visit. During the visit she states that she has not been feeling well, reporting the flu. She also
states she has not taken her medication in the last five days. Which of the following symptoms
would she be describing if you suspect selective serotonin reputable inhibitors (SSRIs)
discontinuation syndrome? ✔✔A) Agitation; nausea, dysphoria, and disequilibrium
The patient has SSRI discontinuation syndrome and would be presenting with flu-like symptoms.
If the patient had serotonin syndrome, she would present with symptoms of autonomic instability.
Which of the following statements reflect the current understanding of dopamine (DA) pathways
and clinical symptoms in schizophrenia? ✔✔A) Negative symptoms are related to DA deficit in
the cerebral cortex; positive symptoms are related to DA excess in the nucleus accumbens and
mesolimbic system.
Negative symptoms & cognitive impairment are thought to be related to hypoactivity of the
mesocortical dopiminergic tract, which by its association with the prefrontal cortex and neocortex
contributes to motivation, planning, sequencing of behaviors in time, attention, and social
behavior. Positive symptoms (hallucination and delusions) are thought to be caused by dopamine
hyperactivity in the mesolimbic tract, which regulates emotion. This hyperactivity could result in
overactive modulation of nueurotransmission from the nucleus accumbens.
Norepinephrine is a neurotransmitter that is implicated in alertness and anxiety. What area of the
brain has a large majority of norepinephrine neurons? ✔✔Locus coeruleus
There are two areas in the brain that produce norepinephrine neurons, one is the locus coeruleus
and the other is the medullary reticular formation.
Which cytochrome (CYP) enzyme is implicated as a tobacco inducer when an individual is treated
on clozapine? ✔✔A) 1A2

Practice Questions and Answers PMHNP
Latest Updated 2022
what term describes a scientific study that gathers multiple studies and analyzes them to draw a
larger conclusion? ✔✔systematic review
borderline personality disorder falls under which cluster of personality disorder traits? ✔✔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? ✔✔akathisia
which part of medicare provides optional coverage for beneficiaries? ✔✔part c
the cerebrum contains all of the following areas of the brain except one. cerebral cortex, brainstem,
limbic system, or hypothalamus ✔✔brainstem
in a family systems context, what is the definition of morphogenesis? ✔✔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? ✔✔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? ✔✔desvenlafaxine/pristiq
it is an S.N.R.I.
which personality disorder is most likely to have fantasies of success? ✔✔narcissistic

who should receive a shingles vaccine? ✔✔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
✔✔mid-level providers
eating disorders are characterized by what? ✔✔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. ✔✔1. electronic prescribing

2. electronic medication interaction checks
3. computerized provider order entry
   for an act to be considered criminal, it must have 2 components: actus reus & mens rea. what is
   actus reus? ✔✔voluntary conduct
   which complementary & alternative medicine technique is based on manipulating the flow of
   energy throughout the body? ✔✔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? ✔✔institute of medicine
   is a durable power of attorney limited to terminal illness only? ✔✔no
   what term describes a system where the insurer is not only the payer but also the provider of care?
   ✔✔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? ✔✔health alliance
freud would argue that adults who use ‘biting’ sarcasm as a defense mechanism are fixated in which
psychosexual stage of development? ✔✔oral
what term is used to describe patients who injure themselves by self-mutilation but who do not
wish to die? ✔✔parasuicide
what most accurately describes an individual with avoidant personality disorder? ✔✔these patients
are timid and easily wounded by criticism from others
what are 3 reasons for homelessness? ✔✔mental illness, poverty, & inadequate public assistance
what is the primary goal of the AMA’s scope of practice partnership initiative? ✔✔to limit patients’
choice of which health care provider they can see for treatment
as a nurse practitioner you are expected to be competent in what areas? ✔✔policy, practice inquiry,
and technology and information literacy
what term describes a digital version of a patient’s medical file? ✔✔electronic health record
what term describes the death rate for a given population? ✔✔mortality rate
what action takes place during the working phase of a therapeutic relationship? ✔✔clarifying
patient expectations and mutually identifying goals

PMHNP ANCC Exam Questions and
Answers Already Graded A+
Descriptive Vividness ✔✔The researcher describes the data gathering process in sufficient detail
that the reader can personally experience it. The data collected, often in the form of personal
statements, should be quoted directly and extensively, because this is the raw data from the study.
Methodological Congruence ✔✔The researcher presents the philosophical and methodological
approach used and cites references to support their approach. The subjects, sampling method, datagathering and data-analysis strategies, and processes for informed consent are clearly and
concisely described.
Theoretical Conectedness ✔✔Any theory developed from the study is clearly stated, logically
consistent, reflective of the data, and in accord with other available knowledge.
Analytical Precision ✔✔Is not concerned with statistics and instruments. If refers to the decisionmaking process by which the researchers synthesize concrete data (words of the subjects) into an
abstract that clarifies the meaning and the importance of the study. The last of the 5 criteria is
Heuristic Relevance – The researcher clarifies the significance of the study, its applicability to
public health or community nursing, and its likely influence o the future research.
Phenelzine ✔✔An MAOI that patients with atypical depression respond particularly well to.
Atomoxetine ✔✔A norepinephrine reuptake inhibitor approved for the treatment of ADHD.
Loxapine ✔✔A typical, tetracyclic antipsychotic with antidepressant properties. Its active
metabolite is amoxapine, which is a secondary amine tricyclic antidepressant.

HITECH ✔✔Implementation of EHR for information exchanges and improving population health.
This was done by Obama and the ARRA.
Suppression ✔✔The intentional or conscious exclusion of painful or disturbing thoughts or
emotions from awareness.
A healthy defense mechanism because the client channels conflicting energies into growthpromoting activities.
Medications that can induce depression ✔✔beta blockers, steroids, interferon, Accutane,
benzodiazepines, progesterone, some antivirals, and antineoplasmics.
Medications that can induce mania ✔✔Steroids, Isoniazid, antidepressants (in people who already
have bipolar disorder), and Antabuse.
Medigap Insurance Policies ✔✔Private insurance policies purchased by elderly individuals to
cover some or all of their medical expenses not paid for by Medicare.
Medicare Advantage Plan ✔✔Formerly Medicare + Choice, this created regional Preferred
Provider Organizations (PPOs) and gave Medicare enrollees the option of enrolling in private
insurance plans.
Medicare + Choice ✔✔Was a part of the Balanced Budget Act of 1997 that significantly increase
the number of managed care insurance plans available to recipients. This was replaced with the
Medicare Advantage Plan in 200.
List of the Second Generation (atypical) Antipsychotics (9) ✔✔Clozaril (clozapine), Zyprexa
(olanzapine), Latuda (lurasidone), ziprasidone, Risperdal (risperidone), Invega Sustenna
(palperidone), Fanapt (iloperidone), Seroquel (quetiapine), Saphris (asenapine),

List of First Generation (typical) Antipsychotics (10) ✔✔Haldol (haloperidol), Prolixin
(fluphenazine), Navane (thiothixene), Thorazine (chlorpromazine), Loxitane (loxapine), Mellaril
(thioridazine), Trilafon (perphenazine), Orap (pimozide), Solian amisulpride), Stellazine
(trifluoperazine)
List the 6 common benzodiazepines in order from shortest to longest half-life ✔✔Xanax
(alprazolam): 6-10 hrs
Serax (oxazepam): 8 hrs
Ativan (lorazepam): 12-18 hrs
Klonopin (clonazepam): 30-40 hrs
Valium (diazepam): 100 hrs
Librium (chlordiazepoxide): 36-200 hrs
List of SNRIs (6) ✔✔Cymbalta (duloxetine), Pristiq (desvenlafaxine), Effexor (venlafaxine),
Fetzima (levomilnacipran), Savella (milnacipran), Strattera (atomoxetine)
Action of Tricyclic Antidepressants (TCAs) ✔✔They target serotonin, norepinephrine, and
histamine-1 receptors
List the Tricyclic Antidepressants (9) ✔✔Pamelor (nortriptyline), Elavil (amitriptyline),
amoxapine (no branded), Anafranil (clomipramine), Norpramin (desipramine), Tofranil
(imipramine), Vivactil (protriptyline), Sinequan/Silenor (doxepin), Surmontil (trimipramine)
FINISH acronym for SSRI withdrawal ✔✔Flu-like symptoms
Irritability
Nausea
Imbalance/instability/incoordination/dizzy (motor)
Sensory disturbances
Headache, hyperarousal (anxiety/agitation)

ANCC Certification PMHNP Chapter 7
Questions and Answers Rated A+
Mood Disorders ✔✔Most common psych illnesses
Primary characteristic is persistent disturbance in mood ✔✔Major Depressive Disorder
Often occurs without precipitating event ✔✔MDD
Object loss theory ✔✔Fairbairn, Winnicott & guntrip
Aggression turned inward theory of MDD ✔✔Freud
Cognitive Theory ✔✔Beck
Learned Helplessness-Hopelessness Theory ✔✔Seligman
Genetic predisposition ✔✔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 ✔✔Probably related to etiology of MDD
Sleep disturbances, appetite disturbances, libido disturbances, lethargy, anhedonia are
neurovegitative symptoms that are related to functions of the ✔✔Hypothalamus and pituitary
gland secretions
Endocrine dysfunction and pregnancy ✔✔A high incidence of postpartum mood disturbances is
suggested with this

Hypothalamic-pituitary-adrenal axis (HPA) ✔✔A theory of MDD, may be a result of an abnormal
stress response related to dysregulation of this system
HPA axis ✔✔Controls the physiological response to stress and is composed of interconnective
feedback pathways between the hypothalamus, pituitary gland, and adrenal gland.
Hypothalamus releases ✔✔corticotropin-releasing hormone (CRH)
Adrenocorticotropin hormone (ACTH) ✔✔Released by pituitary in response to CRH by
hypothalamus
Cortisol ✔✔Released by adrenal glands in response to ACTH by pituitary gland
Hyperactivity of the HPA axis ✔✔Demonstrated to be present in individuals with MDD. May also
have elevated cortisol levels
Elevated cortisol levels ✔✔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
Dexamethasone suppression test (DST) ✔✔Not commonly used in clinical practice for screening
of depression as it is too non specific.
Hypovolemic hippocampus and hypovolemic prefrontal cortex-limbic striatal regions
✔✔Abnormalities demonstrated by neuroimaging in individuals with chronic and severe
depression
Brain damage, including that from stroke and trauma ✔✔Depression is a acommon comorbidity
in individuals who have experienced these events

PMHNP Exam Reported Questions
images, PMHNP 2022/2023 Graded A+
DBT (dialectical behavior therapy) ✔✔relaxation muscle prior to DBT
Greatest patient at risk for Violence ✔✔Substance abuse
EMDR (eye movement desensitization and reprocessing) ✔✔eye movement desensitization and
reprocessing
What is dissemination? ✔✔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? ✔✔Moderate cognitive impairment
What is Tegretol in the CYP450 system? ✔✔Inducer –>will lower dose of Lamictal and BCP’s
What do BCP’s do to Lamictal? ✔✔Inducer – will lower dose of Lamictal
What is a Type I research error? ✔✔There IS a difference but you say there isn’t a difference.
What is a Type II research error? ✔✔There is NO difference but you say there is a difference.
What is pseudo-dementia? ✔✔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? ✔✔Yes.
What is a drug 1/2 life? ✔✔The time it takes for 50% of a drug to be eliminated from the body.
What 3 atypicals can be used with teens? ✔✔Zyprexa, Abilify, Seroquel – low doses
What is a risk of using Tramadol? ✔✔Serotonin Syndrome as it is very serotonergic.
What is the allele seen in Asians that increase the risk of SJS? ✔✔HLAB-1502
When might you see toxic epidermal necrolysis? ✔✔With worsening of SJS
How many generations do you include for a genogram? ✔✔1st degree – mother, father, siblings
2nd degree – grandparents & cousins
3rd degree –
What does messenger RNA code for? ✔✔Amino Acids
What is epigenetics? ✔✔Factors that affect genes – environmental, smoking, stress, etc…
What part of the brain is involved with OCD? ✔✔Basal Ganglia
Occipito-Frontal
What happens to the brain during adolescence? ✔✔Dendritic pruning
Emotions are controlled by amygdala
By adulthood, PFC involved as well
When do males typically present with schizophrenia? ✔✔10-25 yo

When do females typically present with schizophrenia? ✔✔25-35 yo
What does Erythromycin to trileptal? ✔✔You will need to decreases the level because
Trileptal(inducer) and erythromycin is a inhibitor
ACE Inhibitors are the drug of choice for what? ✔✔Heart Failure
HTN
What are some psychiatric side effects seen with some asthma drugs ✔✔Leukotriene receptor
agonists – singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression,
insomnia, SI, tremor
What should you watch for with Tegretol? ✔✔Agranulocytosis and Hyponatremia
What are the 3 CK muscle enzyme tests? ✔✔CKBB, CKMM, CKMB
Which one of the 3 muscle enzymes are related to cardiac muscle damage? ✔✔CKMB
What is the risk of a seriously elevated CKMB? ✔✔Polymyositis
Rhabdo
What is a normal CKMB? ✔✔0.3 mcg/L
What psychoactives does Detrol interact with? ✔✔Topamax
KCL
Zonegran

What CN are you assessing when you have the patient shrug their shoulders? ✔✔CN XI – Spinal
Accessory
What do you see in labs with HIV & Dementia? ✔✔CD4 <200
Viral Load is high
<20% get it with antiretroviral treatment
What is the scoring with the Beck Depression Inventory? ✔✔Self-Report – 0-63
0-13 – minimal
14-19 – mild
20-28 – moderate
29-63 – severe
What is sensitivity? ✔✔Helps rule-out disease = True Positive = Snout
What is specificity? ✔✔Helps rule-in disease = True Negative = Spin
What does a sed rate measure? ✔✔Inflammation (ESR – Erythrocyte Sedimentation Rate) =
distance in mm RBC’s have descended in 1 hour.
What is a normal sed rate or ESR? ✔✔0-22 males
0-29 females
What is a retic count? ✔✔Measures % of reticulocytes in blood (immature RBC’s) Indicates
whether enough RBC’s are being produced by bone marrow.
What does a decreased retic count indicate? ✔✔Anemia – acute or chronic bleeding
What does an increased retic count indicate? ✔✔Bone marrow disorder or Vitamin Deficiency

ANCC Review Questions (PMHNP IQ)
Latest 2022/2023 Already Graded A
What direct-acting dopamine receptor agonist is recommended to be used in the treatments of
neuroleptic malignant syndrome (NMS) fo help lower the dopamine blockade?
A) benzotropine (Cogentin)
B) bromocriptine (Parlodel)
C) dantrolene (Dantrium)
D) trihexyphenidyl (Artane) ✔✔A) Bromocriptine (Parlodel) is the recommended direct acting
dopamine receptor agonist to help decrease the dopamine blockade. Danrolene (Dantrium) is a
muscle relaxant. Benzotropine (Cogentin) and Trihexyphenidyl (Artane) are anticholinergic
medications used for extrapyramidal side effects (EPS).
Mr. Smith is a 56 year old white male who has been successfully treated on Selegiline for over 4
years. Mr. Smith is going in for elective surgical procedure. Which medication is strictly
contraindicated with Selegiline?
A) Non-steroidal anti-inflammatory drugs (NSAIDS)
B) Codeine
C) Morphine
D) Meperidine ✔✔D) Meperidine is strictly prohibited when a patient is treated on a monoamine
oxidase inhibitor (MAOI) due to the risk of hypertensive crisis and death.
A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP to take which of the
following actions?
A) Consult with hematologist to determine appropriate antibiotic regimen and monitor closely.
B) Institute twice-weekly complete blood count with differentials and monitor closely.
C) Discontinue clozapine, initiate alternative antipsychotic medication and monitor closely.

D) Institute daily complete blood count with differentials and monitor closely. ✔✔B) Institute
twice-weekly complete blood count with differentials and monitor closely.
The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to 3,000 or
granulocytes of 1,000 to 1,500 for agranulocytosis and severely compromised immune system. At
a WBC of 4,000, the recommendation is to closely monitor CBC with differential twice a week
while patient may continue clozapine in the absence of any other signs or symptoms.
A patient with a diagnosis of schizophrenia has a history of suicidal ideation and suicide attempts.
The PMHNP should consider which antipsychotic medication that is the only antipsychotic to
reduce the risk of suicide in schizophrenia?
A) Abilify (aripriprazole)
B) Latuda (lurasidone)
C) Invega (iloperidone)
D) Clozaril (clozapine) ✔✔D) Clozaril (clozapine) is the only known antipsychotic medication
that had been shown to reduce the risk of suicide in patients diagnosed with schizophrenia.
A patient being treated for major depressive disorder and on sertraline (Zoloft), 150 mg po daily
for the past 16 years, presents to the psychiatric mental health practitioner for an outpatient followup visit. During the visit she states that she has not been feeling well, reporting the flu. She also
states she has not taken her medication in the last five days. Which of the following symptoms
would she be describing if you suspect selective serotonin reputable inhibitors (SSRIs)
discontinuation syndrome?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea. ✔✔A) Agitation; nausea, dysphoria,
and disequilibrium

PMHNP Study/practice questions and
answers 100% pass
Which of the following statements does not reflect current understanding of neurotransmitter
pathways implicated in anxiery disorders?
A. Increase levels of CRF in amygdala, hippocampus and LC increase symptoms of anxiety.
B. Decreaseing GABA in the Mesolimbic cortex diminishes symptoms of anxiery.
C. Increasing serotoneric activity in the amygdala diminishes symptoms of anxiety.
D. Decreasing NE in the LC diminishes symptoms of anxiety. ✔✔A, C & D are all correct so the
answer is B
As a PMHNP, you know anti-psychotic meds have side effects. Which side effects of antipsychotic
meds has an insidious delayed-onself of 1-2 after starting the medication? ✔✔A. Dry Mouth
B. Tardive Dyskinesia
C. Wt gain
D. Sedation
We know that Dry mouth, drowsiness, dizziness, restlessness, wt gain, constipation & N/V are all
SE but, Tardive Dyskinesia does not start for 1-2 years.
My answer – B. Tardive Dyskinesia (TD)
** long standing blockage of DA2 in nigrostriatal pathway leads to TD
Which Serotonin receptor antagonism makes an antipsychotic “atypical”?
A. 5HT1A
B. 5HT3A
C. 5HT4A
D. 5HT2A ✔✔Atypical antipsychotic drugs such as clozapine, olanzapine, quetiapine, risperidone,
sertindole, and ziprasidone are potent 5-HT2a receptor antagonists and relatively weaker dopamine
D2 antagonists.
Commonly Prescribed Typical and Atypical Antipsychotic Medications
Typical antipsychotics include:

Haldol (haloperidol); Loxitane (loxapine);
Mellaril (thioridazine); Geodon (ziprasidone)
Moban (molindone); Seroquel (quetiapine)
Navane (thiothixene); Zyprexa (olanzapine)
Prolixin (fluphenazine); Serentil (mesoridazine)
Stelazine (trifluoperazine); Trilafon (perphenazine)
Thorazine (chlorpromazine)
Atypical antipsychotics include:
Abilify (aripiprazole); Clozaril (clozapine)
Geodon (ziprasidone); Seroquel (quetiapine)
Zyprexa (olanzapine)
Which medication inhibits both dopamine and norepinephrine?
A. Venlafaxine (effexor)
B. Duloxetine (Cymbalta)
C. Buproprion (Wellbutrin)
D. Imipramine (Tofranil) ✔✔C. Buproprion (Wellbutrin)
Bupropion inhibits the presynaptic reuptake of both dopamine (DA) and noradrenaline (NA),
leading to increased levels of both of these neurotransmitters in the synaptic cleft
Current understanding of Dopamine (DA) pathways & clinical symptoms in schizophrenia is
reflected in which statement?
A. Neg symptoms are related to DA deficit in meslimbic system and pos (+) symptoms are related
to DA excess in the (SN) substanita nigra & (VTA) ventral tegmental area.
B. (-) symptoms are related to DA excess in the CC cerebral cortex; + symptoms are related to DA
in the (NA) nucleus accumbens and mesolimbic system
C. (-) related to DA in (MS) mesolimbic system; + are related to DA deficit in the SN and VTA
D. (-) related to DA deficit in the CC; (+) related to DA excess in the NA & MS ✔✔ANS. D?

PMHNP Comprehensive Questions and
Answers Latest Update Already Passed
AIMS ✔✔Abnormal Involuntary Movement Scale for 8 and older
12 item tool to assess symptoms of tardive dyskinesia for patients taking antipsychotics
Rating 0-4, >2 to diagnose TD and reduce dose
BARS ✔✔Barnes Akathisia Rating Scale for 8 and older
4 item tool to assess objective and subjective symptoms of akathisia with antipsychotics and/or
SSRIs
CRS-R ✔✔Connors Rating Scales – Revised for 3-17
ADHD Parent (80 items) and Teacher Scales (59 items)
Low T-score of 61= mildly atypical; >70 = markedly atypical
Subscales for Oppositional Behaviors, Cognitive Problems, Hyperactivity, ADHD Index,
Anxious-Shy, Perfectionism, Social Problems, DSM-IV Subscales and Connors’ Global Index
Vanderbilt ADHD Parent and Teacher ✔✔55 parent, 43 teacher items for 6-12
Initial assessment rates symptoms and impairment in academic and behavioral performance
ASRS-1 ✔✔Adult ADHD Self-Report Scale, 16 and older
Two-part Screening
Part A: 6 questions, 4 symptoms suggest ADHD
Part B: 12 questions to clarify and quantify
AUDIT-C ✔✔Alcohol Use Disorders Identification Test – Consumption, > 13
Documents use and frequency in prior year
0-4, F >3 = positive, M >4 = positive, >8 = hazardous drinking

CAGE-AID ✔✔IDs problem drinking or druging, 13 and older
(C=cut down, A=annoy, G=guilty, E=Eye-opener, AID=altered to include drugs
CRAFFT ✔✔6-item screen for alcohol or drugs in adolescents, 14-18
(C=car, R=relax, A=alone, F=forget, F= family or friends, T= trouble)
BAI ✔✔Beck Anxiety Inventory, 17 and older
Assesses 21 symptoms of anxiety, 0-36 scores
HAM-A ✔✔Hamilton Anxiety Scale, most commonly used
14 domains, 14=mild, 18-24= moderate, 25-30=severe
LSAS-CA ✔✔Liebowitz Social Anxiety Scale-Child/Adolescent Version, 7 and older
24 items, social and performance
55-65=moderate social phobia, 65-80=marked, 80-95=severe, >95=very severe
MMSE ✔✔Mini Mental Status Exam
30 items, 24-30= no cognitive impairment; 18-23=mild cognitive impairment; 0-17= severe
cognitive impairment
MOCA ✔✔Montreal Cognitive Assessment

26=normal, add point for <12th grade education
SPMSQ ✔✔Short Portable Mental Status Questionnaire
10 items, more than 3 incorrect indicates dementia
BDI-2 ✔✔Beck Depression inventory, 13 and older
presence and impact of depressive symptoms
21 items, <10=normal; 11-17=mild depression; 18-23=moderate; 24+=severe

CCSD ✔✔Cornell Scale for Depression in Dementia
19 items, <6=no significant depression; 8-17=probable major depression; >18=definite depression
MDQ ✔✔Mood Disorder Questionnaire
Screen for mania or hypomania
positive if 7 or more of 13 items in question #1 present and #2 is yes and #3 gets moderate or
serious problem response
YMRS ✔✔Young Mania Rating Scale, 11 items (adult)
Range 0-60; adults with 12 or more=mania
CY-BOCS ✔✔…
YBOCS ✔✔Yale-Brown Obsessive Compulsive Scale
10 items; age 14 and older
gold standard for OC symptoms
score indicates level of severity
BPRS ✔✔Brief Psychiatric Rating Scale, 18 and older
Assesses psychopathology (+, – and affective) with schizophrenia, not for screening or DX
PANSS ✔✔Positive and Negative Syndrome Scale, 18 and older
measures changes in symptom intensity in psychosis and schizophrenia
Gold standard in studies of treatment efficacy
SPS ✔✔Suicide Probability Scale, 13 and older
Rapid measure of suicide risk
higher score indicates greater risk
CIWA-Ar ✔✔Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised

9 item symptom rating scale, max score 67; <10 does not warrant intervention COWS ✔✔Clinical Opiate Withdrawal Scale Quantifies severity of withdrawal syndrome, guides dosing, monitors over time Used for induction of Suboxone 5-12=mild; 13-24= moderate; 25-36=mod to severe; >36=severe
T4, FREE THYROXINE ✔✔0.8-2.8
Increased In Graves
Decreased In Hypothyroidism
TSH ✔✔2- 10 mu/l
Normal values can range from 0.4 – 4.0 mIU/L (milli-international units per liter),
Calcium, Ca++ ✔✔8.8-10.5
<7.0, tetany

11.0, hyperparathyroidism
13.5, hypercalcemic coma, metastatic cancer
Sodium, Na+ ✔✔135-148 mEq/L
hypernatremia ✔✔dehydration
hypovolemia
diabetes insipidus
eating too much salt
gastroenteritis
drugs such as adrenocorticosteroids, methyldopa, hydrazine, cough meds
hyponatremia ✔✔drugs such as lithium, vasopressin, diuretics
addisons

PMHNP Exam Prep Questions and
Answers Rated A+
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?
Question 1 options:a)
Narcissistic
b)
Paranoid
c)
Antisocial
d)
Histrionic ✔✔Antisocial
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 ✔✔Religious/cultural factors and living situations
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 ✔✔Use of mature defense mechanisms
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 finance ✔✔Protecting the patient’s biopsychosocial safety
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. ✔✔
Symptoms of anxiety and panic are associated with a low level of which neurotransmitter?

a)
Cortisol
b)
Dopamine
c)
Gamma-aminobutyric acid
d)
Glutamate ✔✔Gamma-aminobutyric acid
Which class of antidepressants has the most anticholinergic side effects?
a)
Monoamine oxidase inhibitors (MAOIs)
b)
Selective serotonin reuptake inhibitors (SSRIs)
c)
Tricyclic antidepressants (TCAs)
d)
Serotonin norepinephrine reuptake inhibitors (SNRIs) ✔✔Tricyclic antidepressants (TCAs)

ANCC PMHNP Psych-Mental Health
NP_Test 1 Questions and Answers Rated
A+
Your patient, whose wife died a few months ago, appears to be very unkempt and apathetic.
Although several months have passed since his wife’s death he has not progressed at all through
his grieving. You assess this condition as which of the following?
disenfranchised grief
panic disorder
complicated grief
physiologic grief ✔✔Correct Answer:
complicated grief
A person has uncomplicated grief when he or she has normal physical, psychological, cognitive
and spiritual responses to the death of a significant other. But when the person shows persistent
maladaptive behaviors such as not taking care of personal hygiene and/or appearance and does not
progress through the mourning process, this is complicated grief.
If a patient has had a myocardial infarction, which of the following atypical antidepressants should
not be prescribed within the recovery phase?
Trazodone
Duloxetine
Bupropion
Desvenlafaxine ✔✔Correct Answer:
Trazodone
If a patient has had a myocardial infarction, during the recovery phase, the patient should not be
prescribed this medication. Trazodone (Desyrel) can cause the patient to develop orthostatic
hypotension and priapism.

To get your teaching ideas and concepts across to a poor reader which of the following would be
most appropriate?
Use longer sentences.
Use abstract concepts.
Discourage questioning.
Use examples and review. ✔✔Correct Answer:
Use examples and review.
To get the idea across to a poor reader use examples and review. The other choices are not helpful.
You should use short sentences and easy to read layouts; be concrete rather than abstract; and teach
them how to ask questions about their health. Also, tell context first and use visual, use common
words and examples, and explain meaning.
A 21-year old woman presents with complaints of milky discharge from her breasts. She doesn’t
have any other symptoms and is not pregnant, nor has been before. She tells the nurse about each
medication that she takes. Which of these drugs may be implicated as the cause of the symptom?
aspirin
Lamotrigine
Risperidone
sertraline ✔✔Correct Answer:
Risperidone
Risperidone can cause the greatest prolactin elevation among atypical psychotics. A milky white
discharge known as galactorrhea could be a sign of an underlying condition. The fact that the
woman takes Risperidone, an atypical antipsychotic, would likely point to the cause and should be
switched with one less likely to have that same side effect.
Which of the following would be considered one of the main things that is responsible for about
2/3 of psychiatric hospital readmissions?
Not sufficient care.

Medication noncompliance
Biophysical assessments
None of the above ✔✔Correct Answer:
Medication noncompliance
Medication noncompliance is a major problem with the psychiatric mental health patients. The
home health nurses assists by helping the patients
to see the relationship between their compliance with their medication regimen and control of their
symptoms.
Which of the following would be considered an important form of communication that can help to
promote consistency in the care of the patient at the
same time that it justifies their stay in the hospital?
Review of care.
Documentation
Verbal reporting
None of the above ✔✔Correct Answer:
Documentation
The other 3 options above are incorrect.
One of the most important aspects of nursing is documentation. Documentation can promote
consistency in the care of the patient and is also used to help justify the patient remaining in the
hospital.
Effects of an overdose of LSD (Lysergic acid diethylamide) can include all of the following
except?
Vomiting
Respiratory failure
Hypertensive crisis
Seizures ✔✔Correct Answer:
Hypertensive crisis

Hypertensive crisis would be considered a symptom of PCP overdose. Vomiting, respiratory
failure and seizures would be considered an effect
of LSD overdose.
Symptoms of serotonin syndrome include all of the following EXCEPT:
insomnia
nausea
loss of coordination
sweating or shivering with goose bumps ✔✔Correct Answer:
nausea
Symptoms of serotonin syndrome can present in patients that have drug combinations that are
contraindicated. They can vary from restlessness and agitation to tremors, chills, headaches, and
insomnia as well as loss of coordination. Nausea has not been implicated in serotonin syndrome.
What is the rate of suicide attempts for patients having dissociative identity disorder?
30%
45%
70%
60% ✔✔Correct Answer:
70%
People with dissociative identity disorder have one of the highest risks for suicide. According to
the Diagnostic and Statistical Manual of Mental Disorders (DSM-5),more than 70% of outpatients
with DID have attempted suicide, and multiple suicide attempts are common.
Of the following, which would not be considered a phase of schizophrenia treatment?
Maintenance
Acute
Cognitive

Clinical PMHNP Exam 1 study questions
with complete solutions
Which theory of depression was developed based on observing that patients who were being
treated for Hep C developed depressive symptoms?
A. The monoamine theory
B. The inflammation theory
C. The HPA axis theory
D. The stress-diathesis theory ✔✔b. The inflammation theory
Which of the following health conditions have a high co-morbidity with depression?
A. Hypertension
B. Asthma
C. Diabetes mellitus
D. Cardiovascular disease
E. Celiac disease
F. Cognitive impairment
G. Obesity
H. Cancer ✔✔A. Hypertension
C. Diabetes Mellitus
D. Cardiovascular disease
F. Cognitive impairment
G. Obesity
H. Cancer
In the Cutler video on depression, he highlights that there are 200 different ways to meet the
diagnostic criteria for depression.
A. True
B. False ✔✔A. True

You have diagnosed a 53-year-old male with moderate MDD and he has declined psychotherapy
but has agreed to pharmacotherapy. He has diagnoses of Type 2 D.M. with a BMI of 32.1. Which
of the following antidepressants would provide a dual benefit for this patient?
A. Sertraline
B. Fluoxetine
C. Duloxetine
D. Mirtazapine ✔✔C. Duloxetine
Your patient was started on fluoxetine and after ten weeks of treatment his PhQ 9 score is 9. What
is your assessment of the efficacy of treatment based on this score?
A. The patient is in remission
B. The response is adequate but not in remission
C. The response is possibly inadequate
D. The response is inadequate ✔✔B. The response is adequate but not in remission
In the Star*D trial what percentage of patients treated for depression failed to respond to initial
pharmacotherapy?
A. 20%
B. 30%
C. 40%
D. 50% ✔✔D. 50%
In the Star D trial for patients that achieved remission what percentage relapsed after 4.4 months?
A. 25%
B. 33%
C. 42%
D. 53% ✔✔B. 33%
When should adjunctive therapy be considered in treating MDD? (select all that apply)
A. Already tried 3 or > antidepressants

B. Initial antidepressant well tolerated
C. Partial response (>50% improvement)
D. Specific residual symptoms or side effects that can be targeted
E. Severity of depression, more functional impairment
F. Patient preference ✔✔B. Initial antidepressant well tolerated
D. Specific residual symptoms or side effects that can be targeted
E. Severity of depression, more functional impairment
F. Patient preference
Rates of remission increased with each additional change in therapy, especially when switching.
A. True
B. False ✔✔B. False
You have diagnosed your patient with Major Depressive Disorder and after six weeks of being
treated with fluoxetine 20 mg there is no treatment response. According to the VA/DoD Guidelines
for treatment of MDD what is the next step?
A. Switch to another monotherapy either an antidepressant or psychotherapy.
B. Switch to a different antidepressant
C. Augment with a second antidepressant
D. Augment with a second medication or psychotherapy
A. A, C
B. B
C. C
D. A, D ✔✔D. A,D
Your patient has experienced her first episode of MDD and is in remission. How long should the
antidepressant be continued after remission has been achieved to reduce the risk of relapse?
A. 2 months
B. 4 months
C. 6 months
D. One year ✔✔C. 6 months

PMHNP I – Exam 1 – Review Book
Questions and Answers with Verified
Solutions
The purpose of the ANA’s PMH Nsg: Scope and Standards of Practice is to:
a. Define the role and actions for the NP
b. Establish the legal authority for the prescription of psychotropic medications
c. Define the legal statutes of the role of the PMHNP
d. Define the differences between the physician role and the NP role ✔✔a. Define the role and
actions for the NP
The trend in legal rulings on cases involving mental illness over the past 25 years has been to:
A – Encourage juries to find defendants not guilty by reason of insanity
B – Protect the individual’s freedoms or rights when he or she is committed to a mental hospital
C – Place increasing trust in mental health professionals to make good and ethical decisions
D – Decrease the “red tape” associated with commitments so that commitments are faster and easier
✔✔B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric
clients.
Mr Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to
take any of his ordered medication because he believes “Jesus Christ told me I am the prophet and
must fast for a year.” Your actions should be based on your knowledge that:
A – Psych clients cannot refuse treatment
B – Psych clients don’t always know what’s good for them
C – Psych clients can refuse treatment
D – Psych clients cannot be trusted to make good healthcare decisions and, therefore, the nurse’s
best clinical judgment should guide actions ✔✔C. As with any client, psych clients can refuse
treatment unless a legal process resulting in a mandatory court order for treatment has been
obtained.

Which of the following statements best reflects the difference between the nurse-client (N-C)
relationship and a social relationship? In the N-C relationship…
A – the primary focus is on the client and his needs.
B – goals are deliberately left vague and unspoken so that the client can work on any issue.
C – the nurse is solely responsible for making the relationship work.
D – there is no place for social interaction. ✔✔A – the primary focus is on the client and his needs.
Social relationships are mutual interpersonal relationships in which the needs of both parties are
addressed. The N-C relationship is most concerned with meeting the needs of the client.
In forming a therapeutic relationship with clients, the PMHNP must consider developing many
characteristics that are known to be helpful in relationship-building. These characteristics include
all of the following EXCEPT:
A – genuineness
B – acceptance
C – authenticity
D – accuracy in assessment ✔✔D – accuracy in assessment
Although an important aspect of the PMHNP role, accuracy in assessment does not in and of itself
facilitate relationship building
In forming a therapeutic relationship with clients, the PMHNP must consider developing many
characteristics that are known to be helpful in relationship building. Which of the following is an
essential part of building a therapeutic relationship?
A. Collecting a family history
B. Like-mindedness
C. Authenticity

ANCC Exam Prep – PMHNP Latest 2022
FH, family tree, pedigree, genogram ✔✔Tools used in determining likelihood of genetic disorder
in family, inheritance patterns, and risk of recurrence in family members
U.S. Surgeon General’s Family History Initiative ✔✔Recommended that families know their
family history
Autosomal dominant conditions may be present in more than one generation and ✔✔In up to 50%
of offspring when one parent is affected (such as Marfan syndrome)
Recessive conditions ✔✔Appear only in one generation
Affects individuals who have two copies of a faulty gene, one from each (unaffected) parent
✔✔Recessive conditions (ex: CF, hemochromatosis)
X-linked disorders are caused by faulty genes on an ✔✔X chromosome (fragile X syndrome, color
blindness)
Communication process used whenever there is a genetic risk and often involves offering a test
that could provide info about the genetic status of the person/implications for the family
✔✔Genetic counseling
Primary role is to offer info and support to persons concerned a out an illness that may have a
genetic basis ✔✔Genetic Counselor
There are a total of ✔✔46 chromosomes, in 23 pairs
Chromosomes ✔✔Structures of DNA

PMHNP BOARDS QUESTIONS AND
ANSWERS RATED A
State legislative statues do what two things ✔✔1. grant legal authority for NP practice

2. Provides nurse practice act specific to state
   What does the Nurse Practice Act do ✔✔1. provides title protection
3. defines advanced practice
4. prevailing state laws that define scope of practice
5. places restriction on practice
6. disciplinary action
7. regulate NP development of collaborative agreement with MD
8. guides statutory law
9. oversees license
10. credentialing
11. certification
    11 defines scope of practice
12. defines standards of practice
    what are state grounds for disciplinary action ✔✔- practicing with out licesne

• falsification of records
• medicare fraud
• failure to use appropriate nursing judgement
  -failure to follow accepted nursing standards
• failure to complete accurate nursing documentation
  what is a collaborative aggrement ✔✔also known as a protocol that describes whaty types of durgs
  might be prescribed and difines some form of oversight for NP practice

what is statutory law ✔✔-rules and regulations difer for each state
-may further define scope of practice and practice requirements
-may provide restrictions in practice unique to specific state
what is licensure ✔✔- a process by which an agency of state gov. grants permission to persons to
engate in the practice of that profession
-also progibits all others from legally doing protectedpractice
what is credentialing ✔✔process used to protect the public y ensureing a minimum level of
professional competence
What is certification? ✔✔-a credential that provides title protection
-determines scope of practice
-the process by which a professional organization or association certifies that a person licensed to
practic as a professional has met certain predetermed standsrds specified by that profession for
specialty practice
-assuuers the public that a person has mastery of specified body of knowledge
-assures that the person has acquired the skils necessary to function in a particular specialty
define scope of practice ✔✔-defines the NP roles and actions
-identifies the competencies assumed to be held by all nps who function in a particluar role

-varies broadly from state to state

what are standards of practice. ✔✔authoritative statements regarding the quality and type of
practice that should be provided
-provide a way to judge the nature of care provided
-reflect professional agreement focused on the minimum levels of acceptable performance
-reflect the expectation for the care that should be provided to clients with vaious illnesses
-can be used to legally describe the standard of care that must be met by a provider

-may be precise protocols thta must be followed o more general guidelines that recommend
actions.
what is confidentiality ✔✔-the clients right to assume that information given to the healthcare
provider will not be discoled
-protected under federal statute through the medical record confidentiality act of 1995
-pretains to verbal and written client information
-requires that the provider discuss confidentiality issues with clients establish consent and clarify
andy questions about disclosure of information
-requires that provider obtain a signed medical authorization and consent form to reease medical
records and information when requested by the client o another healthcare provider
What is HIPPA ✔✔-the first nathional comprehensive rivacy protection act
-guarantees clients four fundamental rights to:
-to be educated about HIPAA privacy protection
-to have access to their own medi al records,
-to request amendment of their health inforamtion to which they object
-to require their permission for disclosure of their prsonal information
What is the HITECH Act? ✔✔incentive payments for sharing specific electronic health record
data
meaningful use incentives
electronic heal reconds can improve both individual and population based health outcomes
electronic health records can improve quality safety efficiency effectiveness and outcome
what does HITECH include ✔✔e-prescribing
computerized physican order set
tracking care and avoiding uplication of services

PMHNP board exam nonpharmacological treatment questions
and answers graded A
Most common issues for individual therapy ✔✔1. losses

2. interpersonal conflicts
3. symptomatic presentations such as panic
   phobias, and negativity
4. Unfulfilled expectations at life transitions
5. Characterological issues such as narcissim
   or aggressiveness
   Psychoanalytic therapy ✔✔1. Originated by Freud
6. believed that behavior is determined by
   unconsious motivations and instincual drives .
7. promotes change by the development of
   greater insight and awareness of maladaptive
   defenses
8. attends to past developmental and
   psychodynamic factors which shape present
   behaviors.
   Cognitive Therapy ✔✔1. Originated by Beck
9. Purports that external events do not cause
   anxiety or maladaptive responses
10. States that a persons expectations, perceptions,
    and interpretations of events cause anxiety
11. allows clients to view relaity more clearly
    through an examination of their central distorted

cognitions

5. Goal is to change clients irrational beliefs, faulty
   conceptions and negative cognitive disortions
   Behavioral Therapy ✔✔Originated by Lazarus
   Focuses on changing maladaptive behaviors by participating in active behavioral techniques such
   as exposure, relaxation, problem-solving, and role playing
   Dialectical behavioral therapy ✔✔Originated by linehan
   commonly used with people with borderline personality disorder
   focuses on emotional regulation, tolerance for distress, self-management skills, interpersonal
   effectiveness, and mindfulness, with an emphasis on treating therapy-interfering bheaviours
   Goals of dialectical behavioral therapy ✔✔Decrease suicidal behaviors
   decrease therapy interfering behaviors
   decrease emotional reactivity
   decrease sel-invalidation
   decrease crisis-generalting behaviors
   decrease passivity
   increase realistic decision making
   increase accurate communication of emotions and competencies