ANCC Psychiatric-Mental Health Nursing 2 — Questions and Answers
Question 1: What is the primary purpose of milieu therapy in an inpatient psychiatric unit?
- To isolate patients from environmental stressors
- To use the therapeutic environment to promote healing and social skills (Correct answer)
- To reduce the need for psychotropic medications
- To provide structured one-on-one psychotherapy sessions
Correct answer: To use the therapeutic environment to promote healing and social skills
Milieu therapy uses the entire treatment environment — including peers, staff, and activities — as a therapeutic tool.
Question 2: A patient with borderline personality disorder is engaging in splitting behavior. How should the nursing staff respond?
- Assign only one nurse to avoid conflict
- Maintain consistent communication and unified team responses (Correct answer)
- Allow staff the patient prefers to handle all care
- Limit the patient's interactions with other patients
Correct answer: Maintain consistent communication and unified team responses
Consistent team communication prevents the patient from manipulating staff through idealization and devaluation dynamics.
Question 3: Which symptom cluster is most characteristic of post-traumatic stress disorder (PTSD)?
- Grandiosity, decreased need for sleep, racing thoughts
- Intrusion, avoidance, negative cognitions, hyperarousal (Correct answer)
- Depressed mood, anhedonia, psychomotor retardation
- Obsessions, compulsions, and anxiety
Correct answer: Intrusion, avoidance, negative cognitions, hyperarousal
PTSD is defined by four symptom clusters: intrusion symptoms, avoidance, negative alterations in cognition/mood, and hyperarousal.
Question 4: A nurse is conducting a suicide risk assessment. Which factor is most strongly associated with completed suicide?
- Being female
- Previous suicide attempt (Correct answer)
- Experiencing grief
- Living alone
Correct answer: Previous suicide attempt
A previous suicide attempt is the single strongest predictor of a future completed suicide.
Question 5: Which antipsychotic medication requires mandatory REMS (Risk Evaluation and Mitigation Strategy) enrollment due to risk of agranulocytosis?
- Risperidone
- Haloperidol
- Clozapine (Correct answer)
- Quetiapine
Correct answer: Clozapine
Clozapine requires REMS enrollment with mandatory absolute neutrophil count monitoring due to its risk of life-threatening agranulocytosis.
Question 6: A patient with major depressive disorder is started on an SSRI. The nurse teaches that full antidepressant effects typically occur after how long?
- 24–48 hours
- 3–5 days
- 2–4 weeks (Correct answer)
- 6–8 weeks
Correct answer: 2–4 weeks
SSRIs typically require 2–4 weeks to show initial antidepressant benefit, with full effects often seen at 4–6 weeks.
ANCC Psychiatric-Mental Health Nursing 2
What is the primary purpose of milieu therapy in an inpatient psychiatric unit?