Clinical Nurse Specialist Psychiatric & Mental Health Nursing 2

Question 1

A patient with borderline personality disorder engages in splitting by telling the night nurse that the day nurse is 'incompetent and cruel.' The most therapeutic CNS response to the team is to:

Accepted Answer

Implement consistent limit-setting and unified team communication strategies

Answer

Splitting is managed by maintaining a unified, consistent treatment team approach with clear limit-setting, preventing staff from being divided into 'all good' or 'all bad' roles.

Question 2

Which of the following is the FIRST priority intervention when de-escalating a verbally aggressive patient in an inpatient psychiatric unit?

Accepted Answer

Ensure personal safety and position yourself near the exit

Answer

Before any therapeutic intervention, the CNS must ensure personal safety by positioning themselves near an exit and maintaining a safe distance, as safety is always the first clinical priority.

Question 3

A patient with post-traumatic stress disorder (PTSD) is experiencing hypervigilance, nightmares, and avoidance of trauma reminders. Which first-line evidence-based psychotherapy is recommended by VA/DoD clinical practice guidelines?

Accepted Answer

Prolonged Exposure (PE) therapy

Answer

Prolonged Exposure (PE) therapy is a first-line, evidence-based psychotherapy for PTSD that involves systematic, repeated engagement with trauma memories and reminders to reduce avoidance and distress.

Question 4

A CNS assessing a patient for alcohol use disorder uses the CIWA-Ar scale. A score of 15 on this scale indicates:

Accepted Answer

Moderate withdrawal requiring pharmacological intervention

Answer

CIWA-Ar scores of 8–15 indicate moderate alcohol withdrawal, typically requiring pharmacological treatment (usually benzodiazepines) to prevent progression to severe withdrawal or delirium tremens.

Question 5

The use of physical restraints in an inpatient psychiatric setting requires which of the following per The Joint Commission standards?

Accepted Answer

Face-to-face evaluation within one hour of restraint initiation

Answer

The Joint Commission requires that a physician or licensed independent practitioner conduct a face-to-face evaluation within one hour of initiating restraints to ensure patient safety and appropriateness.

Clinical Nurse Specialist Practice Test

Clinical Nurse Specialist Practice Test

Clinical Nurse Specialist Psychiatric & Mental Health Nursing 2