ISPN & CGFNS Qualifying Exam — Questions and Answers

Question 1: A foreign-educated nurse completes CGFNS Certification; what must they still typically obtain to practice as an RN in a U.S. state?

A second bachelor's degree
Nothing further
A state nursing license, usually by passing the NCLEX-RN (Correct answer)
A medical degree

Correct answer: A state nursing license, usually by passing the NCLEX-RN

CGFNS Certification does not grant a license; the nurse must still obtain state licensure, typically by passing the NCLEX-RN.

Question 2: A patient reports a pain level of 8 out of 10 after surgery; the nurse's priority action is to:

Tell the patient pain is expected
Document and reassess in 4 hours
Assess the pain and administer prescribed analgesia (Correct answer)
Discharge the patient

Correct answer: Assess the pain and administer prescribed analgesia

Severe reported pain warrants assessment and prompt administration of prescribed pain relief.

Question 3: A nurse notes that a patient looks away and becomes quiet whenever family is mentioned. The nurse says 'I notice you seem uncomfortable when we talk about your family.' This is an example of:

Confrontation
Making observations (Correct answer)
Voicing doubt
Interpreting behavior

Correct answer: Making observations

Making observations involves describing what the nurse has noticed about the patient's behavior or affect without interpreting it, inviting the patient to explore its meaning.

Question 4: What is the minimum number of questions an NCLEX-RN candidate can answer before the exam ends under the current NGN format?

265 questions
25 questions
50 questions
85 questions (Correct answer)

Correct answer: 85 questions

Under the current NGN format, the NCLEX-RN has a minimum of 85 questions, which includes both scoreable and pretest items before CAT can determine competency.

Question 5: For the CGFNS VisaScreen, which minimum English language score on TOEFL iBT is generally required?

Scores are not used; only oral interviews count
A total score of 83 with specific minimum scores in each section (Correct answer)
Any passing score above 60
A perfect score of 120

Correct answer: A total score of 83 with specific minimum scores in each section

CGFNS generally requires a TOEFL iBT total score of at least 83 with specified minimums in speaking, listening, reading, and writing sections.

Question 6: A 35-year-old male who has used cocaine is being assessed by an emergency room nurse. What are the signs that the client has overdosed?

Myocardial infarction and ataxia (Correct answer)
Blank stare and tremors
Vomiting and disorientation
Constricted pupils and hypotension

Correct answer: Myocardial infarction and ataxia

Cocaine is a powerful stimulant that causes severe vasoconstriction, increased heart rate, and elevated blood pressure. These effects significantly increase the risk of myocardial infarction (heart attack) due to coronary artery spasm and increased cardiac oxygen demand. Ataxia, or impaired coordination, is also a common neurological sign of severe cocaine intoxication or overdose, reflecting its impact on the central nervous system.

Question 7: Which nursing assessment finding would most concern a psychiatric nurse evaluating a patient for command hallucinations?

The patient reports mild anxiety about hospitalization
The patient refuses to eat breakfast
The patient sleeps more than 10 hours per night
The patient reports hearing a voice telling them to hurt themselves or others (Correct answer)

Correct answer: The patient reports hearing a voice telling them to hurt themselves or others

Command hallucinations — voices instructing the patient to harm themselves or others — represent an acute safety risk requiring immediate intervention.

Question 8: Which of the following is a NON-THERAPEUTIC communication technique?

Using therapeutic silence
Reflecting the patient's feelings
Seeking clarification
Giving false reassurance (Correct answer)

Correct answer: Giving false reassurance

Giving false reassurance dismisses the patient's real concerns and closes off genuine communication by minimizing problems with empty comfort.

Question 9: Which assessment tool is specifically used to identify symptoms of post-traumatic stress disorder (PTSD) in a psychiatric nursing evaluation?

Geriatric Depression Scale (GDS)
Mini-Mental State Examination (MMSE)
PTSD Checklist for DSM-5 (PCL-5) (Correct answer)
Confusion Assessment Method (CAM)

Correct answer: PTSD Checklist for DSM-5 (PCL-5)

The PCL-5 is a validated 20-item self-report measure that assesses the presence and severity of DSM-5 PTSD symptoms.

Question 10: Which medication is used to treat extrapyramidal side effects (EPS) caused by antipsychotics?

Flumazenil (Romazicon)
Naloxone (Narcan)
Benztropine (Cogentin) (Correct answer)
Lithium carbonate

Correct answer: Benztropine (Cogentin)

Benztropine is an anticholinergic medication used to treat EPS including acute dystonia, pseudoparkinsonism, and akathisia caused by antipsychotic drugs.

Question 11: A assistance group has been talking with a depressed hospital patient. Which behaviors suggest that the patient is on the verge of committing suicide?

The patient expresses his dissatisfaction with the other members of the group to the nurse.
Because he dislikes the group leader, the patient requests to be placed in another group.
The patient begins to give away his or her stuff. (Correct answer)
The patient has outbursts of anger

Correct answer: The patient begins to give away his or her stuff.

A critical warning sign of impending suicide, especially in a depressed individual, is the act of giving away cherished possessions or making final arrangements. This behavior often indicates that the person has made a decision to end their life and is 'tying up loose ends.' It suggests a shift from suicidal ideation to concrete planning and intent, requiring immediate and urgent intervention.

Question 12: Which ethical principle is most directly tested in psychiatric nursing when a patient refuses recommended medication?

Beneficence
Autonomy (Correct answer)
Fidelity
Justice

Correct answer: Autonomy

Autonomy is the ethical principle at stake when a competent patient refuses treatment; psychiatric nurses must respect informed refusal while ensuring safety.

Question 13: Which of the following best describes the 'advanced practice' tier of psychiatric nursing recognized by ISPN?

Staff nurses who work on inpatient psychiatric units
Psychiatric-Mental Health Nurse Practitioners who diagnose and prescribe (Correct answer)
Nurses who have completed a CE course in mental health
Nurses with 2 years of psychiatric experience only

Correct answer: Psychiatric-Mental Health Nurse Practitioners who diagnose and prescribe

Advanced practice psychiatric nursing is represented by PMHNPs who have graduate education and are authorized to diagnose mental health conditions and prescribe medications.

Question 14: A patient says 'I've been feeling really anxious about everything lately.' The nurse responds, 'You've been feeling a lot of anxiety lately.' This is an example of:

Clarification
Reflection of feeling
Restating (Correct answer)
Summarizing

Correct answer: Restating

Restating involves repeating back the patient's key words to acknowledge what was said and invite the patient to continue elaborating.

Question 15: Which English language test is commonly accepted within the CGFNS Certification Program?

SAT
TOEFL iBT or IELTS Academic (Correct answer)
GRE
GMAT

Correct answer: TOEFL iBT or IELTS Academic

CGFNS accepts approved English proficiency tests such as the TOEFL iBT and IELTS Academic.

Question 16: A nurse who identifies a medication error they made should first:

Blame the pharmacy
Report it promptly and assess the patient for harm (Correct answer)
Wait until the end of the shift
Conceal it to avoid blame

Correct answer: Report it promptly and assess the patient for harm

Ethical and safe practice requires promptly reporting the error and assessing the patient for any harm.

Question 17: An indwelling abdominal catheter is used by a client who is having peritoneal dialysis for chronic renal failure. If the client spills water over the catheter dressing, what should the nurse do?

Reinforce the dressing
Change the dressing (Correct answer)
Sterilize the catheter with povidone-iodine
Replace the catheter

Correct answer: Change the dressing

An indwelling abdominal catheter for peritoneal dialysis creates a direct pathway into the peritoneal cavity, making sterility paramount. Spilling water on the dressing compromises its sterile barrier and creates a moist environment conducive to bacterial growth. Changing the dressing immediately is crucial to prevent infection, which is a serious and potentially life-threatening complication of peritoneal dialysis.

Question 18: Which framework guides the ANCC PMHN-BC exam content outline?

ISPN's Psychiatric-Mental Health Nursing: Scope and Standards of Practice (Correct answer)
DSM-5 diagnostic criteria exclusively
The Joint Commission behavioral health standards
The NIH mental health research agenda

Correct answer: ISPN's Psychiatric-Mental Health Nursing: Scope and Standards of Practice

The ANCC PMHN-BC exam content outline is derived from ISPN's Scope and Standards of Practice, which defines the competencies of psychiatric-mental health nurses.

Question 19: The VisaScreen certificate issued by CGFNS is required for what purpose?

Hospital employment in the home country
Obtaining an occupational visa to work as a healthcare professional in the U.S. (Correct answer)
U.S. state licensure
Enrolling in a nursing program

Correct answer: Obtaining an occupational visa to work as a healthcare professional in the U.S.

The VisaScreen certificate is required by U.S. immigration law for foreign healthcare workers seeking an occupational visa.

Question 20: What is the primary eligibility requirement related to licensure for the PMHN-BC certification?

A current, active RN license in the US or its territories (Correct answer)
A foreign nursing credential verified by CGFNS
A DNP degree from an accredited program
An LPN license with 10 years of psychiatric experience

Correct answer: A current, active RN license in the US or its territories

Applicants must hold a current, active RN license in the US or its territories to be eligible for the PMHN-BC certification.

Question 21: Which step of the nursing process involves collecting subjective and objective data?

Evaluation
Implementation
Assessment (Correct answer)
Planning

Correct answer: Assessment

Assessment is the first step of the nursing process, focused on gathering subjective and objective data.

Question 22: Which NCLEX-RN format change adopted in 2023 affects test-taking strategy for international nurses?

Next Generation NCLEX (NGN) with new item types including case studies and extended multiple response (Correct answer)
Replacement of multiple-choice with all essay questions
Addition of a hands-on clinical simulation component
Reduction of the exam to 50 questions maximum

Correct answer: Next Generation NCLEX (NGN) with new item types including case studies and extended multiple response

The NGN introduced new item types such as extended multiple response, matrix questions, and case studies to better measure clinical judgment, which internationally educated nurses must prepare for.

Question 23: Passing the CGFNS Qualifying Exam predicts likelihood of success on which U.S. exam?

The MCAT
The USMLE
The NCLEX-RN (Correct answer)
The TOEFL

Correct answer: The NCLEX-RN

The CGFNS Qualifying Exam is designed to predict a candidate's likelihood of passing the NCLEX-RN.

Question 24: A patient taking an atypical antipsychotic gains 15 pounds and develops hyperglycemia. These findings are characteristic of which side effect syndrome?

Metabolic syndrome (Correct answer)
Stevens-Johnson syndrome
Serotonin syndrome
Tardive dyskinesia

Correct answer: Metabolic syndrome

Atypical antipsychotics are associated with metabolic syndrome, which includes weight gain, hyperglycemia, dyslipidemia, and increased cardiovascular risk.

Question 25: CGFNS International is headquartered in which U.S. city?

New York, New York
Washington, D.C.
Philadelphia, Pennsylvania (Correct answer)
Chicago, Illinois

Correct answer: Philadelphia, Pennsylvania

CGFNS International is headquartered in Philadelphia, Pennsylvania.

Question 26: Which benzodiazepine property is most important for psychiatric nurses to teach patients regarding long-term use?

No risk of interaction with other CNS depressants
Permanent cure of anxiety disorders after 6 months of use
Physical dependence and the risk of withdrawal seizures if stopped abruptly (Correct answer)
Improved cognitive function over time

Correct answer: Physical dependence and the risk of withdrawal seizures if stopped abruptly

Benzodiazepines cause physical dependence, and abrupt discontinuation after prolonged use can trigger life-threatening withdrawal seizures, requiring gradual tapering.

Question 27: Which credential is most directly comparable in purpose to CGFNS for foreign-educated nurses entering the U.S.?

A teaching certificate
A CPR card
A pharmacy technician license
A state board credentials evaluation service (Correct answer)

Correct answer: A state board credentials evaluation service

A state board's credentials evaluation serves a comparable purpose, assessing foreign education against U.S. licensure standards.

Question 28: The technique of 'focusing' in therapeutic communication is BEST described as:

Repeating the main points the patient has made
Pausing to allow the patient to think in silence
Asking multiple questions to explore all aspects of a problem simultaneously
Directing the conversation to a specific theme or concern (Correct answer)

Correct answer: Directing the conversation to a specific theme or concern

Focusing helps the patient concentrate on a specific topic that is particularly relevant to their care, preventing the conversation from becoming too diffuse.

Question 29: If a client is experiencing dizziness after receiving procainamide (Procanbid) intravenously, the first nursing action is to:

Using a rhythm strip, record the heart rate.
Obtain a blood pressure reading by auscultating the client's apical pulse. (Correct answer)
Obtain a 12-lead electrocardiogram as soon as possible.
Administer the nitroglycerin pills as directed.

Correct answer: Obtain a blood pressure reading by auscultating the client's apical pulse.

Procainamide is an antiarrhythmic medication that can cause hypotension as a significant side effect, especially with intravenous administration. Dizziness is a common symptom of hypotension. Therefore, the nurse's first and most crucial action is to assess the client's blood pressure to confirm hypotension and guide appropriate interventions to ensure patient safety.

Question 30: What does the acronym CGFNS stand for?

Certification Group for Foreign Nursing Specialists
Council for General Foreign Nursing Standards
Center for Global Foreign Nurse Services
Commission on Graduates of Foreign Nursing Schools (Correct answer)

Correct answer: Commission on Graduates of Foreign Nursing Schools

CGFNS International stands for the Commission on Graduates of Foreign Nursing Schools.

ISPN & CGFNS Qualifying Exam

The CGFNS Qualifying Exam evaluates foreign-educated nurses for U.S. licensure eligibility across NCLEX-style client needs domains, while the ISPN PMH-BC certification validates psychiatric-mental health nursing competencies for registered nurses.

Questions

35 min

Time Limit

70%

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