NCAS Mental Health and Psychiatric Nursing 1 — Questions and Answers
Question 1: Which brief validated tool is most widely used in community settings to screen for depression in adults?
- Patient Health Questionnaire-9 (PHQ-9) (Correct answer)
- Mini-Mental State Examination (MMSE)
- GAD-7 for anxiety only
- Beck Depression Inventory-II (BDI-II)
Correct answer: Patient Health Questionnaire-9 (PHQ-9)
The PHQ-9 is a 9-item validated screening tool widely used in primary care and community settings to screen for and monitor depression severity.
Question 2: A community nurse is assessing a patient who reports hearing voices commanding self-harm. The MOST appropriate immediate action is:
- Conduct a full suicide and homicide risk assessment and arrange immediate psychiatric evaluation (Correct answer)
- Document the complaint and schedule a follow-up in 2 weeks
- Prescribe antipsychotic medication independently
- Reassure the patient that the voices will go away on their own
Correct answer: Conduct a full suicide and homicide risk assessment and arrange immediate psychiatric evaluation
Command hallucinations for self-harm represent a psychiatric emergency requiring immediate risk assessment and urgent psychiatric evaluation or hospitalization.
Question 3: Which US law mandates that insurance coverage for mental health and substance use disorders be comparable to coverage for medical and surgical care?
- Mental Health Parity and Addiction Equity Act (MHPAEA) (Correct answer)
- Americans with Disabilities Act (ADA)
- Affordable Care Act (ACA) only
- HIPAA Privacy Rule
Correct answer: Mental Health Parity and Addiction Equity Act (MHPAEA)
The MHPAEA (2008) and its 2010 ACA amendments require that mental health and substance use disorder benefits be provided on par with medical/surgical benefits.
Question 4: In the context of community mental health, what does 'recovery' mean according to SAMHSA?
- A process of change through which individuals improve health and wellness, live self-directed lives, and reach their full potential (Correct answer)
- Complete elimination of all mental health symptoms
- Discharge from all psychiatric services
- Returning to the same level of functioning as before illness onset
Correct answer: A process of change through which individuals improve health and wellness, live self-directed lives, and reach their full potential
SAMHSA's recovery model defines recovery as a personal, holistic process focused on wellness, self-determination, and meaningful participation in life beyond symptom elimination.
Question 5: A community health nurse is assessing a teenager using the Columbia Suicide Severity Rating Scale (C-SSRS). This tool primarily assesses:
- Suicidal ideation intensity and suicidal behavior history (Correct answer)
- Anxiety disorder severity
- Substance use frequency
- Academic performance decline
Correct answer: Suicidal ideation intensity and suicidal behavior history
The C-SSRS is a validated, evidence-based tool that systematically assesses the type and severity of suicidal ideation and history of suicidal behavior.
Question 6: Which therapeutic communication technique should a community nurse use when a patient with schizophrenia expresses a delusion?
- Do not reinforce the delusion but acknowledge the patient's feelings without arguing about reality (Correct answer)
- Firmly correct the patient and explain why they are wrong
- Agree with the delusion to build rapport
- Change the subject immediately without acknowledgment
Correct answer: Do not reinforce the delusion but acknowledge the patient's feelings without arguing about reality
The therapeutic approach to delusions is to avoid reinforcing them while acknowledging the patient's emotional experience without directly confronting or agreeing with the delusion.
NCAS Mental Health and Psychiatric Nursing 1
Which brief validated tool is most widely used in community settings to screen for depression in adults?