Psychiatric-Mental Health Nurse Practitioner Exam Mental Health and Psychiatric Nursing 2

Question 1

A patient with schizophrenia is prescribed clozapine. Which laboratory monitoring is MOST critical due to the risk of agranulocytosis?

Accepted Answer

Absolute neutrophil count (ANC) per REMS protocol

Answer

Clozapine carries a black box warning for agranulocytosis, requiring ANC monitoring through the Clozapine REMS program before dispensing.

Question 2

A PMHNP is assessing a patient using motivational interviewing. Which technique best exemplifies the 'rolling with resistance' strategy?

Accepted Answer

Reflecting the patient's ambivalence without challenging it directly

Answer

Rolling with resistance in motivational interviewing involves acknowledging ambivalence and reflecting it back rather than confronting or arguing, reducing defensiveness.

Question 3

A patient reports racing thoughts, decreased need for sleep, grandiosity, and increased goal-directed activity for 5 days without hospitalization. The PMHNP should document this episode as:

Accepted Answer

Manic episode

Answer

A manic episode requires at least 7 days (or any duration if hospitalization is needed) of elevated/expansive/irritable mood with 3+ symptoms; 5 days with functional impairment severe enough to describe meets manic criteria.

Question 4

A teenager presents with sudden onset of paralysis in one arm with no neurological findings on MRI. The patient recently witnessed a traumatic accident. The PMHNP suspects which condition?

Accepted Answer

Conversion disorder (Functional Neurological Symptom Disorder)

Answer

Conversion disorder presents with neurological symptoms (paralysis, blindness, seizures) incompatible with neurological disease, often triggered by psychological stress.

Question 5

Which medication is considered first-line pharmacotherapy for PTSD according to current evidence-based guidelines?

Accepted Answer

Sertraline

Answer

Sertraline (and paroxetine) are FDA-approved SSRIs for PTSD and are recommended as first-line pharmacotherapy by VA/DoD and APA guidelines.

Psychiatric-Mental Health Nurse Practitioner Exam Practice Test

Psychiatric-Mental Health Nurse Practitioner Exam Practice Test

Psychiatric-Mental Health Nurse Practitioner Exam Mental Health and Psychiatric Nursing 2