Psychiatric-Mental Health Nurse Practitioner Exam Mental Health and Psychiatric Nursing 3

Question 1

A PMHNP evaluates a 70-year-old patient with new-onset paranoid delusions and visual hallucinations. Which assessment finding would most strongly suggest a medical etiology rather than a primary psychiatric disorder?

Accepted Answer

Acute onset with fluctuating consciousness and disorientation

Answer

Acute onset, fluctuating consciousness, and disorientation are hallmarks of delirium—a medical emergency—rather than a primary psychiatric illness like schizophrenia.

Question 2

Under Tarasoff duty-to-warn statutes, a PMHNP is legally obligated to take protective action when a patient:

Accepted Answer

Makes a specific, credible threat against an identifiable third party

Answer

The Tarasoff ruling established the duty to protect identifiable third parties when a patient makes a specific, serious, credible threat of harm toward them.

Question 3

A patient on a stable dose of an SSRI reports decreased libido and inability to achieve orgasm. The PMHNP's BEST initial intervention is:

Accepted Answer

Add bupropion to address sexual side effects

Answer

Augmenting with bupropion (which has pro-dopaminergic/noradrenergic activity) is a common evidence-based strategy to counteract SSRI-induced sexual dysfunction.

Question 4

Which of the following is a cardinal feature that differentiates borderline personality disorder (BPD) from bipolar II disorder?

Accepted Answer

Mood episodes lasting less than one hour triggered by interpersonal events

Answer

In BPD, dysphoric mood episodes are typically brief (hours), reactive to interpersonal stressors, and return to baseline, unlike the days-long episodes seen in bipolar disorder.

Question 5

A nurse practitioner is using the Columbia Suicide Severity Rating Scale (C-SSRS). Which item would place a patient at the HIGHEST level of suicide ideation on this scale?

Accepted Answer

Active ideation with a specific plan and intent to act

Answer

The C-SSRS categorizes ideation from passive wish to die up to active ideation with a specific plan and intent, with the latter representing the highest and most critical risk level.

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 3