Psychiatric-Mental Health Nurse Practitioner Exam Nursing MCQ 3 — Questions and Answers
Question 1: A patient taking phenelzine (an MAOI) asks which food they must strictly avoid. What is the correct response?
- Grapefruit juice
- Aged cheeses (Correct answer)
- Shellfish
- Green leafy vegetables
Correct answer: Aged cheeses
Aged cheeses contain high levels of tyramine, which can trigger a hypertensive crisis when combined with MAOIs.
Question 2: A patient with borderline personality disorder (BPD) displays a pattern of idealizing and then abruptly devaluing their treatment providers. This defense mechanism is called:
- Projection
- Splitting (Correct answer)
- Intellectualization
- Reaction formation
Correct answer: Splitting
Splitting is the hallmark defense mechanism of BPD, where individuals perceive people as all good or all bad without integration.
Question 3: Which instrument is the gold standard for measuring the severity of alcohol withdrawal?
- PHQ-9
- CAGE questionnaire
- Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) (Correct answer)
- Addiction Severity Index (ASI)
Correct answer: Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar)
The CIWA-Ar is the validated tool for assessing and guiding pharmacological management of alcohol withdrawal severity.
Question 4: A PMHNP is assessing a patient for tardive dyskinesia. Which area of the body is most commonly affected first?
- Trunk and torso
- Orofacial region (Correct answer)
- Hands and fingers
- Lower extremities
Correct answer: Orofacial region
Tardive dyskinesia characteristically begins with repetitive, involuntary movements of the lips, tongue, and jaw (orofacial region).
Question 5: A patient with anorexia nervosa is medically stable and has been restricting intake. What is the most serious refeeding risk the PMHNP must monitor for?
- Hyperkalemia
- Refeeding syndrome with hypophosphatemia (Correct answer)
- Hyperglycemia
- Metabolic alkalosis
Correct answer: Refeeding syndrome with hypophosphatemia
Refeeding syndrome causes a dangerous drop in serum phosphate as insulin shifts phosphate intracellularly, risking cardiac arrhythmias and respiratory failure.
Question 6: Which second-generation antipsychotic carries the highest risk for metabolic syndrome, including significant weight gain and dyslipidemia?
- Aripiprazole
- Ziprasidone
- Clozapine (Correct answer)
- Lurasidone
Correct answer: Clozapine
Clozapine and olanzapine carry the highest risk of metabolic side effects among second-generation antipsychotics.
Question 7: A nurse is applying motivational interviewing (MI) techniques. Which response best exemplifies a reflective listening statement?
- 'You should consider stopping drinking for your health.'
- 'It sounds like you feel torn between wanting to change and enjoying alcohol.' (Correct answer)
- 'Have you tried attending an AA meeting?'
- 'Most people in your situation find it helps to set a quit date.'
Correct answer: 'It sounds like you feel torn between wanting to change and enjoying alcohol.'
Reflective listening in MI involves mirroring the patient's expressed ambivalence without judging or directing, which builds rapport and fosters change talk.
Psychiatric-Mental Health Nurse Practitioner Exam Nursing MCQ 3
A patient taking phenelzine (an MAOI) asks which food they must strictly avoid.
What is the correct response?