+1443 776-2705 panelessays@gmail.com
  

To Prepare

· Reflect on your practice exam question results from Week 2. Identify content-area strengths and opportunities for improvement.

· Also reflect on your overall test taking. Was the length of time allotted comfortable, or did you run out of time? Did a particular question format prove difficult?

The Assignment

· Based on your practice test question results, and considering the national certification exam, summarize your strengths and opportunities for improvement. Note: Your grade for this Assignment will not be derived from your test results but from your self-reflection and study plan.

· Create a study plan for this quarter to prepare for the certification exam, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.

· Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.

Based on your practice test question results and considering the national certification exam, summarize your strengths and opportunities for improvement.

23 (23%) – 25 (25%)

The response provides an accurate, clear, and complete summary of both the strengths and opportunities for improvement.

20 (20%) – 22 (22%)

The response provides an accurate summary of both the strengths and opportunities for improvement.

18 (18%) – 19 (19%)

The response provides a somewhat vague and/or inaccurate summary of both the strengths and opportunities for improvement.

0 (0%) – 17 (17%)

A summary of both the strengths and opportunities for improvement are incomplete or missing.

Create a study plan, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.

27 (27%) – 30 (30%)

The response provides three or four clear and appropriate SMART goals for the study plan, including tasks to complete to accomplish each goal. A clear timeline is provided for the study plan as well as a description of how progress toward goal completion will be measured.

24 (24%) – 26 (26%)

The response provides three or four appropriate SMART goals and objectives for the practicum experience. Appropriate tasks, timeline, and description of how progress will be measured are provided.

21 (21%) – 23 (23%)

The response provides three or four somewhat vague or general goals for the study plan. Tasks, timeline, and description of how progress toward goals will be measured are vague or somewhat inappropriate.

0 (0%) – 20 (20%)

The response provides three or four unclear or inappropriate goals for the study plan, or goals are missing. Tasks, timeline, and a description for how progress will be measured are incomplete or missing.

Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.

27 (27%) – 30 (30%)

The response provides a clear description of appropriate resources to support the study plan that are tailored to individual need.

24 (24%) – 26 (26%)

The response provides a description of appropriate resources to support the study plan that are somewhat tailored to individual need.

21 (21%) – 23 (23%)

The response provides a description of general resources that are not tailored to individual need.

0 (0%) – 20 (20%)

The response provides a description of inappropriate resources to support the study plan, or the description of resources is vague or missing.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment are vague or off topic.

0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time.

Purpose statement, introduction, and conclusion were not provided.

Written Expression and Formatting – English Writing Standards:
Correct grammar, mechanics, and proper punctuation

5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors

4 (4%) – 4 (4%)

Contains one or two grammar, spelling, and punctuation errors

3.5 (3.5%) – 3.5 (3.5%)

Contains several (three or four) grammar, spelling, and punctuation errors

0 (0%) – 3 (3%)

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference list.

5 (5%) – 5 (5%)

Uses correct APA format with no errors

4 (4%) – 4 (4%)

Contains one or two APA format errors

3.5 (3.5%) – 3.5 (3.5%)

Contains several (three or four) APA format errors

0 (0%) – 3 (3%)

Contains many (five or more) APA format errors

Total Points: 100

To Prepare

Reflect on your practice exam question results from Week 2. Identify content-area strengths and opportunities for improvement.

Also reflect on your overall test taking. Was the length of time allotted comfortable, or did you run out of time? Did a particular question format prove difficult?

The Assignment

Based on your practice test question results, and considering the national certification exam, summarize your strengths and opportunities for improvement. Note: Your grade for this Assignment will not be derived from your test results but from your self-reflection and study plan.

Create a study plan for this quarter to prepare for the certification exam, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.

Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.

PRACTICE TEST

QUESTIONS

1. A 42-year-old male with alcohol use disorder for 5 years is referred to

the PMHNP from his primary care provider for addiction treatment.

Which of the following laboratory findings would be consistent with

his diagnosis?

A. Increased urine and serum creatinine levels

B. Increased mean corpuscular volume and triglycerides

C. Increased potassium and chloride levels

D. Decreased mean corpuscular volume and normal triglyceride level

2. A 9-year-old girl with a history of generalized anxiety disorder has been

stable on fluoxetine 10 mg for 6 months and presents for follow-up

complaining of bilateral leg pain. The physical exam, complete blood

count, and metabolic profile are normal except for an elevated alkaline

phosphatase. The PMHNP understands that this finding is:

A. Consistent with liver disease

B. Abnormal and should be repeated immediately

C. Abnormal and requires further evaluation of autoimmune hepatitis

D. A commonly occurring pre-puberty finding known as growing

pains

3. A 50-year-old physician presents with complaints of fatigue, headache,

abdominal distress, and weight loss. His husband reports increasing

irritability, inattentiveness, and low libido over the last month. He was

seen by his primary care provider, who just notified him he had pre-

diabetes, hypercholesterolemia, and hypertension despite weight loss.

These findings are most consistent with

A. Dysthymia

B. Major depression

C. Generalized anxiety disorder

D. Seasonal affective disorder

4. The purpose of a professional organization’s scope and standards of

practice is to:

A. Define the roles and actions for that particular profession

B. Define the differences between professions

C. Establish the legal authority to practice for a profession

D. Define the legal statutes that are governing a profession

5. An APRN recognizes the essential nature of primary prevention

strategies for a community. Which of the following is an example of a

primary prevention strategy?

A. A skills class for at risk adolescents

B. A suicide hotline

C. Mandated treatment

D. A psychosocial clubhouse for the mentally ill

6. Which of the following is representative of legal ruling trends over the

past 30 years?

A. Juries have been encouraged to find defendants not guilty because

of insanity

B. People with mental illness retain their inalienable rights even when

committed to a mental hospital

C. Courts place increased trust in the professional judgment of mental

healthcare providers to make ethical decisions

D. The time in bringing cases before a magistrate for commitment

hearings has been reduced

7. A patient who has been voluntarily committed is experienc2i3n6g

symptoms of psychosis; he declares he has the right to refuse his

medications despite the court order because God told him he would be

healed by his faith alone. Based on your knowledge of court-ordered

treatment, which of the following statements is true?

A. Psychiatric clients cannot refuse treatment

B. Psychiatric clients can refuse treatment unless it is court ordered

C. Psychiatric clients cannot act in their own best judgment

D. The professional judgment of the PMHNP supersedes the client’s

right to refuse medication

8. Which of the following elements is reflective of a professional

relationship rather than a social relationship?

A. In a professional relationship, there is no place for social

interactions

B. In a professional relationship, the PMHNP is solely responsible for

making the relationship work

C. In a professional relationship, the primary focus is on the client

and their needs

D. In a professional relationship, goals are left vague so that the client

feels any issue can be discussed

9. In light of the recent school shootings, the local high schools have

noticed an unusually high incidence of depressive symptoms and illicit

drug use among their students. The PMHNP formulates a plan to

address the problem. The goal of the program is to enhance the

capabilities of families and teachers to identify antecedents of

depression and drug use and to prevent new cases from developing.

What level of prevention is this strategy?

A. Tertiary prevention

B. Secondary prevention

C. Solution-focused prevention

D. Primary prevention

237

10. A 45-year-old White female agreed to hospitalization after presenting to

the emergency department with passive suicidal ideations. After 24

hours she states that she wishes to leave because “this place cannot

help me.” Which of the following actions reflects the legal right of the

client?

A. The patient should be discharged immediately

B. The patient is discharged after she signs forms indicating her

actions and acknowledging her actions are against medical advice

C. Contact a collaborating physician to convert the patient to an

involuntary status

D. Explain that the patient cannot leave until further assessments are

completed and collateral information is obtained

11. The PMHNP is aware that the essentials of the therapeutic alliance

include all of the following except:

A. Formulating a differential diagnosis

B. Genuineness

C. Acceptance

D. Authenticity

12. A 39-year-old woman has been in therapy for the last 3 months. She has

shown much improvement in her functioning and has developed much

insight into her illness. This week during her session you discuss

service determination, and she suddenly begins to demonstrate the first

symptoms that brought her into therapy initially. She is now hesitant

for discharge and wants to continue services as she is displaying

regressed behavior. What is the best explanation for her symptom

return?

A. Acute stress reaction

B. Reaction formation

C. A normal resistance seen in the termination time of therapy

D. A sign of undiagnosed pathological attachment

13. A 30-year-old man reports low self-esteem, demonstrates poor selfcontrol, exhibits much self-doubt, and requires a high degree of

reassurance. What developmental task has he failed to master?

A. Trust versus mistrust

B. Industry versus inferiority

C. Generativity versus stagnation

D. Integrity versus despair

14. A 25-year-old male has been seeing his psychoanalyst four times a week

for the last year and is bothered by recent episodes of forgetfulness

including misplacing everyday items and missing appointments.

Which Freudian psychodynamic principle assumes all behavior

conveys purpose?

A. The Ego development principle

B. Psychic determinism principle

C. The Id principle

D. The Superego mediation principle

15. Which of the following is an example of a mature defense mechanism?

A. Projection

B. Repression

C. Altruism

D. Regression

16. A Black man in the fifth decade of life has been seen for several weeks

of psychotherapy to discuss his current stressors. He proceeds to curl

up in the fetal position and lie on the floor. Which defense mechanism

is he manifesting?

A. Repression

B. Projection

C. Denial

D. Regression

17. An ambulance brings a 26-year-old female to the emergency department

after a suicide attempt by self-mutilation. Which of the following is the

most critical factor to consider when conducting your assessment?

238

A. Past medical and psychiatric history

B. Hemodynamic stability

C. The current level of suicidality

D. Effective coping mechanisms

18. For which of the following reasons are selective serotonin reuptake

inhibitors (SSRIs) considered the first-line drug of choice for

depression without psychotic features?

A. Ease of dosing for step-wise titration

B. Promote sleep

C. Difficulty in overdosing for suicidal patients

D. Drug level monitoring capabilities

19. A man diagnosed with major depressive disorder is started on a selective

serotonin reuptake inhibitor (SSRI). Which of the following ways is

most effective for the PMHNP to monitor the client’s response to

medication?

A. An EKG for QTc prolongation

B. Basic metabolic profile

C. Urine toxicology screen

D. A standardized rating scale for depression

20. The following statement is reflective of which type of therapy: “If a

miracle were to happen and all of your symptoms that brought you into

therapy no longer existed, what would be different?”

A. Cognitive behavioral therapy

B. Dialectical behavioral therapy

C. Solution-focused therapy

D. Psychoanalysis

21. According to family systems theory, which of the following is

reflective of homeostasis?

A. Family members placate each other to keep the peace

B. Family members behave erratically to reduce predictability

C. Stability in the interpersonal relationships despite dysfunctions

D. A crisis restores peace

22. A married couple of 7 years presents for therapy because the wife

perceives her husband to be a constant nag. He believes that he is

correct and only trying to help. You assign him a paradoxical directive

to schedule 1 hour per day in which he nags her, and once that hour is

over to keep a list and save it until the next day. The PMHNP

recognizes this type of therapy as:

A. Experiential therapy

B. Strategic therapy

C. Structural therapy

D. Solution-focused therapy

23. Which of the following is an essential principle of cognitive behavioral

therapy?

A. Recognizing and accepting automatic thoughts

B. Recognizing and changing automatic thoughts

C. Seeing reality as the private provider sees it

D. Changing reality through environmental restructuring

24. Which of the following principles of group dynamics enhances

therapeutic efficacy?

A. Cost efficiency

B. Acquiring curative factors

C. Enhancing social skills

D. All of the above

25. The patient is referred by his primary care physician for the treatment of

panic disorder with agoraphobia. He had been titrated on paroxetine

CR 37.5 mg daily and clonazepam 0.5 mg daily as needed. He has

been on this regimen for the last year, but he admits that he sometimes

requires as many as five clonazepam tablets to get the same effect.

Which pharmacokinetic property is influencing this phenomenon?

A. Potency

239

B. Tolerance

C. Kindling

D. Addiction

26. The process by which the body affects the drug is known as:

A. Metabolism

B. Distribution

C. Pharmacokinetics

D. Pharmacodynamics

27. Which of the following neuroleptic mood stabilizing medications

commonly used to treat bipolar disorder is associated with which

teratogenic effects?

A. Divalproex (shortened limbs); lithium (seizure disorder)

B. Lithium (Ebstein’s anomaly); divalproex (neural tube defects)

C. Divalproex (Ebstein’s anomaly); lithium (cleft lip and palate)

D. Lithium (spina bifida); divalproex (neural tube defects

28. Which of the following conditions that occur with the aging process

affects drug metabolism?

A. Increased muscle mass

B. Reduced protein binding

C. Increased liver metabolization pathways leading to toxicity

D. Decreased body fat

29. Which of the following classes of medications is thought to exacerbate

or cause depression?

A. Proton pump inhibitors

B. Beta blockers

C. Antihistamines

D. PD 5 inhibitors

30. A patient with chronic renal failure and type 2 diabetes is sent to the

PMHNP with symptoms of depression marked by increasing fatigue,

confusion, irritability, anhedonia, and apathy. Which of the following

is the best action to take at this time?

A. Increase his antidepressant medication

B. Augment his selective serotonin reuptake inhibitor (SSRI) with a

partial agonist antipsychotic

C. Order blood work to evaluate his renal function and electrolytes

D. Order a 12-lead EKG

31. A 36-year-old pharmacist has a history of depression and suicide attempt

1 month ago by hanging. She had been started on a tricyclic

antidepressant but abruptly stopped taking the medication a week after

she started saying it was “ineffective.” The PMHNP meets with this

patient to plan care. Which of the following is the most appropriate

initial action?

A. Ask the patient how to help her

B. Provide teaching about the long timeframe it takes for tricyclic

antidepressants (TCAs) to work

C. Contract with the patient for six sessions of therapy

D. Tell the patient how suicide might affect her family

32. A 90-year-old Black woman tells the PMHNP “some days life is just not

worth living. I would be less of a burden if I were not here anymore.”

The most therapeutic response for the PMHNP to make is

A. “Everybody loves you and likes being around you”

B. “Tell me what you mean when you say ‘life is not worth living’”

C. Therapeutic use of silence

D. “Are you thinking suicide might be an option for you?”

33. During the first session of therapy, the patient makes the following

statement: “All my other kids got through their drug use phase and

were able to get on with their lives. I have grounded him, taken away

his privileges, and I even tried to cut out his allowance, but I’m just not

sure what I should do now?” What is the most therapeutic response for

the PMHNP to make?

240

A. Therapeutic use of silence

B. “I wonder if locking him in his room was abusive.”

C. “Maybe that depends on what you’re trying to accomplish.”

D. “Perhaps talking to his friends, coaches, and teachers would be

helpful.”

34. While performing a mental status exam on a patient, you ask them to

interpret this proverb: “A stitch in time saves nine.” The patient replies

“The garment would be more likely to rip.” How would you interpret

these findings?

A. The patient is psychotic

B. The patient is anxious

C. The patient is intellectually disabled

D. There is not enough information to interpret the statement without

knowing the client’s age

35. A client states that he “did not realize the time” and apologized for

running late. The PMHNP replies “This is the fourth time in a row

that you’ve been late to our sessions; I’m just wondering how

committed you are to this therapy.” What communication technique

was used by the PMHNP?

A. Reflecting

B. Restating

C. Presenting reality

D. Validating

36. The PMHNP will evaluate a recently admitted 22-year-old male and

formulate the initial treatment plan. The patient asks to go to his room

because “people make me nervous.” The PMHNP’s action should be

based on the awareness that the best location to do an initial evaluation

is:

A. In the patient’s room because it’s the least noisy and most

comfortable for him

B. In a public area to observe his interactions with others

C. In a treatment room with the door closed in a neutral location

D. In a quiet but public place to get assistance should it be required

during the evaluation

37. What is the primary goal of a comprehensive psychiatric evaluation?

A. To complete the necessary forms for a maximum reimbursement

B. To develop a correct diagnosis

C. To communicate with others about the patient’s healthcare needs

D. To identify the mental health needs of the patient

38. Psychotropic medications are used to treat

A. Psychiatric disorders

B. Psychiatric symptoms

C. Neurological conditions

D. Endocrine disorders

39. A patient is experiencing memory deficits, difficulty in prioritizing and

planning, no insight into problems, and poor impulse control. Which

lobe of the brain is responsible for the symptoms?

A. Parietal lobe

B. Frontal lobe

C. Temporal lobe

D. Occipital lobe

40. Which of the following neurotransmitters is excitatory?

A. Gamma-aminobenzoic acid (GABA)

B. Dopamine

C. Norepinephrine

D. Glutamate

41. Which of the following is a contraindication for brain MRI?

A. Automated internal cardiac defibrillator (AICD)/pacemaker

B. History of traumatic brain injury

241

C. Hip replacement

D. Pregnancy

42. Which area of the brain regulates appetite, the sleep-wake cycle, and

libido?

A. Hippocampus

B. Amygdala

C. Hypothalamus

D. Limbic system

43. Which of the following areas of the brain produces dopamine?

A. Substantia nigra

B. Raphe nuclei

C. Locus ceruleus

D. Basal nucleus

44. What purpose does a neurotransmitter serve in the nervous system?

A. Enzyme breakdown

B. Amino acid scaffolding

C. Communication medium

D. Enzyme production

45. A patient who was able to escape the World Trade Center during 9/11 is

dysphoric several months after the event and tells the PMHNP that she

does not want to talk about her coworkers who were lost because it

hurts so much. Which defense mechanism is being utilized?

A. Denial

B. Suppression

C. Undoing

D. Projection

46. A patient who is unable to recall his involvement in a psychological

trauma is using which of the following defense mechanisms?

A. Denial

B. Suppression

C. Deep depression

D. Undoing

47. A sole survivor from a house fire tells the PMHNP that she does not

remember anything about how she got out. Which defense mechanism

is being used?

A. Suppression

B. Denial

C. Repression

D. Sublimation

48. A man finds his coworkers exceptionally difficult to work with, and he

finds them generally incompetent. He does not share his thoughts with

his coworkers or his boss out of fear of hurting their feelings. He

suddenly has the urge to bring baked goods several times a week.

Which defense mechanism is the best explanation for this behavior?

A. Denial

B. Suppression

C. Repression

D. Undoing

49. Which of the following is a defense mechanism purpose?

A. Alert to danger

B. Protect the Id

C. Resolve conflicts

D. Suppress intuition

50. Which of the following is the best intervention for a client experiencing

ataque de nervios?

A. Benzodiazepines

B. Using a family member to interpret

C. Involuntary admission

242

D. Referral to supportive psychotherapy by a therapist who speaks the

language

51. Which of the following ADHD symptoms overlap with PTSD in

children and adolescents?

A. Talkativeness, hyperactivity, distractibility

B. Avoidance behaviors, mood lability, irritability

C. Recklessness, hypervigilance, aggressiveness

D. Disorganization, interrupting, carelessness

52. A 17-year-old male, high school senior who is on the wrestling team, is

being treated for an eating disorder. He is of average weight, socially

engaged, and attention seeking at times among his peers. Which of the

following eating disorders is most consistent with these symptoms?

A. Anxiety-induced eating disorder

B. Binge eating disorder

C. Bulimia nervosa

D. Anorexia nervosa

53. His two fathers bring a hyperactive 7-year-old boy for follow-up

treatment of attention deficit hyperactivity disorder. Also on this visit

is the newest addition to the family, an 8-month-old baby boy. The

PMHNP notices that this child has a small head along with stereotypic

motions of the hands, slapping and licking behaviors, and is seemingly

regressed. Language skills are also more primitive than expected.

What medical condition does the PMHNP suspect the 8-month-old

baby boy has developed?

A. Autism spectrum disorder

B. Rett syndrome

C. Selective mutism

D. Progeria

54. A PMHNP is about to start an 8-year-old girl on a stimulant for attention

deficit hyperactivity disorder (ADHD). Your clinical observations and

rating scales corroborate the diagnosis. What assessments need to be

completed before starting stimulant medication?

243

A. The ADHD rating scale completed by the grandparents

B. Rule out a family history of bipolar disorder

C. Check blood pressure and pulse

D. Blood pressure, pulse, height, weight, and 12-lead EKG

55. Many psychotropic medications come with a black box warning,

particularly for use in children and young adults. What specific

education must you provide to a 22-year-old male as the PMHNP to

the patient?

A. Risk of increased impulsive behavior

B. Risk of increased suicidal thoughts

C. Risk of sexual side effects

D. Risk of teratogenic sperm production

56. According to the DSM-5, personality disorders are categorized according

to which of the following?

A. Axis II

B. Axis III

C. Axis IV

D. The primary psychiatric disorder

57. Which of the following is NOT an example of the defense mechanism of

isolation, as may be exhibited by someone with a Cluster C personality

disorder?

A. Not leaving the house for many days

B. Declining invitations for social events

C. Remaining private and introverted in the workplace to avoid

coworkers

D. Expressing detailed information without flat affect

58. Which of the following is considered a genetic and social risk factor

for a person to develop antisocial personality disorder?

A. Psychotic disorders

B. Oppositional defiant disorder

C. Generalized anxiety disorders

D. Affective disorders

59. A 35-year-old female with a Cluster A personality disorder states that “I

hear people outside the office door during our sessions. Are they

listening in on us?” What would be your best response?

A. Validate her, and ask her to tell of a time in her life when she had a

similar experience

B. Using humor, ask a rhetorical question to stimulate reflection and

then reassure her that she is that special

C. Distract her from the topic and insist that there is no way for

someone outside to hear your session

D. Validate her, and inform her that the white noise sound machine

muffles the sounds of the session and it would be hard to hear the

conversation outside the office

60. In speaking with a 50-year-old man with a Cluster A personality

disorder, which would be the best strategy?

A. Do not challenge his negative views or recollections of past events

B. Confront misinterpreted thoughts and feelings, especially those

that are negative

C. Make time for a detailed and emotionally engaging dialogue

D. Deflate any grandiose though