ANCC Domain 5 Practice Questions Answers

ANCC Domain 5 Practice Questions & Answers

You have students from local psychiatric nurse practitioner programs follow you in your clinical practice to show them what you do as a Psychiatric

Nurse Practitioner. This is called being a:

• Preceptor
• Mentor
• Professor
• Teacher

-Ans- A

A Psychiatric Mental Health Nurse Practitioner providing psychiatric consultation makes a home visit after the police found an 86-year-old widow wandering the streets at 4AM after emergency call from her daughter. The woman has been living with her daughter for the past ten years, after her husband died. Her daughter is a 66-year-old, single, retired schoolteacher, appears thin, exhausted, and reports little sleep for past two years trying to care for her mother. The daughter reports that her mother becomes increasingly confused every evening and wanders the house unable to sleep at night. The daughter is unable to leave her mother alone for even a short period of time because unsupervised her mother will turn on the gas stove burner, leave it unattended, and she escapes the house at every chance to wander the neighborhood. Her mother is socially pleasant, disoriented to time and place, and does not recognize her daughter. Her mother thinks that the daughter is a housekeeper intent on stealing her money and possessions, which is upsetting to the daughter. What is the most important in determining the level of care needed for this elderly client?

• Appraisal of daughter's health and her ability and willingness to continue

caring for mother in home.

• Modification of environment such as bright lights in evening,

identification bracelet, and safety lock on stove. 1 / 3

• Trial of low-dose atypical antipsychotic to reduce paranoid ideation, help

sleep, and decrease wandering.

• Linkage with home health aide 4 to 6 hours, three times per week, and

community resources for respite care. -Ans- A

As a psychiatric nurse practitioner, you evaluate your patients for health concerns and beyond, in a holistic manner. your current patient has a blood sugar of 186 and a hemoglobin A1C of 6.7. You refer this patient to an internal medicine practitioner with whom you frequently share patients. You

have just violated:

• The DATA Act
• The Adams Act
• No statute
• The Stark law

-Ans- C

Which of the following is not insured by the Universal Bill of Rights for Mental Health Patients?

• The right to refuse a particular mode of treatment regardless of

informed, voluntary, written consent, or situation.

• The right to freedom from restraint or seclusion, other than as a mode of

treatment during an emergency situation.

• The right to be given a reasonable explanation of one's general mental

and physical condition, the objectives of treatment, and the possible adverse effects of recommended treatment.

• The right to ongoing participation in the planning of mental health

services provided in a manner appropriate to a person's capabilities.-Ans- A

During an outpatient medication evaluation a depressed client reports persistent anger toward his former boss after losing his job due to arguments and assaultive behavior toward co-workers. The client has been waiting outside the plant in the afternoon, watching for the boss to leave to confront him regarding his terminated employment. What responsibility does the PMHNP have in this situation? 2 / 3

• Contact the client's boss to notify him of potential harm.
• Ask the client to sign a "no harm to others" agreement and document in

chart.

• Consult state board of nursing regarding state law requirements on

reporting potential harm.

• Advise the client to stop going to the plan and avoid any contact with his

former boss.-Ans- C

Your patient is a 32-year-old who is diagnosed with major depression- recurrent, insomnia, and chronic lower back pain. The patient has seen you for three medication management sessions over the last two months.During the fourth medication management session, the patient states that money is tight and an appointment is required with the general practice (GP) physician every time a refill of the Hydrocodone (pain medication) is needed. The patient asks you to refill the Hydrocodone to save the cost of

another medical visit. you:

• State that you certification is for psychiatric care only and refer him back

to his GP.

• State that you are willing to discuss alternative medications to manage

his pain.

• State that you can refill this prescription just once.
• State that you would be willing to call his GP to discuss the issues and

help him out.-Ans- A

You are a nurse practitioner (NP) who performs psychotherapy. your patient is distraught, and you call in the NP who is performing the medication management to sit in and discuss and determine if an emergency medication evaluation is needed. After the discussion of medication changes that will take place, the medication manager NP asks the crying patient if she needs a hug. The patient stands and extends her arms outward. The medication NP gives her a chaste hug and leaves the room. Is this a case of inappropriate touch or battery?

• / 3