review q's Flashcards
A 32-year-old male patient with a history of bipolar disorder presents to your clinic.
He reports experiencing elevated mood, racing thoughts, decreased need for sleep, and increased energy for the past week. He has not been taking his prescribed mood stabilizers consistently. He mentions that he feels invincible and has been overspending money on frivolous purchases. He denies any suicidal ideation or aggression. Which of the following actions should the PMHIP prioritize in the initial assessment?
A. Conduct a thorough mental status examination to assess cognitive function and
judgment.
B. Inquire about the patient’s support system and current stressors.
C. Administer a urine drug screen to rule out substance use.
D. Recommend immediate hospitalization due to manic symptoms.
A. Conduct a thorough mental status examination to assess cognitive function and
judgment.
A Psychiatric Mental Health Nurse Practitioner (PHNP) has been treating a 34-year-old male patient diagnosed with major depressive disorder for the past three months.
The patient has been responding well to psychotherapy and medication. During a recent follow-up appointment, the patient confided in the PMHIP that he is experiencing suicidal thoughts. He states that he has a plan and has already written a suicide note. What should be the priority action of the PMHIP?
A. Advise the patient to keep his feelings to himself and not share them with anyone.
B. Inform the patient’s family about his suicidal thoughts without his consent.
C. Collaborate with the patient to develop a safety plan, including identifying support
systems and contacting crisis services if necessary.
D. Increase the patient’s medication dosage without discussing it with him to prevent
further distress.
C. Collaborate with the patient to develop a safety plan, including identifying support
systems and contacting crisis services if necessary.
What is a standard practice for PMHNs when a patient expresses suicidal thoughts?
Collaborating with the patient to develop a safety plan
This includes assessing risk, identifying coping strategies, and involving crisis services if necessary.
What does developing a safety plan for a patient involve?
Assessing the level of risk, identifying coping strategies, creating a safety plan
May also include involving crisis services if necessary.
True or False: Advising a patient to keep his feelings to himself is appropriate.
False
Encouraging the patient to keep suicidal thoughts to himself is contrary to the ethical responsibility of a PMHNP.
What is the ethical responsibility of a PMHNP regarding a patient expressing suicidal thoughts?
Ensuring the patient’s safety
This includes not encouraging the patient to remain silent about his feelings.
Is it recommended to inform a patient’s family about his suicidal thoughts without consent?
No
Sharing confidential information without consent can breach trust unless there is an immediate risk to the patient’s life.
What could happen if a PMHNP increases a patient’s medication dosage without discussion?
It can lead to misunderstandings and may not address underlying issues
Changes in medication should be discussed with the patient to avoid distress.
A 45-year-old male patient with a history of bipolar disorder presents to a mental health clinic. He reports a recent manic episode characterized by decreased need for sleep, excessive spending, and risky behaviors. He mentions that he stopped taking his prescribed mood stabilizer two weeks ago. What should be the PHNP’s initial action in managing this patient?
A. Reassess the patient’s diagnosis and medication history.
B. Perform a comprehensive mental status examination.
C. Ensure the patient’s physical safety.
D. Explore potential triggers for the manic episode.
C. Ensure the patient’s physical safety.
Sarah, a 30-year-old woman with a history of major depressive disorder, is exploring treatment options with her mental health provider. Which statement aligns best with the recovery model?
A. “Sarah, we will manage your symptoms through medication and therapy.”
B. “Let’s work together to identify your personal goals and strengths for a meaningful life.”
C. “Our primary focus is on symptom reduction to achieve stability”
D. “ will provide you with a treatment plan that outlines specific interventions.”
B. “Let’s work together to identify your personal goals and strengths for a meaningful life.”
Mark, a 25-year-old diagnosed with schizophrenia, is considering vocational rehabilitation services. What approach is most consistent with the recovery model?
A. Focusing on managing symptoms before addressing employment goals.
B. Encouraging Mark to accept a sheltered workshop position.
C. Collaboratively exploring vocational aspirations and providing support accordingly
D. Recommending long-term disability as the primary option.
C. Collaboratively exploring vocational aspirations and providing support accordingly
The recovery model in mental health emphasizes a person-centered and strengths-based approach. It focuses on empowering individuals to set their own goals and work towards a fulfilling life, which includes vocational aspirations. This option aligns with this recovery-oriented approach by emphasizing collaboration with Mark to explore his vocational aspirations and providing support based on his goals and preferences. This approach respects his autonomy and recognizes that employment can be a meaningful part of his recovery journey.
Emily, a 35-year-old with bipolar disorder, expresses a desire to reduce her reliance on medication. What response is most consistent with the recovery model?
A. “Maintaining your current medication regimen for stability is crucial.”
B. “Let’s explore your reasons for wanting to reduce medication and develop a plan
together.”
C. “You should follow the prescribed medication plan without questioning it.”
D. “Reducing medication is not a viable option at this time.”
“Let’s explore your reasons for wanting to reduce medication and develop a plan
together.!
The recovery model emphasizes collaboration and shared decision-making. This option acknowledges Emily’s perspective and encourages joint exploration and planning.
John, a 40-year-old man in recovery from substance use disorder, experiences a setback and briefly returns to using substances. How might a PHNP employing the recovery model respond?
A. “This setback is a failure in your recovery. Let’s reassess your treatment plan.”
B. “It’s important to focus on abstinence, and any substance use is unacceptable.”
C. “Let’s explore what led to the setback, learn from it, and adjust your recovery plan
accordingly.”
D. “You should consider more intensive inpatient treatment to address your relapse.”
C. “Let’s explore what led to the setback, learn from it, and adjust your recovery plan
accordingly.”
The recovery model views setbacks as opportunities for learning and adjustment. This option aligns with the recovery-oriented approach, emphasizing exploration and adaptation.
Maria, a 28-year-old with a history of self-harm, is working on her safety plan with her therapist. What reflects a recovery-focused approach to safety planning?
A. “The primary goal is to prevent any form of self-harm at all costs.”
B. “Let’s collaboratively create a safety plan that includes coping strategies and support
networks.”
C. “You should rely solely on professional help during moments of distress.”
D. “Your safety plan will be determined by the treatment team without much input from
you.”
“Let’s collaboratively create a safety plan that includes coping strategies and support networks.
A recovery-focused approach to safety planning recognizes the importance of collaboration and empowerment of the individual. It involves working together with the person to develop a plan that suits their needs and preferences. This option aligns with this approach by emphasizing collaboration in creating a safety plan and including coping strategies and support networks. This approach acknowledges the individual’s role in their own safety and recovery.
A 40-year-old patient with a history of trauma has been attending individual therapy sessions with a psychiatric mental health nurse practitioner (PMHIP) for several months. The patient expresses a desire to establish a personal friendship outside of therapy. What is the PHIP’s most appropriate action?
A. Accept the patient’s invitation to establish a personal friendship outside of therapy to
support their recovery.
B. Decline the patient’s invitation, explaining the importance of maintaining professional
boundaries in the therapeutic relationship.
C. Suggest a compromise, such as attending a support group together, to foster a sense of
connection outside of therapy.
D. Refer the patient to another mental health professional who may be more comfortable
establishing a personal friendship.
Decline the patient’s invitation, explaining the importance of maintaining professional
boundaries in the therapeutic relationship.
