The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing:
Scope and Standards of Practice is to
a. Define the role and actions for the NP
b. Establish the legal authority for the prescription of psychotropic medications
c. Define the legal statutes of the role of the PMHNP
d. Define the differences between the physician role and the NP role
Correct Answer: A. The ANAs Psych-Mental Health Nursing Scope and Standards of
Practice defines the role and actions of the nurse practitioner.
D. Information reduces incidence of disease.
Correct Answer: Primary prevention care practices are an essential aspect of the
PMHNP role. Which of the following is the best example of a primary prevention care
strategy for community behavioral health?
a. Aftercare program for chronically mentally ill clients recently discharged from the
hospital
b. Court-ordered counseling for abusive parents
c. 24-hour crisis hotlines
d. Parenting skills classes for pregnant adolescents
P a g e 1 | 51
,The trend in legal rulings on cases involving mental illness over the past 25 years has
been to
a. Encourage juries to find defendants not guilty by reason of insanity
b. Protect the person's freedoms or rights when he or she is committed to a mental
hospital
c. Place increasing trust in mental health professionals to make good and ethical
decisions
d. Decrease the "red tape" associated with commitments so that commitments are
faster and easier
Correct Answer: B. Identifies the trend of ensuring the protection of individual civil
liberties for psychiatric clients.
Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms,
refuses to take any of his ordered medication because he believes "Jesus Christ told
me I am the prophet and must fast for a year." Your actions should be based on your
knowledge of which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare decisions and,
therefore, the nurse's best clinical judgment should guide actions
P a g e 2 | 51
,Correct Answer: C. As with any client, psychiatric clients can refuse treatment unless
a legal process resulting in involuntary commitment or mandatory court order for
treatment has been obtained.
Which of the following statements best reflects the difference between the nurse-client
(N-C) relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the client's needs.
b. Goals in the N-C relationship are deliberately left vague and unspoken so that the
client can work on any issue.
c. In the N-C relationship, the nurse is solely responsible for making the relationship
work.
d. In the N-C relationship, there is no place for social interaction.
Correct Answer: A. Social relationships are mutual interpersonal relationships in
which the needs of both parties are addressed. The N-C relationship is most concerned
with meeting the needs of the client.
A community has an unusually high incidence of depression and drug use among the
teenage population. The public health nurses decide to address this problem, in part, by
modifying the environment and strengthening the capacities of families to prevent the
development of new cases of depression and drug use. What is this is an example of?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
P a g e 3 | 51
, d. Protective factorial prevention
Correct Answer: A. This action focuses on interventions designed to reduce the
incidence of new cases of disease.
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes
to leave because "this place can't help me." The best nursing action that reflects the
legal right of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further assessment
c. Allow the client to leave but have her sign forms stating she is leaving against
medical advice
d. Immediately start the paperwork to commit the client and to allow you to treat her
against her wishes
Correct Answer: B. Almost every state allows for a brief for a period detainment to
assess a client for dangerousness to self or others before allowing the client to leave a
hospital setting, even if the admission was voluntary.
In forming a therapeutic relationship with clients, the PMHNP must consider developing
many characteristics that are known to be helpful in relationship-building. Which of the
following is an essential part of building a therapeutic relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
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