The Psychiatric-Mental Health Nurse Practitioner Certification Review Manual (2020)

Name: The Psychiatric-Mental Health Nurse Practitioner Certification Review Manual (2020)
Brand: Academic Documents Platform
Price: 16.99 USD
Availability: InStock
Author: Samuel White

The Psychiatric-Mental Health Nurse Practitioner Certification Review Manual (2020) provides everything you need to pass your certification test.

Samuel White

Contributor

4.3

about 2 months ago

Preview (31 of 559)

i
THE PSYCHIATRIC-MENTAL
HEALTH NURSE
PRACTITIONER
CERTIFICATION REVIEW
MANUAL

iiRaymond Zakhari, DNP, EdM, NP, has a diverse clinical background
ranging from intensive care to medical house calls. He began his career at
Duke University Medical Center in the cardiothoracic ICU and made his way
back to the Northeast as a traveling ICU and ED nurse. In 2009 he founded
Metro Medical Direct, the first concierge, nurse practitioner-owned,
medical/psychiatric house call and tele-health practice in New York City. Dr.
Zakhari was also trained in sex therapy at the New York University School of
Medicine/Langone Medical Center by Dr. Virginia Sadock (co-author of The
Synopsis of Psychiatry). Dr. Zakhari is appointed to the staff of NewYork-
Presbyterian Hospital, Department of Internal Medicine in Psychiatry at the
Payne Whitney Clinic, and provides consultative services as a Sexual Assault
Forensic Examiner. He is a former officer of the New Jersey Air National
Guard and has deployed in support of Operation Iraqi Freedom. He has held
adjunct faculty appointments at the Hunter Bellevue School of Nursing, New
York University, and Liberty University. Dr. Zakhari hosts a podcast called
The Psychology of It All. Over the years, Dr. Zakhari has published in peer-
reviewed journals and has presented at both regional and national
conferences. He currently is a member of the American Academy of Nurse
Practitioners (AANP), the Society for Sex Therapists and Researchers
(SSTAR), and the International Association of Forensic Nurses. Dr. Zakhari
is a graduate of Liberty University (BSN), Hunter College-The City
University of New York (MS, ANP, PMHNP), Columbia University (EdM),
Mount Saint Mary College (FNP), and Chatham University (DNP). Dr.
Zakhari lives in Manhattan with his wife, two children, and dog Maslow. He
spends his downtime experimenting in the kitchen, hosting dinner parties,
and planning his next endeavor.

Loading page 4...

Loading page 5...

Loading page 6...

vi
Copyright © 2021 Springer Publishing Company, LLC
All rights reserved.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form
or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior
permission of Springer Publishing Company, LLC, or authorization through payment of the appropriate
fees to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-
8400, fax 978-646-8600, info@copyright.com or on the Web at www.copyright.com.
Springer Publishing Company, LLC
11 West 42nd Street
New York, NY 10036
www.springerpub.com
http://connect.springerpub.com/home
Acquisitions Editor: Adrianne Brigido
Compositor: diacriTech
ISBN: 978-0-8261-7942-5
ebook ISBN: 978-0-8261-7943-2
DOI: 10.1891/9780826179432
20 21 22 23 / 5 4 3 2 1
The author and the publisher of this Work have made every effort to use sources believed to be reliable
to provide information that is accurate and compatible with the standards generally accepted at the time
of publication. The author and publisher shall not be liable for any special, consequential, or exemplary
damages resulting, in whole or in part, from the readers’ use of, or reliance on, the information
contained in this book. The publisher has no responsibility for the persistence or accuracy of URLs for
external or third-party Internet websites referred to in this publication and does not guarantee that any
content on such websites is, or will remain, accurate or appropriate.
Library of Congress Control Number: 2020900382
Contact us to receive discount rates on bulk purchases.
We can also customize our books to meet your needs.
For more information please contact: sales@springerpub.com

Loading page 7...

Loading page 8...

Loading page 9...

vii
CONTENTS
Preface
Acknowledgments
Chapter 1: Preparing to Pass the Psychiatric-Mental Health Nurse
Practitioner Certification Exam
Chapter 2: The Role of the Psychiatric-Mental Health Nurse
Practitioner: Regulations and Scope of Practice
Questions
Answers
Chapter 3: Theoretical Foundations of Care and Nonpharmacological
Therapies
Questions
Answers
Chapter 4: Neuroanatomy, Physiology, and Mental Illness
Questions
Answers
Chapter 5: Psychopharmacology
Questions
Answers
Chapter 6: Physical Assessment, Diagnostic Tests, and Differential
Diagnosis
Questions

Loading page 10...

viii
Answers
Chapter 7: Substance Use Disorders
Questions
Answers
Chapter 8: Delirium and Neurocognitive Disorders
Questions
Answers
Chapter 9: Psychotic Disorders and Delusions
Questions
Answers
Chapter 10: Sleep Disorders
Questions
Answers
Chapter 11: Mood Disorders
Questions
Answers
Chapter 12: Anxiety Disorders
Questions
Answers
Chapter 13: Child/Adolescent Neurodevelopmental Disorders
Questions
Answers
Chapter 14: Personality Disorders
Questions

Loading page 11...

Loading page 12...

ix
PREFACE
The work of psychiatry seeks to maintain and restore social order by
mitigating maladaptive coping mechanisms that adversely affect the
individual, family, and society. Psychiatry is a secular belief system that
attempts to help people feel better by reducing all suffering. The Diagnostic
and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), called
the Bible of psychiatry, requires faith (the confidence in what we hope for
while resting in the assurance of what we do not see). The various
committees of the American Psychiatric Association categorize abnormal
behaviors of the human condition by classifying signs and symptoms with
varying degrees of duration and intensity in the hope of clearly distinguishing
between mental illness and normal functioning. The things labeled disorders
are social constructs articulated using biological metaphors. As the values of
society change, morality also changes. Etiology theories range from the
sociological to the physiological and are subject to the will of current
sociopolitical values of an elite group of academics during a particular time in
history.
Research in the field is significantly limited due to ethical constraints, and
often offers correlation and association in place of cause and effect, and
equates statistical significance with clinically meaningful outcomes. The
caveat to all mental health professionals is that we should be cautious that our
strong desire to relieve human suffering does not pull the veil over our eyes
and cause us to diagnose all human suffering as a disorder. Irrational thoughts
and emotional variability require context to meet the criteria for mental
illness. Diagnosing and treating mental illness are often very complicated.
The primary job of the psychiatric-mental health nurse practitioner is to
identify the unifying disorder that accounts for the various signs and
symptoms. These signs and symptoms are often shared among numerous
conditions and for this reason diagnostic certainty is currently impossible. As
such, treatments often fail, and patients continue to suffer, some without

Loading page 13...

x
finding meaning.
We can offer our patients a sense of belonging and hope. We can help
them develop a skill set that allows them to navigate the complexities of this
world in which suffering and uncertainty are the only constants. Helping
patients discover a sense of purpose and connection to something greater than
themselves restores their dignity as a human being comprised of body, mind,
and spirit (soul). Both patients and therapists are often very eager to bring
order to chaos by labeling a group of symptoms as a disorder. The clinician’s
eagerness to alleviate their personal feeling of powerlessness and reduce the
patient’s turmoil can lead to premature conclusions. The act of diagnosing
and treating communicates to the patient that they are not alone in their
condition, but the diagnosis must be accurate because patients will often
adopt an identity congruent with the disorder.
This text provides a survey of core content that will be tested on the
psychiatric-mental health nurse practitioner board exam of the American
Nurses Credentialing Center (ANCC). Practice questions and rationales are
presented at the end of each chapter and in a practice test to reinforce the
chapter’s content and to stimulate critical thinking in the prospective test
taker.

Loading page 14...

Loading page 15...

1
1
PREPARING TO PASS THE
PSYCHIATRIC-MENTAL
HEALTH NURSE PRACTITIONER
CERTIFICATION EXAM
OBJECTIVES
■ Identify self-care strategies and a study timeline
■ Describe evidence-based study strategies
■ Demonstrate understanding of the American Nurses Credentialing Center
(ANCC) test outline and major content areas
INTRODUCTION
Congratulations! You have made it to a point in your career where you are
allowed to sit for board certification as a psychiatric-mental health nurse
practitioner (PMHNP). This review book helps you organize the large
amount of information that you have previously mastered in your graduate
education. This chapter presents a method to help you organize and maximize
your studying efforts for the exam, and provides an overview of the
information that will be tested based on the American Nurses Credentialing
Center (ANCC) test map. The ANCC testing and review handbook is
available at www.nursingworld.org/ancc. Review and bookmark this site for
future reference as this will contain the most up-to-date information about the
exam. Finally, this chapter explains how to dissect questions in order to help
you choose the best answer.
You may be experiencing many feelings as you embark on this journey to

Loading page 16...

validate your knowledge and achieve board certification. Some things that
may give you comfort:
■ You went to an accredited school, which means it met the standards of
preparing graduates to successfully pass certification exams.
■ The pass rate for this test is >80% (a large majority of test takers pass).
■ Reviewing the material in this book will reassure you of the information
needed to pass the test.
■ This book will explain how to dissect a question to maximize selection of
the best possible answer.
■ This book will explain what to do after you pass.
STUDYING AND CARING FOR YOURSELF
Preparing to study for the exam is an important step in the process of passing
the boards. The subject matter can seem so voluminous that it may not seem
possible to recall and apply everything that is covered on this exam. The
following is a list of evidence-based studying techniques that can
significantly increase your likelihood of passing. The study tips draw from
the field of educational psychology, adult learning theory, and cognitive
behavioral theory. Reviewing and implementing these techniques before you
begin preparing for the ANCC exam will greatly increase your chance of
success. In order for you to be successful and pass your test, you must
read this list, preferably twice.
■ Make time (6–8 months before applying for the test): Studying for an
important exam requires special dedication time. Studying will be far less
effective if added on to existing obligations rather than having a dedicated
schedule for it in your life. In order to effectively study for this test using
the evidence-based strategies set forth, you will need to create the
necessary time to cover all the essential material on a consistent and
scheduled basis.
• Timeline: Creating a timeline will help you learn to delay gratification.
Learn to build a successful timeline for studying.
■ Create a list of all of your obligations including as many things as
possible that you do on a regular basis (household cleaning, cooking,
childcare, transporter, church, laundry, exercise, holiday gatherings,
birthdays, phone calls, upcoming major life events) and then plot

Loading page 17...

2
these on a grid with approximate time requirements.
■ Decide how soon you will be taking the test (ideally within 90–120
days of graduation).
■ Review the table of contents of this book and the latest ANCC test
map.
■ Identify when will be your study time. What will you have to cut out
or do less of? Study times should be done in blocks of 2 to 4 hours
and free of all distractions. If this means driving to a library, you will
need to include that in your timeline. Decide if you are a morning or
night person and try to schedule your block of time accordingly. Be
formal in your scheduling; add study time to a paper calendar or
digital calendar (smartphone, app, electronic reminders).
• Distractions: Your studying should be free from any distractions.
Ideally, you want to simulate the testing environment as much as
possible. During test day you will check all of your electronic devices
into a locker and pass through a metal detector. You will not be able to
bring anything into the test room with you. Practice being out of touch
when you are studying. Give your studies undivided attention and avoid:
■ Chatting
■ Eating, drinking
■ Social media
■ Phone, smart watch, and so on
■ Being responsible for watching children when studying if possible
(or wait until they’re asleep)
■ Visualization: Appropriately done this can help you succeed as a student;
the first step in this process is to imagine in detail passing your exam.
Think deeply about where you’ll be when you find out that you’ve passed,
how you’ll feel, and how your friends and family will feel. Then visualize
yourself doing the necessary work to pass. See yourself following your
study timeline, blocking time to study, delaying gratification, blocking
distractions, and putting off social obligations. Visualize yourself covering
the various topics to be covered on the exam. Visualize yourself pressing
through something you did not want to do and the sense of
accomplishment you will have.
■ Rereading: This involves reading all study materials through twice, as
well as any associated materials you may not know well. Reading does not

Loading page 18...

mean stopping to take notes along the way. Read for understanding and to
refresh. Rereading more than twice does not increase retention and
becomes a procrastination tactic that deceives the student into believing
they are making progress.
■ Note-taking: Note-taking (particularly by hand) while going through
printed material significantly increases retention of information.
Reviewing notes and checking it against a source enhances your ability to
recall.
■ Rehearsing: This technique involves going over information repeatedly
until you can remember it. This is best accomplished by removing all
distractions from the study environment and giving undivided attention to
the task at hand. It also helps to recite the material out loud, chunking it
along the way.
■ Synthesizing: Piecing together information helps you understand the
relationship between ideas and concepts. Synthesis is better than simple
memorization because this will help you apply your information to various
scenarios. One way to synthesize is to draw graphs or charts reflecting the
core concepts. Organizing a chart will help you organize the information
for easy recall. Mapping is particularly helpful when trying to remember
specific steps in a procedure.
■ Practicing: Answering many practice questions is very useful in helping
overcome test anxiety. As you practice answering questions, you will
develop a habit of carefully reading the stems of the questions and each of
the answer choices to help you select the best answers.
■ Self-verbalizing: This procedure involves verbalizing the steps that you
need to follow in order to complete the task. In this process you should
whisper to yourself aloud a strategy that can work particularly well while
you are actually taking the test.
■ Justifying: This procedure involves explaining important concepts that
help to determine if the premise and a question are true. How do you
distinguish a brief psychotic episode from schizophrenia? How do you
distinguish dysthymia from major depressive disorder? Distinguish normal
use from a substance use disorder? Explaining the distinctions among
these types of questions will help you solidify in your mind the rationales
for the answers to various questions.
■ Self-care: The study tips are predicated on the assumption of consistent

Loading page 19...

3and adequate attention to basic physiological, psychological, and
sociological needs. Human beings require consistent care for optimal
performance.
■ Sleep: Impaired or inadequate sleep hinders your ability to learn and retain
information. It is imperative that you get adequate and consistent sleep,
particularly when preparing for an exam or enduring something
particularly stressful (Feldman & Kubota, 2015). On average, 6 to 8 hours
is recommended per night. As a PMHNP, one of the most common
areas you will counsel your patients about is the importance of
healthy sleep hygiene. Some common recommendations include:
■ Avoiding screen time (e.g., TV, computer, tablet) 2 hours before
going to bed
■ Setting a cool enough room temperature
■ Going to bed at the same time each night
■ Ensuring the room is as dark as possible
■ Implementing white noise
■ Turning on a fan to keep the air circulating
■ Sleeping naked or with minimal clothing
■ Taking any medications for sleep as prescribed
■ Avoiding alcohol and caffeine
■ Radical acceptance: Forgiving yourself for all of the time you have
previously wasted and all the obligations you have failed to meet is
essential (Feldman & Kubota, 2015). You must forgive yourself in order
to release this burden from your mind as you prepare for the exam.
■ Avoid extremes: Engaging in marathon study sessions has been shown to
reduce retention by as much as 30% (Rohrer & Pashler, 2007). It is better
to study for shorter periods over a longer period of time so that your
hippocampus can consolidate your memory, making it easier to retrieve
information through your limbic pathway during times of stress (like the
ANCC exam).
■ Enhance self-efficacy: As a PMHNP, many theoretical models and
treatment plans rely heavily on the concept of the belief in oneself or rely
on the therapist expressing belief in the patient’s likelihood of success.
Building your confidence in your studying and testing ability will
significantly increase your success (Feldman & Kubota, 2015). If you are
sitting for board certification, you have likely passed many exams

Loading page 20...

4
containing much more detailed content than the ANCC exam. Also,
convince yourself how much you love studying and taking tests, which
may require some effort. It may help just to do it and build yourself a
reward system. Eventually, you may truly enjoy studying.
■ Eating: It is important to eat consistent meals and avoid concentrated
sweets that can surge and then plunge your blood sugar (Hasegawa,
Tachibana, Ono, & Kishimoto, 2017). It is also best to avoid very heavy
meals before a study or test session. Lightly sweetened coffee can be
helpful if it is something you usually drink. Trying coffee for the first time
just before the exam is not a good idea. Gum chewing has also been found
to be minimally helpful while studying or taking a test (Hasegawa et al.,
2017). It can also be a great distraction if you are blowing bubbles or
making noise. If you do chew gum, do it very quietly.
■ Exercise: Engaging in consistent physical activity for at least 20 minutes
daily can significantly increase your mental acuity and ability to retain
information. Exercise can also help you build the necessary structure into
your day as you prepare for the exam (van Dongen, Kersten, Wagner,
Morris, & Fernández, 2016). While exercising you should not try to study
by listening to lectures or reading. Fast classical music has been shown to
enhance retention by stimulating various neurons, a controversial theory
called the Mozart effect (Hetland, 2000; Nantais & Schellenberg, 1999).
■ Relationships: It will be vital that you pay attention to close relationships.
These people have been and will be your support system. Social
interactions can also significantly reduce stress and remind you of your
higher purpose in life. Some experts say it is best not to broadcast your
test date because it may add unnecessary pressure.
■ Personal hygiene: Attending to hygiene helps make your study efforts
more deliberate. You should prepare for your study sessions as if you are
going to work. The ritual of preparation for the task helps organize the
mind and prepares it for the task at hand. While showering, shaving,
brushing your teeth, and so on, visualize what your study session will be
like, the topics that you will cover, the practices you will do, and how
long the study session will take. Some people who work from home even
dress up as if they are going into the office because it makes them more
productive. Studying in your pajamas or bathrobe does not prepare your
mind and body for serious work.

Loading page 21...

ABOUT THE ANCC PMHNP BOARD CERTIFICATION
EXAM
■ ANCC is a subsidiary of the American Nurses Association (ANA), serving
as the independent professional credentialing body for professional
nursing practice. The organization accredits healthcare organizations that
provide and approve continuing nursing education. The ANCC offers
APRN board certification exams for:
• Family Nurse Practitioner (FNP)
• Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)
• Adult-Gerontology Acute Care Nurse Practitioner (AGACNP)
• Pediatric Primary Care Nurse Practitioner (PPCNP)
• Psychiatric-Mental Health Nurse Practitioner (PMHNP)
■ Passing the exam allows the nurse practitioner to apply the board certified
(BC) designation post-nominally; for example, Raymond Zakhari,
PMHNP-BC. The ANCC is the only credentialing body to offer a board
certification exam for PMHNPs.
■ The test is administered at various Prometric Testing Centers
(prometric.com) around the world. You can only schedule your exam once
you have received the Authorization to Test (ATT) from the ANCC. Your
ATT is only sent once your online application has been completed and
your transcripts have been validated by ANCC.
■ Qualifying: In order to qualify for board certification testing you must be
a graduate of an accredited master’s, doctoral, or postgraduate NP
program. The program must have included at least 500 supervised clinical
hours in the respective specialty for which you are seeking certification.
• The accreditation of the program must be by the Commission on
Collegiate Nursing Education (CCNE) or the Accreditation Commission
for Education in Nursing (ACEN).
• Prospective candidates must also have an unencumbered RN license.
• Students educated outside the United States or one of its territories may
be able to sit for the exam if the ANCC criteria have been met by the
preparatory programs. For further information, contact the ANCC
(nursingworld.org/ancc/).
■ New exam release: A new Test Content Outline (formerly called the test

Loading page 22...

5
map) was released on December 16, 2019. Content on the PMHNP
exam is based on the Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM-5). It is always best to check the website
for the latest test content outline.
• Each ANCC exam has several versions.
• Each version of the exam is randomly assigned.
• The exam is not computer adaptive.
• Most of the exam questions will be multiple choice.
• There are alternate format questions including drag and drop, extended
multiple choice questions where you are asked to pick more than one
correct answer, hot spot questions in which you will be asked to identify
a structure in response to a test question; for example, which lobe of the
brain is responsible for executive functioning? You would have to click
on the lobe of the brain represented in a diagram.
• The test will have 175 questions. Twenty-five of the questions are not
graded and are only used for statistical validation purposes.
• The time limit is 3.5 hours to complete the test. Once the clock starts,
there is no way to pause the time even if you go to the bathroom. Once
the allotted time expires, the test will automatically shut down.
• Unanswered questions are marked as incorrect.
• You can mark and return to questions within the allotted time.
• There will be separate time allocated for a computer tutorial before the
exam begins.
• Sample ANCC exams are available on the website to try before you sit
for the exam. A sample test can be taken as many times as you wish.
■ Passing rate: According to ANCC (2017), 1,777 individuals took the
PMHNP exam. Of those individuals, 1,563 passed the exam (88% of the
people who took the test passed the test). Note that these data are based on
results prior to the December 2019 test revision.
■ Applying for the exam: If you are in a Doctorate of Nursing Practice
(DNP) program, you can apply when you are 6 months from completing
your studies. The clinical hours and didactic content related to your
specialty certification must be completed. The application must contain
proof of your RN licenses, an official transcript, and the validation of
education form signed by the NP program director.
• ANCC can take 4 to 6 weeks to process a COMPLETED

Loading page 23...

application. During slower times of the year, it may take as little as 3
weeks. Peak application season is from April to July, and from
November to January.
■ Expediting: This option allows the processing time to be shortened
to 5 days (FOR COMPLETED APPLICATIONS ONLY). There is
an additional cost for this option. Caveat: This assumes that all
parties required to send information have done so. If your school is
delayed due to holiday or summer hours, or if it is using a third-party
vendor, you will not be processed in an expedited manner. I do not
recommend this option unless you know for sure all parties have
fulfilled their obligations. For more information on this option,
contact aprnvalidation@ana.org.
■ Validation of education: A form that is signed by the program
director attesting to the content of your education. The original (NOT
A COPY) must accompany your application for testing.
■ Scheduling your exam: Waiting to schedule your exam may limit
your options. Schedule your exam as soon as you receive your ATT.
• Make sure you have created your study timeline before you
apply for the test, and that you have started studying.
• If you must test on a certain day, you can broaden your search to
another testing center; you may have to look in another state.
• Missed appointment OR expired ATT: You will be considered a
no show and your testing window automatically expires. Call the
Prometric testing center as soon as possible, then contact ANCC.
ANCC will allow for one reschedule, but you will be charged a
rescheduling fee.
■ Pass/fail: You will find out immediately whether you passed or
failed the exam. Once you complete your exam and leave the room,
the proctor will have a printout containing your unofficial result. An
official result will be mailed to you. The unofficial result cannot be
used as proof of passing for any official purpose.
• Notifying the state board of nursing: The ANCC does not
automatically notify the board of nursing. You will need to sign a
release of score consent form (part of the application package).
• Certification: Valid for 5 years. Tracking your continuing
education credits will make recertifying much easier. If you fail to

Loading page 24...

6
take the required 75 credit hours, your certification will expire and
you will have to retest. If your certification expires, you can no
longer claim to be BC. THERE IS NO GRACE PERIOD OR
BACKDATING.
□ Renewal: You can start this process 1 year before your
expiration date but no later than 3 months before.
□ Practice hours: You must have 1,000 clinical practice hours in
the clinical specialty within the preceding 5 years.
□ Continuing education: Seventy-five contact hours are
required. Also, you need one or more of the eight ANCC
renewal categories (academic credits, presentations, preceptor
hours, quality improvement projects, professional service,
practice hours, research, publication, or retest). This means
that, in addition to continuing education hours, you must do one
of these eight things every 5 years.
□ Pharmacology: Of the contact hours, 25 of them must be in
pharmacotherapy.
• If you fail: The ANCC allows you to retake the exam up to three
times in 12 months, but there must be at least 60 days between
attempts. You must wait 5 days (after taking your exam) to
reapply to test.
• Reapplying: You must resubmit all materials as if you were
applying for the first time and pay all the associated fees again.
■ PMHNP test content map
• The test is comprised of five domains: Scientific Foundation (20%),
Advanced Practice Skills (25%), Diagnosis and Treatment (25%),
Psychotherapy and Related Theories (15%), and Ethical and Legal
Principles (15%). Approximately 40% to 50% of the test contents
(pathophysiology, pharmacology, physical assessment, health
promotion, ethics, scope of practice, role delineation, ethics, screenings,
and regulatory requirements) are common to all of the nurse practitioner
specialities. The test will contain a total of 175 questions, of which only
150 will be counted for scoring. The test is not presented in a categorical
format, but rather questions can come from any of the five domains at
any point during the test. You should not ascribe any special meaning if
you find yourself answering a string of questions related to a specific

Loading page 25...

topic. Likewise, if you find you are not asked about a seemingly
common topic related to psychiatric-mental health care, this does not
mean you are taking the wrong exam. Following is more detailed
information regarding the test content outline and the number of
questions you can expect for each category.
■ Scientific foundation (30 questions)—Includes content related to general
pathophysiology, pharmacology (including therapeutic and adverse
effects), and physical assessment across the life span. Following is a list of
other key terms and concepts included in this section of the test:
• Physiology, neurodevelopment, genomics, and epigenetics
• Pathophysiology and clinical manifestation of altered health states
• Anatomy and physiology, specifically neuroanatomy and
neurophysiology
• The relationship between physiology and pathophysiology produced by
altered health states (including common movement disorders associated
with psychopharmacology)
• Pharmacology and psychopharmacology
• Pharmacotherapeutic categories of medications
■ Anti-infectives
■ Antineoplastic
■ Cardiovascular
■ Endocrine
■ Eye, ear, and skin
■ Gastrointestinal
■ Genitourological
■ Immunological
■ Musculoskeletal/analgesic
■ Neurological
■ Psychiatric
■ Respiratory
• Pharmacokinetics and pharmacodynamics of the broad categories
• Pharmacokinetics and pharmacodynamics of psychotropic medications
■ Advanced practice skills (38 questions)—Includes content specific to the
work of nurse practitioners such as interviewing, obtaining history and
physical examination, assessing for intoxication and withdrawal, altered
mental status, using psychometrically validated tools, and suicide risk

Loading page 26...

7
assessment. Following is a list of other key terms and concepts included in
this section of the test:
• Analyzing response to illness and treatment modalities
■ Assessing neurological function based on patient presentation
■ Interpreting findings from diagnostic testing
• Identifying the needs of individuals with system dysfunction
■ Risk assessment
■ Assessing facilitators and barriers to care
■ Health promotion and disease prevention
■ Growth and development
■ Neuroprotective strategies
■ Individualizing strategies
■ Anticipatory guidance
■ Interviewing and formulating
■ Crisis intervention
■ Group dynamics
■ Starting, weaning, tapering, and titrating medication
■ Evidence-based practice
■ Translating research into practice
■ Disseminating evidence from inquiry to diverse populations using
multiple modalities
■ Diagnosis and treatment (37 questions)—Includes content related to the
DSM-5 classifications, as well as developing differential diagnoses,
ordering and interpreting diagnostic tests, appropriate referrals, therapeutic
drug monitoring, and applying evidence-based practice. Following is a list
of other key terms and concepts included in this section of the test:
• Mental health disorders due to general medical conditions and physical
conditions associated with mental health disorders
■ Developing a comprehensive health assessment that includes
neuropsychiatric developmental, genetic, and epidemiological factors
■ Complementary and alternative treatments
■ Assess risk factors and barriers to health promotion and disease
prevention (socioeconomic, genetics, biological, environmental,
community-specific variables)
■ Synthesize epidemiological data to design and deliver evidence-
based practice

Loading page 27...

■ Incorporating patient ability, experiences, preferences, lifestyle,
values, goals, rights, and responsibilities into care
■ Cultural competencies and spirituality
■ Enhancing health literacy
■ Promoting resilience and recovery
■ Psychotherapy and related theories (22 questions)—Includes content
related to conceptual models and frameworks for understanding behavior
across the life span, theories of change, and the family system applied to
various clinical situations. The primary skill is to develop a therapeutic
alliance. Following are some key terms and concepts included in this
section of the test:
• Trauma-informed care
• Recovery-oriented care
• Transtheoretical model/motivational interviewing
• Developmental theories
• Establishing and maintaining a therapeutic alliance
• Nonpharmacological treatment modalities (types of talk therapy)
• Psychotherapeutic theories
■ Ethical and legal principles (23 questions)—Includes content related to
the role of the nurse practitioner, legal barriers, political activities,
advocacy, social justice, patients’ rights, team building, and collaboration.
Following are some key terms and concepts that are included in this
section of the test:
• Principles and concepts of interprofessional and intradisciplinary
practice
■ Reflective thinking principles, concepts, and practices
■ Conflict resolution, negotiation, mediation, and professional civility
■ Political activism
■ Advocating for the value and role of the nurse practitioner
■ Fostering collaboration with multiple stakeholders to improve
healthcare
■ Building and leading collaborative interprofessional care teams
■ Communicating within or across organizations
■ Advancing practice through the development and implementation of
innovations incorporating principles of change
• Health policy development

Loading page 28...

8
• Advocating for social justice, and improved access to quality and cost-
effective care
• Analyzing ethical, legal, and social factors influencing policy
development
• Influencing health policies to ameliorate the impact of stigma on
services for the prevention and treatment of mental health problems and
substance use disorders
• Ethical and legal issues related to the use of information technology,
including scope of confidentiality, release of information, and duty to
warn
• Using information and communication technologies, resources, and
principles of learning to teach and/or treat
• Translating technical and scientific health information for complex
decision-making
• Organizational practices
• Analyzing and organizational structure, functions, and resources to
improve and sustain the delivery of care
• Current American Nurses Association scope and standards of practice
• Regulations and guidelines related to the psychiatric-mental health nurse
practitioner practice
• Promoting just culture of safety
■ Dissecting questions: In order to choose the best possible answer, you
must know exactly what you are being asked. The majority of questions
will be multiple choice. Multiple choice questions consist of three parts.
They are the entire question, the stem (the essential information of the
question), and the answer choices (one correct and three distractors).
ALWAYS READ THE ENTIRE QUESTION AND ALL THE
ANSWERS BEFORE SELECTING ANYTHING!
• Do not read into the question.
• Do not assume information that is not presented; that is, do not
overanalyze.
■ If the information is not given, assume it is not needed and has no
effect on the answer.
• Step 1: Is the question asking you to recall a fact or apply information?
Moreover, is the question asking you to do something or find out
something?

Loading page 29...

■ Are there any keywords in the question such as avoid, best, except,
not, initial, first, most, least, of the following? (Are you looking for
correct answers or wrong answers?)
• Step 2: Can you apply Maslow’s hierarchy of needs? Just because this is
a psychiatric exam you cannot forget that physiological needs always
take priority over psychosocial needs. Remember to choose the safest
answer and consider what would happen if each answer is chosen. (Does
the answer choice answer the question?)
• Step 3: Is the answer choice an assessment or implementation? For the
exam, assessment answers are when you are gathering more information
either by physical exam, ordering a diagnostic test, or by interviewing
the patient or collateral sources. Implementation answers are when you
give advice, change medication, or teach something. Also, consider if
the assessment or implementation matches the stem of the question.
■ EXAMPLE: A client with an absolute neutrophil count <1,000 has
been taking his clozapine 500 mg daily. What should the PMHNP do
first?
A. Tell the patient to stop taking the medication immediately
B. Order a stat complete blood count (CBC)
C. Instruct the patient on the importance of taking the medication
exactly as prescribed
D. Remind the patient of the importance of proper hand hygiene
The stem of this question deals with agranulocytosis in someone
taking clozapine. The question asks for an implementation. The stem
is asking about a physiological condition. The answer should be a
physiological intervention that addresses the stem. Based on this
information the correct answer is A.
Ordering a stat blood test does not address the problem.
Instructing on the importance of medication adherence would
worsen the problem in this case. Reminding of good hand hygiene,
while helpful and related to the agranulocytosis, would not take
priority over stopping the medication.
• Step 4: Select the correct answer. Remember to eliminate answer
choices after you have read the entire question and all the choices to
increase your odds of selecting the correct answer. Do not second guess
your answer choice unless you have a compelling reason, you recall an

Loading page 30...

9
essential concept that directly relates to the stem, or you have a clearer
understanding of the question that you did not initially have.
• Most people change the correct answer to the wrong answer rather than
a wrong answer to the correct answer.
• If you are unsure about an answer choice, you can mark the question and
come back to it for later review.
■ Drag and drop questions:
• In this question format, you will be asked to match the choices that are
alpha-numerically presented. This is common with questions about
evidence-based practice or anatomy.
EXAMPLE: Correlate the lobes of the brain with their respective
functions:
1) Frontal lobe A) Memory, understanding, and language
2) Parietal lobe B) Vision
3) Occipital lobe C) Executive functions
4) Temporal lobe D) Auditory perception
Answers: 1: C, 2: A, 3: B, 4: D
■ Hot spot questions
• In this question format, you may be asked to identify a specific location
on a diagram. To do this, you would point and click with the mouse.
■ Final tips about choosing the correct answer
• If you have two answers that seem equally good, choose the least
expensive, least invasive option that allows you to answer the question.
For example, if your choice is between a CT scan of the head or a
focused neurological exam, the latter will likely be the best option.
(There are no scans or biomarkers in psychiatry that can diagnose a
psychiatric condition. Once something appears on a scan it becomes
a neurological condition.)
• See whether the answer choices have something in common or are very
similar. If two answers are very similar, they are likely incorrect. If all
three are related, they too can usually be excluded.
• Be mindful of results that are wide ranging. Middle of the road values

Loading page 31...

28 more pages available. Scroll down to load them.

Preview Mode

100%

Study Now!

XY-Copilot AI

Unlimited Access

Secure Payment

Instant Access

24/7 Support

AI Assistant

Document Details

Subject

Nursing

The Psychiatric-Mental Health Nurse Practitioner Certification Review Manual (2020)

Study Now!

Document Details

Related Documents

Test Bank for Medical-Surgical Nursing in Canada, 4th Edition

Test Bank for Community and Public Health Nursing: Evidence for Practice, 3rd Edition (Chapters 1-25)

Test Bank For Understanding Medical-Surgical Nursing, 5th Edition

Test Bank for Maternity and Women's Health Care, 13th Edition (Chapters 1-37)

Test Bank for Lehne's Pharmacology for Nursing Care, 11th Edition (Chapters 1-112)

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57)

Test Bank for LPN to RN Transitions, 5th Edition (Chapters 1-18)

Test Bank for Fundamentals of Nursing, 10th Edition (Chapters 1-11)

Test Bank for Foundations for Population Health in Community/Public Health Nursing, 6th Edition (Chapters 1-32)

Test Bank for Clinical Nursing Skills and Techniques, 10th Edition (Chapters 1-43)