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Nursing PMHN-BC Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Assessment24%- Analysis and use of data
  • 1. Differential diagnosis consideration
  • 2. Identification of patterns and variances
- Collection of data
  • 1. Risk assessment (suicide, violence, abuse)
  • 2. Biophysical assessment
  • 3. Mental status examination
  • 4. Psychosocial assessment
Topic 2: Outcome Identification12%- Short-term and long-term goals
  • 1. SMART criteria
  • 2. Realistic and measurable outcomes
  • 3. Patient-centered outcomes
Topic 3: Planning15%- Plan development
  • 1. Coordination of care
  • 2. Evidence-based interventions
  • 3. Therapeutic modalities
  • 4. Health teaching and health promotion
Topic 4: Diagnosis18%- Analysis of data
  • 1. NANDA-I nursing diagnoses
  • 2. Psychiatric diagnoses (DSM criteria)
  • 3. Collaborative problems
Topic 5: Evaluation6%- Outcomes assessment
  • 1. Plan modification as needed
  • 2. Documentation of outcomes
  • 3. Reassessment of patient response
Topic 6: Implementation25%- Milieu therapy
  • 1. Safety protocols
  • 2. Boundary maintenance
  • 3. Therapeutic environment
- Psychopharmacological interventions
  • 1. Side effect management
  • 2. Medication administration and monitoring
  • 3. Patient education on medications
- Therapeutic interventions
  • 1. Group therapy
  • 2. Crisis intervention
  • 3. Individual psychotherapy
  • 4. Family therapy approaches

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Nursing ANCC Psychiatric–Mental Health Nursing Certification (PMHN-BC) Sample Questions (Q60-Q65):

NEW QUESTION # 60
Alzheimer's disease (AD) must be distinguished from vascular dementi
a. Vascular dementia has all but which of the following characteristics?

Answer: A

Explanation:
To effectively distinguish between Alzheimer's disease (AD) and vascular dementia, it is crucial to understand the different characteristics of each condition. The question at hand revolves around identifying a characteristic that is not typically associated with vascular dementia. Among the listed options-step-wise deterioration, insidious onset, patient history of falls, personality change-the characteristic that is not consistent with vascular dementia is "insidious onset." Here is an expanded explanation of each characteristic and its relation to vascular dementia:
**Step-wise deterioration:** Vascular dementia often exhibits a step-wise deterioration in cognitive function. This pattern is characterized by periods of sudden decline followed by plateaus, where the condition stabilizes before another decline occurs. This occurs due to the nature of the vascular damage in the brain, typically resulting from strokes or other events that disrupt blood flow, leading to brain damage in a non-uniform and abrupt manner.
**Insidious onset:** In contrast to vascular dementia, an insidious onset is more characteristic of Alzheimer's disease. "Insidious" refers to a gradual progression that is not easily noticeable in the early stages. Alzheimer's typically begins with mild memory problems and slowly progresses over several years. Vascular dementia, however, usually has a more abrupt onset, often following a significant vascular event like a stroke. This sudden change in cognitive function is a key differentiator from the more gradual decline seen in Alzheimer's.
**Patient history of falls:** Individuals with vascular dementia might have a history of falls. This can be related to the brain damage that affects physical coordination and balance. Strokes or mini-strokes leading to vascular dementia can impair parts of the brain that are responsible for motor control and spatial awareness, thereby increasing the risk of falls.
**Personality change:** Changes in personality can occur in various forms of dementia, including vascular dementia. These changes might be due to the location and extent of brain damage resulting from vascular issues. Personality changes in vascular dementia might include sudden emotional outbursts, apathy, or irritability, which differ from the individual's usual behavior.
In summary, when differentiating vascular dementia from Alzheimer's disease, it is important to note that vascular dementia is characterized by a step-wise deterioration, potential history of falls, and possible personality changes, all linked to brain damage from vascular events. The key distinguishing feature is the onset; vascular dementia typically has an abrupt onset following a vascular event, unlike Alzheimer's disease, which has a slow and insidious onset. Thus, among the options provided, "insidious onset" is not a characteristic of vascular dementia.


NEW QUESTION # 61
he possible signs and symptoms of anorexia nervosa would not include which of the following?

Answer: C

Explanation:
The question asks which of the listed symptoms would not be associated with anorexia nervosa. The possible symptoms listed are peripheral edema, weight gain, yellow skin, and dry or brittle nails.
Anorexia nervosa is an eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or shape. Individuals with anorexia nervosa often go to extreme lengths to control their weight and shape, which can significantly interfere with their health and daily activities.
Peripheral edema might occur in severe cases of anorexia, usually due to protein deficiency caused by extreme malnutrition, affecting the body's ability to maintain fluid balance. Yellow skin (jaundice) is not a typical symptom of anorexia but may occur in severe cases due to liver damage or dysfunction, which would be more likely from complications related to severe malnutrition or associated behaviors such as excessive use of alcohol or drugs. Dry or brittle nails are a common sign, indicative of malnutrition, particularly deficiencies in vitamins and minerals essential for nail health.
Weight gain, however, is not a symptom of anorexia nervosa. In fact, weight loss-often severe-is a hallmark of the disorder. Individuals with anorexia nervosa typically exhibit a significant fear of gaining weight, even when they are underweight. This fear drives behaviors aimed at further weight loss, even in the face of health risks.
Therefore, out of the options given, "Weight gain" is the one that would not be included as a possible sign or symptom of anorexia nervosa. The other symptoms-peripheral edema, yellow skin, and dry or brittle nails-can indeed manifest in individuals suffering from this eating disorder, particularly in advanced stages or as part of complex medical complications related to the condition.


NEW QUESTION # 62
Which of the following is an example of a medication commonly classified as a chemical restraint?

Answer: B

Explanation:
Chemical restraints are substances administered to control or restrict the freedom of a patient or to manage a patient's behavior or movement, and not as a standard treatment or dosage for the patient's medical or psychiatric condition. They are often used as a last resort when a patient poses a threat to themselves or others.
Antipsychotic medications are a type of chemical restraint that can be administered when the necessity arises. These medications have a fast-acting effect that can help to subdue a patient who is posing a threat to themselves or others. Some examples of these medications include Haldol, Droleptan, or Thorazine.
These antipsychotic medications are used to treat serious mental illnesses such as schizophrenia, bipolar disorder or delusional disorder. They can help to calm a patient down and prevent them from causing harm to themselves or others. However, they should only be used as a last resort when other methods of managing the patient's behavior have failed.
The use of these chemical restraints should be carefully monitored by healthcare professionals to ensure that they are not causing further harm to the patient. Misuse of chemical restraints can lead to serious health consequences and ethical concerns.
It is important to note that the use of chemical restraints is not a long-term solution, and should always be accompanied by a comprehensive treatment plan that addresses the root cause of the patient's behavior.


NEW QUESTION # 63
What would be the appropriate response to a patient who was prescribed Ambien two days prior and is now having increased difficulty sleeping?

Answer: D

Explanation:
When a patient begins treatment with Ambien (zolpidem), a medication commonly prescribed for insomnia, they might experience an initial increase in their sleeping difficulties. This phenomenon is referred to as "rebound insomnia." Rebound insomnia occurs because the body is adjusting to the effects of the medication, which is intended to alter sleep patterns and promote relaxation and sleepiness. It's important for patients to understand that this is a relatively common initial response and not necessarily indicative of the medication's ineffectiveness or a worsening of their underlying condition.
In this situation, the appropriate response would be to reassure the patient that experiencing increased difficulty sleeping after starting Ambien can be a normal side effect, and it typically resolves within a few days as the body adjusts to the medication. It is crucial, however, to set a clear expectation with the patient. They should monitor their sleep patterns, and if the insomnia does not improve or worsens after a week of consistent use of the medication, they should contact their healthcare provider. The healthcare provider might need to reassess the treatment plan, which could include adjusting the dosage or trying an alternative therapy depending on the patient's specific health needs and response to the medication.
It is not advisable to immediately stop taking Ambien without first consulting with a healthcare provider. Abrupt discontinuation might lead to withdrawal symptoms or exacerbate insomnia. Similarly, increasing the dosage without professional guidance is not recommended as it could lead to potential overdose or increased side effects. The focus should be on proper adherence to the prescribed dosage and clear communication with the healthcare provider about any concerns or persistent symptoms.
Overall, patient education and reassurance are key components in managing initial side effects when starting a new medication like Ambien. Ensuring that the patient understands what to expect and when to seek further medical advice is essential for effective management of insomnia and the safe use of sleep-inducing medications.


NEW QUESTION # 64
Pender's Health Promotion Model includes three general areas of concern to health-promoting behavior. Which of the following is NOT one of them?

Answer: D

Explanation:
Pender's Health Promotion Model (HPM) is a theoretical framework designed to be a "complementary counterpart to models of health protection." It defines health as a positive dynamic state rather than simply the absence of disease. The model focuses on three key areas: individual characteristics and experiences, behavior-specific cognitions and affect, and behavioral outcomes. These elements are used to understand and predict how individuals engage in health-promoting behaviors.
The correct answer to the question, "Which of the following is NOT one of the three general areas of concern to health-promoting behavior in Pender's Health Promotion Model?" is "perceived susceptibility to a condition." This concept is actually a part of another well-known health model called the Health Belief Model (HBM). The HBM is centered around concepts including perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action, and self-efficacy. It is primarily focused on disease prevention and how beliefs about health problems, perceived benefits of action, and barriers to action can affect health-related behavior.
In contrast, Pender's Health Promotion Model includes: 1. **Individual characteristics and experiences** - This area recognizes the impact of previous experiences and inherited and acquired characteristics on personal behavior. Factors like biological, psychological, and sociocultural characteristics are considered to shape how individuals think about health. 2. **Behavior-specific cognitions and affect** - This aspect of Pender's model includes perceptions of benefits of and barriers to engaging in specific health behavior, perceived self-efficacy, activity-related affect, interpersonal influences (such as norms, social support, and modeling), and situational influences. These factors contribute to the motivation of the individual in making health-promoting behavior choices. 3. **Behavioral outcomes** - This is the end result of the model where the action of engaging in a health-promoting behavior is the outcome. The desired behavioral outcomes are directed by goals set by the individual, and actions are taken to achieve these goals which are influenced by the individual's commitments, perceived barriers, and competing demands and preferences.
Understanding the distinction between these models is crucial for health professionals in designing interventions and educational programs. Pender's HPM emphasizes the positive approach to wellness, expanded focus on the individual's motivation and readiness to act, and the dynamic nature of the individual-environment interaction necessary for promoting health. In contrast, the HBM is more focused on preventing disease through addressing negative health behaviors and evaluating personal risks and outcomes.


NEW QUESTION # 65
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