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ANCC Adult Psychiatric and Mental Health CNS (PMHCNS) Practice Tests & Test Prep by Exam Edge - Topics


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Understanding what is on the ANCC Adult Psychiatric and Mental Health CNS exam is crucial step in preparing for the exam. You will need to have an understanding of the testing domain (topics covered) to be sure you are studing the correct information.

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ANCC Adult Psychiatric and Mental Health CNS Exam Blueprint

Understanding the exact breakdown of the ANCC Adult Psychiatric and Mental Health CNS test will help you know what to expect and how to most effectively prepare. The ANCC Adult Psychiatric and Mental Health CNS has multiple-choice questions The exam will be broken down into the sections below:

ANCC Adult Psychiatric and Mental Health CNS Exam Blueprint
Domain Name % Number of
Questions
Direct Care 59% 59
Professional Practice 30% 30
Organizational/System 11% 11

ANCC Adult Psychiatric and Mental Health CNS - Exam Topics Sample Questions

A client who unconsciously channels unacceptable impulses to a primary goal that is socially acceptable is using which of the following defense mechanisms?

Correct Answer:
sublimation


the correct answer to the question is sublimation. sublimation is a psychological defense mechanism wherein socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior, possibly resulting in a long-term conversion of the initial impulse.

for example, a person experiencing extreme anger might take up kickboxing as a means of venting frustration. here the aggressive impulse is redirected into a socially laudable activity (i.e., sport), rather than into unacceptable aggression towards another person. this transformation of emotions or drives into something positive or constructive is the hallmark of sublimation.

sublimation is considered one of the more mature and adaptive defense mechanisms. it allows individuals to function normally in socially acceptable ways, unlike other mechanisms that do not transform the impulse but rather deny or distort it. for instance, rationalization involves justifying one’s unacceptable behavior or feelings with a logical but false explanation. undoing involves attempting to 'undo' an unhealthy thought or behavior with another action. projection involves attributing one's own unacceptable feelings or thoughts to someone else.

thus, unlike these other mechanisms, sublimation does not avoid or distort the impulses but instead channels them into behaviors that are beneficial and acceptable, resulting in a positive outcome both socially and for the individual. this ability to transform destructive impulses into constructive activities is what sets sublimation apart from other defense mechanisms like rationalization, undoing, and projection, which tend to either mask or perpetuate the underlying psychological issues.

What drug will increase the risk of bleeding in a 53-year-old patient who is taking Luvox (fluvoxamine)?

Correct Answer:
nsaid


fluvoxamine, marketed under the brand name luvox, is a selective serotonin reuptake inhibitor (ssri) commonly prescribed for the treatment of obsessive-compulsive disorder (ocd) and other anxiety disorders. this medication works by increasing the levels of serotonin in the brain, a neurotransmitter that helps regulate mood, anxiety, and other functions.

when considering drug interactions with fluvoxamine, it's important to understand how the drug is metabolized and its impact on other substances. fluvoxamine can affect the metabolism of various drugs through its influence on liver enzymes, particularly the cytochrome p450 system. this interaction can alter the levels and effects of other medications.

among the options provided, nonsteroidal anti-inflammatory drugs (nsaids) are particularly noteworthy in the context of increased bleeding risk. nsaids, such as ibuprofen and naproxen, are commonly used to manage pain and inflammation but are known to affect platelet function and gastrointestinal mucosa integrity. this can lead to an increased risk of bleeding, particularly in the gastrointestinal tract.

combining nsaids with fluvoxamine can heighten this risk. fluvoxamine may increase the concentration of nsaids in the blood by inhibiting certain liver enzymes responsible for their metabolism. this not only enhances the therapeutic and side effects of nsaids but also increases the likelihood of gastrointestinal bleeding. additionally, fluvoxamine's effect on serotonin in platelets can further impair platelet aggregation, exacerbating the risk of bleeding.

other medications listed, such as cns depressants, maois (monoamine oxidase inhibitors), and other ssris, also interact with fluvoxamine but do not specifically increase bleeding risk as nsaids do. cns depressants mainly enhance sedative effects, while maois and concurrent ssri use primarily increase the risk of serotonin syndrome, a potentially life-threatening condition.

in conclusion, among the given choices, nsaids are the correct answer as they specifically increase the risk of bleeding when taken with fluvoxamine. it is crucial for healthcare providers to monitor patients closely and consider alternative pain relief options or protective measures like prescribing proton pump inhibitors (ppis) to mitigate these risks.