1. A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical
examination is unremarkable. Laboratory results are within normal limits except for a markedly elevated
alkaline phosphatase level. The psychiatric-mental health nurse practitioner:
interprets the findings as normally occurring during a rapid adolescent growth spurt.
obtains a rheumatoid profile because elevated alkaline phosphatase is a sign of early rheumatic fever.
orders a repeat blood test.
suspects that the patient has acute pancreatitis.
2. Laboratory findings for a patient with an alcohol use disorder indicate increased liver function values
and:
a decreased mean corpuscular volume (MCV) and normal triglyceride levels.
elevated potassium and chloride levels.
increased MCV and elevated triglyceride levels.
increased urine and serum creatinine levels.
3. A new patient arrives at the office for treatment for depression. The patient reports taking simvastatin
(Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatric-mental health nurse
practitioner eliminates fluoxetine (Prozac), based on the knowledge that the combination can lead to
increased plasma levels of the statin, resulting in an increased risk of muscle damage and
rhabdomyolysis. The nurse practitioner's reason is that:
both medications are CYP450 3A4 inhibitors.
both medications are CYP450 3A4 substrates.
one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inducer.
one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor.
4. During a mental status examination, an 18-year-old patient reports feeling bugs crawling under the
skin. The psychiatric-mental health nurse practitioner documents this statement as:
a developmental disorder, and suspects cocaine use.
a hypnagogic hallucination, and suspects schizophrenia.
a hypnopompic hallucination, and suspects schizophrenia.
a perceptual disturbance, and suspects the use of cocaine.
5. The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement at a
community mental health clinic. The effective strategy for evaluating the clinic's services is to:
analyze the data from epidemiological studies.
conduct a root cause analysis.
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