PMHNP練習試験テスト最新問題2026年08月
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質問 # 356
Which of the following statements is true regarding adolescents and suicide?
- A. The suicide rate in adolescents has remained stable over the past few decades
- B. Suicide is a significant risk in adolescents suffering from depression
- C. A prior suicide attempt does not increase an adolescent's risk of attempting again
- D. More adolescent girls attempt and commit suicide than adolescent boys
正解：B
解説：
Suicide is a significant risk in adolescents with depression. Suicide should always be specifically addressed during psychiatric evaluations.
More adolescent girls than boys attempt suicide; however, adolescent boys are five times more likely to complete suicide. A history of a prior suicide attempt greatly increases a person's risk of attempting again. The suicide rate in adolescents has been increasing over the past few decades.
質問 # 357
A patient has been prescribed lithium for the treatment of bipolar disorder. The patient returns to the clinic three weeks later with symptoms of nausea, vomiting, and tremors. Which of the following are possible causes of these symptoms?
- A. Drug interactions
- B. Lithium toxicity
- C. Lithium deficiency
- D. Allergic reaction
正解：B
解説：
Lithium toxicity can occur with excessive levels of lithium in the blood, which can cause symptoms such as nausea, vomiting, tremors, and confusion. The psychiatric nurse practitioner should suspect lithium toxicity in this scenario, as high lithium levels can be dangerous and even life-threatening.
Lithium deficiency, drug interactions, and allergic reactions are unlikely to fit this patient's presentation as well as lithium toxicity.
質問 # 358
What would prohibit nurse practitioners in a managed care plan from discussing alternative treatment options not covered by the insurance plan?
- A. Special interest order
- B. Gag rule
- C. Political action rule
- D. Health alliance
正解：B
解説：
Gag rules prohibit nurse practitioners in a managed care setting from discussing alternative treatment options not covered by the insurance plan. They are also prohibited from providing information on the limitations of the plan or commenting negatively about the plan to patients.
A health alliance is a public agency that uses its bargaining power to negotiate competitive prices for health insurance from the private insurance market. A special interest agency (not order) is a group of people seeking or receiving special advantages through political lobbying. A political action committee (not rule) is an organization that raises money privately to influence elections or legislation, especially at the federal level.
質問 # 359
Which school was the site of the first nurse practitioner program?
- A. University of Colorado
- B. Vanderbilt University
- C. University of Pennsylvania
- D. University of Washington
正解：A
解説：
In 1965, Dr. Loretta Ford (a public health nurse) and Dr. Henry Silver (a pediatrician) established the first nurse practitioner program at the University of Colorado. This program educated pediatric nurse practitioners with a focus on disease prevention and health promotion. Over the next decade, nurse practitioner schools proliferated across the country. Today, there are over 205,000 nurse practitioners.
質問 # 360
The Nursing Interventions Classification (NIC) contains over how many detailed interventions?
- A. 5000 .
- B. 10,000 .
- C. 50 .
- D. 500 .
正解：D
解説：
The Nursing Interventions Classification (NIC) is a comprehensive, standardized classification of interventions that nurses perform. It is an essential resource for nursing students, researchers, and practitioners aiming to ensure accurate and consistent practices across the field of nursing.
The NIC system includes more than 500 detailed interventions. This extensive array is designed to cover virtually any action that a nurse might need to perform in a wide variety of settings-from hospitals and clinics to home care. Each intervention in the NIC is precisely defined and accompanied by a set of activities that detail how the intervention should be carried out. These activities provide clear guidance to nurses, helping them to implement interventions effectively and uniformly.
The interventions in the NIC are grouped into different domains and classes that reflect the scope and specialty of nursing practice. This organization aids in locating specific interventions quickly and facilitates educational training and research in nursing methodologies. The NIC not only enhances communication among nurses and healthcare providers but also supports documentation, billing, and quality assurance processes within the healthcare system.
By standardizing the language and procedures used in nursing, the NIC helps to ensure that nurses provide consistent and high-quality care to patients, regardless of where they are located or the specific healthcare settings in which they operate. This consistency is crucial for evaluating patient outcomes and improving the overall effectiveness of nursing interventions on a broad scale.
質問 # 361
What is an example of a factor constraining the growth of the nurse practitioner role?
- A. Patient satisfaction with nurse practitioners
- B. Patient demand for services
- C. Decreasing stigmatization of psychiatric illnesses
- D. Mandatory physician supervision
正解：D
解説：
Factors facilitating the growth of the nurse practitioner role:
* Patient demand for services
* Patient acceptance of and satisfaction with nurse practitioners
* Decreasing stigmatization of psychiatric illnesses
* Emphasis on the need for integrated healthcare services
Factors constraining the growth of the nurse practitioner role:
* Growing competition in the job market
* Reduction in salary due to nurse practitioner oversupply
* Reimbursement struggles with Medicare and private insurance companies
* Legislative battles for independent practice
* Mandatory physician supervision
* Resistance from powerful medical organizations
質問 # 362
What term best describes the integration of computer science, information science, and health care?
- A. Hardware
- B. Electronic medical record
- C. Evidence-based medicine
- D. Healthcare informatics
正解：D
解説：
Healthcare informatics is the integration of computer science, information science, and health care. Examples of such tools include clinical guidelines, electronic health records, patient care technology devices, and databases of healthcare outcomes.
質問 # 363
What complementary medicine originated in China and is the oldest system of medicine?
- A. Herbal
- B. Ayurveda
- C. Homeopathy
- D. Bach flower remedies
正解：A
解説：
The practice of herbal medicine originated in China and is the oldest system of medicine.
Homeopathy and Bach flower remedies are much more modern in their origins than herbal medicine. Ayurveda is an ancient system of medicine that originated in India.
質問 # 364
Which legislative act incentivizes pharmaceutical companies to develop drugs to treat rare diseases?
- A. New Chemical Entities Act
- B. Nyman Model Act
- C. Physician Payment Review Commission Act
- D. Orphan Drug Act
正解：D
解説：
The Orphan Drug Act incentivizes pharmaceutical companies to develop drugs to treat rare diseases. These drugs are otherwise unprofitable to develop because the demand is low.
The other options are not acts of Congress. New chemical entities refer to any new substance submitted to the FDA for approval. The Nyman model is an economic theory positing that private health insurance acts as an income transfer between the sick and the healthy. The Physician Payment Review Commission is an independent legislative advisory committee advising the U.S. Congress on methods to pay physicians for services to Medicare beneficiaries.
質問 # 365
Why is the outermost surface of the brain covered in sulci and fissures?
- A. They connect large bundles of white matter
- B. They coordinate communication between the right and left hemispheres
- C. They increase the surface area of the brain
- D. They provide the most focal area for personality development
正解：C
解説：
The outermost surface of the brain contains small shallow dips (sulci) and deep grooves (fissures). These sulci and fissures increase the surface area of the brain to allow for more cell communication. The sulci and fissures also provide anatomical landmarks for reference points.
質問 # 366
Of the following, which is an inappropriate breach of patient confidentiality?
- A. The patient demonstrates increased potential for self-harm or harm to others
- B. The nurse suspects child or elder abuse
- C. The nurse practitioner needs to vent about a patient to a coworker
- D. The patient requests that their information be shared with a third party
正解：C
解説：
Patient confidentiality is protected by the Health Insurance Portability and Accountability Act (HIPAA). However, patient confidentiality can be broken in the following circumstances:
* The patient demonstrates increased potential for self-harm or harm to others
* There is suspected abuse of children, older adults, or people with disabilities
* The nurse practitioner determines that the patient needs to be hospitalized
* The patient requests that their information be shared with a third party It is inappropriate for the nurse practitioner to vent or complain about a patient to anyone, even a coworker.
質問 # 367
What is the term for a complete set of all a person's or an organism's DNA?
- A. Gene
- B. Chromosome
- C. mRNA
- D. Genome
正解：D
解説：
A genome is a complete set of DNA.
DNA is made up of two twisted, paired strands composed of sugars linked by nucleotide bases. Messenger RNA (mRNA) codes for an amino acid. Chromosomes are structures of DNA in the nucleus of the cell, and each chromosome only contains a fraction of an individual's DNA. A gene is a section of DNA that results in a biological effect.
質問 # 368
In the relapse prevention model, both immediate determinants and covert antecedents increase the risk of lapse and relapse. Which of the following is an example of an immediate determinant?
- A. Accessibility to substance
- B. Minimizing consequences
- C. Rationalization
- D. Coping skills
正解：D
解説：
Coping skills are considered an immediate determinant. Coping skills can be strong or weak, and their presence or absence can be a determinant of relapse.
Accessibility to substance, rationalization, and minimizing consequences are all antecedents to lapse and relapse.
質問 # 369
Understanding pharmacokinetics and the distribution of medication in the bloodstream, the PMHNP monitors which of the following patients for possible toxicity and a need for lowered dosing?
- A. A 20-year-old patient with a high fever
- B. A malnourished patient
- C. A patient with Crohn's disease
- D. An athletic patient
正解：B
解説：
The principle of distribution requires that the medication binds to a protein for movement through the body. The chemicals are not active when they are protein-bound. The active form of medication is the unbound chemicals in the bloodstream. When a person is malnourished, they may be protein-deficient and have less protein for the medications to bind. This leaves more active medication in the bloodstream and increases the risk of toxicity. Extremely thin, malnourished, protein-deficient, or elderly patients are at risk for toxicity due to decreased muscle mass.
Crohn's disease impacts absorption, however, the presence of the disease is not as important of a consideration as malnourishment. A young person with a high fever is not routinely monitored for drug toxicity. An athletic body does not indicate malnourishment or protein deficiency.
質問 # 370
In common psychiatric disorders, neurotransmitters are implicated in the complex pathophysiology of certain disease processes. A decrease in dopamine is most likely to cause an exacerbation of which disorder?
- A. Anhedonia
- B. Anxiety disorders
- C. Psychosis
- D. Obsessive-compulsive disorders
正解：A
解説：
Patients suffering from anhedonia present with a decrease in dopamine activity.
Patients suffering from psychosis and schizophrenia present with an increase in dopamine activity. Patients suffering from anxiety disorders present with a decrease in gamma-aminobutyric acid. Patients suffering from obsessive-compulsive disorders present with a decrease in serotonin activity.
質問 # 371
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