Welcome to the PMHNP Podcast! This is the audio version of our weekly live sessions from www.PMHNPtesting.com, where PMHNP students come together to practice questions and dive into discussions about the content studied each week. Join us to sharpen your skills, review key concepts, and prepare for success in your PMHNP journey!

Question reviewed:

1. A PMHNP is treating a 30-year-old undocumented immigrant with a confirmed diagnosis of post-traumatic stress disorder (PTSD), scoring 32 on the Clinician-Administered PTSD Scale (CAPS-5), who expresses significant fear of seeking mental health services due to concerns about potential deportation. The patient reports nightmares and hypervigilance following a traumatic event in their home country and is reluctant to continue treatment despite severe symptoms. As a PMHNP, you must address this ethical dilemma, balancing patient safety, confidentiality, and cultural sensitivity. What is the PMHNP’s most ethical response?

A. Report the patient’s status to immigration authorities for proper intervention

B. Reassure the patient that mental health treatment is not contingent upon immigration status

C. Document the patient’s concerns and avoid further discussion of legal issues

D. Advise the patient to seek legal counsel before continuing psychiatric treatment

2. A PMHNP receives a request to release patient records for a legal case involving a 45-year-old male patient with a history of bipolar disorder. The patient, currently stable on lithium, declines to provide consent, citing privacy concerns, and has no active suicidal or homicidal ideation. The PMHNP must determine the legal basis for disclosing protected health information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA). Under which of the following conditions is it legally permissible to disclose PHI without patient consent?

A. When a family member requests access due to concern

B. When the patient is undergoing an involuntary psychiatric hold

C. When the information is subpoenaed by a court order

D. When requested by the patient’s employer

3. A PMHNP is evaluating a 55-year-old male patient with severe depression, scoring 24 on the PHQ-9, who requests electroconvulsive therapy (ECT) as a treatment option after failing multiple antidepressant trials. The provider thoroughly explains the risks (e.g., memory loss, confusion), benefits (e.g., rapid symptom relief), and alternatives (e.g., medication adjustment, psychotherapy), but the patient struggles to recall the details of the discussion, appearing disoriented during the session. As a PMHNP, you must ensure ethical and legal standards are met before proceeding with this invasive treatment. What should the provider do next?

A. Proceed with the treatment since the patient initially consented

B. Have the patient sign a consent form and move forward with the procedure

C. Reassess the patient’s decision-making capacity before proceeding

D. Proceed with treatment only if a family member agrees to the procedure

4. A PMHNP is managing a 29-year-old female patient diagnosed with borderline personality disorder (BPD) who presents with repeated suicide threats over the past week, including a recent statement about overdosing on her medications. She firmly refuses hospitalization, expressing distrust in treatment settings, but her mental status exam shows emotional instability and a Zanarini Rating Scale for BPD score of 18. The PMHNP, after assessing her risk, believes hospitalization is necessary to ensure her safety. Which of the following best identifies the ethical principle that supports this decision?

A. Justice

B. Beneficence

C. Autonomy

D. Fidelity

5. A PMHNP is reviewing ethical and legal considerations in psychiatric practice to ensure compliance with healthcare regulations. The team is discussing scenarios that might involve violations of the Stark Law. Which of the following situations best illustrates a violation of the Stark Law in psychiatric practice?

A. A psychiatrist referring a patient to a therapist employed at the same hospital

B. A PMHNP receiving financial incentives for prescribing a particular brand of antipsychotics

C. A psychiatric provider discussing a patient’s case with an interdisciplinary team

D. A PMHNP accepting an invitation to speak at a mental health conference

For help preparing for your PMHNP (ANCC or AANP) certification exam, go to www.PMHNPtesting.com

Clarity Education Systems and www.PMHNPtesting.com

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